An Update on Wastewater Multi-Resistant Bacteria: Identification of Clinical Pathogens Such as Escherichia coli O25b:H4-B2-ST131-Producing CTX-M-15 ESBL and KPC-3 Carbapenemase-Producing Klebsiella oxytoca

Mesquita, E.; Ribeiro, Rita P.; Silva, Carla J C; Alves, Rita Maria; Baptista, Rita; Condinho, Sílvia; Rosa, Maria João; Perdigão, João; Caneiras, Cátia; Duarte, Aida

doi:10.3390/microorganisms9030576

Cited by 13 publications

(15 citation statements)

References 49 publications

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“…Interestingly, the majority of Klebsiella isolates carrying bla CTX-M genes were detected in sites located in urban areas (P3, P5, and P6), next to WWTPs (P3 and P14), or in the proximity of pig farms (P8 and P9). All CTX-M variants identified in this study have been previously identified in Portugal in ESBL producers isolated not only in clinical, but also in environmental samples, such as, for example, from companion [52,53] and wild animals [54], retail meat [55], and wastewater-treated effluents or rivers [14,15,40,56,57]. Most variants were also previously found in rivers in Portugal [40], although, to the best of our knowledge, this is the first report showing the presence of bla CTX-M-65 in a Portuguese river.…”

Section: Discussionmentioning

confidence: 70%

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CTX-M-Producing Bacteria Isolated from a Highly Polluted River System in Portugal

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Teixeira

et al. 2022

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Enterobacteriaceae resistant to third-generation cephalosporins are a great concern for public health, as these are first-line drugs to treat infections. The production of carbapenemases and extended spectrum beta-lactamases (ESBLs) and/or the overexpression of AmpC β-lactamases are the main mechanisms of resistance to these antibiotics. Among the ESBLs, CTX-M β-lactamases are the most prevalent worldwide. Our aims were to determine the prevalence of cefotaxime-resistant Enterobacteriaceae along a heavily polluted river and characterize blaCTX-M carriers. River water was collected in 11 sites along the main course and tributaries, in two sampling moments. Water quality was evaluated and a collection of cefotaxime-resistant isolates was obtained. blaCTX-M carriers were characterized regarding phylogenetic affiliation, clonality, antibiotic susceptibility, gene diversity, and context. Water presented very low quality in all sites. From 147 cefotaxime-resistant isolates, 46% carried blaCTX-M and were affiliated with Escherichia, Klebsiella, Enterobacter, and Citrobacter. Molecular typing revealed clonal isolates in different sites and over the two years, suggesting survival of the strains in the river or continuous pollution inputs from the same sources. Eight variants of blaCTX-M were found, with blaCTX-M-15 being the most prevalent (52.5%). Sites with a lower water quality showed the highest resistance rates and prevalence of blaCTX-M, suggesting that river water may embody human health risks.

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Section: Discussionmentioning

confidence: 70%

“…The bla CTX-M-15 was identified for the first time in 1980s and, since then, has become the most prevalent bla CTX-M gene variant worldwide, in both hospitals and the environment [40,[61][62][63][64]. It was also the main variant found in Portuguese aquatic systems [25,39] and WWTPs, including in treated effluents [14,15,57].…”

Section: Discussionmentioning

confidence: 99%

CTX-M-Producing Bacteria Isolated from a Highly Polluted River System in Portugal

Tacão

Laço

Teixeira

et al. 2022

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“…Dissemination of K. pneumoniae strains harbouring the carbapenemase NDM-1 continues to increase, with various outbreak reports worldwide, including in several European countries in recent years [23][24][25][26][27][28][29][30]. Regarding the recent molecular studies on carbapenemproducers performed in Portugal [31][32][33][34][35], only a few reports of NDM-positive Enterobacterales strains were described [11][12][13]. Of relevance, none of them being in K. pneumoniae strains, indicating the limited presence of this metallo-beta-lactamase gene in the country.…”

