Prevalence and Diversity of Carbapenem-Resistant Bacteria in Untreated Drinking Water in Portugal

Henriques, Isabel; Araújo, Susana; Azevedo, José Luís; Alves, Marta; Chouchani, Chedly; Pereira, Anabela; Correia, António

doi:10.1089/mdr.2012.0029

Cited by 30 publications

(32 citation statements)

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“…In Portugal, its use is restricted to hospital settings to prevent resistance dissemination. 18 When compared with the proportion of cefotaxime-resistant bacteria (4.64%) found in the same rivers and sampling period, 41 the percentage of imipenem-resistant isolates (0.19%) was clearly lower. A low prevalence of imipenem-resistant bacteria was found in a previous study on bacteria from untreated drinking water in Portugal.…”

Section: Discussionmentioning

confidence: 94%

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Low Prevalence of Carbapenem-Resistant Bacteria in River Water: Resistance Is Mostly Related to Intrinsic Mechanisms

Tacão

Correia

Henriques

2015

Microbial Drug Resistance

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Carbapenems are last-resort antibiotics to handle serious infections caused by multiresistant bacteria. The incidence of resistance to these antibiotics has been increasing and new resistance mechanisms have emerged. The dissemination of carbapenem resistance in the environment has been overlooked. The main goal of this research was to assess the prevalence and diversity of carbapenem-resistant bacteria in riverine ecosystems. The presence of frequently reported carbapenemase-encoding genes was inspected. The proportion of imipenem-resistant bacteria was on average 2.24 CFU/ml. Imipenem-resistant strains (n=110) were identified as Pseudomonas spp., Stenotrophomonas maltophilia, Aeromonas spp., Chromobacterium haemolyticum, Shewanella xiamenensis, and members of Enterobacteriaceae. Carbapenem-resistant bacteria were highly resistant to other beta-lactams such as quinolones, aminoglycosides, chloramphenicol, tetracyclines, and sulfamethoxazole/trimethoprim. Carbapenem resistance was mostly associated with intrinsically resistant bacteria. As intrinsic resistance mechanisms, we have identified the blaCphA gene in 77.3% of Aeromonas spp., blaL1 in all S. maltophilia, and blaOXA-48-like in all S. xiamenensis. As acquired resistance mechanisms, we have detected the blaVIM-2 gene in six Pseudomonas spp. (5.45%). Integrons with gene cassettes encoding resistance to aminoglycosides (aacA and aacC genes), trimethoprim (dfrB1b), and carbapenems (blaVIM-2) were found in Pseudomonas spp. Results suggest that carbapenem resistance dissemination in riverine ecosystems is still at an early stage. Nevertheless, monitoring these aquatic compartments for the presence of resistance genes and its host organisms is essential to outline strategies to minimize resistance dissemination.

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Section: Discussionmentioning

confidence: 94%

“…8 In some countries, including Portugal, the use of carbapenems is still limited to hospital settings. 18 However, there has been a continuous increase in the prevalence of bacterial resistance to carbapenems in clinical settings. 33,35 Some resistance mechanisms are still geographically constrained, but others have spread worldwide.…”

Section: Introductionmentioning

confidence: 99%

Low Prevalence of Carbapenem-Resistant Bacteria in River Water: Resistance Is Mostly Related to Intrinsic Mechanisms

Tacão

Correia

Henriques

2015

Microbial Drug Resistance

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“…(Docquier et al, 2002;Aubron et al, 2005;Girlich et al, 2010b;Henriques et al, 2012). Functional metagenomics studies have disclosed carbapenemase orthologs from bacteria in an Alaskan soil never inhabited by humans highlighting the huge pool of carbapenem resistance genes in the environment, which seems to predate the introduction of carbapenems in the therapeutic arsenal (Allen et al, 2009;Gonzalez and Vila, 2012).…”

