Prevalence of ESBL-producing Escherichia coli and carbapenem-resistant Enterobacteriaceae in treated wastewater: a comparison with nosocomial infection surveillance

Abstract The increasing prevalence of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and carbapenem-resistant Enterobacteriaceae (CRE) is a worldwide health threat. Monitoring of these resistant bacteria in the environment can provide regional prevalence reflecting both healthy and infected populations, although the quantitative monitoring of those resistant bacteria, especially CRE, is difficult due to their low proportion in the total Enterobacteriaceae population and the possible interference by autochthonous species with intrinsic resistance. In this study, these resistant bacteria in treated wastewater were quantified at 12 different treatment plants. The proportions of cefotaxime-resistant and ESBL-producing E. coli in the total E. coli population in the chlorinated effluents in Tokyo were 5.7 and 5.3%, respectively. The estimated proportion of CRE was 0.007% with the constituting species of Klebsiella spp. and Enterobacter spp., although the conditions during the first incubation may have affected the estimation even after the correction by the proportion of resistant population in the isolates. The observed resistant proportions in this study were lower than those in the surveillance on nosocomial infection not only for inpatients but also for outpatients, and higher than those in the veterinary monitoring.

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Detection of antimicrobial resistance genes of carbapenem-resistant Enterobacteriaceae in Escherichia coli isolated from the water supply of smallholder dairy farms in Saraburi and Maha Sarakham, Thailand

International Journal of One Health ◽

10.14202/ijoh.2020.1-5 ◽

2020 ◽

Vol 6 (1) ◽

pp. 1-5

Author(s):

Natapol Pumipuntu ◽

Sangkom Pumipuntu

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Resistance Genes ◽

Water Samples ◽

Dairy Farms ◽

Drug Resistant ◽

E Coli ◽

Carbapenem Resistant ◽

Carbapenem Resistant Enterobacteriaceae ◽

Smallholder Dairy Farms

Background and Aim: The problem of antimicrobial resistance of bacteria in both humans and animals is an important public health concern globally, which is likely to increase, including in Thailand, where carbapenem-resistant Enterobacteriaceae (CRE), such as Escherichia coli, are of particular concern. They are pathogens found in the gastrointestinal tract of humans and other animals as well as in the environment. They may cause opportunistic infection and are often resistant to antibiotics in various fields especially in animal husbandry, such as pets or livestock farms. This study aimed to investigate the occurrence of carbapenem-resistant E. coli from water samples of smallholder dairy farms in Saraburi and Maha Sarakham, Thailand. Materials and Methods: Sixty-four water samples were collected from 32 dairy farms in Kaeng Khoi district, Muak Lek district, and Wang Muang district of Saraburi Province, and Kantharawichai district and Mueang district of Maha Sarakham Province, Thailand. All samples were cultured and isolated for E. coli by biochemical tests. All E. coli isolates were tested for drug susceptibility using imipenem, meropenem, and drug resistance genes of carbapenemases such as blaNDM, blaIMP, and blaOXA48 of drug-resistant E. coli isolates detected by polymerase chain reaction (PCR) technique. Results: A total of 182 E. coli isolates were found (140 and 42 isolates from Saraburi and Maha Sarakham, respectively). Drug sensitivity tests found that two isolates of E. coli from water in Kaeng Khoi were resistant to imipenem; therefore, the incidence of E. coli resistance to carbapenem was 1.43% of Saraburi Province. On the other hand, there was no incidence of drug-resistant E. coli in Maha Sarakham. In addition, the detection of the drug-resistant gene of E. coli in both isolates by PCR showed the expression of blaNDM. Conclusion: This study reports E. coli resistance to antimicrobial drugs on livestock farms. It can be considered to be the first report of E. coli CRE detection in a dairy farm at Saraburi, which should be the subject of further extended study.

