Vancomycin resistant enterococci: From the hospital effluent to the urban wastewater treatment plant

► Total, vancomycin and ciprofloxacin resistant enterococci were isolated from hospital and urban wastewater. ► Hospital effluent and raw urban wastewater had identical counts of vancomycin resistant enterococci. ► Vancomycin resistant enterococci were significantly more prevalent in the hospital effluent than in the urban wastewater. ► Similar multidrug-resistance phenotypes were observed in isolates from patients, hospital effluent and urban wastewater. ► This study suggests that hospital effluents may contribute to spread vancomycin resistant enterococci to the environment.