Section: Discussionmentioning

confidence: 99%

First Outbreak of NDM-1-Producing Klebsiella pneumoniae ST11 in a Portuguese Hospital Centre during the COVID-19 Pandemic

et al. 2022

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New Delhi metallo-β-lactamase (NDM) carbapenemase has been considered a global threat due to its worldwide widespread in recent years. In Portugal, a very low number of infections with NDM-producing Enterobacterales has been reported. A total of 52 strains from 40 patients and 1 environmental sample isolated during COVID-19 pandemic were included in this study. Wholegenome sequencing (WGS) was performed on 20 carbapenemase-producing strains, including 17 NDM-1-producing Klebsiella pneumoniae ST11-KL105 lineage strains, one NDM-1-producing Escherichia coli ST58 strain and one KPC-3-producing K. pneumoniae ST147 strain, recovered from a total of 19 patients. Of interest, also one NDM-1-producing K. pneumoniae ST11-KL105 was collected from the hospital environment. Genome-wide phylogenetic analysis revealed an ongoing dissemination of NDM-1-producing K. pneumoniae ST11 strains (n = 18) with the same genetic features seen across multiple wards. Furthermore, the ST58 E. coli strain, collected from a patient rectal swab that was also colonised with a K. pneumoniae strain, also showed the IncFIA plasmid replicon and the blaNDM-1 gene (preceded by IS30 and followed by genes bleMBL, trpF, dsbC, cutA, groES and groEL). The blaNDM-1 is part of Tn125-like identical to those reported in Poland, Italy and India. The blaKPC-3 K. pneumoniae ST147-KL64 strain has the genetic environment Tn4401d isoform. In conclusion, herein we report the molecular epidemiology, resistome, virulome and mobilome of the first NDM-1 carbapenemase outbreak caused by K. pneumoniae ST11-KL105 lineage during the COVID-19 pandemic in Portugal. Moreover, the outbreak strains characterised included seventeen different patients (infected and colonised) and one environmental sample which also emphasises the role of commensal and hospital environment strains in the dissemination of the outbreak.

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“…The genomic analysis of i.e., ESBL-producing isolates revealed that the three most common sequence types (STs) associated with bloodstream infections (ST131, ST73, and ST95) and the specific and most common for livestock (ST10) were found in wastewater samples [ 120 ]. In many other studies, human-associated, multidrug-resistant, and highly virulent clone ST131 E. coli was detected in WWTP samples as well [ 75 , 87 , 113 , 131 , 132 , 133 , 134 ].…”

Section: Clinically Significant β-Lactam Resistance Genes In Wastewat...mentioning

confidence: 99%

Clinically Relevant β-Lactam Resistance Genes in Wastewater Treatment Plants

Waśko

Kozińska

Kotlarska

et al. 2022

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Antimicrobial resistance (AMR) is one of the largest global concerns due to its influence in multiple areas, which is consistent with One Health’s concept of close interconnections between people, animals, plants, and their shared environments. Antibiotic-resistant bacteria (ARB) and antibiotic-resistance genes (ARGs) circulate constantly in various niches, sediments, water sources, soil, and wastes of the animal and plant sectors, and is linked to human activities. Sewage of different origins gets to the wastewater treatment plants (WWTPs), where ARB and ARG removal efficiency is still insufficient, leading to their transmission to discharge points and further dissemination. Thus, WWTPs are believed to be reservoirs of ARGs and the source of spreading AMR. According to a World Health Organization report, the most critical pathogens for public health include Gram-negative bacteria resistant to third-generation cephalosporins and carbapenems (last-choice drugs), which represent β-lactams, the most widely used antibiotics. Therefore, this paper aimed to present the available research data for ARGs in WWTPs that confer resistance to β-lactam antibiotics, with a particular emphasis on clinically important life-threatening mechanisms of resistance, including extended-spectrum β-lactamases (ESBLs) and carbapenemases (KPC, NDM).

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An Update on Wastewater Multi-Resistant Bacteria: Identification of Clinical Pathogens Such as Escherichia coli O25b:H4-B2-ST131-Producing CTX-M-15 ESBL and KPC-3 Carbapenemase-Producing Klebsiella oxytoca

Cited by 13 publications

References 49 publications

CTX-M-Producing Bacteria Isolated from a Highly Polluted River System in Portugal

CTX-M-Producing Bacteria Isolated from a Highly Polluted River System in Portugal

First Outbreak of NDM-1-Producing Klebsiella pneumoniae ST11 in a Portuguese Hospital Centre during the COVID-19 Pandemic

Clinically Relevant β-Lactam Resistance Genes in Wastewater Treatment Plants

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