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Carbapenem and colistin-resistant bacteria in North Lebanon: Coexistence of mcr-1 and NDM-4 genes in Escherichia coli

The Journal of Infection in Developing Countries ◽

10.3855/jidc.14176 ◽

2021 ◽

Vol 15 (07) ◽

pp. 934-342

Author(s):

Charbel Al-Bayssari ◽

Tania Nawfal Dagher ◽

Samar El Hamoui ◽

Fadi Fenianos ◽

Nehman Makdissy ◽

...

Keyword(s):

Escherichia Coli ◽

Pseudomonas Aeruginosa ◽

Resistance Genes ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

Ionization Time ◽

E Coli ◽

Flight Mass Spectrometry ◽

Carbapenem Resistant ◽

The Matrix

Introduction: The increasing incidence of infections caused by multidrug-resistant bacteria is considered a global health problem. This study aimed to investigate this resistance in Gram-negative bacteria isolated from patients hospitalized in North-Lebanon. Methodology: All isolates were identified using the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic susceptibility testing was achieved using disk diffusion, E-test and Broth microdilution methods. Phenotypic detection of carbapenemase was carried out using the CarbaNP test. RT-PCR, standard-PCR and sequencing were performed to detect resistance genes and oprD gene. Conjugal transfer was carried out between our isolates and Escherichia coli J53 to detect the genetic localization of resistance genes. MLST was conducted to determine the genotype of each isolate. Results: Twenty-three carbapenem-resistant Enterobacterales of which eight colistin-resistant Escherichia coli, and Twenty carbapenem-resistant Pseudomonas aeruginosa were isolated. All isolates showed an imipenem MIC greater than 32 mg/mL with MICs for colistin greater than 2 mg/L for E. coli isolates. All the Enterobacterales isolates had at least one carbapenemase-encoding gene, with E. coli isolates coharboring blaNDM-4 and mcr-1 genes. Moreover, 16/20 Pseudomonas aeruginosa harbored the blaVIM-2 gene and 18/20 had mutations in the oprD gene. MLST revealed that the isolates belonged to several clones. Conclusions: We report here the first description in the world of clinical E. coli isolates coharboring blaNDM-4 and mcr-1 genes, and K. pneumoniae isolates producing NDM-6 and OXA-48 carbapenemases. Also, we describe the emergence of NDM-1-producing E. cloacae in Lebanon. Screening for these isolates is necessary to limit the spread of resistant microorganisms in hospitals.

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The occurrence of antibiotic-resistant bacteria, including Escherichia coli, in municipal wastewater and river water

E3S Web of Conferences ◽

10.1051/e3sconf/201910000061 ◽

2019 ◽

Vol 100 ◽

pp. 00061 ◽

Cited By ~ 1

Author(s):

Adriana Osińska ◽

Ewa Korzeniewska ◽

Monika Harnisz ◽

Sebastian Niestępski ◽

Piotr Jachimowicz

Keyword(s):

Escherichia Coli ◽

Wastewater Treatment ◽

River Water ◽

Municipal Wastewater ◽

High Efficiency ◽

Treated Wastewater ◽

Resistant Bacteria ◽

Antibiotic Resistant Bacteria ◽

Antibiotic Resistant ◽

E Coli

Wastewater treatment plants (WWTPs) are major reservoirs of antibiotic-resistant bacteria (ARB) which are transported to the natural environment with discharged effluents. Samples of untreated wastewater (UWW) and treated wastewater (TWW) from four municipal WWTPs and samples of river water collected upstream (URW) and downstream (DRW) from the effluent discharge point were analyzed in the study. The total counts of bacteria resistant to β-lactams and tetracyclines and the counts of antibiotic-resistant Escherichia coli were determined. Antibiotic-resistant bacteria, including antibiotic-resistant E. coli, were removed with up to 99.9% efficiency in the evaluated WWTPs. Despite the above, ARB counts in TWW samples were high at up to 1.25x105 CFU/mL in winter and 1.25x103 CFU/mL in summer. Antibiotic-resistant bacteria were also abundant (up to 103 CFU/ml) in URW and DRW samples collected in winter and summer. In both UWW and TWW samples, the counts of ARB and antibiotic-resistant E. coli were at least one order of magnitude lower in summer than in winter. The study revealed that despite the high efficiency of bacterial removal in the wastewater treatment processes, considerable amounts of ARB are released into the environment with TWW and that the percentage of ARB in total bacterial counts increases after wastewater treatment.

