A medical establishment such as hospitals and medical centers generate a sizable amount of hazardous waste. In Yemen, the hospitals' wastes are still largely mismanaged, mainly because the sector did not know what to do with the waste. The present study was undertaken to determine the bacterial and fungal agents present in different various of the hospitals' solid waste. The samples were collected from the different wards/departments and from the central storage rooms/dustbins of the hospitals in Sana'a city, Yemen. The presence of bacterial and fungal agents in the hospitals' waste was determined using the conventional bacteria, and fungi identification methods. The bacteria and fungi were detected in the hospitals' solid waste were Klebsiella spp. (9.3%), E. coli (12.7%), Citrobacter spp. (8.5), Candida spp. (18.6%), Proteus spp. (9.3%), Cladosporium werneckii spp. (19.5%), Bacillus spp. (9.3%), Aspergillus spp. (7.6%), Trichothecium spp. (0.8%), Mucor spp. (3.4%), and Acinetobacter spp. (0.8%). This study results confirmed that the prevalence types of microorganism vary based on seasonal and spatial variables

Al-Hakimi, Saif A.

Al-Mikhlafi, Ahmed S.

Alwabr, Gawad M. A.

Dughish, Munira A.

English

ZENODO

ISSN 2449-8866 Current  Life Sciences Research Article      Current Life Sciences 2016; 2 (3): 67-71  Identification of bacteria and fungi in the solid waste generated in hospitals of Sana'a city, Yemen  Gawad M. A. Alwabr1*, Ahmed S. Al-Mikhlafi2, Saif A. Al-Hakimi2,  Munira A. Dughish3   1 Sana'a Community College, Sana'a, Yemen 2 Department of Earth and Environmental Sciences, Faculty of Science, University of Sana'a, Yemen 3 Department of Biochemistry, Faculty of Medicine, University of Sana'a, Yemen *Corresponding author: Gawad M. A. Alwabr; Tel: (+967) 777160932; E-mail: alwabr2000@yahoo.com    ABSTRACT  A medical establishment such as hospitals and medical centers generate a sizable amount of hazardous waste. In Yemen, the hospitals' wastes are still largely mismanaged, mainly because the sector did not know what to do with the waste. The present study was undertaken to determine the bacterial and fungal agents present in different various of the hospitals' solid waste. The samples were collected from the different wards/departments and from the central storage rooms/dustbins of the hospitals in Sana'a city, Yemen. The presence of bacterial and fungal agents in the hospitals' waste was determined using the conventional bacteria,  and fungi identification methods. The bacteria and fungi were detected in the hospitals' solid waste were Klebsiella spp. (9.3%), E. coli (12.7%), Citrobacter spp. (8.5), Candida spp. (18.6%), Proteus spp. (9.3%), Cladosporium werneckii spp. (19.5%), Bacillus spp. (9.3%), Aspergillus spp. (7.6%), Trichothecium spp. (0.8%), Mucor spp. (3.4%), and Acinetobacter spp. (0.8%). This study results confirmed that the prevalence types of microorganism vary based on seasonal and spatial variables.               Keywords: Hospitals waste; Healthcare waste; Pathogenic bacteria and fungi.   1. INTRODUCTION   Hospitals' wastes are a source of potentially dangerous microorganisms that can infect hospital patients, personnel, and the general public. If waste is inadequately managed, these microorganisms can be transmitted by direct contact, through the air or by a variety of vectors, and can pose a serious threat to human health and to the environment [1]. There are many different exposure routes: through injury (cut, prick), through contact with the skin or mucous membranes, through inhalation or through ingestion [2]. More specifically hospitals' waste has a high potential of carrying microorganisms that can infect people who are exposed to it, as well as the commu-nity at large if it is not properly disposed of [3]. Hospitals' solid waste may contain varieties of bacteria. The types and quantity of bacteria depend on the hospitals' solid waste compositions and its generation source. Commonly identified bacterial pathogens such as Pseudomonas spp., Corynebac-terium diphtheriae, E. coli, and Staphylococcus spp.,  have been reported to be part of the hospitals' wastes. Hospitals' waste should be carefully con-Received: 23 April 2016; Revised submission: 26 June 2016; Accepted: 12 July 2016 Copyright: © The Author(s) 2016. Current Life Sciences © T.M.Karpiński 2016. This is an open access article licensed under the terms  of the Creative Commons Attribution Non-Commercial International License (http://creativecommons.org/licenses/by-nc/4.0/) which  permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.  