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Garba Z, Bonkoungou IOJ, Millogo NO, Natama HM, Vokouma PAP, Bonko MDA, Karama I, Tiendrebeogo LAW, Haukka K, Tinto H, Sangaré L, Barro N. Wastewater from healthcare centers in Burkina Faso is a source of ESBL, AmpC-β-lactamase and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae. BMC Microbiol 2023; 23:351. [PMID: 37978428 PMCID: PMC10655474 DOI: 10.1186/s12866-023-03108-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Extended-spectrum β-lactamase (ESBL), plasmid-mediated AmpC-β-lactamase and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae have spread into the environment worldwide posing a potential public health threat. However, the prevalence data for low- and middle-income countries are still scarce. The aim of this study was to evaluate the presence of ESBL, AmpC-β-lactamase and carbapenemase-producing and multidrug-resistant E. coli and K. pneumoniae in wastewaters from healthcare centers in Burkina Faso. RESULTS Eighty-four (84) wastewater samples were collected from five healthcare centers and plated on selective ESBL ChromAgar. E. coli and Klebsiella pneumoniae isolates were identified using API20E. ESBL-producing bacteria were detected in 97.6% of the samples and their average concentration per hospital ranged from 1.10 × 105 to 5.23 × 106 CFU/mL. Out of 170 putative ESBL-producing isolates (64% of them were E. coli) and 51 putative AmpC-β-lactamase-producing isolates, 95% and 45% were confirmed, respectively. Carbapenemase production was detected in 10 isolates, of which 6 were NDM producers, 3 were OXA-48 producers and 1 was NDM and OXA-48 producer. All isolates were multidrug resistant and, moreover, all of them were resistant to all tested β-lactams. Resistance to ESBL inhibitors was also common, up to 66% in E. coli and 62% in K. pneumoniae. Amikacin, fosfomycin and nitrofurantoin were the antibiotics to which the least resistance was detected. CONCLUSIONS This study showed that wastewater from healthcare centers constitutes a reservoir of multidrug-resistant bacteria in Burkina Faso, including carbapenemase producers. Untreated healthcare wastewater entering the environment exposes people and animals to infections caused by these multi-resistant bacteria, which are difficult to treat, especially in the resource-poor settings.
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Affiliation(s)
- Zakaria Garba
- Department of Biochemistry and Microbiology, Université Joseph KI-ZERBO, Ouagadougou, Burkina Faso.
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de La Santé, Nanoro, Burkina Faso.
| | - Isidore O J Bonkoungou
- Department of Biochemistry and Microbiology, Université Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - Nadège O Millogo
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de La Santé, Nanoro, Burkina Faso
| | - H Magloire Natama
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de La Santé, Nanoro, Burkina Faso
| | - Pingdwendé A P Vokouma
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de La Santé, Nanoro, Burkina Faso
| | - Massa Dit A Bonko
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de La Santé, Nanoro, Burkina Faso
| | - Ibrahima Karama
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de La Santé, Nanoro, Burkina Faso
| | | | - Kaisa Haukka
- Department of Microbiology and Human Microbiome Research Program, University of Helsinki, Helsinki, Finland
| | - Halidou Tinto
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de La Santé, Nanoro, Burkina Faso
| | - Lassana Sangaré
- Department of Health Sciences, Université Joseph KI-ZERBO, Ouagadougou, Burkina Faso
| | - Nicolas Barro
- Department of Biochemistry and Microbiology, Université Joseph KI-ZERBO, Ouagadougou, Burkina Faso
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Sharma E, Sivakumar M, Kelso C, Zhang S, Shi J, Gao J, Gao S, Zhou X, Jiang G. Effects of sewer biofilms on the degradability of carbapenems in wastewater using laboratory scale bioreactors. WATER RESEARCH 2023; 233:119796. [PMID: 36863281 DOI: 10.1016/j.watres.2023.119796] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/04/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Carbapenems are last-resort antibiotics used to treat bacterial infections unsuccessfully treated by most common categories of antibiotics in humans. Most of their dosage is secreted unchanged as waste, thereby making its way into the urban water system. There are two major knowledge gaps addressed in this study to gain a better understanding of the effects of their residual concentrations on the environment and environmental microbiome: development of a UHPLC-MS/MS method of detection and quantification from raw domestic wastewater via direct injection and study of their stability in sewer environment during the transportation from domestic sewers to wastewater treatment plants. The UHPLC-MS/MS method was developed for four carbapenems: meropenem, doripenem, biapenem and ertapenem, and validation was performed in the range of 0.5-10 μg/L for all analytes, with limit of detection (LOD) and limit of quantification (LOQ) values ranging from 0.2-0.5 μg/L and 0.8-1.6 μg/L respectively. Laboratory scale rising main (RM) and gravity sewer (GS) bioreactors were employed to culture mature biofilms with real wastewater as the feed. Batch tests were conducted in RM and GS sewer bioreactors fed with carbapenem-spiked wastewater to evaluate the stability of carbapenems and compared against those in a control reactor (CTL) without sewer biofilms, over a duration of 12 h. Significantly higher degradation was observed for all carbapenems in RM and GS reactors (60 - 80%) as opposed to CTL reactor (5 - 15%), which indicates that sewer biofilms play a significant role in the degradation. First order kinetics model was applied to the concentration data along with Friedman's test and Dunn's multiple comparisons analysis to establish degradation patterns and differences in the degradation observed in sewer reactors. As per Friedman's test, there was a statistically significant difference in the degradation of carbapenems observed depending on the reactor type (p = 0.0017 - 0.0289). The results from Dunn's test indicate that the degradation in the CTL reactor was statistically different from that observed in either RM (p = 0.0033 - 0.1088) or GS (p = 0.0162 - 0.1088), with the latter two showing insignificant difference in the degradation rates observed (p = 0.2850 - 0.5930). The findings contribute to the understanding about the fate of carbapenems in urban wastewater and the potential application of wastewater-based epidemiology.