Section: 72mentioning

confidence: 99%

Scientific Opinion on Carbapenem resistance in food animal ecosystems

Publication¹

2013

EFS2

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Carbapenems are broad-spectrum β-lactam antimicrobials used for the treatment of serious infections in humans. To date only sporadic studies have reported the occurrence of carbapenemase-producing (CP) bacteria in foodproducing animals and their environment. The bacteria and enzymes isolated include VIM-1 producing Escherichia coli and Salmonella Infantis from pigs and poultry in Germany, OXA-23-producing Acinetobacter spp. from cattle and horses in France and Belgium, and NDM-producing Acinetobacter spp. from pigs and poultry in China. In the German S. Infantis and E. coli isolates, the VIM-1-encoding genes were located on IncHI2 plasmids. A methodology including selective culture is proposed for the detection of CP strains of Enterobacteriaceae and Acinetobacter spp. The choice of selective media for the surveillance of carbapenem resistance for testing animal and food samples needs to be experimentally evaluated and validated. Biochemical and phenotypic tests for the confirmatory identification of CP bacteria are available. For CP bacteria in animals and food, active/passive monitoring and/or targeted surveys should cover key zoonotic agents, animal pathogens and indicator organisms. Priority should be given to broilers, fattening turkeys, fattening pigs, veal calves and meat thereof. Because there are no data on the comparative efficacy of individual control options, prioritisation is complex. Continued prohibition of the use of carbapenems in food-producing animals would be a simple and effective option. As genes encoding carbapenemase production are mostly plasmid-mediated, and co-resistance may be an important issue in the spread of such resistance mechanisms, decreasing the frequency of use of antimicrobials in animal production in the EU in accordance with prudent use guidelines is also of high priority. The effectiveness of any control measures should be monitored by targeted surveys, using selective isolation methods and pre-enrichment of samples. Control measures should be proactively implemented at national and international levels to prevent CP strains become widespread in livestock. SUMMARYThe European Food Safety Authority (EFSA) asked the Panel on Biological Hazards (BIOHAZ) to provide a scientific opinion on the carbapenem resistance in food animal ecosystems. Carbapenems are broad-spectrum beta (β)-lactam antimicrobials mostly used for the treatment of serious infections in humans, frequently in hospitalised patients, and are considered last-line therapy for infections caused by multidrug-resistant Gram-negative bacteria. In particular, the panel was asked: (i) to define the carbapenemase-producing (CP) bacterial strains and genes relevant for public health and linked to food-producing animals or food-borne transmission; (ii) to review the information on the epidemiology of acquired resistance to carbapenems, including the genes coding for such resistance, in food-producing animals and food; (iii) to perform a critical analysis of the methods (phenotypic and genotypic) and the interpr...

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“…Indeed, members of the same taxa have been described as carriers of different b-lactam resistance genes (Gonzalez and Vila, 2012;Henriques et al, 2012;Literacka et al, 2004;Vaz-Moreira et al, 2011). In addition, AmpC -lactamase, a class C serine cephalosporinase, is frequently found in enterobacteria, such as C.…”

Section: Characterization Of the Mixed Culture (Mc)mentioning

confidence: 99%

Solar photocatalytic oxidation of recalcitrant natural metabolic by-products of amoxicillin biodegradation

et al. 2014

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The contamination of the aquatic environment by non-metabolized and metabolized antibiotic residues has brought the necessity of alternative treatment steps to current water decontamination technologies. This work assessed the feasibility of using a multistage treatment system for amoxicillin (AMX) spiked solutions combining: i) a biological treatment process using an enriched culture to metabolize AMX, with ii) a solar photocatalytic system to achieve the removal of the metabolized transformation products (TPs) identified via LC-MS, recalcitrant to further biological degradation. Firstly, a mixed culture (MC) was obtained through the enrichment of an activated sludge sample collected in an urban wastewater treatment plant (WWTP). Secondly, different aqueous matrices spiked with AMX were treated with the MC and the metabolic transformation products were identified. Thirdly, the efficiency of two solar assisted photocatalytic processes (TiO2/UV or Fe 3+ /Oxalate/H2O2/UV-Vis) was assessed in the degradation of the obtained TPs using a lab-scale prototype photoreactor equipped with a compound parabolic collector (CPC). Highest AMX specific biodegradation rates were obtained in buffer and urban wastewater (WW) media (0.10 ± 0.01 and 0.13 ± 0.07 gAMX gbiomass -1 h -1 , respectively). The resulting TPs, which no longer presented antibacterial activity, were identified as amoxicilloic acid (m/ z = 384). The performance of the Fe /Oxalate/H2O2/UV-Vis system in the 2 removal of the TPs from WW medium was superior to the TiO2/UV process (TPs no longer detected after 40 min (QUV = 2.6 kJ L -1 ), against incomplete TPs removal after 240 min (QUV = 14.9 kJ L -1 ), respectively).

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Prevalence and Diversity of Carbapenem-Resistant Bacteria in Untreated Drinking Water in Portugal

Cited by 30 publications

References 24 publications

Low Prevalence of Carbapenem-Resistant Bacteria in River Water: Resistance Is Mostly Related to Intrinsic Mechanisms

Low Prevalence of Carbapenem-Resistant Bacteria in River Water: Resistance Is Mostly Related to Intrinsic Mechanisms

Scientific Opinion on Carbapenem resistance in food animal ecosystems

Solar photocatalytic oxidation of recalcitrant natural metabolic by-products of amoxicillin biodegradation

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