DOI: http://dx.doi.org/10.5281/zenodo.57550 68 | Alwabr et al.   Identification of bacteria and fungi in the solid waste generated in hospitals of Sana'a city, Yemen Current Life Sciences 2016; 2 (3): 67-71  trolled and monitored to prevent nosocomial infection associated with the exposure to these wastes [4]. The present study was undertaken to determine the bacterial and fungal agents present in different various of the hospitals' solid waste.   2. MATERIALS AND METHODS  2.1. Sampling collection   The leachate's samples from hospitals' solid waste were collected in a sterile screw-capped bottle from the different wards/departments and from the central storage rooms/dustbins of the hospitals of (Al-Thawora, Al-Kuwait, Republic, and Military) in the summer and winter sessions, in Sana'a city. The bottles were labeled with a sample number, date, and time of collection; then immediately delivered to the National Center for Laboratories of Public Health in Sana'a. Samples collections were conduc-ted for a period of eight months from August to March 2013.  2.2. Identification of the bacteria in hospitals' solid waste using the conventional methods   Bacteria were isolated and characterized using cultural identification, and morphological identification using gram staining reaction, sugar fermentation reaction, and biochemical tests. Fungi were isolated using the growth rate, colonial morphological features, and microscopic morpho-logical features as described by Cheesbrough [5].  Each sample was directly inoculated onto blood agar and MacConkey agar using a standard calibrated wire loop (10 μl) for bacterial identi-fication. Streaked culture plates were incubated at 37oC overnight. On the next day, the bacterial growth on the respective media was observed, and the total colony count was done and checked for significant bacteria. Blood and MacConkey agar medium were used to culture the bacteria for gram positive and gram negative bacteria, respectively. Biochemical tests including: Kligler media, SIM, citrate, and urease test were used for the identi-fication of pathogenic bacteria. Each sample also was directly inoculated onto Sabouraud dextrose (SAB) agar for fungal identi-fication. Streaked culture plates were incubated at 24oC overnight. On the next day, the fungal growth on the respective media was observed, and the total colony count was done and checked for a significant of some fungal such as Candida spp. Additional incubation in Petri plates at 22-24 o C for 7-10 days. After 7-10 days the fungal growth on the respective media was observed, and the total colony count was done and checked for an indication others fungi. Small plaques from the edge and the center of each growing colony were transferred onto glass slides and then were examined using a compound light microscope (Olympus BX41 system microscope) to ensure the exact identification of fungi. Analysis    of data was performed by the use of Excel soft- ware program. Frequencies and percentages were computed.   3. RESULTS AND DISCUSSION     This study results (Table 1) showed that the microorganisms appeared in the different sites and seasons were: Klebsiella spp. (9.3%), E. coli (12.7%), Citrobacter spp. (8.5%), Candida spp. (18.6%), Proteus spp. (9.3%), Cladosporium werneckii spp. (19.5%), Bacillus spp. (9.3%), Aspergillus spp. (7.6%), Trichothecium spp. (0.8%), Mucor spp. (3.4%), and Acinetobacter spp. (0.8%). These findings were observed might because that almost types of bacteria that appeared in this study have high ability to resist difficult environ-mental conditions under the impact of three methods of defense are: Thickness of cell wall, the ability to produce chemicals from inside the cell to oxidation and reduction of toxic substances faced the cell, and its ability to keep the food inside, which gives them a greater chance to maintain their growth for a longer period. Also, appearance of these species of fungi might due to their ability to grow and multiply for a longer period of time, because they have the ability to mutate into spores, such as Cladosporium werneckii spp., resist high temperatures, such as Trichothecium spp., its ability to branching and bifurcation such as Aspergillus spp., excreted goloco-protein such as Mucor spp., and have high resistant such as Candida spp.  