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Affiliation(s)
- Elipsha Sharma
- School of Civil, Mining, Environmental & Architectural Engineering, University of Wollongong, Australia
| | - Muttucumaru Sivakumar
- School of Civil, Mining, Environmental & Architectural Engineering, University of Wollongong, Australia
| | - Celine Kelso
- School of Chemistry and Molecular Bioscience, University of Wollongong, Australia; Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Australia; Molecular Horizons, University of Wollongong, Australia
| | - Shuxin Zhang
- School of Civil, Mining, Environmental & Architectural Engineering, University of Wollongong, Australia
| | - Jiahua Shi
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Australia
| | - Jianfa Gao
- College of Chemistry and Environmental Engineering, Shenzen University, Shenzen, 518060, China
| | - Shuhong Gao
- State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, Harbin, 150090, China
| | - Xu Zhou
- State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, Harbin, 150090, China
| | - Guangming Jiang
- School of Civil, Mining, Environmental & Architectural Engineering, University of Wollongong, Australia; Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Australia.
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Mondragón-Quiguanas A, Villaquirán-Muriel MÁ, Rivera SP, Rosero-García D, Aranaga C, Correa A, Falco A. Beta-Lactam-Resistant Enterobacterales Isolated from Landfill Leachates. Pathogens 2022; 11:1077. [PMID: 36297134 PMCID: PMC9609224 DOI: 10.3390/pathogens11101077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 11/25/2023] Open
Abstract
Antibiotic resistance is one of the main challenges worldwide due to the high morbidity and mortality caused by infections produced by resistant bacteria. In Colombia, this problem has been studied mainly from the clinical perspective; however, it is scarcely studied in the leachates produced in landfills. The objective of this study was to detect, identify and determine the antibiotic sensitivity profile of Enterobacterales isolated from a leachate treatment plant located in Cali, Colombia. Detection was performed using selective culture media, bacterial identification using Matrix-Assisted Laser Desorption/Ionization-Time-Of-Flight (MALDI-TOF, bioMérieux) and by sequencing the gene coding for the 16S ribosomal RNA subunit when discrepancies were observed between phenotypic characteristics and MALDI-TOF. Antibiotic sensitivity profiling was determined using the automated VITEK®2 system (bioMérieux). Twenty-one isolates were obtained, of which Klebsiella pneumoniae was the most frequent (23.8%), and 34% of the isolates showed decreased sensitivity to beta-lactam antibiotics such as cefoxitin, ampicillin/sulbactam and piperacillin/tazobactam. These findings suggest that leachates from landfills could be a reservoir of pathogenic bacteria carrying antibiotic resistance determinants, so periodic microbiological characterization of these effluents should be performed, promoting the One Health approach.
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Affiliation(s)
- Alejandra Mondragón-Quiguanas
- Universidad Santiago de Cali, Grupo de Investigación en Microbiología, Industria y Ambiente (GIMIA), Facultad de Ciencias Básicas, Cali 760035, Colombia
| | - Miguel Ángel Villaquirán-Muriel
- Universidad Santiago de Cali, Grupo de Investigación en Microbiología, Industria y Ambiente (GIMIA), Facultad de Ciencias Básicas, Cali 760035, Colombia
| | - Sandra Patricia Rivera
- Universidad Santiago de Cali, Grupo de Investigación en Microbiología, Industria y Ambiente (GIMIA), Facultad de Ciencias Básicas, Cali 760035, Colombia
- Laboratorio de Salud Pública Departamental, Secretaria Departamental de Salud del Valle del Cauca, Gobernación del Valle del Cauca, Cali 760045, Colombia
| | - Doris Rosero-García
- Universidad Santiago de Cali, Grupo de Investigación en Microbiología, Industria y Ambiente (GIMIA), Facultad de Ciencias Básicas, Cali 760035, Colombia
| | - Carlos Aranaga
- Universidad Santiago de Cali, Grupo de Investigación en Química y Biotecnología (QUIBIO), Facultad de Ciencias Básicas, Cali 760035, Colombia
| | - Adriana Correa
- Universidad Santiago de Cali, Grupo de Investigación en Microbiología, Industria y Ambiente (GIMIA), Facultad de Ciencias Básicas, Cali 760035, Colombia
- Clínica Imbanaco, Cali 760042, Colombia
| | - Aura Falco
- Universidad Santiago de Cali, Grupo de Investigación en Microbiología, Industria y Ambiente (GIMIA), Facultad de Ciencias Básicas, Cali 760035, Colombia
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Sommaggio LRD, Oliveira FA, Malvestiti JA, Mazzeo DEC, Levy CE, Dantas RF, Marin-Morales MA. Assessment of phytotoxic potential and pathogenic bacteria removal from secondary effluents during ozonation and UV/H 2O 2. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2022; 318:115522. [PMID: 35759961 DOI: 10.1016/j.jenvman.2022.115522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 05/25/2022] [Accepted: 06/11/2022] [Indexed: 06/15/2023]
Abstract
Wastewater reuse is an important strategy for water resource management. For this reason, the disinfection process must be appropriated, eliminating pathogenic microorganisms. Ozonation (O3) and UV/H2O2 treatments can be used for effluent disinfection, but few studies just address the Escherichia coli quantification. In this study, secondary effluents from two wastewater treatment plants with different characteristics were exposed to O3 (5 and 10 mg L-1) or UV/H2O2 (H2O2: 90 mg L-1) treatments and evaluated by BD Phoenix ™ 100 (Becton Dickinson, USA) and MALDI-TOF for the characterization of the indigenous microorganisms in the effluents, before and after treatments. Additionally, all the samples were tested for phytotoxicity by Lactuca sativa bioassay. The results showed that the highest ozone dose and the UV/H2O2 treatment were effective in removing E. coli. UV/H2O2 was more efficient as it eliminated most of the microorganisms. Acinetobacter sp., Aeromonas and Pseudomonas were still found after O3 treatment. Bacillus sp. was found after O3 and UV/H2O2 treatments. The results with L. sativa showed inhibition of root growth for all dry period (low rainfall) samples of one of the WWTP, due to the high concentration of the phytotoxicity compounds. For environmental and human health safety, treated effluents should be evaluated for their toxic and pathogenic potential before being released into the environment. Pathogens evaluation on treated effluents should cover a wider range of pathogenic microorganisms than those routinely required by legislation.
