Ahammad SZ

Graham DW

Gupta S

Lamba M

Shukla R

Sreekrishnan TR

Antimicrobial resistance (AMR) is a major global concern, especially in India where the burden of infectious diseases is high and health care spending is low. Here we quantiﬁed total coliform, faecal coliforms (FC), carbapenem-resistant enteric bacteria (CRE), blaNDM-1, and three integron genes in samples collected from wastewater eﬄuent of 12 hospitals, 12 sewage treatment plants (STPs), 20 sewer drains, and ﬁve locations along the Yamuna River in New Delhi over two seasons. Signiﬁcant correlations were found between FC levels, CRE (r = 0.903, p = 0.004, n = 49) and blaNDM-1 (r = 0.787, p = 0.003, n = 49) concentrations across all samples. Concentrations of coliforms, CRE, blaNDM-1, int1, and int3 were highest in hospital eﬄuents compared to other locations in both seasons. Although absolute concentration data indicate greater abundances of CRE and blaNDM-1 in the winter, normalised data indicates greater carriage of blaNDM-1 per cell in summer samples. In general, observed CRE levels were highest in surface water downstream of areas with higher population densities. Among CRE isolates (n = 4077), 82%, 75%, 71% and 43% of the strains from hospitals, sewer drains, river samples, and STPs, respectively, contained blaNDM-1, implying STPs have relatively fewer blaNDM-1 positive CRE in their efflents. The most common CRE isolates in the drains were Pseudomonas putida (39%) followed by Acinetobacter baumanni (20%) and Pseudomonas montelli (19%). The present scenario in New Delhi highlights the urgent need for increased coverage of appropriate waste treatment facilities across the city to reduce CRE exposures from polluted surface waters

Carbapenem resistance exposures via wastewaters across New Delhi

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