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Susceptibility of Tigecycline against Carbapenem Resistant Enterobacteriaceae

Pakistan Journal of Medicine and Dentistry ◽

10.36283/pjmd10-3/004 ◽

2021 ◽

Keyword(s):

Escherichia Coli ◽

Respiratory Tract ◽

Antimicrobial Susceptibility ◽

Bacterial Infections ◽

Large Family ◽

Klebsiella Species ◽

Cross Sectional ◽

E Coli ◽

Carbapenem Resistant ◽

Carbapenem Resistant Enterobacteriaceae

Background: Enterobacteriaceae, a large family of Gram-negative bacteria, are one of the commonest etiological agents causing serious bacterial infections to humans. Carbapenems are the group of antibiotics with a broad spectrum of antimicrobial action. Infections caused due to Carbapenem resistant Enterobacteriaceae (CRE) are a huge challenge for existing medical practice. Therefore, this project aimed to find out the antimicrobial susceptibility pattern of Tigecycline against CRE. Methods: This cross-sectional study with non-probability consecutive sampling was done at Ziauddin Hospital Microbiology Laboratory from 15th August 2017 to 15th April 2018. Accordingly, 151 isolates of CRE were collected from cultures of blood, respiratory tract, wound pus and other body fluids. The growth inhibition zones were measured following the Food and Drug Administration (FDA) disk diffusion breakpoint criteria. Frequencies and percentages were computed for gender, microorganism, and antimicrobial susceptibility. Chi-squared test was applied and p≤ 0.05 was considered as statistically significant. Results: Klebsiella species were most commonly isolated pathogen, 67.5% (n=102) followed by Escherichia coli (E. coli) 23.2% (n=35), Enterobacter 7.3% (n=11) and Serratia species 2% (n=3). Tigecycline was 97% (34 /35) sensitive for E. coli, 86.3% (88/102) for Klebsiella species), 91% (10/11) for Enterobacter species, and 100% for Serratia species. Klebsiella species showed the highest rate of resistance to tigecycline i.e., 13.7% of the total Klebsiella isolates. Conclusion: Among the Enterobacteriaceae family, Klebsiella species have the greatest ability to acquire resistance. Tigecycline showed good activity against isolates of CRE recovered from infections of skin, soft tissue, intra-abdomen, lower respiratory tract and blood stream. Keywords: Carbapenems; beta-Lactamases; Anti-Bacterial Agents; Tigecycline; Klebsiella; Escherichia coli.

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Shedding of OXA-181 carbapenemase-producing Escherichia coli from companion animals after hospitalisation in Switzerland: an outbreak in 2018

Eurosurveillance ◽

10.2807/1560-7917.es.2019.24.39.1900071 ◽

2019 ◽

Vol 24 (39) ◽

Cited By ~ 6

Author(s):

Aurélien Nigg ◽

Michael Brilhante ◽

Valentina Dazio ◽

Mathieu Clément ◽

Alexandra Collaud ◽

...

Keyword(s):

