Detection of Carbapenem-Resistance Genes in Klebsiella Species Recovered from Selected Environmental Niches in the Eastern Cape Province, South Africa

Abstract

Carbapenemase-producing Enterobacteriaceae (CPE) have been heavily linked to hospital acquired infections (HAI) thereby leading to futility of antibiotics in treating infections and this have complicated public health problems. There is little knowledge about carbapenemase-producing Klebsiella spp. (CPK) in South Africa. This study aimed at determining the occurrence of CPK in different samples collected from selected environmental niches (hospitals, wastewater treatment plants, rivers, farms) in three district municipalities located in the Eastern Cape Province, South Africa. Molecular identification and characterization of the presumptive isolates were determined using polymerase chain reaction (PCR) and isolates that exhibited phenotypic carbapenem resistance were further screened for the possibility of harbouring antimicrobial resistance genes. One hundred (43%) of the 234 confirmed Klebsiella spp. isolates harboured carbapenem-resistance genes; 10 isolates harboured blaOXA-48-like; 17 harboured blaKPC; and 73 isolates harboured blaNDM-1. The emergence of blaKPC, blaOXA-48-like, and blaNDM-1 carbapenem-resistance genes in Klebsiella species associated with environmental sources is of great concern to public health.

Occurrence, Antibiotic Susceptibility and Genes Encoding Antibacterial Resistance of Salmonella spp. and Escherichia coli From Milk and Meat Sold in Markets of Bushenyi District, Uganda

“…Such resistant phenotypes indicate antibiotic failure, should these members of antibiotics be used in the treatment of any disease case implicated by any of the characterized members of organisms. Similar resistant phenotypes have been previously reported by 2 , 3 , 9 amongst some enteric associated bacterial pathogens, which show a failure of the various antibiotic regimen used, thereby arousing the need for effective alternative antibiotics. The antibacterial signatures also yielded multiple antibiotic-resistant phenotypes (MARP) with a profile of antibiotic resistance numbers ranging from 4 to 8 and multiple antibiotic-resistant indexes (MARI) range 0.4 to 0.7.…”

“…Primary infections associated with the aforementioned bacterial pathogens have remained a public health concern due to the multiple antibiotic resistance (MAR) revealed in the studies of various investigators. 2 , 3 …”

Wastewaters, with or without Hospital Contribution, Harbour MDR, Carbapenemase-Producing, but Not Hypervirulent Klebsiella pneumoniae

“…Our results are consistent with those of previous studies testing the antimicrobial resistance in Klebsiella isolates recovered from wastewaters. They were defined as MDR, being resistant to almost all tested antimicrobial agents [ 10 , 17 , 40 ]. Besides the resistance to all penicillins, beta-lactamase inhibitors, non-extended spectrum cephalosporins (1st and 2nd generation), extended-spectrum cephalosporins (3rd and 4th generation), broad-spectrum cephalosporins (5th generation), carbapenems, monobactams, fluoroquinolones, we encountered a high percentage (73%) of resistance to tigecycline (TGC).…”

“…The dissemination of antibiotic resistance genes (ARGs) worldwide, especially the carbapenemase family (CRG), became an urgent global health threat [ 9 , 10 ], mostly because their presence was detected in both clinical and environmental settings [ 11 ]. Wastewaters represent a hotspot for the development and dissemination of AMR and ARGs [ 12 ], being a key factor in this process [ 13 ].…”

Municipal Wastewaters Carry Important Carbapenemase Genes Independent of Hospital Input and Can Mirror Clinical Resistance Patterns

“…For instance, monitoring the antibiotic resistance level trends in the community using WBE methods cannot provide information about the nonhuman sources of bacteria and genes. Some authors have shown that livestock, slaughterhouses, domestic pets, food waste ( 69 ), wildlife, and animal farms sewage can contain carbapenem-resistant bacteria and CRGs ( 70 ), but not in significant amounts. For example, Europe registered a prevalence of <1% carbapenem-resistant Enterobacteriaceae among livestock and pets ( 71 ).…”