Surveillance of Antimicrobial Resistance in Hospital Wastewater: Identification of Carbapenemase-Producing Spp

Overview

Journal Antibiotics (Basel)

Specialty Pharmacology

Date 2022 Mar 25

PMID 35326752

Authors

Miguel Galarde-Lopez

Maria Elena Velazquez-Meza

Miriam Bobadilla-Del-Valle

Berta Alicia Carrillo-Quiroz

Patricia Cornejo-Juarez

Alfredo Ponce-de-Leon

Alejandro Sassoe-Gonzalez

Celia Mercedes Alpuche-Aranda

Affiliations

Soon will be listed here.

Abstract

The objective of this study was to investigate the presence and persistence of carbapenemase-producing spp. isolated from wastewater and treated wastewater from two tertiary hospitals in Mexico. We conducted a descriptive cross-sectional study in two hospital wastewater treatment plants, which were sampled in February 2020. We obtained 30 spp. isolates. Bacterial identification was carried out by the Matrix-Assisted Laser Desorption/Ionization-Time of Flight mass spectrometry (MALDI-TOF MS) and antimicrobial susceptibility profiles were performed using the VITEK2 automated system. The presence of carbapenem resistance genes (CRGs) in spp. isolates was confirmed by PCR. Molecular typing was determined by pulsed-field gel electrophoresis (PFGE). High rates of spp. resistance to cephalosporins and carbapenems (80%) were observed in isolates from treated wastewater from both hospitals. The molecular screening by PCR showed the presence of and genes. The PFGE pattern separated the isolates into 19 patterns (A-R) with three subtypes (C1, D1, and I1). Microbiological surveillance and identification of resistance genes of clinically important pathogens in hospital wastewater can be a general screening method for early determination of under-detected antimicrobial resistance profiles in hospitals and early warning of outbreaks and difficult-to-treat infections.

Citing Articles

Bacterial Communities and Resistance and Virulence Genes in Hospital and Community Wastewater: Metagenomic Analysis.

Velazquez-Meza M, Galarde-Lopez M, Cornejo-Juarez P, Bobadilla-Del-Valle M, Godoy-Lozano E, Aguilar-Vera E Int J Mol Sci. 2025; 26(5).

PMID: 40076673 PMC: 11900532. DOI: 10.3390/ijms26052051.

Presence and Persistence of Bacteria before and after Hospital Wastewater Treatment.

Galarde-Lopez M, Velazquez-Meza M, Godoy-Lozano E, Carrillo-Quiroz B, Cornejo-Juarez P, Sassoe-Gonzalez A Microorganisms. 2024; 12(6).

PMID: 38930614 PMC: 11206169. DOI: 10.3390/microorganisms12061231.

Wastewater from healthcare centers in Burkina Faso is a source of ESBL, AmpC-β-lactamase and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae.

Garba Z, Bonkoungou I, Millogo N, Natama H, Vokouma P, Bonko M BMC Microbiol. 2023; 23(1):351.

PMID: 37978428 PMC: 10655474. DOI: 10.1186/s12866-023-03108-0.

Characterization of a novel genus of jumbo phages and their application in wastewater treatment.

Hu M, Xing B, Yang M, Han R, Pan H, Guo H iScience. 2023; 26(6):106947.

PMID: 37324530 PMC: 10265529. DOI: 10.1016/j.isci.2023.106947.

Wastewater treatment plants, an "escape gate" for ESCAPE pathogens.

Marutescu L, Popa M, Gheorghe-Barbu I, Czobor Barbu I, Rodriguez-Molina D, Berglund F Front Microbiol. 2023; 14:1193907.

PMID: 37293232 PMC: 10244645. DOI: 10.3389/fmicb.2023.1193907.

References

Jones K, Patel N, Levy M, Storeygard A, Balk D, Gittleman J . Global trends in emerging infectious diseases. Nature. 2008; 451(7181):990-3. PMC: 5960580. DOI: 10.1038/nature06536. View

Al-Agamy M, Aljallal A, Radwan H, Shibl A . Characterization of carbapenemases, ESBLs, and plasmid-mediated quinolone determinants in carbapenem-insensitive Escherichia coli and Klebsiella pneumoniae in Riyadh hospitals. J Infect Public Health. 2017; 11(1):64-68. DOI: 10.1016/j.jiph.2017.03.010. View

Vera-Leiva A, Barria-Loaiza C, Carrasco-Anabalon S, Lima C, Aguayo-Reyes A, Dominguez M . [KPC: Klebsiella pneumoniae carbapenemase, main carbapenemase in Enterobacteriaceae]. Rev Chilena Infectol. 2018; 34(5):476-484. DOI: 10.4067/S0716-10182017000500476. View

Shibl A, Al-Agamy M, Memish Z, Senok A, Khader S, Assiri A . The emergence of OXA-48- and NDM-1-positive Klebsiella pneumoniae in Riyadh, Saudi Arabia. Int J Infect Dis. 2013; 17(12):e1130-3. DOI: 10.1016/j.ijid.2013.06.016. View

Aubron C, Poirel L, Ash R, Nordmann P . Carbapenemase-producing Enterobacteriaceae, U.S. rivers. Emerg Infect Dis. 2005; 11(2):260-4. PMC: 3320444. DOI: 10.3201/eid1102.030684. View