Escherichia Coli ◽

Prospective Observational Study ◽

Core Genome ◽

Ad Hoc ◽

Companion Animals ◽

E Coli ◽

Carbapenem Resistant ◽

Carbapenemase Gene ◽

Carbapenem Resistant Enterobacteriaceae

Background Carbapenem-resistant Enterobacteriaceae pose a serious threat to public health worldwide, and the role of companion animals as a reservoir is still unclear. Aims This 4-month prospective observational study evaluated carriage of carbapenem-resistant Enterobacteriaceae at admission and after hospitalisation in a large referral hospital for companion animals in Switzerland. Methods Rectal swabs of dogs and cats expected to be hospitalised for at least 48 h were taken from May to August 2018 and analysed for the presence of carbapenem-resistant Enterobacteriaceae using selective agar plates. Resistant isolates were further characterised analysing whole genome sequences for resistance gene and plasmid identification, and ad hoc core genome multilocus sequence typing. Results This study revealed nosocomial acquisition of Escherichia coli harbouring the carbapenemase gene bla OXA-181, the pAmpC cephalosporinase gene bla CMY-42 as well as quinolone resistance associated with qnrS1 and mutations in the topoisomerases II (GyrA) and IV (ParC). The bla OXA-181 and qnrS1 genes were identified on a 51 kb IncX3 plasmid and bla CMY-42 on a 47 kb IncI1 plasmid. All isolates belonged to sequence type ST410 and were genetically highly related. This E. coli clone was detected in 17 of 100 dogs and four of 34 cats after hospitalisation (21.6%), only one of the tested animals having tested positive at admission (0.75%). Two positive animals were still carriers 4 months after hospital discharge, but were negative after 6 months. Conclusions Companion animals may acquire carbapenemase-producing E. coli during hospitalisation, posing the risk of further dissemination to the animal and human population and to the environment.

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Abundance of colistin-resistant Escherichia coli harbouring mcr-1 and extended-spectrum β-lactamase-producing E. coli co-harbouring blaCTX-M-55 or -65 with blaTEM isolates from chicken meat in Vietnam

10.21203/rs.3.rs-904323/v1 ◽

2021 ◽

Author(s):

Tatsuya Nakayama ◽

Le Thi Hien ◽

Ngo Thanh Phong ◽

Doan Nguyen Minh Tran ◽

Oanh Thi Hoang Nguyen ◽

...

Keyword(s):

Escherichia Coli ◽

Food Contamination ◽

Antibiotic Resistance Genes ◽

Chicken Meat ◽

Health Concern ◽

Resistant Bacteria ◽

Antibiotic Resistant ◽

E Coli ◽

Carbapenem Resistant ◽

Extended Spectrum

Abstract Although the spread of plasmid-mediated antibiotic-resistant bacteria is a public health concern, food contamination with plasmid-mediated antibiotic-resistant Escherichia coli has not been well investigated in Vietnam. The aim of this study was to describe the prevalence of colistin-resistant, carbapenem-resistant and endemic blaCTX−M in extended-spectrum β-lactamase (ESBL)-producing E. coli isolates. Colistin- and carbapenem-resistant ESBL-producing E. coli were isolated from chickens in Vietnam and Japan. The results showed that 52% and 93% of Vietnamese chicken was isolated with colistin-resistant and AmpC/ESBL-producing E. coli, respectively, while 52.7% of Japanese chickens were isolated with AmpC/ESBL-producing E. coli. Carbapenem-resistant E. coli has not been isolated in Vietnam or Japan. Genotyping revealed that colistin-resistant E. coli harboured mcr-1, and most of the AmpC/ESBL-related genes were blaCTX−M−55 and blaCTX−M−65 together with blaTEM in Vietnamese chickens, and blaCMY−2 in Japanese chickens. Multidrug resistance analysis showed that ESBL-producing E. coli isolates were more resistant to quinolones, streptomycin, and chloramphenicol compared with colistin-resistant E. coli isolates from Vietnam, suggesting selection in ESBL-producing E. coli for multiple antibiotic resistance genes. In conclusion, colistin-resistant E. coli was detected in about half of the chicken meat samples, the majority of which were found to harbour mcr-1. The high prevalence of ESBL-producing E. coli has remained constant across the last five years, and the predominant blaCTX−M for ESBL-producing E. coli was found to be blaCTX−M−55 or blaCTX−M−65, with the coexistence of blaTEM in Vietnam. Our results can be implemented in monitoring systems to combat the development of antimicrobial resistance.