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Affiliation(s)
- Lais Roberta Deroldo Sommaggio
- Department of Biology, Institute of Biosciences, São Paulo State University (Unesp), Av. 24-A, 1515, 13506-900, Rio Claro, SP, Brazil.
| | - Flávio A Oliveira
- Department of Clinical Pathology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Alexander Fleming, 105, 13081-970, Campinas, SP, Brazil.
| | | | - Dânia Elisa Christofoletti Mazzeo
- Department of Biotechnology and Plant and Animal Production, Center for Agricultural Sciences, Federal University of São Carlos (UFSCAR), Araras, SP, Brazil.
| | - Carlos Emílio Levy
- Department of Clinical Pathology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Alexander Fleming, 105, 13081-970, Campinas, SP, Brazil.
| | - Renato Falcão Dantas
- School of Technology, University of Campinas - UNICAMP, Paschoal Marmo 1888, 13484332, Limeira, SP, Brazil.
| | - Maria Aparecida Marin-Morales
- Department of Biology, Institute of Biosciences, São Paulo State University (Unesp), Av. 24-A, 1515, 13506-900, Rio Claro, SP, Brazil.
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Aristizabal-Hoyos A, Rodríguez EA, Torres-Palma RA, Jiménez JN. Concern levels of beta-lactamase-producing Gram-negative bacilli in hospital wastewater: hotspot of antimicrobial resistance in Latin-America. Diagn Microbiol Infect Dis 2022; 105:115819. [DOI: 10.1016/j.diagmicrobio.2022.115819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 07/03/2022] [Accepted: 09/16/2022] [Indexed: 11/24/2022]
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Zou H, Berglund B, Wang S, Zhou Z, Gu C, Zhao L, Meng C, Li X. Emergence of bla NDM-1, bla NDM-5, bla KPC-2 and bla IMP-4 carrying plasmids in Raoultella spp. in the environment. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 306:119437. [PMID: 35537555 DOI: 10.1016/j.envpol.2022.119437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 06/14/2023]
Abstract
To date, carbapenem-resistant Enterobacteriaceae have been found predominantly in clinical settings worldwide. Raoultella belongs to the Enterobacteriaceae family which can cause hospital-acquired infections, and carbapenem-resistant Raoultella spp. (CRR) is sporadically reported in the environment. We investigated the distribution and underlying resistance mechanisms of CRR in a wastewater treatment plant (WWTP) from eastern China between January 2018 and February 2019. A total of 17 CRR were isolated from 324 environmental samples, including Raoultella ornithinolytica (n = 15) and Raoultella planticola (n = 2). The detection of CRR was more frequent in the water inlet compared to anaerobic tank, aerobic tank, sludge thickener, activated sludge, mud cake storage area, and water outlet, and CRR was detected in mud cake stacking area. All CRR were resistant to imipenem, meropenem, ampicillin, piperacillin-tazobactam, cefotaxime, ceftazidime, trimethoprim-sulfamethoxazole and fosfomycin. Four different carbapenemase genes were identified, including blaKPC-2 (n = 13), blaNDM-1 (n = 8), blaNDM-5 (n = 1), blaIMP-4 (n = 1). Interestingly, isolated R. ornithinolytica from the WWTP were closely related to those reported from human samples in China. Plasmid analysis indicated that IncFII(Yp), IncP6, and IncU mediated blaKPC-2 spread, IncX3 and IncN2 mediated blaNDM spread in the environment. The core structure of the Tn3-ISKpn27-blaKPC-2-ISKpn6, ISAba125-blaNDM-bleMBL-trpF-dsbD were identified. The study provides evidence that Raoultella spp. may spread alarming carbapenem resistance in the environment and, therefore, the continuous surveillance for carbapenem resistance in the WWTP should be conducted, especially sludge.
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Affiliation(s)
- Huiyun Zou
- Department of Environment and Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Björn Berglund
- Department of Clinical and Experimental Medicine, Linköping University, 581 85, Linköping, Sweden
| | - Shuang Wang
- Institute of Infection Disease Control, Shandong Centre for Disease Control and Prevention, Jinan, China
| | - Ziyu Zhou
- Department of Environment and Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Congcong Gu
- Department of Environment and Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Ling Zhao
- Department of Environment and Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Chen Meng
- Department of Environment and Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China
| | - Xuewen Li
- Department of Environment and Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
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Urase T, Goto S, Sato M. Monitoring Carbapenem-Resistant Enterobacterales in the Environment to Assess the Spread in the Community. Antibiotics (Basel) 2022; 11:antibiotics11070917. [PMID: 35884172 PMCID: PMC9311640 DOI: 10.3390/antibiotics11070917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/02/2022] [Accepted: 07/06/2022] [Indexed: 11/20/2022] Open
Abstract
The usefulness of wastewater-based epidemiology (WBE) was proven during the COVID-19 pandemic, and the role of environmental monitoring of emerging infectious diseases has been recognized. In this study, the prevalence of carbapenem-resistant Enterobacterales (CRE) in Japanese environmental samples was measured in the context of applying WBE to CRE. A total of 247 carbapenem-resistant isolates were obtained from wastewater, treated wastewater, and river water. Treated wastewater was shown to be an efficient target for monitoring CRE. The results of the isolate analysis showed that WBE may be applicable to Escherichia coli-carrying New Delhi metallo-β-lactamase (NDM)-type carbapenemase, the Enterobacter cloacae complex and Klebsiella pneumoniae complex-carrying IMP-type carbapenemase. In addition, a certain number of CRE isolated in this study carried Guiana extended spectrum (GES)-type carbapenemase although their clinical importance was unclear. Only a few isolates of Klebsiella aerogenes were obtained from environmental samples in spite of their frequent detection in clinical isolates. Neither the KPC-type, the oxacillinase (OXA)-type nor the VIM-type of carbapenemase was detected in the CRE, which reflected a low regional prevalence. These results indicated the expectation and the limitation of applying WBE to CRE.
