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Background  Multi-drug resistant forms of  Pseudomonas aeruginosa  (MDRPA) are a major source of nosocomial infections and when discharged into streams and rivers from hospital wastewater treatment plants (HWWTP) they are known to be able to persist for extended periods. In the city of Manaus (Western Brazilian Amazon), the effluent of three HWWTPs feed into the urban Mindu stream which crosses the city from its rainforest source before draining into the Rio Negro. The stream is routinely used by Manaus residents for bathing and cleaning (of clothes as well as domestic utensils) and, during periods of flooding, can contaminate wells used for drinking water.    Results  16S rRNA metagenomic sequence analysis of 293 cloned PCR fragments, detected an abundance of  Pseudomonas aeruginosa  ( P. aeruginosa ) at the stream’s Rio Negro drainage site, but failed to detect it at the stream’s source. An array of antimicrobial resistance profiles and resistance to all 14 tested antimicrobials was detected among  P. aeruginosa  cultures prepared from wastewater samples taken from water entering and being discharged from a Manaus HWWTP. Just one  P. aeruginosa  antimicrobial resistance profile, however, was detected from cultures made from Mindu stream isolates. Comparisons made between  P. aeruginosa  isolates’ genomic DNA restriction enzyme digest fingerprints, failed to determine if any of the  P. aeruginosa  found in the Mindu stream were of HWWTP origin, but suggested that Mindu stream  P. aeruginosa  are from diverse origins. Culturing experiments also showed that  P. aeruginosa  biofilm formation and the extent of biofilm formation produced were both significantly higher in multi drug resistant forms of  P. aeruginosa .    Conclusions  Our results show that a diverse range of MDRPA are being discharged in an urban stream from a HWWTP in Manaus and that  P. aeruginosa  strains with ampicillin and amikacin can persist well within it.

Multidrug resistant Pseudomonas aeruginosa survey in a stream receiving effluents from ineffective wastewater hospital plants