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Arooba Khalid
Dr Shazia Dawood
Dr. Sheikh Khurram Salam Sehgal
Eiman Syed
Um E Salma
Ayesha Khalid


Staphylococcus aureus, antibiotic resistance, hospital wastewater, community water supplies, Faisalabad


Background: Staphylococcus aureus (S. aureus) is well recognized as a major human pathogen responsible for causing devastating infections including bacteremia, endocarditis and pneumonia. Because antibiotics are so widely used, hospitals have long been breeding grounds for antibiotic-resistant bacteria including S. aureus-which can cause difficult-to-treat diseases such as pneumonia and sepsis. This study was designed to estimate the occurrence and antibiotic susceptibility patterns of S. aureus in hospital wastewater as well as community water supply of Faisalabad.

Objectives: The primary objectives were to estimate the prevalence of S. aureus in the environment, characterize their antibiotic resistance patterns, and assess seasonal variations in their occurrence.

Methodology: Hospital effluents and community tap water samples were collected from January 2023 to July 2023. These were cultured to obtain S. aureus with selective media and confirmed by Polymerase chain reaction (PCR). All of the isolates were then tested for antibiotic susceptibility to ascertain their respective resistance patterns.

Results: Community tap water samples (n = 488) had S. aureus isolates in 237, with a prevalence of 48.55%, confirming heavy environmental contamination. Resistance to various antibiotics was alarmingly high among the isolates with Erythromycin (87.87%), Aztreonam (100%) and Cefixime (100%) being highest. Moreover, isolates from hospital wastewater presented more frequent resistant rates and, when associated to multiple third-generation cepalosporins and macrolides. Intriguingly, the study was also able to observe seasonal viruses with the highest prevalence in April for S. aureus which may indicate a weather, upstream or operational effect on bacterial growth (Sanchez et al. Differences were also observed in the resistance patterns between community and hospital sources, particularly with regards to hospital isolates, which exhibited greater drug resistance on the whole; evidence of selective pressure from clinical antibiotic use.

Conclusion: The findings emphasize the pressing need for enhanced surveillance, improved wastewater management, and stringent antibiotic stewardship in hospital settings to mitigate the spread of antibiotic-resistant S. aureus. Public health interventions should also extend to community water systems to reduce exposure risks and safeguard community health.

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