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Municipal sewage as a pathway for multidrug-resistant KPC-producing Klebsiella pneumoniae from hospital effluent to urban stream: challenges for wastewater management

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Autor(es):
Zagui, Guilherme Sgobbi ; Moreira, Natalia Columbaro ; Ferreira, Joseane Cristina ; Agnesini, Marilia Vasconcellos ; Barth, Patricia Orlandi ; Barth, Afonso Luis ; Darini, Ana Lucia Costa ; Andrade, Leonardo Neves ; Segura-Munoz, Susana Ines
Número total de Autores: 9
Tipo de documento: Artigo Científico
Fonte: INTERNATIONAL JOURNAL OF HYGIENE AND ENVIRONMENTAL HEALTH; v. 269, p. 9-pg., 2025-08-25.
Resumo

Carbapenemase-producing Klebsiella pneumoniae is among the mainly reasons for death from bacterial infection associated with antibiotic resistance. Its widespread dissemination, especially due to KPC enzyme, is one of the main challenges in One Health perspective. Here, we studied 42 KPC-producing K. pneumoniae isolates from hospital wastewater, municipal wastewater from wastewater treatment plant (WWTP), and urban stream which receives treated municipal effluent. The isolates presented broad resistance to beta-lactams antibiotics, as well as to fluoroquinolones, and show antibiotic resistance profile very similar, even those from out-of-hospital settings. Along to blaKPC gene, blaCTX-M-1 (33,3 %, n = 14), blaCTX-M-8 (19 %, n = 8), qnrB (52,3 %, n = 22), qnrS (2,38 %, n = 1), and rmtB (19 %, n = 8) were detected. There was a predominance of gene that confers tolerance to silver and copper metals, as well as to virulence factor related to enterobactin and colibactin production. Macrorestriction genomic analysis by XbaI enzyme demonstrated several pulsotype, but some ones are related. Isolates from hospital wastewater were detected after 4 months at the same sampling point, as well as similar to those detected in WWTP and urban stream demonstrating the effluents role as spreaders of antibiotic resistance. This study provides data on the characterization of KPC-producing K. pneumoniae, which contributes to the epidemiological characterization of human pathogens transmitted by aquatic matrices. In view of the universal sanitation and control of antimicrobial resistance in the One Health perspective, greater investment in effluent treatment is necessary to avoid contamination and environmental dissemination of antibiotic-resistant bacteria. (AU)

Processo FAPESP: 19/05938-3 - Antibióticos, metais tóxicos e bactérias multirresistentes em esgoto hospitalar e urbano e seu potencial impacto em ecossistemas hídricos receptores
Beneficiário:Guilherme Sgobbi Zagui
Modalidade de apoio: Bolsas no Brasil - Doutorado
Processo FAPESP: 19/18663-2 - Antibióticos, metais tóxicos e bactérias multirresistentes em esgoto hospitalar e urbano e seu potencial impacto em ecossistemas hídricos receptores
Beneficiário:Susana Segura Muñoz
Modalidade de apoio: Auxílio à Pesquisa - Regular