Assessment of Hospital Waste and the Associated Antibacterial Resistance Gene: A Case Study of Federal University Teaching Hospital, Owerri
Authors: Ekeleme Uzochukwu Godswill , Onuoha Queeneth Chiamaka , Chukwuocha Uchechukwu (M) , Chukwuemeka Ijeoma (G.) , Ogujiuba Chiamaka (C.) , Ukachukwu Chigozie (C) , Opara Chinwendu (L.) , Nwokoro Amarachi (B.) , Okereke Christopher Chike (A.) , Akanazu Chidinma (O.) 
Published: November 2024

Abstract

Background: Hospital waste management is critical for minimizing health risks and environmental damage, particularly in developing countries where inadequate training and resources exacerbate these issues. The Federal University Teaching Hospital, Owerri, serves as a case study to assess hospital waste and associated antibacterial resistance genes.
Objectives: This study aimed to evaluate healthcare workers' knowledge, attitudes, and perceptions regarding waste management; identify waste types and disposal methods; assess bacterial contamination; and characterize antibacterial resistance genes in pathogens in hospital waste.
Methods: A cross-sectional descriptive and experimental study design was employed. Data were collected from 347 healthcare workers through stratified random sampling, and hospital waste samples were analysed for bacterial contamination and antibiotic resistance via microbiological standards. The data were analysed via the Statistical Package for Social Sciences (SPSS) computer software version 25, and the chi-square test was used to test for associations between hospital waste types, disposal methods, and bacterial characteristics for significant relationships. A p value less than 0.05 was considered statistically significant.
Results: This study revealed that 66.3% of healthcare workers possessed good knowledge of waste management, 79.2% had a positive attitude toward waste management, with females (82.0%) being slightly more positive than males (76.0%), and 72.1% perceived the waste management system as effective. Infectious and pathological wastes are primarily treated through incineration and autoclaving, with incineration being used 25 times per month, autoclaving 15 times, and landfilling 20 times for infectious waste. The infectious waste had the highest total viable count (9.86±0.28 CFU/g), indicating a high level of microbial presence, whereas the sharps waste presented a much lower total viable count of 5.40±0.52 CFU/g. The highest number of infectious waste isolates was 45 (30.2), followed by general waste 41 (27.5) and chemical waste 8 (5.4). Among the infectious waste, Enterobacter cloacae (50%) was the most common bacteria, followed by Staphylococcus Scuri ssp. Lentus (32%). Among the sharps waste, Staphylococcus gallinarum (12%) was the most common, followed by Staphylococcus xylosus and Escherichia coli (11%). In general, waste, Pantoea ananatis (100%) was the most prevalent bacteria, followed by Escherichia coli (38.9%), and the least prevalent bacterium was Staphylococcus Scuri ssp. Lentus (20%). We detected isolates harboring blaSHV and blaTEM resistance genes; of these, 2 (50%) had blaTEM, 2 (50%) had only blaSHV, and 1 (25%) had both the blaTEM and blaSHV genes. The p values (< 0.05) indicate a statistically significant association between the type of hospital waste, disposal method, bacterial count, distribution, and antibiotic resistance pattern, which supports the alternative hypothesis (H₁) that these factors have a significant impact on bacterial characteristics.
Conclusion: This study highlights the need for improved training on hospital waste management and stricter adherence to disposal protocols to mitigate the spread of resistant pathogens. Continuous monitoring and updated waste management strategies are essential to protect public health and the environment.