Islam M, Islam M, Hasan R, Hossain M, Nabi A, Rahman M . Environmental Spread of New Delhi Metallo-β-Lactamase-1-Producing Multidrug-Resistant Bacteria in Dhaka, Bangladesh. Appl Environ Microbiol. 2017; 83(15). PMC: 5514672. DOI: 10.1128/AEM.00793-17. View

Guo L, An J, Ma Y, Ye L, Luo Y, Tao C . Nosocomial Outbreak of OXA-48-Producing Klebsiella pneumoniae in a Chinese Hospital: Clonal Transmission of ST147 and ST383. PLoS One. 2016; 11(8):e0160754. PMC: 4973971. DOI: 10.1371/journal.pone.0160754. View

Alpuche-Arand C . [Emerging infections, the great challenge of global health: Covid-19]. Salud Publica Mex. 2020; 62(2):123-124. DOI: 10.21149/11284. View

Siddiqui M, Mondal A, Ahmad Gogry F, Husain F, Alsalme A, Haq Q . Plasmid-Mediated Ampicillin, Quinolone, and Heavy Metal Co-Resistance among ESBL-Producing Isolates from the Yamuna River, New Delhi, India. Antibiotics (Basel). 2020; 9(11). PMC: 7699290. DOI: 10.3390/antibiotics9110826. View

10.

Garza-Gonzalez E, Franco-Cendejas R, Morfin-Otero R, Echaniz-Aviles G, Rojas-Larios F, Bocanegra-Ibarias P . The Evolution of Antimicrobial Resistance in Mexico During the Last Decade: Results from the INVIFAR Group. Microb Drug Resist. 2020; 26(11):1372-1382. DOI: 10.1089/mdr.2019.0354. View

11.

Logan L, Weinstein R . The Epidemiology of Carbapenem-Resistant Enterobacteriaceae: The Impact and Evolution of a Global Menace. J Infect Dis. 2017; 215(suppl_1):S28-S36. PMC: 5853342. DOI: 10.1093/infdis/jiw282. View

12.

Bonardi S, Pitino R . Carbapenemase-producing bacteria in food-producing animals, wildlife and environment: A challenge for human health. Ital J Food Saf. 2019; 8(2):7956. PMC: 6603432. DOI: 10.4081/ijfs.2019.7956. View

13.

Kock R, Daniels-Haardt I, Becker K, Mellmann A, Friedrich A, Mevius D . Carbapenem-resistant Enterobacteriaceae in wildlife, food-producing, and companion animals: a systematic review. Clin Microbiol Infect. 2018; 24(12):1241-1250. DOI: 10.1016/j.cmi.2018.04.004. View

14.

Stoesser N, Sheppard A, Peirano G, Anson L, Pankhurst L, Sebra R . Genomic epidemiology of global Klebsiella pneumoniae carbapenemase (KPC)-producing Escherichia coli. Sci Rep. 2017; 7(1):5917. PMC: 5517641. DOI: 10.1038/s41598-017-06256-2. View

15.

von Wintersdorff C, Penders J, van Niekerk J, Mills N, Majumder S, van Alphen L . Dissemination of Antimicrobial Resistance in Microbial Ecosystems through Horizontal Gene Transfer. Front Microbiol. 2016; 7:173. PMC: 4759269. DOI: 10.3389/fmicb.2016.00173. View

16.

Cuzon G, Ouanich J, Gondret R, Naas T, Nordmann P . Outbreak of OXA-48-positive carbapenem-resistant Klebsiella pneumoniae isolates in France. Antimicrob Agents Chemother. 2011; 55(5):2420-3. PMC: 3088266. DOI: 10.1128/AAC.01452-10. View

17.

Chea N, Bulens S, Kongphet-Tran T, Lynfield R, Shaw K, Vagnone P . Improved Phenotype-Based Definition for Identifying Carbapenemase Producers among Carbapenem-Resistant Enterobacteriaceae. Emerg Infect Dis. 2015; 21(9):1611-6. PMC: 4550143. DOI: 10.3201/eid2109.150198. View

18.

Rodriguez-Zulueta P, Silva-Sanchez J, Barrios H, Reyes-Mar J, Velez-Perez F, Arroyo-Escalante S . First outbreak of KPC-3-producing Klebsiella pneumoniae (ST258) clinical isolates in a Mexican Medical Center. Antimicrob Agents Chemother. 2013; 57(8):4086-8. PMC: 3719740. DOI: 10.1128/AAC.02530-12. View

19.

Penes N, Muntean A, Moisoiu A, Muntean M, Chirca A, Bogdan M . An overview of resistance profiles ESKAPE pathogens from 2010-2015 in a tertiary respiratory center in Romania. Rom J Morphol Embryol. 2017; 58(3):909-922. View

20.

Bradford P, Bratu S, Urban C, Visalli M, Mariano N, Landman D . Emergence of carbapenem-resistant Klebsiella species possessing the class A carbapenem-hydrolyzing KPC-2 and inhibitor-resistant TEM-30 beta-lactamases in New York City. Clin Infect Dis. 2004; 39(1):55-60. DOI: 10.1086/421495. View