This study results are in agreement with some findings of previous studies. A study conducted in Malaysia has shown several pathogenic bacteria in clinical solid waste such as Klebsiella pneumonia, 69 | Alwabr et al.   Identification of bacteria and fungi in the solid waste generated in hospitals of Sana'a city, Yemen Current Life Sciences 2016; 2 (3): 67-71  and Acinetobacter baumannii [6]. A study conduc-ted in Tanzania reported that the bacteria that isolated from the biomedical waste were Bacillus subtilis (12%), Klebsiella pneumonia (6%), and     E. coli (15%) [7]. A study conducted in India has reported that the different types of bacteria isolated from biomedical waste were E. coli (22.79%), Klebsiella sp. (8.82%), Proteus vulgaris (5.88%), Citrobacter sp. (2.20%) [8]. A study conducted in Bangladesh reported that the different fungi such as Aspergillus spp., and Mucor spp. were commonly found in the lab analysis [9], while were contrary to other studies. A study conducted in Odisha reported that the fungi species that would be identified were Rhizopus nigricans, Aspergillus flavus, Penicillium rubrum, Trichothecium roseum, and Penicillium viricadum [10]. A study conducted in Nigeria has mentioned that the fungi species that were isolated from soil of hospital dumpsite were, Rhizopus nigricans, Penicillium rubrum, Trichothecium rose-um, and Penicillium viricadum [11].     Table 1. The types of microorganism that isolated from the samples were taken from the different sites and seasons. No. A* Counts CFU/ml B** Counts CFU/ml C*** Counts CFU/ml D**** Counts CFU/ml 1 Klebsiella spp. ≥10 5 Klebsiella spp. ≥10 5 Klebsiella spp. ≥10 5 Klebsiella spp. ≥10 4 2 E. coli ≥103 E. coli ≥10 5 E. coli ≥10 2 E. coli ≥10 3 3 Proteus spp. ≥10 2 Proteus spp. ≥10 2 Proteus spp. ≥10 2   4 Citrobacter spp. ≥10 2 Citrobacter spp. ≥10 5 Citrobacter spp. ≥10 4 Citrobacter spp. ≥10 4 5 Candida spp. ≥10 4 Candida spp. ≥10 1 Candida spp. ≥10 1 Candida spp. ≥10 5 6   Bacillus spp. ≥10 5   Bacillus spp. ≥10 3 7 Aspergillus spp. ≥103       8 Trichothecium spp. ≥101       9   Cladosporium werneckii spp. ≥10 5 Cladosporium werneckii spp. ≥10 4 Cladosporium werneckii spp. ≥10 3 10     Acinetobacter spp. ≥10 1   11   Mucor spp. ≥10 2 Mucor spp. ≥10 1   * The samples from the hospitals' dumpsites in the winter season.  ** The samples from the departments' waste bags in the winter season. *** The samples from the departments' waste bags in the summer season. **** The samples from hospitals' dumpsites in the summer season.    The types of bacteria that were isolated in the present study are responsible for causing many diseases and risks to the community such as, pneumonia, meningitis, urinary tract infection, wound infection, respiratory infection, gastrointes-tinal illness (Klebsiella spp., proteus spp. and Bacillus spp.), diarrhea (E. coli), Primary blood-stream infections, pneumonia (Acinetobacter spp.), opportunistic, peritonitis (Citrobacter spp.) [9, 12].  Acinetobacter baumannii is a major cause of hospital-acquired infections including pneumonia, lung abscess, meningitis, septicaemia, urinary tract and wound infections [13].  The types of fungi that were isolated in the present study are responsible for causing many diseases and risks to the community, such as candidiasis [14]. Many fungi are opportunistic organisms and cause infections during extended antibiotic treatment and severe immunosuppression such as Candida albicans and Aspergillus spp. [15].  70 | Alwabr et al.   Identification of bacteria and fungi in the solid waste generated in hospitals of Sana'a city, Yemen Current Life Sciences 2016; 2 (3): 67-71  In all the samples the total bacterial and fungal counts were in the range of 101 to 105 CFU/ml (Table 1). This might because the physicochemical characteristics of the leachate such as pH, anaerobic conditions, and the presence of significant concentrations of toxic substances (phenol, aniline, and heavy metals), all that contributed to reducing the number of species.  