Persistent transmission of carbapenem-resistant, hypervirulent Klebsiella pneumoniae between a hospital and urban aquatic environments

被引：27

作者：

Zou, Huiyun ^{[1
]}

Zhou, Ziyu ^{[1
]}

Berglund, Bjorn ^{[2
]}

Zheng, Beiwen ^{[3
]}

Meng, Min ^{[1
]}

Zhao, Ling ^{[1
]}

Zhang, Hui ^{[1
]}

Wang, Zhongyi ^{[1
]}

Wu, Tianle ^{[1
]}

Li, Qi ^{[1
]}

Li, Xuewen ^{[1
]}

机构：

[1] Shandong Univ, Cheeloo Coll Med, Sch Publ Hlth, Dept Environm & Hlth, Jinan 250012, Shandong, Peoples R China

[2] Uppsala Univ, Dept Cell & Mol Biol, S-75124 Uppsala, Sweden

[3] Zhejiang Univ, Affiliated Hosp 1, Collaborat Innovat Ctr Diag & Treatment Infect Dis, Coll Med,State Key Lab Diag & Treatment Infect Dis, Hangzhou, Peoples R China

来源：

WATER RESEARCH | 2023年 / 242卷

基金：

中国国家自然科学基金;

关键词：

Carbapenem-resistant hypervirulent Klebsiella; pneumoniae; Transmission; Hospital; Wastewater treatment plant; Rivers; SLUDGE; PREVALENCE; EMERGENCE; GENES; CHINA;

D O I：

10.1016/j.watres.2023.120263

中图分类号：

X [环境科学、安全科学];

学科分类号：

08 ; 0830 ;

摘要：

The increasing prevalence of infections caused by carbapenem-resistant hypervirulent Klebsiella pneumoniae strains (CR-hvKP) prompts the question of whether these strains also circulate outside of clinical settings. However, the environmental occurrence and dissemination of CR-hvKP are poorly studied. In the current study, we investigated the epidemiological characteristics, and dissemination dynamics of carbapenem-resistant K. pneumoniae (CRKP) isolated from a hospital, an urban wastewater treatment plant (WWTP), and adjacent rivers in Eastern China during one year of monitoring. A total of 101 CRKP were isolated, 54 were determined to be CR-hvKP harboring pLVPK-like virulence plasmids, which were isolated from the hospital (29 out of 51), WWTP (23 out of 46), and rivers (2 out of 4), respectively. The period with lowest detection rate of CR-hvKP in the WWTP, August, corresponded with the lowest detection rate at the hospital. Comparing the inlet and outlet of the WWTP, no significant reduction of the detection of CR-hvKP and relative abundance of carbapenem resistance genes was observed. The detection rate of CR-hvKP and the relative abundance of carbapenemase genes were significantly higher in the WWTP in colder months compared to warmer months. Clonal dissemination of CR-hvKP clones of ST11-KL64 between the hospital and the aquatic environment, as well as the horizontal spread of IncFII-IncR and IncC plasmids carrying carbapenemase genes, was observed. Furthermore, phylogenetic analysis showed that the ST11-KL64 CR-hvKP strain has spread nationally by interregional transmission. These results indicated transmission of CR-hvKP clones between hospital and urban aquatic environments, prompting the need for improved wastewater disinfection and epidemiological models to predict the public health hazard from prevalence data of CR-hvKP.

引用

页数：12

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