Hospital sewage water: a reservoir for variants of New Delhi metallo-β-lactamase (NDM)- and extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae

Parvez, Shadab; Khan, Asad U.

doi:10.1016/j.ijantimicag.2017.08.032

Cited by 63 publications

(39 citation statements)

References 32 publications

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“…All these species were identified to harbour bla NDM gene. Besides, 59% of isolates were found to contain bla CTX-M [52]. Moreover, the authors found the coexistence of several resistance determinants in the isolates such as bla NDM , bla CMY , bla OXA -type, bla CTX-M , and AmpC [52].…”

Section: Northern Regionmentioning

confidence: 97%

“…Enterobacteriaceae are belonging to the family of Gram-negative bacilli that includes the genera of Escherichia, Klebsiella, Enterobacter, Serratia, Citrobacter, Proteus, and Morganella [51]. Gram-negative bacteria that produce β-lactamases can inactivate β-lactams antibiotics, rendering them useless [52]. Carbapenems, a group of broad-spectrum antibiotics, are β -lactams, including imipenem, meropenem, and ertapenem, which currently are used to treat multidrug-resistant Enterobacteriaceae [53,54].…”

Section: Carbapenem Resistance Enterobacteriaceaementioning

confidence: 99%

“…It is evident that the genes encoding resistance to carbapenem are mostly located on plasmids and associated with insertion sequences, integrons, and transposons, which facilitate their further spread [57]. The primary causative reason associated with its rapid spread is the horizontal gene transfer (HGT) mechanism among the Enterobacteriaceae [52]. There have been three main classes of carbapenemases reported, including Ambler class A ß-lactamases (KPC), class B (metallo-enzymes NDM, VIM), and class D carbapenem-hydrolysing oxacillinase (OXA-48 type) [58].…”

Section: Carbapenem Resistance Enterobacteriaceaementioning

confidence: 99%

See 2 more Smart Citations

Environmental Prevalence of Carbapenem Resistance Enterobacteriaceae (CRE) in a Tropical Ecosystem in India: Human Health Perspectives and Future Directives

Sivalingam

Poté

Prabakar³

2019

Pathogens

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In the past few decades, infectious diseases have become increasingly challenging to treat, which is explained by the growing number of antibiotic-resistant bacteria. Notably, carbapenem-resistant Enterobacteriaceae (CRE) infections at global level attribute a vast, dangerous clinical threat. In most cases, there are enormous difficulties for CRE infection except a few last resort toxic drugs such as tigecycline and colistin (polymyxin E). Due to this, CRE has now been categorized as one among the three most dangerous multidrug resistance (MDR) pathogens by the US Centres for Disease Control and Prevention (CDC). Considering this, the study of the frequency of CRE infections and the characterization of CRE is an important area of research in clinical settings. However, MDR bacteria are not only present in hospitals but are spreading more and more into the environment, thereby increasing the risk of infection with resistant bacteria outside the hospital. In this context, developing countries are a global concern where environmental regulations are often insufficient. It seems likely that overcrowding, poor sanitation, socioeconomic status, and limited infrastructures contribute to the rapid spread of MDR bacteria, becoming their reservoirs in the environment. Thus, in this review, we present the occurrence of CRE and their resistance determinants in different environmental compartments in India.

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Section: Northern Regionmentioning

confidence: 97%

Section: Carbapenem Resistance Enterobacteriaceaementioning

confidence: 99%

Section: Carbapenem Resistance Enterobacteriaceaementioning

confidence: 99%

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Environmental Prevalence of Carbapenem Resistance Enterobacteriaceae (CRE) in a Tropical Ecosystem in India: Human Health Perspectives and Future Directives

Sivalingam

Poté

Prabakar³

2019

Pathogens

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“…In particular, extended spectrum β-lactamase (ESBL)-producing E. coli or carbapenemase-producing organisms (CPOs) have been detected in rivers, lakes [10][11][12], and WWTP treated water [13][14][15] in several countries, posing a potential risk of infection, and Japan is no exception [16,17]. Moreover, hospital wastewater is the most ARB-contaminated source in WWTP [5,13,[18][19][20][21][22] and there is concern about the relationship between hospital wastewater and environmental pollution [23,24].…”

