The Hydric Environment: A Hub for Clinically Relevant Carbapenemase Encoding Genes

Abstract

Carbapenems are β-lactams antimicrobials presenting a broad activity spectrum and are considered as last-resort antibiotic. Since the 2000s, carbapenemase producing Enterobacterales (CPE) have emerged and are been quickly globally spreading. The global dissemination of carbapenemase encoding genes (CEG) within clinical relevant bacteria is attributed in part to its location onto mobile genetic elements. During the last decade, carbapenemase producing bacteria have been isolated from non-human sources including the aquatic environment. Aquatic ecosystems are particularly impacted by anthropic activities, which conduce to a bidirectional exchange between aquatic environments and human beings and therefore the aquatic environment may constitute a hub for CPE and CEG. More recently, the isolation of autochtonous aquatic bacteria carrying acquired CEG have been reported and suggest that CEG exchange by horizontal gene transfer occurred between allochtonous and autochtonous bacteria. Hence, aquatic environment plays a central role in persistence, dissemination and emergence of CEG both within environmental ecosystem and human beings, and deserves to be studied with particular attention.

Persistence and Dissemination Capacities of a blaNDM-5-Harboring IncX-3 Plasmid in Escherichia coli Isolated from an Urban River in Montpellier, France

“…Thus, if water contains carbapenemase-producingbacteria such as B26 or B28 or other autochtonous bacteria, and has acquired the plasmid by horizontal gene transfer, it represents a risk for human health (i) directly by causing antimicrobial-resistant bacterial infections [71] and (ii) indirectly by participating in the dissemination of bla NDM-5 on the occasion of gut colonization [71,72], or transit. These resistant bacteria can transfer the plasmid to host microbiota bacteria, making a "shuttle" between aquatic environment and humans [7,71]. We described for the first time the in situ persistence of a bla NDM-5 harboring IncX-3 self-conjugative plasmid in an E. coli lineage in an aquatic environment.…”

“…At first neglected, the environment is now considered as a main player in the emergence and diffusion of AMR. Water plays a major role in interconnecting different ecosystems such as humans, animals, soils and hydrosystems [ 4 , 5 , 6 , 7 , 8 ]. Urban and rural surface waters constitute hotspots for exchanges among microorganisms of human and environmental origin, which are all subject to strong selection pressures due to diverse pollutions [ 3 , 5 ].…”

“…β-lactams are by far the most widely consumed antibiotics worldwide [ 9 ], and among β-lactams, carbapenems are last resort treatment for multidrug-resistant bacterial infections [ 10 , 11 , 12 ]. Several studies reported the occurrence of Carbapenemase Encoding Genes (CEGs) in aquatic environments [ 6 , 7 , 8 ]. However, there is a lack of studies on the persistence and dissemination capacities of CEGs and bacteria carrying CEGs in waters.…”

Genomic characterization of carbapenem-non-susceptible Pseudomonas aeruginosa in Singapore

“…p10265-KPC, pCOL-1) and may be mobilized between species [ 31 , 32 ]. While KPC carbapenemases appear to be rare in our P. aeruginosa , the identification of a broad-range plasmid in our isolate suggests the possibility of hidden bla KPC-2 environmental reservoirs (especially aquatic environments) or mobilization from other clinically relevant species such as those from the Enterobacterales family where local bla KPC-2 prevalence is high [ 33 , 34 ].…”

Seasonal resistome diversity and dissemination of WHO priority antibiotic-resistant pathogens in Lebanese estuaries

“…Here, we identified the estuaries of Lebanon as putative host-spots for the dissemination of ARGs and resistant bacteria into the Mediterranean Sea. Recreational waters as rivers and beaches have gained increased attention as having a central role in the persistence, dissemination, and emergence of antibiotic resistance 54 . Specific surveillance systems should be put in place that traces urban movements, contact with recreational waters, pollution levels, and WW treatment levels and management to trace the actual dissemination of antimicrobial resistance through recreational waters 55 .…”