Large-scale characterisation of hospital wastewater system microbiomes and clinical isolates from infected patients: profiling of multidrug-resistant microbial species

Hospital-acquired infection (HAI) and infectious agents exhibiting antimicrobial resistance (AMR) are challenges globally. Environmental patient-facing wastewater apparatus including handwashing sinks, showers and toilets are increasingly identified as sources of infectious agents and AMR genes.

We performed large-scale metagenomic analysis of the wastewater system in a large teaching hospital in the Republic of Ireland experiencing multidrug-resistant HAI outbreaks. Immediately prior to refurbishment of a medical ward where HAI has been endemic, wastewater pipe sections (n=20) were removed. These comprised toilet u-bends, sink and shower drains and, following DNA extraction, each underwent metagenomic analysis.