The occurrence and dissemination of antibiotic resistant genes (ARGs) that are associated with clinical pathogens and the evaluation of associated risks are still little investigated in developing countries under tropical conditions. In this context, cultivable and molecular approaches were performed to assess the dissemination of bacteria and their antibiotic resistance genes in aquatic environment in Kinshasa, Democratic Republic of the Congo. Cultivable approach quantified β-lactam, carbapenem resistant, and total Escherichia coli (E. coli) and Enterbacteriaceae (Ent) in river sediments and surface waters that receive raw hospital effluents. The molecular approach utilized Quantitative Polymerase Chain Reaction (qPCR) to quantify the total bacteria and the richness of relevant bacteria (Escherichia coli (E. coli), Enterococcus, and Pseudomonas (P. spp)), and antibiotic resistance genes (ARGs: blaOXA-48, blaCTX-M, blaIMP, blaTEM) in sediment samples. Statistical analysis (ANOVA method, principle component analysis, and correlation matrix) were used to explore the significance of hospital contribution and seasonal variation of bacteria and ARGs into explored aquatic ecosystems in suburban municipalities of Kinshasa, Democratic Republic of the Congo. The contribution of hospitals to antibiotic resistance proliferation is higher in the dry season than during the wet season (P value<0.05). Hospital similarly contributed significantly fecal bacteria and Pseudomonas (P. spp) and ARGs to the sediments in both seasons (P value<0.05). The organic matter content correlated positively with E. coli (r=0.50, P value<0.05). The total bacterial load correlated with Enterococcus, and Pseudomonas (0.49<0.69, P value<0.05). Each ARG correlated with the total bacterial load or at least one relevant bacteria (0.41<0.81, P value<0.05). Our findings confirms that hospital wastewaters contributed significantly to antibiotic resistance profile and the significance of this contribution increased in dry season. Moreover, our analysis highlights this risk from untreated hospital wastewaters in developing countries, which presents a great threat to public health.