Multidrug-Resistant Enterobacteriaceae in Coastal Water: An Emerging Threat

Abstract

Background: The environmental role of carbapenemase-producing Enterobacteriaceae (CPE) acquisition and infection in human disease has been described but not thoroughly investigated. We aimed to assess the occurrence of CPE in nearshore aquatic bodies.Methods: Enterobacteriaceae were cultured from coastal and estuary water near Netanya, Israel in June and July of 2018. Bacteria were identified by VITEK2® and their antimicrobial susceptibility was tested according to the CLSI guidelines. Enterobacteriaceae genomes were sequenced to elucidate their resistome and carbapenemase types. Results: Among other clinically relevant bacteria, four CPE (three Enterobacter spp and one Escherichia coli isolate) were isolated from two river estuaries (Poleg and Alexander Rivers) and coastal water at a popular recreational beach (Beit Yanai). Molecular analysis and genome sequencing revealed the persistent presence of rare beta-lactamase resistance genes, including blaIMI-2 and a previously unknown blaIMI-20 allele, which were not found among the local epidemiological strains. Genome comparisons revealed the high identity of riverine and marine CPE that were cultivated one month apart. Conclusions: We show that CPE contamination was widespread in nearshore marine and riverine habitats. The high genome-level similarity of riverine and marine CPEs, isolated one month apart, hints at the common source of infection We discuss the clinical implications of these findings and stress the urgent need to assess the role of the aquatic environment in CPE epidemiology.

Distribution of antibiotic resistant bacteria and genes in sewage and surrounding environment of Tórshavn, Faroe Islands

“…P. aeruginosa, and A. hydrophila were also detected in oceanic samples and are known to cause disease in humans, such as necrotizing fasciitis (Tsai et al, 2012). It is not clear, how the bacteria natural to the GI tract, can survive the extreme changes from gut to wastewater to oceanic waters (Cohen et al, 2020). However, it has been speculated that the spatial and temporal heterogeneity in osmolarity within the human gut has led to an adaption, enabling the gut bacteria to cope with varying salinity levels, which might improve their chances of survival in the marine environment (Cohen et al, 2020).…”