Hospital effluent: A reservoir for carbapenemase-producing Enterobacterales?

被引：90

作者：

Cahill, Niamh ^{[1
,2
]}

O'Connor, Louise ^{[1
,2
]}

Mahon, Blathnaid ^{[1
,2
]}

Varley, Aine ^{[1
]}

McGrath, Elaine ^{[3
]}

Ryan, Phelim ^{[1
]}

Cormican, Martin ^{[1
,2
,3
]}

Brehony, Carina ^{[1
]}

Jolley, Keith A. ^{[4
]}

Maiden, Martin C. ^{[4
]}

Brisse, Sylvain ^{[5
]}

Morris, Dearbhsile ^{[1
,2
]}

机构：

[1] Natl Univ Ireland, Sch Med, Antimicrobial Resistance & Microbial Ecol Grp, Galway, Ireland

[2] Natl Univ Ireland, Ryan Inst, Ctr Hlth Environm, Galway, Ireland

[3] Univ Hosp Galway, Dept Med Microbiol, Carbapenernase Producing Enterobacterales Referen, Galway, Ireland

[4] Univ Oxford, Dept Zool, Oxford, England

[5] Inst Pasteur, Biodivers & Epidemiol Bacterial Pathogens, Paris, France

来源：

SCIENCE OF THE TOTAL ENVIRONMENT | 2019年 / 672卷

关键词：

Antimicrobial resistant bacteria; Carbapenem resistance; Hospital wastewater; Municipal wastewater; Carbapenemase-encoding genes; ANTIBIOTIC-RESISTANT BACTERIA; METALLO-BETA-LACTAMASE; WASTE-WATER; ESCHERICHIA-COLI; GENES; DISSEMINATION; INFECTIONS; PLASMIDS; BLA(NDM); VARIANT;

D O I：

10.1016/j.scitotenv.2019.03.428

中图分类号：

X [环境科学、安全科学];

学科分类号：

08 ; 0830 ;

摘要：

Antimicrobial resistance is a major public health concern. Carbapenemase-producing Enterobacterales (CPE) represent a significant health threat as some strains are resistant to almost all available antibiotics. The aim of this research was to examine hospital effluent and municipal wastewater in an urban area in Ireland for CPE. Samples of hospital effluent (n = 5), municipal wastewater before (n = 5) and after (n = 4) the hospital effluent stream joined the municipal wastewater stream were collected over a nine-week period (May-June 2017). All samples were examined for CPE by direct plating onto Brilliance CRE agar. Isolates were selected for susceptibility testing to 15 antimicrobial agents in accordance with EUCAST criteria. Where relevant, isolates were tested for carbapenemase encoding genes by real time PCR. CPE were detected in five samples of hospital effluent, one sample of pre-hospital wastewater and three samples of post-hospital wastewater. Our findings suggest hospital effluent is a major contributor to CPE in municipal wastewater. Monitoring of hospital effluent for CPE could have important applications in detection and risk management of unrecognised dissemination of CPE in both the healthcare setting and the environment. (C) 2019 The Authors. Published by Elsevier B.V.

引用

页码：618 / 624

页数：7

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