Antibiotic resistant Klebsiella spp. from a hospital, hospital effluents and wastewater treatment plants in the uMgungundlovu District, KwaZulu-Natal, South Africa

King, Tracy; Schmidt, Štefan; Essack, Sabiha Y.

doi:10.1016/j.scitotenv.2019.135550

Cited by 39 publications

(23 citation statements)

References 34 publications

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“…This trend is similar to a report from Kwazulu-Natal Province in South Africa, where most Klebsiella spp. (n = 72) isolated from hospital effluents were resistant against fluoroquinolone, aminoglycosides, and β-lactams [1]. In this study, the lowest resistance frequencies were observed in the antibiotic class carbapenems with a rate of 20% and 25% against imipenem and meropenem, respectively.…”

Section: Discussionmentioning

confidence: 59%

“…The hospital setting and its resultant waste can be regarded as significant hot spots for the presence and potential distribution of antibiotic-resistant bacteria (ARB) [1,2]. Apart from the high bacterial loads commonly reported in hospital effluents, they also contain sub-therapeutic antibiotic concentrations [3].…”

Section: Introductionmentioning

confidence: 99%

“…The development of multidrug-resistant (MDR) members of the Enterobacteriaceae family, most notably the Klebsiella pneumoniae and K. oxytoca, is quite concerning. These Klebsiella species are widely known as opportunistic hospital pathogens, which can escape from the hospital environment via wastes [1,11]. Other clinically significant genera of this family include food-related pathogens such as Salmonella spp.…”

Section: Introductionmentioning

confidence: 99%

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Distribution and molecular characterization of ESBL, pAmpC β-lactamases, and non-β-lactam encoding genes in Enterobacteriaceae isolated from hospital wastewater in Eastern Cape Province, South Africa

Fadare

Okoh

2021

PLoS ONE

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Globally, there is an increasing occurrence of multidrug-resistant (MDR) Enterobacteriaceae with extended-spectrum β-lactamases (ESBLs) and/or plasmid-encoded AmpC (pAmpC) β-lactamases in clinical and environmental settings of significant concern. Therefore, we aimed to evaluate the occurrence of ESBL/pAmpC genetic determinants, and some essential non-β-lactam genetic determinants in the MDR phenotypic antimicrobial resistance in Enterobacteriaceae isolates recovered from hospital wastewater. We collected samples from two hospitals in Amathole and Chris Hani District Municipalities in the Eastern Cape Province, South Africa, within October and November 2017. Using the matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF), we identified a total of 44 presumptive Enterobacteriaceae isolates. From this, 31 were identified as the targeted Enterobacteriaceae members. Thirty-six percent of these belonged to Klebsiella oxytoca, while 29% were Klebsiella pneumoniae. The other identified isolates included Citrobacter freundii and Escherichia coli (10%), Enterobacter asburiae (6%), Enterobacter amnigenus, Enterobacter hormaechei, and Enterobacter kobei (3%). We established the antibiotic susceptibility profiles of these identified bacterial isolates against a panel of 18 selected antibiotics belonging to 11 classes were established following established guidelines by the Clinical and Laboratory Standard Institute. All the bacterial species exhibited resistance phenotypically against at least four antibiotic classes and were classified as MDR. Notably, all the bacterial species displayed resistance against cefotaxime, ampicillin, nalidixic acid, and trimethoprim-sulfamethoxazole. The generated multiple antibiotic resistance indices ranged between 0.5 to 1.0, with the highest value seen in one K. oxytoca isolated. Molecular characterization via the Polymerase Chain Reaction uncovered various ESBLs, pAmpCs, and other non-β-lactam encoding genes. Of the phenotypically resistant isolates screened for each class of antibiotics, the ESBLs detected were blaCTX-M group (including groups 1, 2, and 9) [51.6% (16/31)], blaTEM [32.3% (10/31)], blaOXA-1-like [19.4% (6/31)], blaSHV [12.9% (4/31)], blaPER [6.5% (2/31)], blaVEB [3.2% (1/31)], blaOXA-48-like and blaVIM [15.4% (2/13)], and blaIMP [7.7% (1/13)]. The pAmpC resistance determinants detected were blaCIT [12.9% (4/31)], blaFOX [9.7% (3/31)], blaEBC [6.5% (2/31)], and blaDHA [3.2% (1/31)]. The frequencies of the non-β-lactam genes detected were catII [79.2% (19/24)], tetA [46.7% (14/30)], sulI and sulII [35.5% (11/31)], tetB [23.3% (7/30)], aadA [12.9% (4/31)], tetC [10% (3/30)], and tetD [3.3% (1/30)]. These results indicate that hospital wastewater is laden with potentially pathogenic MDR Enterobacteriaceae with various antibiotic resistance genes that can be spread to humans throughout the food chain, provided the wastewaters are not properly treated before eventual discharge into the environment.

