1. The route of antimicrobial resistance from the hospital effluent to the environment: focus on the occurrence of KPC-producing Aeromonas spp. and Enterobacteriaceae in sewage.
- Author
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Picão RC, Cardoso JP, Campana EH, Nicoletti AG, Petrolini FV, Assis DM, Juliano L, and Gales AC
- Subjects
- Acinetobacter drug effects, Acinetobacter isolation & purification, Aeromonas drug effects, Brazil, DNA Transposable Elements, Enterobacteriaceae drug effects, Hospitals, Teaching, Kluyvera drug effects, Microbial Sensitivity Tests, Plasmids genetics, Pseudomonas drug effects, Pseudomonas isolation & purification, Aeromonas isolation & purification, Bacterial Proteins genetics, Drug Resistance, Multiple, Bacterial, Enterobacteriaceae isolation & purification, Kluyvera isolation & purification, Sewage microbiology, beta-Lactamases genetics
- Abstract
We investigated the antimicrobial resistance profile and the occurrence of Klebsiella pneumoniae carbapenemase (KPC)-producing Gram-negative rods in sewage samples obtained from a Brazilian teaching hospital and from the wastewater treatment plant (WWTP) that receives it for treatment. We identified multidrug-resistant bacteria as well as KPC-2-producing Aeromonas spp. and several Enterobacteriaceae species, including Kluyvera spp., in the hospital effluent and in different sites of the WWTP. Most isolates showed the blaKPC-2 gene harbored on a transposon that was carried by conjugative plasmids. The presence of KPC production among Aeromonas spp., Kluyvera spp., and other Enterobacteriaceae indicates the adaptability of such isolates to aquatic environments, not only in the hospital effluent but also throughout the WWTP. Although secondary treatment seems to decrease the amount of KPC producers in sewage, multidrug-resistant isolates are continually disposed in the urban river. Thus, sewage treatment regulations are urgently needed to decelerate the evolution of antimicrobial resistance beyond hospitals., (Copyright © 2013 Elsevier Inc. All rights reserved.)
- Published
- 2013
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