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Rajabi A, Farajzadeh D, Dehghanzadeh R, Aslani H, Mousavi S, Mosaferi M, Dehghani MH, Asghari FB. Characterization of antibiotic resistance genes and bacteria in a municipal water resource recovery facility. WATER ENVIRONMENT RESEARCH : A RESEARCH PUBLICATION OF THE WATER ENVIRONMENT FEDERATION 2022; 94:e10750. [PMID: 35765862 DOI: 10.1002/wer.10750] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/17/2022] [Accepted: 05/25/2022] [Indexed: 06/15/2023]
Abstract
Municipal water resource recovery facilities (WRRFs) are important sources of antibiotic-resistant bacteria and genes (ARB and ARGs). In this study, antibiotic-resistant total heterotrophic bacteria (THBR ) counts (CFU/ml) cultivated from influent, effluent of activated sludge process, and outflow of disinfection unit of an urban WRRF were investigated for the presence of 16, 32, 64, and 128 μg/ml of nine antibiotics. The isolates of Pseudomonas spp., Acinetobacter spp., and Escherichia coli obtained from effluent of activated sludge process were subjected for molecular identification by detecting the 16S rRNA gene sequences. Additionally, using the polymerase chain reaction method (PCR), the isolates were investigated for the presence of blaSHV , blaTEM , blaCTX-M , blaVIM , sul1, and qnrS genes. According to the results, the abundance of THBR counts was not significantly reduced by the biological treatment except for cefixime and sulfamethoxazole; it also increased for some antibiotics after disinfection unit. The average removal efficiency of THBR resistant to ciprofloxacin, sulfamethoxazole, and ceftazidime were 7.9 ± 1.7%, 41.8 ± 2.1%, and 14.4 ± 6.2%, respectively. Also, all the tested isolates were resistant to at least four antibiotics. For all antibiotics, the resistance ratio (THBR /THB) significantly increased in the effluent and after chlorination unit. Among 12 resistant isolates, blaTEM and sul1 genes were the most frequently detected ones involved in 92% and 83% of the isolates, respectively. Both blaTEM and sul1 genes were found in 100% of E. coli, and 83% and 67% of Pseudomonas spp. isolates, respectively. Further efforts are necessary to limit the transmission of ARB and ARGs from WRRFs into the environment and prevent human health threats. PRACTITIONER POINTS: The ratio of resistance significantly increased after biological treatment. Up to 40% of heterotrophic bacteria in the effluent was antibiotic resistant. blaTEM and sul1 genes were more prevalent (92%) in all isolates of bacteria. Both blaTEM and sul1 genes were found in 100% of E. coli isolates. Pseudomonas spp. holds blaTEM and sul1 genes in 83% and 67% of isolates, respectively.
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Affiliation(s)
- Akbar Rajabi
- Department of Environmental Health Engineering, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Davoud Farajzadeh
- Department of Cellular and Molecular Biology, Faculty of Biological Sciences, Azarbaijan Shahid Madani University, Tabriz, Iran
| | - Reza Dehghanzadeh
- Department of Environmental Health Engineering, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
- Health and Environment Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hassan Aslani
- Department of Environmental Health Engineering, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
- Health and Environment Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeid Mousavi
- Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Mosaferi
- Department of Environmental Health Engineering, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
- Health and Environment Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hadi Dehghani
- Institute for Environmental Research, Center for Solid Waste Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Baghal Asghari
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Resistant Genes and Multidrug-Resistant Bacteria in Wastewater: A Study of Their Transfer to the Water Reservoir in the Czech Republic. Life (Basel) 2022; 12:life12020147. [PMID: 35207435 PMCID: PMC8875776 DOI: 10.3390/life12020147] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/15/2022] [Accepted: 01/17/2022] [Indexed: 01/01/2023] Open
Abstract
Wastewater is considered the most serious source of the spread of antibiotic resistance in the environment. This work, therefore, focuses on the fate and spread of antibiotic resistance genes (ARGs) in wastewater and the monitoring of multidrug-resistant strains. ARGs were monitored in the nitrification and sedimentation tanks of the wastewater treatment plant (WWTP) and in the dam into which this WWTP flows, at various times. The highest relative abundance was found for the blaTEM > tetW > blaNDM-1 > vanA resistance genes, respectively. An increased concentration of tetracycline (up to 96.00 ng/L) and ampicillin (up to 19.00 ng/L) was found in water samples compared to other antibiotics detected. The increased incidence of seven ARGs and four antibiotics was observed in the November and December sampling times. Isolated ampicillin-resistant strains showed a high degree of resistance to ampicillin (61.2% of the total isolates had a minimum inhibitory concentration (MIC) ≥ 20 mg/mL). In 87.8% of isolates, out of the total number, the occurrence of two or more ARGs was confirmed. These multidrug-resistant strains were most often identified as Aeromonas sp. This strain could represent a significant role in the spread of multidrug resistance through wastewater in the environment.