Section: Introductionmentioning

confidence: 99%

“…In the clinical setting, resistance to carbapenems in Enterobacteriaceae-related infections [39] is a serious concern, owing to limited treatment options [40,41] and high mortality rates [42]. The presence of CPOs in hospital sewage [5,13,21,22], urban sewage [43], and coastal water environments [31,44] has also increased. Therefore, active surveillance and management are necessary to avoid undesirable dissemination of ARB from hospital sewage to WWTP.…”

Section: Introductionmentioning

confidence: 99%

Metagenomic survey and whole genome sequencing of antimicrobial resistant bacteria in the sewage of a Japanese hospital

Katagiri

Kuroda

Sekizuka

et al. 2020

Preprint

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Background The dissemination of antimicrobial-resistant bacteria (ARB) and the transfer of antimicrobial resistance genes (ARGs) are a threat to public health. Antibiotics are indispensable therapeutic agents essential for the treatment of infectious diseases; however, inappropriate use of antibiotics leads to the emergence of ARB. It is established that hospitals are closely involved in the spread of antimicrobial resistance (AMR), which impedes antibiotic treatment and subsequently increases mortality. In addition, excrement of patients or healthy carriers of ARB are discharged from the hospital sewage through the wastewater treatment plant (WWTP) into the rivers, causing an AMR burden on the environment.Method Metagenomic analysis was performed on the hospital sewage samples, followed by whole genome sequencing of the extended spectrum β-lactamase (ESBL)-producing organisms (EPOs). A comparative genome analysis was also performed between EPO isolates from sewage and clinical isolates.Results Metagenomic analysis showed that the hospital sewage tanks had bacterial flora corresponding to the human gut. During the study period, the hospital was relocated to a newly constructed building with new sewage tanks; however, the presence of ARB/ARGs in the new hospital sewage tanks became markedly equivalent to that of the old hospital within one month. The ESBL blaCTX−M and carbapenemase blaIMP genes were not much detected in the original hospital sewage samples by metagenome analysis, but selection on CHROMagar ESBL increased the sensitivity to detect those β-lactamase genes. Comparative genome analysis between sewage and clinical EPO isolates revealed partial similarity; however, most EPO isolates exhibited a notable difference (≥ 50) in single nucleotide variations based on core-genome phylogeny. This result suggests that only some of the sewage EPO isolates were originated from the clinical patient. Therapeutic agents in the hospital sewage were analyzed and the concentration of levofloxacin and clarithromycin was 0.0325 and 0.0135 µg/mL, respectively.Conclusions Whole genome analysis between sewage and clinical isolates suggested that healthy or asymptomatic carriers may be involved in the contamination of hospital sewage. Moreover, the hospital sewage tank may serve as a hotspot for the horizontal transfer of ARGs under the selective pressure of antimicrobial agents. Therefore, ARB monitoring in hospital sewage is expected to detect the presence of carriers prior to nosocomial ARB outbreaks. In addition, hospital wastewater should be treated suitably to bring ARB below detectable levels to reduce the environmental AMR burden.

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An Escherichia coli isolate from hospital sewage carries blaNDM-1 and blaoxa-10

Chen

Guo

et al. 2021

Arch Microbiol

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Hospital sewage water: a reservoir for variants of New Delhi metallo-β-lactamase (NDM)- and extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae

Cited by 63 publications

References 32 publications

Environmental Prevalence of Carbapenem Resistance Enterobacteriaceae (CRE) in a Tropical Ecosystem in India: Human Health Perspectives and Future Directives

Environmental Prevalence of Carbapenem Resistance Enterobacteriaceae (CRE) in a Tropical Ecosystem in India: Human Health Perspectives and Future Directives

Metagenomic survey and whole genome sequencing of antimicrobial resistant bacteria in the sewage of a Japanese hospital

An Escherichia coli isolate from hospital sewage carries blaNDM-1 and blaoxa-10

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