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Prevalence of Escherichia coli and Antibiotic-Resistant Bacteria During Fresh Produce Production (Romaine Lettuce) Using Municipal Wastewater Effluents

Frontiers in Microbiology ◽

10.3389/fmicb.2021.660047 ◽

2021 ◽

Vol 12 ◽

Author(s):

Harvey N. Summerlin ◽

Cícero C. Pola ◽

Eric S. McLamore ◽

Terry Gentry ◽

Raghupathy Karthikeyan ◽

...

Keyword(s):

Escherichia Coli ◽

Water Reuse ◽

Municipal Wastewater ◽

Treatment Plant ◽

Treated Wastewater ◽

Resistant Bacteria ◽

Romaine Lettuce ◽

Potential Health ◽

Antibiotic Resistant ◽

E Coli

High demand for food and water encourages the exploration of new water reuse programs, including treated municipal wastewater usage. However, these sources could contain high contaminant levels posing risks to public health. The objective of this study was to grow and irrigate a leafy green (romaine lettuce) with treated wastewater from a municipal wastewater treatment plant to track Escherichia coli and antibiotic-resistant microorganisms through cultivation and post-harvest storage to assess their fate and prevalence. Contamination levels found in the foliage, leachate, and soil were directly (p < 0.05) related to E. coli concentrations in the irrigation water. Wastewater concentrations from 177 to 423 CFU ml−1 resulted in 15–25% retention in the foliage. Leachate and soil presented means of 231 and 116% retention, respectively. E. coli accumulation on the foliage was observed (p < 0.05) and increased by over 400% during 14-day storage (4°C). From randomly selected E. coli colonies, in all four biomass types, 81 and 34% showed resistance to ampicillin and cephalothin, respectively. Reclaimed wastewater usage for leafy greens cultivation could pose potential health risks, especially considering the bacteria found have a high probability of being antibiotic resistance. Successful reuse of wastewater in agriculture will depend on appropriate mitigation and management strategies to guarantee an inexpensive, efficient, and safe water supply.

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Detection of themcr-1Colistin Resistance Gene in Carbapenem-Resistant Enterobacteriaceae from Different Hospitals in China

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00440-16 ◽

2016 ◽

Vol 60 (8) ◽

pp. 5033-5035 ◽

Cited By ~ 60

Author(s):

Hua Yu ◽

Fen Qu ◽

Bin Shan ◽

Bin Huang ◽

Wei Jia ◽

...

Keyword(s):

Escherichia Coli ◽

Global Health ◽

Resistance Gene ◽

Clinical Isolates ◽

Chromosomal Integration ◽

Colistin Resistance ◽

Content Type ◽

E Coli ◽

Carbapenem Resistant ◽

Carbapenem Resistant Enterobacteriaceae

ABSTRACTThe spread of the plasmid-mediated colistin resistance gene,mcr-1, into carbapenem-resistantEnterobacteriaceae(CRE) clinical isolates poses a significant threat to global health. Here we report the identification of threemcr-1-harboring carbapenem-resistantEscherichia colistrains, collected from three patients in two provinces in China. Our results show thatmcr-1-harboring CRE strains have started to spread in different hospitals in China. In addition, this report presents the first description of chromosomal integration ofmcr-1into a carbapenem-resistantE. colistrain.

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Detection of Carbapenemase Production in Clinical Isolates of Escherichia coli and Klebsiella Species

International Journal of Current Microbiology and Applied Sciences ◽

10.20546/ijcmas.2021.1011.049 ◽

2021 ◽

Vol 10 (11) ◽

pp. 438-450

Author(s):

Harvinder Kaur Sneha Mohan ◽

Tarana Sarwat Dalip K. Kakru

Keyword(s):