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Pereira AL, de Oliveira PM, Faria-Junior C, Alves EG, de Castro E Caldo Lima GR, da Costa Lamounier TA, Haddad R, de Araújo WN. Environmental spreading of clinically relevant carbapenem-resistant gram-negative bacilli: the occurrence of bla KPC-or-NDM strains relates to local hospital activities. BMC Microbiol 2022; 22:6. [PMID: 34979901 PMCID: PMC8725513 DOI: 10.1186/s12866-021-02400-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/26/2021] [Indexed: 12/19/2022] Open
Abstract
Background Aquatic matrices impacted by sewage may shelter carbapenem-resistant (CR) Gram-negative bacilli (GNB) harboring resistance genes of public health concern. In this study, sewage treatment plants (STPs) servicing well-defined catchment areas were surveyed for the presence of CR-GNB bearing carbapenemase genes (blaKPC or blaNDM). Results A total of 325 CR-GNB were recovered from raw (RS) and treated (TS) sewage samples as well as from water body spots upstream (UW) and downstream (DW) from STPs. Klebsiella-Enterobacter (KE) group amounted to 116 isolates (35.7%). CR-KE isolates were recovered from TS, DW (35.7%) and RS samples (44.2%) (p = 0.001); but not from UW samples. KE isolates represented 65.8% of all blaKPC or blaNDM positive strains. The frequency of blaKPC-or-NDM strains was positively associated with the occurrence of district hospitals located near STPs, as well as with the number of hospitalizations and of sewer connections serviced by the STPs. blaKPC-or-NDM strains were recovered from ST samples in 7 out of 14 STPs, including four tertiary-level STPs; and from 6 out of 13 DW spots whose RS samples also had blaKPC-or-NDM strains. Conclusions Clinically relevant GNB bearing blaKPC-or-NDM resist sewage treatments and spread into environmental aquatic matrices mainly from STPs impacted by hospital activities. Supplementary Information The online version contains supplementary material available at 10.1186/s12866-021-02400-1.
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Affiliation(s)
- Alex Leite Pereira
- Campus of Ceilândia, University of Brasília. Centro Metropolitano, Conjunto A, Ceilândia Sul, Brasília, DF, CEP: 72220-275, Brazil.
| | - Pâmela Maria de Oliveira
- Campus of Ceilândia, University of Brasília. Centro Metropolitano, Conjunto A, Ceilândia Sul, Brasília, DF, CEP: 72220-275, Brazil
| | - Célio Faria-Junior
- Central Laboratory for Public Health (LACEN-DF), SGAN 601, Asa Norte, Brasília, DF, CEP: 70830-010, Brazil
| | - Everton Giovanni Alves
- Central Laboratory for Public Health (LACEN-DF), SGAN 601, Asa Norte, Brasília, DF, CEP: 70830-010, Brazil
| | | | - Thaís Alves da Costa Lamounier
- Campus of Ceilândia, University of Brasília. Centro Metropolitano, Conjunto A, Ceilândia Sul, Brasília, DF, CEP: 72220-275, Brazil
| | - Rodrigo Haddad
- Campus of Ceilândia, University of Brasília. Centro Metropolitano, Conjunto A, Ceilândia Sul, Brasília, DF, CEP: 72220-275, Brazil
| | - Wildo Navegantes de Araújo
- Campus of Ceilândia, University of Brasília. Centro Metropolitano, Conjunto A, Ceilândia Sul, Brasília, DF, CEP: 72220-275, Brazil
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11
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Hassan MA, Abd El-Aziz S, Elbadry HM, El-Aassar SA, Tamer TM. Prevalence, antimicrobial resistance profile, and characterization of multi-drug resistant bacteria from various infected wounds in North Egypt. Saudi J Biol Sci 2022; 29:2978-2988. [PMID: 35531185 PMCID: PMC9073052 DOI: 10.1016/j.sjbs.2022.01.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/06/2022] [Accepted: 01/10/2022] [Indexed: 11/30/2022] Open
Abstract
Multi-drug resistant (MDR) bacteria associated with wounds are extremely escalating. This study aims to survey different wounds in Alexandria hospitals, North Egypt, to explore the prevalence and characteristics of MDR bacteria for future utilization in antibacterial wound dressing designs. Among various bacterial isolates, we determined 22 MDR bacteria could resist different classes of antibiotics. The collected samples exhibited the prevalence of mono-bacterial infections (60%), while 40% included poly-bacterial species due to previous antibiotic administration. Moreover, Gram-negative bacteria showed dominance with a ratio of 63.6%, while Gram-positive bacteria reported 36.4%. Subsequently, the five most virulent bacteria were identified following the molecular approach by 16S rRNA and physiological properties using the VITEK 2 automated system. They were deposited in GenBank as Staphylococcus haemolyticus MST1 (KY550377), Pseudomonas aeruginosa MST2 (KY550378), Klebsiella pneumoniae MST3 (KY550379), Escherichia coli MST4 (KY550380), and Escherichia coli MST5 (KY550381). In terms of isolation source, S. haemolyticus MST1 was isolated from a traumatic wound, while P. aeruginosa MST2 and E. coli MST4 were procured from hernia surgical wounds, and K. pneumoniae MST3 and E. coli MST5 were obtained from diabetic foot ulcers. Antibiotic sensitivity tests exposed that K. pneumoniae MST3, E. coli MST4, and E. coli MST5 are extended-spectrum β-lactamases (ESBLs) bacteria. Moreover, S. haemolyticus MST1 belongs to the methicillin-resistant coagulase-negative staphylococcus (MRCoNS), whereas P. aeruginosa MST2 exhibited resistance to common empirical bactericidal antibiotics. Overall, the study provides new insights into the prevalent MDR bacteria in Egypt for further use as specific models in formulating antibacterial wound dressings.
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Affiliation(s)
- Mohamed A. Hassan
- Protein Research Department, Genetic Engineering and Biotechnology Research Institute (GEBRI), City of Scientific Research and Technological Applications (SRTA-City), New Borg El-Arab City, P.O. Box: 21934, Alexandria, Egypt
- Corresponding authors.
| | - Sarah Abd El-Aziz
- Polymer Materials Research Department, Advanced Technology and New Materials Research Institute (ATNMRI), City of Scientific Research and Technological Applications (SRTA-City), New Borg El-Arab City, P.O. Box: 21934, Alexandria, Egypt
- Botany and Microbiology Department, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Horeya M. Elbadry
- Botany and Microbiology Department, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Samy A. El-Aassar
- Botany and Microbiology Department, Faculty of Science, Alexandria University, Alexandria, Egypt
| | - Tamer M. Tamer
- Polymer Materials Research Department, Advanced Technology and New Materials Research Institute (ATNMRI), City of Scientific Research and Technological Applications (SRTA-City), New Borg El-Arab City, P.O. Box: 21934, Alexandria, Egypt
- Corresponding authors.