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Section: Discussionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Distribution and molecular characterization of ESBL, pAmpC β-lactamases, and non-β-lactam encoding genes in Enterobacteriaceae isolated from hospital wastewater in Eastern Cape Province, South Africa

Fadare

Okoh

2021

PLoS ONE

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“…The occurrence of these bacterial species in the environment-especially antibiotic resistant-is an important issue for the environment and public health [74]. Furthermore, there is currently a knowledge gap as to whether the presence of such species in community wastewaters poses a potential risk to human health [75].…”

Section: Identification Of Selected Isolates and Detection Of Argsmentioning

confidence: 99%

Tetracycline Induces the Formation of Biofilm of Bacteria from Different Phases of Wastewater Treatment

et al. 2020

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The study monitored the effect of tetracycline on bacterial biofilm formation and compared biofilm formation by resistant bacterial strains in different phases of the wastewater treatment process in wastewater treatment plant (WWTP). The crystal violet staining method was used to evaluate the biofilm formation. Biofilm-related bacterial properties were characterized by hydrophobicity, autoaggregation and motility tests. The relative abundance of tetracycline resistance genes (tetW, tetM, tetO, tetA and tetB) in wastewaters were subsequently quantified using qPCR. The results show that the isolates from the nitrification tank produce biofilm with up to 10 times greater intensity relative to the isolates from the sedimentation tank. In isolates of Aeromonas sp. from the nitrification tank, increased biofilm production in the occurrence of tetracycline from a concentration of 0.03125 µg/mL was observed. The tetW gene showed the highest relative abundance out of all the tested genes. From the sampling points, its abundance was the highest in the sedimentation tank of the WWTP. Based on these results, it can be assumed that resistant bacteria are able to form a biofilm and sub-inhibitory tetracycline concentrations induce biofilm formation. WWTPs thus represent a reservoir of antibiotic resistance genes and contribute to the spread of resistance in the natural environment.

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“…In fact, the isolates from clinical settings acquired resistance to more β‐lactam as well as non‐β‐lactam antibiotics. Similarly, a comparative susceptibility study of K. pneumoniae isolates collected from wastewater treatment plants and hospitals in South Africa revealed a higher proportion of MDR K. pneumoniae in the hospital effluent (23%) compared to wastewater treatment plants (9%) (King et al ., 2020).…”

Section: Resultsmentioning

confidence: 99%

First report of cross resistance to silver and antibiotics in Klebsiella pneumoniae isolated from patients and polluted water in Tunisia

Miloud

Ali

Boutiba³

et al. 2020

Water & Environment J

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Klebsiella pneumoniae, ubiquitously found in a variety of environmental sources, is an important pathogen in burn wounds and nosocomial infections. Burn wounds have been commonly treated with silver compounds, which are also used in a multitude of (non)medical products. As the latter increased silver discharge into different environments, we evaluated and compared silver resistance in K. pneumoniae isolates collected from patients hospitalized at the Charles‐Nicolle hospital (Tunis, Tunisia) with isolates collected from different metal polluted waters in the north and south of Tunisia. All K. pneumoniae isolates harboured blaTEM‐1 and blaSHV‐1. In addition, all clinical isolates showed a multidrug phenotype and harboured the blaCTX‐M‐15, blaOXA‐1 and blaNDM‐1. Furthermore, all isolates showed resistance to silver nitrate. The silver resistance determinant, screened via the silE gene, was located for all isolates on a large plasmid with a size similar to pMG101. This study showed cross‐resistance between silver and beta‐lactams in clinical as well as environmental K. pneumoniae isolates from Tunisia and showed for the first time that NDM‐1‐producing K. pneumoniae developed resistance to silver.

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Antibiotic resistant Klebsiella spp. from a hospital, hospital effluents and wastewater treatment plants in the uMgungundlovu District, KwaZulu-Natal, South Africa

Cited by 39 publications

References 34 publications

Distribution and molecular characterization of ESBL, pAmpC β-lactamases, and non-β-lactam encoding genes in Enterobacteriaceae isolated from hospital wastewater in Eastern Cape Province, South Africa

Distribution and molecular characterization of ESBL, pAmpC β-lactamases, and non-β-lactam encoding genes in Enterobacteriaceae isolated from hospital wastewater in Eastern Cape Province, South Africa

Tetracycline Induces the Formation of Biofilm of Bacteria from Different Phases of Wastewater Treatment

First report of cross resistance to silver and antibiotics in Klebsiella pneumoniae isolated from patients and polluted water in Tunisia

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