Occurrence of KPC-2-producing Klebsiella pneumoniae strains in hospital wastewater

Abstract

Carbapenem-hydrolysing b-lactamase KPC-producing isolates of Klebsiella pneumoniae are a major problem and concern. The first KPC-producing isolate was K. pneumoniae from the USA, identified in 1996, with subsequent identifications in China, Europe, Israel, Central and Brazil. 1 The KPC b-lactamases, a mostly plasmid-

Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

“…Once established, these hardy strains may ultimately infect debilitated patients (157). Hospital wastewater has been shown to harbor KPC-2-producing K. pneumoniae, suggesting widespread contamination throughout the health care environment (159).…”

Detection of Carbapenemase Genes in Aquatic Environments in Rio de Janeiro, Brazil

“…The detection of the same clonal group of E. kobei and E. asburiae at different points of water collection shows the capacity of these clones to persist and carry their genes along the river, even after passage through the WWTP. The capacity of KPC-producing bacteria to pass through a hospital WWTP has also been shown elsewhere (15,16).…”

Carbapenem-resistant bacteria in a secondary wastewater treatment plant

“…Although the NDM-1 represents one of many mechanisms of carbapenem resistance, genes encoding NDM-1 were present in the domestic and industrial wastewater and each stage of the wastewater treatment process, including the chlorinated effluent (Luo et al, 2014). The finding of KPC-2-producing Gram-negative bacteria after the passage of hospital wastewater through the tertiary wastewater treatment plant (Chagas et al, 2011) suggests a resistance of CRBP to the process of chlorine disinfection. Therefore, the upgrade of the secondary wastewater treatment plant to tertiary stage or conventional disinfection of effluent water does not seem to be a promising method for the elimination of CRBP from municipal wastewater in which hospital wastewaters are diluted with other types of wastewaters.…”

“…Published papers on CRBP in nature are mostly focused on single bacterial isolates. Viable isolates of CRBP were recovered from hospital sewage both before and after disinfection (Ferreira et al, 2011;Chagas et al, 2011;Zhang et al, 2013;Chandran et al, 2014). From the mixture of domestic and hospital wastewaters two carbapenem-resistant Klebsiella pneumoniae and one Escherichia coli were recovered (Galler et al, 2014).…”

“…Therefore, the numbers of viable CRBP in wastewater remain to be determined, in order to quantify the influence of wastewater on the spread of CRBP in the environment. Moreover, the temperature at which the CRBP 35-37°C (Girlich et al, 2010;Ferreira et al, 2011;Walsh et al, 2011;Galler et al, 2014;Tanner et al, 2015) or was not specified at all (Chagas et al, 2011;Poirel et al, 2012;Picao et al, 2013;Zhang et al, 2013). Cultivation at 37°C allows for the isolation of intrinsically carbapenem-resistant bacteria which are autochthonous populations in environmental samples.…”