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12
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Anthropogenic Activities and the Problem of Antibiotic Resistance in Latin America: A Water Issue. WATER 2021. [DOI: 10.3390/w13192693] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Antibiotics revolutionized modern medicine and have been an excellent tool to fight infections. However, their overuse and misuse in different human activities such as health care, food production and agriculture has resulted in a global antimicrobial resistance crisis. Some regions such as Latin America present a more complex scenario because of the lack of resources, systematic studies and legislation to control the use of antimicrobials, thus increasing the spread of antibiotic resistance. This review aims to summarize the state of environmental antibiotic resistance in Latin America, focusing on water resources. Three databases were searched to identify publications on antimicrobial resistance and anthropogenic activities in relation to natural and artificial water ecosystems. We found that antibiotic resistant bacteria, mainly against beta lactam antibiotics, have been reported in several Latin American countries, and that resistant bacteria as well as resistant genes can be isolated from a wide variety of aquatic environments, including drinking, surface, irrigation, sea and wastewater. It is urgent to establish policies and regulations for antibiotic use to prevent the increase of multi-drug resistant microorganisms in the environment.
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13
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Magureanu M, Bilea F, Bradu C, Hong D. A review on non-thermal plasma treatment of water contaminated with antibiotics. JOURNAL OF HAZARDOUS MATERIALS 2021; 417:125481. [PMID: 33992019 DOI: 10.1016/j.jhazmat.2021.125481] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/05/2021] [Accepted: 02/19/2021] [Indexed: 06/12/2023]
Abstract
Large amounts of antibiotics are produced and consumed worldwide, while wastewater treatment is still rather inefficient, leading to considerable water contamination. Concentrations of antibiotics in the environment are often sufficiently high to exert a selective pressure on bacteria of clinical importance that increases the prevalence of resistance. Since the drastic reduction in the use of antibiotics is not envisaged, efforts to reduce their input into the environment by improving treatment of contaminated wastewater is essential to limit uncontrollable spread of antibiotic resistance. This paper reviews recent progress on the use of non-thermal plasma for the degradation of antibiotics in water. The target compounds removal, the energy efficiency and the mineralization are analyzed as a function of discharge configuration and the most important experimental parameters. Various ways to improve the plasma process efficiency are addressed. Based on the identified reaction intermediates, degradation pathways are proposed for various classes of antibiotics and the degradation mechanisms of these chemicals under plasma conditions are discussed.
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Affiliation(s)
- M Magureanu
- National Institute for Lasers, Plasma and Radiation Physics, Department of Plasma Physics and, Nuclear Fusion, Atomistilor Str. 409, P.O. Box MG-36, Magurele, 077125 Bucharest, Romania.
| | - F Bilea
- National Institute for Lasers, Plasma and Radiation Physics, Department of Plasma Physics and, Nuclear Fusion, Atomistilor Str. 409, P.O. Box MG-36, Magurele, 077125 Bucharest, Romania; University of Bucharest, Faculty of Chemistry, Department of Analytical Chemistry, Panduri Avenue 90, 050663 Bucharest, Romania
| | - C Bradu
- University of Bucharest, Faculty of Biology, Department of Systems Ecology and Sustainability, Splaiul Independentei 91-95, 050095 Bucharest, Romania
| | - D Hong
- GREMI, UMR 7344, Université d'Orléans, CNRS, Orléans, France
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14
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Rodríguez EA, Ramirez D, Balcázar JL, Jiménez JN. Metagenomic analysis of urban wastewater resistome and mobilome: A support for antimicrobial resistance surveillance in an endemic country. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 276:116736. [PMID: 33618114 DOI: 10.1016/j.envpol.2021.116736] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 05/10/2023]
Abstract
In developing countries, where high levels of antimicrobial resistance are observed in hospitals, the surveillance of this phenomenon in wastewater treatment plants (WWTPs) and the environment is very limited, especially using cutting-edge culture-independent methods. In this study, the composition of bacterial communities, the resistome and mobilome (the pool of antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs), respectively) at a WWTP were determined using shotgun metagenomics and culture-based approaches. Wastewater samples were collected at four sampling points of a WWTP in Antioquia, Colombia. A total of 24 metagenomes were analyzed. Specifically, there were marked differences in bacterial community composition, resistome, and mobilome, according to the WWTP sampling points. Bacterial families of clinical importance such as Moraxellaceae, Aeromonadaceae, and Enterobacteriaceae were mainly detected in the WWTP influent and effluent samples. Genes encoding resistance to macrolide-lincosamide-streptogramin, β-lactams, and those conferring multidrug resistance (e.g., acrB, adeG, and mexD) were the most abundant. Moreover, some clinically important ARGs such as blaKPC-2 and blaCTX-M, and others not reported locally, such as blaTEM-196, blaGES-23, blaOXA-10, mcr-3, and mcr-5 were frequently detected. Co-occurrence network analyses indicated a significant association of ARGs such as blaOXA-58 and blaKPC genes with Aeromonadaceae and Enterobacteriaceae. Among the markers of MGEs, intI1 and ISCR8 were the most frequently detected. Altogether, this work reveals the importance of shotgun metagenomics and culture-based approaches in antimicrobial resistance studies. The findings also support that WWTPs are hotspots for antimicrobial resistance, whose analysis constitutes a powerful tool to predict the impact of antimicrobial resistance in a population.
