Monitoring Carbapenem-Resistant Enterobacterales in the Environment to Assess the Spread in the Community

Urase, Taro; Goto, Saki; Sato, Mio

doi:10.3390/antibiotics11070917

Cited by 5 publications

(2 citation statements)

References 43 publications

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“…Indeed, GES-type carbapenemase producers have been identified in hospital wastewater samples from various countries ( Gomi et al, 2018 ; Suzuki Y. et al, 2020 ; Maehana et al, 2021 ; Conte et al, 2022 ; Takizawa et al, 2022 ; Zagui et al, 2023 ), which is consistent with our results. Additionally, bla GES -harboring isolates have been widely detected in wastewater treatment plants ( Girlich et al, 2012 ; Urase et al, 2022 ), suggesting that the resistance genes from sewage may also be disseminated into communities. Hence, hospital sewage is a potential hazard for transferring resistant organisms to the environment, which is an important public health issue.…”

Section: Discussionmentioning

confidence: 99%

Novel insights into genetic characteristics of blaGES-encoding plasmids from hospital sewage

Ota,

Prah,

Mahazu

et al. 2023

Front. Microbiol.

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IntroductionThe prevalence of Guiana extended-spectrum (GES)-type carbapenemase producers is increasing worldwide, and hospital water environments are considered as potential reservoirs. However, the genetic features underlying this resistance are not yet fully understood. This study aimed to characterize blaGES-encoding plasmids from a single-hospital sewage sample in Japan.MethodsCarbapenemase producers were screened using carbapenemase-selective agar and polymerase chain reaction. Whole-genome sequencing analyzes were performed on the carbapenemase-producing isolates.ResultsEleven gram-negative bacteria (four Enterobacter spp., three Klebsiella spp., three Aeromonas spp., and one Serratia spp.) with blaGES-24 (n = 6), blaGES-6 (n = 4), and blaGES-5 (n = 1) were isolated from the sewage sample. Five blaGES-24 and a blaGES-5 were localized in IncP-6 plasmids, whereas three blaGES-6 plasmids were localized in IncC plasmids with IncF-like regions. The remaining blaGES-6 and blaGES-24 were, respectively, localized on IncFIB-containing plasmids with IncF-like regions and a plasmid with an IncW-like replication protein. The IncP-6 and IncW-like plasmids had a close genetic relationship with plasmids from Japan, whereas the IncC/IncF-like and IncFIB/IncF-like plasmids were closely related to those from the United States and Europe. All blaGES genes were located on the class 1 integron cassette of the Tn3 transposon-related region, and the IncC/IncF-like plasmid carried two copies of the integron cassette. Eight of the eleven blaGES-encoding plasmids contained toxin-antitoxin system genes.DiscussionThe findings on the plasmids and the novel genetic content from a single wastewater sample extend our understanding regarding the diversity of resistance and the associated spread of blaGES, suggesting their high adaptability to hospital effluents. These findings highlight the need for the continuous monitoring of environmental GES-type carbapenemase producers to control their dissemination.

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Section: Discussionmentioning

confidence: 99%

Novel insights into genetic characteristics of blaGES-encoding plasmids from hospital sewage

Ota,

Prah,

Mahazu

et al. 2023

Front. Microbiol.

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“…Often referred to as wastewater-based epidemiology, this technique can give an unbiased insight into the community's health. Previous work has demonstrated that the supplemented media approach can be effective for detecting CP-CRE in environmental waters [27,28]. Although regarded as laborious and time consuming, culture-based methods allow the detection of some extremely rare resistance types that may go undetected by other methods [29].…”

Section: First Cp-cre Isolated From Hospital Effluent In New Caledoniamentioning

confidence: 99%

Ertapenem Supplemented Selective Media as a New Strategy to Distinguish β-Lactam-Resistant Enterobacterales: Application to Clinical and Wastewater Samples

et al. 2023

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The increase in carbapenem-resistant Enterobacterales (CRE) is mostly driven by the spread of carbapenemase-producing (CP) strains. In New Caledonia, the majority of carbapenemases found are IMP-type carbapenemases that are difficult to detect on routine selective media. In this study, a culture-based method with ertapenem selection is proposed to distinguish non-CRE, non-CP-CRE, and CP-CRE from samples with very high bacterial loads. Firstly, assays were carried out with phenotypically well-characterized β-lactam-resistant Enterobacterales isolates. Then, this approach was applied to clinical and environmental samples. Presumptive CP-CRE isolates were finally identified, and the presence of a carbapenemase was assessed. In a collection of 27 phenotypically well-characterized β-lactam-resistant Enterobacterales, an ertapenem concentration of 0.5 µg.mL−1 allowed distinguishing CRE from non-CRE. A concentration of 4 µg.mL−1 allowed distinguishing CP-CRE from non-CP-CRE after nine hours of incubation. These methods allowed isolating 18 CP-CRE from hospital effluents, including the first detection of a KPC in New Caledonia. All these elements show that this cost-effective strategy to distinguish β-lactam-resistant Enterobacterales provides fast and reliable results. This could be applied in the Pacific islands or other resource-limited settings, where limited data are available.

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Mobile genetic elements contributing to horizontal gene transfer of blaNDM among Escherichia coli in the community setting

Hu,

Han,

Yan

et al. 2024

Microbial Pathogenesis

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Monitoring Carbapenem-Resistant Enterobacterales in the Environment to Assess the Spread in the Community

Cited by 5 publications

References 43 publications

Novel insights into genetic characteristics of blaGES-encoding plasmids from hospital sewage

Novel insights into genetic characteristics of blaGES-encoding plasmids from hospital sewage

Ertapenem Supplemented Selective Media as a New Strategy to Distinguish β-Lactam-Resistant Enterobacterales: Application to Clinical and Wastewater Samples

Mobile genetic elements contributing to horizontal gene transfer of blaNDM among Escherichia coli in the community setting

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