Escherichia Coli ◽

Carbapenem Resistance ◽

Polymyxin B ◽

Clinical Isolates ◽

Resistant Bacteria ◽

Bacterial Strains ◽

Klebsiella Species ◽

Cross Sectional ◽

E Coli ◽

Carbapenem Resistant

The increasingly frequent application of carbapenemases induces a selective pressure on bacteria to acquire resistance against carbapenems. A large variety of carbapenemases have been identified in Enterobacteriaceae. The emergence of carbapenemases in E. coli and Klebsiella species possess a serious therapeutic problem in hospitals because carbapenems are often antibiotics of last resort for the treatment of serious infections caused by multidrug-resistant bacteria. The main aim of this study to determine the carbapenem-resistant strains of Escherichia coli and Klebsiella species. Detection of carbapenemase enzyme in the carbapenem-resistant Escherichia coli and Klebsiella species. This is a cross-sectional study, performed in the bacteriological laboratory. A total of 204 strains of Escherichia coli and 122 strains of Klebsiella species were isolated from patients admitted & attending the OPD at Sharda Hospital during the study period. The identification of the clinical isolates was based on morphological and biochemicals characterization. Result: Among the total number of bacterial growth received during the study period, the E. coli (204) was more in number as compared to other bacterial strains followed by Klebsiella species (122), Pseudomonas species (117), Staphylococcus aureus (100) and Enterococcus species (80). Among the following specimen i.e, urine (58.8%), was highly received during the study period followed by pus (15.3%) and sputum (7.5%). Colistin (100%) and Polymyxin B (100%) is found to be the most sensitive drug. Gentamicin (19.6%) and Cefuroxime (12.2%) are the least sensitive drugs. In the present study, we found that the Klebsiella species (75%) and Escherichia coli (64%) was the major reason of carbapenemase production but the organisms incidentally were susceptible to colistin and polymyxins (100%) followed by other antibiotics. This is a welcome finding in times of increasing carbapenem resistance & is reason enough to suggest the use of Polymyxins in the health care settings where the carbapenems to be used for the treatment of infections caused by Enterobacteriaceae.

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Plasmid-mediated multiple antibiotic resistance of Escherichia coli in crude and treated wastewater used in agriculture

Journal of Water and Health ◽

10.2166/wh.2009.019 ◽

2009 ◽

Vol 7 (2) ◽

pp. 251-258 ◽

Cited By ~ 19

Author(s):

S. Pignato ◽

M. A. Coniglio ◽

G. Faro ◽

F. X. Weill ◽

G. Giammanco

Keyword(s):

Escherichia Coli ◽

Antibiotic Resistance ◽

Treated Wastewater ◽

Resistant Bacteria ◽

Multiple Antibiotic Resistance ◽

Reclaimed Wastewater ◽

Salmonella Spp ◽

Antibiotic Resistant ◽

E Coli ◽

R Plasmids

A total of 273 Escherichia coli isolates from raw and treated municipal wastewaters were investigated to evaluate the frequency and persistence of antibiotic resistance and to detect the occurrence of conjugative R plasmids and integrons. The highest resistance rates were against ampicillin (22.71%), tetracycline (19.41%), sulfamethoxazole (16.84%) and streptomycin (14.28%). Multiple antibiotic resistance was present in 24.17% of the isolates. Several multiple antibiotic-resistant isolates proved to be able to transfer en bloc their resistance patterns by conjugative R plasmids with different molecular sizes and restriction profiles. Class 1 integrons of 1 or 1.5 kbp were found in 5 out of 24 representative multiresistant E. coli isolates. Although wastewater treatments proved to be effective in eliminating Salmonella spp. and in reaching WHO microbiological standards for safe use of wastewater in agriculture, they were ineffective in reducing significantly the frequency of plasmid-mediated multiple antibiotic resistance in surviving E. coli. Since multiple antibiotic-resistant bacteria carrying integrons and conjugative R plasmids can constitute a reservoir of antibiotic-resistance genes in wastewater reclaimed for irrigation, risks for public health should be considered. Bacterial strains carrying R plasmids and integrons could contaminate crops irrigated with reclaimed wastewater and transfer their resistances to the consumers' intestinal bacteria.

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