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Affiliation(s)
- Erika A Rodríguez
- Línea de Epidemiología Molecular y Resistencia Bacteriana. Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia, 050010, Medellín, Colombia.
| | - Diego Ramirez
- Línea de Epidemiología Molecular y Resistencia Bacteriana. Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia, 050010, Medellín, Colombia; Grupo de Investigación en Gestión y Modelación Ambiental, Universidad de Antioquia, 050010, Medellín, Colombia
| | - José L Balcázar
- Catalan Institute for Water Research (ICRA), 17003, Girona, Spain; University of Girona, 17004, Girona, Spain
| | - J Natalia Jiménez
- Línea de Epidemiología Molecular y Resistencia Bacteriana. Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia, 050010, Medellín, Colombia.
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15
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Sánchez-Baena AM, Caicedo-Bejarano LD, Chávez-Vivas M. Structure of Bacterial Community with Resistance to Antibiotics in Aquatic Environments. A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2348. [PMID: 33673692 PMCID: PMC7957730 DOI: 10.3390/ijerph18052348] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/07/2021] [Accepted: 02/09/2021] [Indexed: 12/11/2022]
Abstract
Aquatic environments have been affected by the increase in bacterial resistant to antibiotics. The aim of this review is to describe the studies carried out in relation to the bacterial population structure and antibiotic resistance genes in natural and artificial water systems. We performed a systematic review based on the PRISMA guideline (preferred reporting items for systematic reviews and meta-analyzes). Articles were collected from scientific databases between January 2010 and December 2020. Sixty-eight papers meeting the inclusion criteria, i.e., "reporting the water bacterial community composition", "resistance to antibiotics", and "antibiotic resistance genes (ARG)", were evaluated according to pre-defined validity criteria. The results indicate that the predominant phyla were Firmicutes and Bacteroidetes in natural and artificial water systems. Gram-negative bacteria of the family Enterobacteraceae with resistance to antibiotics are commonly reported in drinking water and in natural water systems. The ARGs mainly reported were those that confer resistance to β-lactam antibiotics, aminoglycosides, fluoroquinolones, macrolides and tetracycline. The high influence of anthropogenic activity in the environment is evidenced. The antibiotic resistance genes that are mainly reported in the urban areas of the world are those that confer resistance to the antibiotics that are most used in clinical practice, which constitutes a problem for human and animal health.
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Affiliation(s)
- Ana María Sánchez-Baena
- Department of Natural Sciences, Exact and Statistics, Faculty of Basic Sciences, Campus Pampalinda, Universidad Santiago de Cali, Cali Calle 5 # 62-00, Colombia;
| | - Luz Dary Caicedo-Bejarano
- Department of Natural Sciences, Exact and Statistics, Faculty of Basic Sciences, Campus Pampalinda, Universidad Santiago de Cali, Cali Calle 5 # 62-00, Colombia;
| | - Mónica Chávez-Vivas
- Department of Biomedical Sciences, Faculty of Health, Campus Pampalinda, Universidad Santiago de Cali, Cali Calle 5 # 62-00, Colombia;
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16
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Parvin MS, Hasan MM, Ali MY, Chowdhury EH, Rahman MT, Islam MT. Prevalence and Multidrug Resistance Pattern of Salmonella Carrying Extended-Spectrum β-Lactamase in Frozen Chicken Meat in Bangladesh. J Food Prot 2020; 83:2107-2121. [PMID: 32663273 DOI: 10.4315/jfp-20-172] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/14/2020] [Indexed: 12/27/2022]
Abstract
ABSTRACT Salmonella is an important foodborne pathogen that causes public health problems globally, and the increase of antimicrobial resistance in Salmonella has intensified the problem. Chicken meat is an important reservoir and disseminator of Salmonella to humans. This study aimed at estimating the burden of Salmonella carrying extended-spectrum β-lactamase (ESBL) and their antimicrobial resistance pattern in 113 domestic frozen chicken meat samples purchased from supershops available in five divisional megacities of Bangladesh. The study also focused on the determination of β-lactamase-, and plasmid-mediated quinolone resistance-encoding genes. All samples were analyzed for the presence of Salmonella using selective media and PCR assay. Antimicrobial susceptibility test was done by disk diffusion test, and ESBL screening was performed by double-disk synergy tests. Resistance genes were detected using multiplex PCR. Of samples, 65.5% were positive for Salmonella spp., and, of these, 58.1% isolates were ESBL producers. All the isolates were multidrug resistant (MDR): 40.5% were resistant to both three to five and six to eight antimicrobial classes; 17.6% were resistant to 9 to 11 classes, and 1.4% isolates to 12 to 15 classes. The highest rates of resistance were observed against oxytetracycline (100%), followed by trimethoprim-sulfamethoxazole (89.2%), tetracycline (86.5%), nalidixic acid (83.8%), amoxicillin (74.3%), and pefloxacin (70.3%). Notably, 48.6% of isolates demonstrated resistance to imipenem. One (1.4%) isolate was possibly extensively drug resistant. All the isolates were positive for the blaTEM gene, 2.7% were positive for blaCTX-M-1, and 20.3% for blaNDM-1. The prevalence of qnrA and qnrS genes was 4.1 and 6.8%, respectively. This study shows that ESBL-producing Salmonella are widespread in frozen chicken meat in Bangladesh, which puts greater responsibility on food processors and policy makers to ensure food safety. HIGHLIGHTS
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Affiliation(s)
- Mst Sonia Parvin
- Population Medicine and AMR Laboratory, Department of Medicine, Farmgate, Dhaka-1215, Bangladesh
| | - Md Mehedi Hasan
- Population Medicine and AMR Laboratory, Department of Medicine, Farmgate, Dhaka-1215, Bangladesh
| | - Md Yamin Ali
- Population Medicine and AMR Laboratory, Department of Medicine, Farmgate, Dhaka-1215, Bangladesh.,Department of Livestock Services, Farmgate, Dhaka-1215, Bangladesh
| | | | - Md Tanvir Rahman
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh
| | - Md Taohidul Islam
- Population Medicine and AMR Laboratory, Department of Medicine, Farmgate, Dhaka-1215, Bangladesh
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17
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Shi HJ, Lee JS, Cho YK, Eom JS. Predictors of Mortality in Patients with Carbapenem-Resistant Gram-Negative Bacilli or Vancomycin-Resistant Enterococci Bacteremia. Infect Drug Resist 2020; 13:3535-3542. [PMID: 33116672 PMCID: PMC7553621 DOI: 10.2147/idr.s269087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/06/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose The incidences of carbapenem-resistant gram-negative bacilli (CRGNB) and vancomycin-resistant Enterococci (VRE) have increased rapidly in South Korea since 2000. The mortality rate for CRGNB or VRE bacteremia cases is higher than that for non-resistant bacteremia cases. The factors associated with higher mortality are unclear. We investigated the factors associated with mortality from CRGNB or VRE bacteremia and compared the relative risk of these factors. Patients and Methods We retrospectively collected data from adult patients with CRGNB or VRE bacteremia. Patients were grouped according to whether they survived or died. The data from both groups were compared. Results During the study period, 171 cases of CRGNB or VRE bacteremia were identified, of which 100 were CRGNB bacteremia cases and 71 were VRE bacteremia cases. Multivariate analysis revealed significant associations with Pitt bacteremia score (PBS) (odds ratio [OR] 1.329, 95% confidence interval [CI] 1.049-1.684). In the multivariate analysis, negative conversion of follow-up blood culture (FUBC) was related with one-week mortality from CRGNB or VRE bacteremia (OR 17.623, 95% CI 5.726-54.244). In the multivariate analysis of risk factors for 28-day mortality for CRGNB or VRE bacteremia, the significant risk factors were bacteremia of respiratory origin (OR 4.491, 95% CI 1.622-12.435) and positive FUBC (OR 4.082, 95% CI 1.626-10.204). Conclusion Despite the high mortality rate in patients with CRGNB or VRE bacteremia, the related mortality could be predicted by independent risk factors of PBS, positive FUBC, and bacteremia of respiratory origin.
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Affiliation(s)
- Hye Jin Shi
- Division of Infectious Diseases, Department of Internal Medicine, Gil Medical Center, Gachon University School of Medicine, Incheon, Republic of Korea
| | - Jin Seo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kangdong Sacred Hospital, Hallym University School of Medicine, Seoul, Republic of Korea
| | - Yong Kyun Cho
- Division of Infectious Diseases, Department of Internal Medicine, Gil Medical Center, Gachon University School of Medicine, Incheon, Republic of Korea
| | - Joong Sik Eom
- Division of Infectious Diseases, Department of Internal Medicine, Gil Medical Center, Gachon University School of Medicine, Incheon, Republic of Korea
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18
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Rodríguez EA, Aristizábal-Hoyos AM, Morales-Zapata S, Arias L, Jiménez JN. High frequency of gram-negative bacilli harboring bla KPC-2 in the different stages of wastewater treatment plant: A successful mechanism of resistance to carbapenems outside the hospital settings. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2020; 271:111046. [PMID: 32778323 DOI: 10.1016/j.jenvman.2020.111046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/09/2020] [Accepted: 07/02/2020] [Indexed: 06/11/2023]
Abstract
Wastewater treatment plants (WWTPs) are considered to be a reservoir and a source of bacterial resistance. Worryingly, the presence of carbapenem-resistant Gram-negative bacilli (CRGNB) in WWTPs has recently been reported, but there are still many research gaps regarding its emergence and impact. The distribution of CRGNB in the different stages of a WWTP in Colombia and the relationship between the physicochemical factors involved with their presence are described in this paper. Additionally, given the impact on public health, the CRGNB detected were compared with isolates previously found in hospital patients. Residual water samples were taken from five different stages of a WWTP between January and July 2017. A total of 390 GNB were isolated, and a significant frequency of CRGNB harboring blaKPC-2 (38.2%, n = 149/390) was detected, of which 57% were Enterobacteriaceae, 41.6% Aeromonadaceae, and 1.3% Pseudomonadaceae. The Enterobacteriaceae were more frequent in the raw effluent compared to the Aeromonadaceae, which in turn were more prevalent in the recycled activated sludge and final effluent. Environmental variables such as pH, oxygen, chemical oxygen demand, and temperature were significantly correlated with the quantification of carbapenem-resistant Enterobacteriaceae (CRE) at specific points in the WWTP. Interestingly, isolated K. pneumoniae harboring blaKPC-2 from the WWTPs were diverse and did not relate genetically to the hospital strains with which they were compared. In conclusion, these results confirm the worrying scenario of the dissemination and persistence of emerging contaminants such as CRGNB harboring blaKPC-2, and reinforce the need to establish strategies aimed at containing this problem using multifocal interventions.
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Affiliation(s)
- E A Rodríguez
- Línea de Epidemiología Molecular y Resistencia Bacteriana. Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia. Postal code: 050010, Medellín, Colombia.
| | - A M Aristizábal-Hoyos
- Línea de Epidemiología Molecular y Resistencia Bacteriana. Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia. Postal code: 050010, Medellín, Colombia
| | - S Morales-Zapata
- Línea de Epidemiología Molecular y Resistencia Bacteriana. Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia. Postal code: 050010, Medellín, Colombia
| | - L Arias
- Grupo de Bioprocesos Microbianos, Escuela de Microbiología, Universidad de Antioquia, Postal code: 050010, Medellín, Colombia
| | - J N Jiménez
- Línea de Epidemiología Molecular y Resistencia Bacteriana. Grupo de Investigación en Microbiología Básica y Aplicada (MICROBA), Escuela de Microbiología, Universidad de Antioquia. Postal code: 050010, Medellín, Colombia.
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