Citrobacter spp. and Enterobacter spp. as reservoirs of carbapenemase blaNDM and blaKPC resistance genes in hospital wastewater

Antibiotic resistance has emerged as a global threat to public health, generating a growing interest in investigating the presence of antibiotic-resistant bacteria in environments influenced by anthropogenic activities. Wastewater treatment plants in hospital serve as significant reservoirs of antim...

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Published in:Applied and environmental microbiology 2024-08, Vol.90 (8), p.1
Main Authors: Duran-Bedolla, Josefina, Téllez-Sosa, Juan, Bocanegra-Ibarias, Paola, Schilmann, Astrid, Bravo-Romero, Sugey, Reyna-Flores, Fernando, Villa-Reyes, Tania, Barrios-Camacho, Humberto
Format: Article
Language:English
Subjects:
Anthropogenic factors
Antibiotic resistance
Antibiotics
Bacteria
Carbapenemase
Citrobacter
Clinical Microbiology
E coli
Enterobacter
Enterobacteriaceae
Environmental Microbiology
Genes
Hospital wastes
Hospitals
Human influences
Medical wastes
Public health
Reservoirs
Strains (organisms)
Wastewater treatment
Wastewater treatment plants
β Lactamase
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Summary:Antibiotic resistance has emerged as a global threat to public health, generating a growing interest in investigating the presence of antibiotic-resistant bacteria in environments influenced by anthropogenic activities. Wastewater treatment plants in hospital serve as significant reservoirs of antimicrobial-resistant bacteria, where a favorable environment is established, promoting the proliferation and transfer of resistance genes among different bacterial species. In our study, we isolated a total of 243 strains from 5 hospital wastewater sites in Mexico, belonging to 21 distinct Gram-negative bacterial species. The presence of β-lactamase was detected in 46.9% (114/243) of the isolates, which belonging to the Enterobacteriaceae family. We identified a total of 169 β-lactamase genes; blaTEM in 33.1%, blaCTX-M in 25.4%, blaKPC in 25.4%, blaNDM 8.8%, blaSHV in 5.3%, and blaOXA-48 in 1.1% distributed in 12 different bacteria species. Among the 114 of the isolates, 50.8% were found to harbor at least one carbapenemase and were discharged into the environment. The carbapenemase blaKPC was found in six Citrobacter spp. and E. coli, while blaNDM was detected in two distinct Enterobacter spp. and E. coli. Notably, blaNDM-1 was identified in a 110 Kb IncFII conjugative plasmid in E. cloacae, E. xiangfangensis, and E. coli within the same hospital wastewater. In conclusion, hospital wastewater showed the presence of Enterobacteriaceae carrying a high frequency of carbapenemase blaKPC and blaNDM. We propose that hospital wastewater serves as reservoirs for resistance mechanism within bacterial communities and creates an optimal environment for the exchange of this resistance mechanism among different bacterial strains.
ISSN:0099-2240
1098-5336
1098-5336
DOI:10.1128/aem.01165-24