Biofilm properties and multidrug resistance profile of Klebsiella pneumoniae , Escherichia coli , and Staphylococcus aureus isolated from hospital wastewater in Bangladesh

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ABSTRACT Hospital wastewater flowchart showing isolation of E. coli, K. pneumoniae, and S. aureus, followed by PCR identification, antimicrobial resistance testing, and biofilm analysis revealing multidrug-resistant biofilm-forming pathogens. Hospital wastewater, a critical source of pathogenic and opportunistic bacteria carrying antimicrobial residues and resistant strains, poses serious public health and environmental risks. This study assessed the biofilm-forming ability and multidrug resistance (MDR) profiles of Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus isolated from hospital wastewater in Savar, Bangladesh. Fifty-three samples were analyzed using selective culture, biochemical tests, PCR, disk diffusion, and crystal violet microtiter plate (CVMP) assay. Among the isolates, 28 (52.8%) were identified as E. coli, 21 (39.6%) as K. pneumoniae, and 15 (28.3%) as S. aureus. High resistance to ampicillin was observed in E. coli (75.0%), K. pneumoniae (90.5%), and S. aureus (80.0%), while the highest sensitivity was found to imipenem in K. pneumoniae (100.0%), imipenem and cefuroxime in E. coli (96.4%), and ceftaroline in S. aureus (73.3%). MDR was detected in 15 (53.6%) E. coli, 5 (23.8%) K. pneumoniae, and 9 (60.0%) S. aureus isolates. E. coli (57.1%) and S. aureus (53.3%) were notable biofilm producers, with strong biofilm formation highest in E. coli (28.6%), followed by S. aureus (33.3%) and K. pneumoniae (23.8%). These findings highlight the critical presence of MDR-biofilm-forming pathogens in hospital effluents and emphasize the urgent need for effective wastewater treatment strategies.

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