Isolation of KPC-2-producing Klebsiella pneumoniae strains belonging to the high-risk multiresistant clonal complex 11 (ST437 and ST340) in urban rivers

Occurrence of carbapenemase-producing bacteria in coastal recreational waters

“…KPC and GES-type carbapenemase producers have been observed in polluted aquatic matrices [4][5][6][7][8][9], although their presence in recreational water was so far unreported. Qnr-encoding genes have already been reported in such an environment [16].…”

“…Nevertheless, reports regarding their occurrence in environmental matrices are increasingly frequent [3]. For instance, Klebsiella pneumoniae carbapenemase (KPC)-producing isolates have been recovered from rivers located in France [4], Portugal [5] and Brazil [6] as well as from sewage samples in China [7], Brazil [8] and Austria [9]. Polluted rivers frequently flow to oceans, likely contaminating seawater with MDR bacteria and making these aquatic environments potential vectors of resistance for beach frequenters.…”

Presence of high-risk clones of OXA-23-producing Acinetobacter baumannii (ST79) and SPM-1-producing Pseudomonas aeruginosa (ST277) in environmental water samples in Brazil

“…Therefore, in urbanized areas, rivers can act as reservoirs of multidrug-resistant (MDR) bacteria, facilitating their transmission to humans and animals exposed through drinking water and/or recreational water (Montezzi et al, 2015). In the last years, reports of the occurrence of clinically relevant bacteria, belonging to hospital-associated high-risk clonal lineages, in sewage and polluted rivers have been increasingly frequent, mainly in Brazil, the biggest country in Latin America (Picão et al, 2013;Oliveira et al, 2014;Sacramento et al, 2016;Dropa et al, 2016). In this study, we report additional information on the environmental dissemination of OXA-23-producing Acinetobacter baumannii and SPM-1-producing Pseudomonas aeruginosa belonging to hospitalassociated clones ST79 and ST277, respectively.…”

“…In fact, carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter baumannii strains have become highly prevalent in nosocomial settings in Latin America(Labarca et al, 2016) Other reports have documented the detection of OXA-23-and NDM-1-producing A. baumannii strains recovered from urban river and hospital sewage samples in France and China, respectively(Girlich et al, 2010;Zhang et al, 2013); as well as, the identification of P. aeruginosa VIM-2 from an urban river sample and sewage downstream from a Hospital discharge site in Portugal(Quinteira and Peixe, 2006), and producing P. aeruginosa in water treated by wastewater treatment plants inFrance (Slekovec et al, 2012), revealing that the environmental spread of carbapenemase-producing A. baumannii and P. aeruginosa can be occurring in different countries around the world.High-risk MDR bacteria have found several routes of entry into the environment, such as sewage from the community or hospitals(Roca et al, 2015).Specifically, in Brazil wastewater from treatment plants and hospitals have become a hot spot for horizontal transfer of antibiotic resistance genes(Dropa et al, 2016; Ferreira et al, 2011). Furthermore, recent studies have report the occurrence of clinically relevant ESBL and/or carbapenemase producers and vanA-containing Enterococcus species in sewage and polluted rivers(Fontes et al, 2011; Picão et al, 2013Oliveira et al, 2014Sacramento et al, 2016). Of particular interest is the fact that the detection of KPC-2-producing K. pneumoniae (belonging to the widely disseminated CC258) and vanA-containing E. faecium has also been reported in the Tietê and Pinheiros Rivers, as well as in contaminated coastal waters, in Brazil(Oliveira et al, 2014; Montezzi et al, 2015;Sacramento et al, 2016), demostrating that high-risk clinically important bacteria are not limited to nosocomial settings, which should exacerbate the public health concerns.In summary, these results highlight the importance of environmental monitoring of pathogenic bacteria that can potentially serve as a source of resistance genes against clinical important antimicrobial agents, emphasizing the urgent need to adopt drastic measures of control and surveillance of discharge of domestic sewage and hospital wastewater.…”

“…Furthermore, recent studies have report the occurrence of clinically relevant ESBL and/or carbapenemase producers and vanA-containing Enterococcus species in sewage and polluted rivers(Fontes et al, 2011; Picão et al, 2013Oliveira et al, 2014Sacramento et al, 2016). Of particular interest is the fact that the detection of KPC-2-producing K. pneumoniae (belonging to the widely disseminated CC258) and vanA-containing E. faecium has also been reported in the Tietê and Pinheiros Rivers, as well as in contaminated coastal waters, in Brazil(Oliveira et al, 2014; Montezzi et al, 2015;Sacramento et al, 2016), demostrating that high-risk clinically important bacteria are not limited to nosocomial settings, which should exacerbate the public health concerns.In summary, these results highlight the importance of environmental monitoring of pathogenic bacteria that can potentially serve as a source of resistance genes against clinical important antimicrobial agents, emphasizing the urgent need to adopt drastic measures of control and surveillance of discharge of domestic sewage and hospital wastewater. Finally, new strategies should be developed to inhibit the extra-hospital spread of clinically important high-risk bacterial clones.…”