Environmental Presence and Genetic Characteristics of Carbapenemase-Producing Enterobacteriaceae from Hospital Sewage and River Water in the Philippines

• DOI: 10.1128/aem.01906-19
• Publication Date: 2019-11-08T15:18:33Z
• Authors: Yuki Suzuki; Pearl Joy Nazareno; Ryuichi Nakano; Melisa Mondoy; Akiyo Nakano; Mark Philip Bugayong; Josie Bilar; Mauricio Perez; Emarld Julian Medina; Mariko Saito-Obata; Mayuko Saito; Kazutoshi Nakashima; Hitoshi Oshitani; Hisakazu Yano
• Keywords: 0301 basic medicine; Genotyping; Genotype; Philippines; Multilocus sequence typing; Enterobacter; FOS: Basic medicine; Wastewater; Microbiology; Plasmid; Gene; beta-Lactamases; Global Challenge of Antibiotic Resistance in Bacteria; 03 medical and health sciences; Endocrinology; Engineering; Bacterial Proteins; Rivers; Enterobacteriaceae; RNA, Ribosomal, 16S; Biochemistry, Genetics and Molecular Biology; Outbreak of Cronobacter sakazakii Infections; Escherichia coli; Genetics; Biology; Waste management; Sewage; Public and Environmental Health Microbiology; Sequence Analysis, RNA; ESKAPE Pathogens; Klebsiella oxytoca; Life Sciences; Typing; Carbapenemases; Pollution; Hospitals; 6. Clean water; 3. Good health; RNA, Bacterial; Klebsiella pneumoniae; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; FOS: Biological sciences; Environmental Science; Physical Sciences; Molecular Medicine; Antibiotic Resistance in Aquatic Environments and Wastewater; Multilocus Sequence Typing

Carbapenemase-producing Enterobacteriaceae (CPE) cause severe health care-associated infections, and their increasing prevalence is a serious concern. Recently, natural ecosystems have been recognized as important reservoirs of antibiotic resistance genes. We investigated the prevalence and genetic characteristics of CPE isolated from the environment (hospital sewage and river water) in the Philippines and found several CPE, including Escherichia coli and other species, with different carbapenemases. The most prevalent carbapenemase gene type was NDM, which is endemic in clinical settings. This study revealed that isolates belonging to carbapenemase-producing E. coli CC10 and K. pneumoniae sequence type 147 (ST147), which are often detected in clinical settings, were dominant in the natural environment. Our work here provides a report on the presence and characteristics of CPE in the environment in the Philippines and demonstrates that both hospital sewage and river water are contaminated by CPE strains belonging to clinically important clonal groups.