4. CONCLUSIONS     This study confirmed the presence of pathogenic bacteria and fungi in the hospitals' solid waste, in the different department/units of the hospitals and in the dumpsite of the hospitals. The hospitals' solid waste contains various types of nosocomial and opportunistic pathogenic bacteria and fungi were appeared in the hospitals sites variation and seasonal variation, confirmed that the prevalence types of microorganism vary based on seasonal and spatial variables.   ACKNOWLEDGEMENT  The authors would like to express thanks to the management of the National Center for Central Public Health Laboratory for the assistance. The authors wish to express appreciation and indebtedness to Dr. Khaled Al-Shibany, Deputy Director of the National Center for Central Public Health Laboratory, Dr. Fuad Bazel, Head of Microbiology department, and Dr. Abdulaziz Raweh, for their assistance. The authors wish to thank all of the workers of the hospitals for their assistance.  AUTHORS’ CONTRIBUTION  All authors have equally contribution in conducted studies and manuscript preparation. The final manuscript has been read and approved by all authors.  TRANSPARENCY DECLARATION  The authors declare no conflicts of interest.    REFERENCES 1. Soliman SM, Amel IA. Overview of biomedical waste management in selected governorates in Egypt: a pilot study. Waste Manag. 2007; 27: 1920-1923. 2. Twinch E. Medical waste management. International committee of the Red Cross (ICRC), Geneva, Switzerland, 2011. 3. Manyele SV, Lyasenga TJ. Factors affecting medical waste management in low-level health facilities in Tanzania. Afr J Environ Sci Technol. 2010; 4(5): 304-318.  4. Nascimento TC, Januzzi WA, Leonel M, Silva VL, Diniz CG. Occurrence of clinically relevant bacteria in health service waste in a Brazilian sanitary landfill and antimicrobial susceptibility profile. Rev Soc Bras Med Trop. 2009; 42(4): 415-419. 5. Cheesbrough M. District laboratory practice in tropical countries, part 2. 2nd edn. Cambridge University Press, 2006. 6. Hossain MS, Nik Norulaini NA, Balakrishnan V, Puvanesuaran VR, Sarker MZI, Ab Kadir MO. Infectious risk assessment of unsafe handling practices and management of clinical solid waste. Int J Environ Res Public Health. 2013; 10(2): 556-567.  7. Anitha J, Jayraaj IA. Isolation and identification of bacteria from biomedical waste (BMW). Int J Pharm Pharmac Sci. 2012; 4(5): 386-388.  8. Rastogi V, Rastogi P, Bhatia S. Bacteriological profile of biomedical waste: management guide-lines. J Indian Acad Forens Med. 2011; 33(2): 145-148.   9. Biswas A, Amanullah ASM, Santra SC. Medical waste management in the tertiary hospitals of Bangladesh: an empirical enquiry. ASA Univ Rev. 2011; 5(2): 149-158. 10. Panda R, Panda PS, Mishra CSK. The effect of hospital solid wastes on the environment. Ecoscan. 2012; 6(1&2): 37-40. 11. Oyeleke SB, Istifanus N. The microbiological effects of hospital wastes on the environment. Afr J Biotechnol. 2009; 8(22): 6253-6257.  12. Flores-Tena FJ, Guerrero-Barrera AL, Avelar-Onzález FJ, Ramírez-López EM, Martínez-Saldaña MC. Pathogenic and opportunistic gram-negative bacteria in soil, leachate and air in San Nicolás landfill at Aguascalientes, Mexico. Rev Latinoam Microbiol. 2007; 49(1-2): 25-30. 13. Giamarellou H, Antoniadou A, Kanellakopoulou K. Acinetobacter baumannii: a universal threat to 71 | Alwabr et al.   Identification of bacteria and fungi in the solid waste generated in hospitals of Sana'a city, Yemen Current Life Sciences 2016; 2 (3): 67-71  public health. Int J Antimicrobial Agents. 2008; 32(2): 106-119. 14. Akter N. Medical waste management: a review, environmental engineering program, school of environment resources and development. Asian Institute of Technology, Khlongluang, Pathumthani, Thailand, 2000. 15. WHO. Prevention of hospital-acquired infections: a practical guide. 2nd edn, WHO/CDS/CSR/EPH/12, 2002.  

Identification of bacteria and fungi in the solid waste generated in hospitals of Sana'a city, Yemen

https://zenodo.org/record/57550/files/CLS2016v2i3art67-71.pdf

Identification of bacteria and fungi in the solid waste generated in hospitals of Sana'a city, Yemen

Abstract

Similar works

Full text

Available Versions

ZENODO