Potential sources of water contamination in Sulaymaniyah city hospitals: isolation and identification of non-fermentative gram-negative bacteria

The World Health Organization guidelines prioritize the detection of coliform bacteria as indicators of water contamination. However, non-fermentative gram-negative bacteria, which pose a potential contamination risk, are not included in these guidelines. This study aimed to isolate and identify these bacteria in public hospital water supply systems in Sulaymaniyah city and evaluate their susceptibility to antibiotics. Water samples were collected from four hospitals, and non-fermentative gram-negative colonies were isolated using two media: MacConkey and Chromogenic Coliform agar (CCA). The identification of these colonies was performed using the automated system VITEK 2. The bacterial isolates' sensitivity to 10 antibiotics was determined using a Kirby-Bauer Disk Diffusion Susceptibility Test.Five species of non-fermentative gram-negative bacteria were identified, including Moraxella lacunata, Achromobacter denitrificans, Brevundimonas diminuta, Acinetobacter lwoffii, and Pseudomonas fluorescens. Notably, Moraxella lacunata was found in all hospitals and was resistant to six of the antibiotics. The other four species exhibited a distribution pattern across the different hospitals and showed varying degrees of sensitivity to the ten used antibiotics. Significantly, the successful implementation of CCA media, typically utilized for the isolation and identification of E. coli and coliform bacteria, proved advantageous in isolating Non-Fermenting Gram-Negative Bacteria during this study. This study emphasizes the risk of non-fermentative gram-negative bacteria in hospital water systems for vulnerable patients. Current WHO guidelines do not prioritize monitoring these bacteria. Regular monitoring and proper management are crucial to prevent infections from these waterborne pathogens.