Prevalence and Abundance of Beta-Lactam Resistance Genes in Hospital Wastewater and Enterobacterales Wastewater Isolates.

Antimicrobial resistance may develop in nature including in hospital wastewater through horizontal genetic transfer. Few studies were conducted on the antimicrobial resistance genes in hospital wastewater and wastewater isolates in Indonesia. The prevalence and abundance of beta-lactam resistance genes in hospital wastewater and Enterobacterales wastewater isolates were investigated. Twelve wastewater samples were collected from an influent wastewater treatment plant. and were isolated from the wastewater samples by culture-based methods. DNA was extracted from wastewater samples and the isolates. Nineteen beta-lactam resistance genes were tested by a high throughput qRT-PCR method. and were the most abundant genes detected in hospital wastewater and , respectively ( < 0.001). The relative abundance of , , , , , and in was higher than in the wastewater and ( < 0.001; = 0.006; = 0.012; < 0.001; = 0.005; < 0.001). might be associated with resistance to piperacillin/tazobactam, ceftriaxone, and cefepime ( < 0.001; = 0.001; < 0.001). In conclusion, ESBL genes showed higher abundance than carbapenemase genes in hospital wastewater samples. The ESBL-producing bacteria that were predominantly found in hospital wastewater may originate from clinical specimens. The culture-independent antibiotic resistance monitoring system might be developed as an early warning system for the increasing beta-lactam resistance level in clinical settings.