Key findings The mean total bacterial load of hospital effluents was 5.7×10⁷ CFU/mL. Identified species included Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus spp., Staphylococcus aureus, Citrobacter spp., Enterobacter spp., and Acinetobacter baumannii. Most isolates were multidrug resistant (resistant to ≥3 antibiotic classes), notably to beta-lactams, aminoglycosides, and fluoroquinolones. ESBL-producing and carbapenemase-producing Enterobacterales, methicillin- and vancomycin-resistant S. aureus, vancomycin-resistant enterococci, and ceftazidime-resistant P. aeruginosa were detected. Bacterial populations differed between effluent and clinical isolates (p = 0.0107), while resistance profiles were comparable(p=0.438). This publication is available in full in Health Sciences and Disease.