Genetic Characterization of Carbapenem-Resistant Klebsiella spp. from Municipal and Slaughterhouse Wastewater

Mykhailo Savin; Gabriele Bierbaum; Nico T Mutters; Ricarda Maria Schmithausen; Judith Kreyenschmidt; Isidro García-Meniño; Silvia Schmoger; Annemarie Käsbohrer; Jens Andre Hammerl

doi:10.3390/antibiotics11040435

Genetic Characterization of Carbapenem-Resistant Klebsiella spp. from Municipal and Slaughterhouse Wastewater

Antibiotics (Basel). 2022 Mar 24;11(4):435. doi: 10.3390/antibiotics11040435.

Authors

Affiliations

¹ Institute for Hygiene and Public Health, University Hospital Bonn, 53127 Bonn, Germany.
² Institute of Animal Sciences, University of Bonn, 53115 Bonn, Germany.
³ Institute for Medical Microbiology, Immunology and Parasitology, Medical Faculty, University of Bonn, 53115 Bonn, Germany.
⁴ Department of Hygiene and Environmental Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany.
⁵ Department of Fresh Produce Logistics, Hochschule Geisenheim University, 65366 Geisenheim, Germany.
⁶ Department for Biological Safety, German Federal Institute for Risk Assessment, 10589 Berlin, Germany.
⁷ Laboratorio de Referencia de Escherichia coli (LREC), Departamento de Microbioloxía e Parasitoloxía, Facultade de Veterinaria, Universidade de Santiago de Compostela (USC), 27002 Lugo, Spain.
⁸ Unit for Veterinary Public Health and Epidemiology, University of Veterinary Medicine, AT-1210 Vienna, Austria.

Abstract

Currently, human and veterinary medicine are threatened worldwide by an increasing resistance to carbapenems, particularly present in opportunistic Enterobacterales pathogens (e.g., Klebsiella spp.). However, there is a lack of comprehensive and comparable data on their occurrence in wastewater, as well as on the phenotypic and genotypic characteristics for various countries including Germany. Thus, this study aims to characterize carbapenem-resistant Klebsiella spp. isolated from municipal wastewater treatment plants (mWWTPs) and their receiving water bodies, as well as from wastewater and process waters from poultry and pig slaughterhouses. After isolation using selective media and determination of carbapenem (i.e., ertapenem) resistance using broth microdilution to apply epidemiological breakpoints, the selected isolates (n = 30) were subjected to WGS. The vast majority of the isolates (80.0%) originated from the mWWTPs and their receiving water bodies. In addition to ertapenem, Klebsiella spp. isolates exhibited resistance to meropenem (40.0%) and imipenem (16.7%), as well as to piperacillin-tazobactam (50.0%) and ceftolozan-tazobactam (50.0%). A high diversity of antibiotic-resistance genes (n = 68), in particular those encoding β-lactamases, was revealed. However, with the exception of bla_GES-5-like, no acquired carbapenemase-resistance genes were detected. Virulence factors such as siderophores (e.g., enterobactin) and fimbriae type 1 were present in almost all isolates. A wide genetic diversity was indicated by assigning 66.7% of the isolates to 12 different sequence types (STs), including clinically relevant ones (e.g., ST16, ST252, ST219, ST268, ST307, ST789, ST873, and ST2459). Our study provides information on the occurrence of carbapenem-resistant, ESBL-producing Klebsiella spp., which is of clinical importance in wastewater and surface water in Germany. These findings indicate their possible dissemination in the environment and the potential risk of colonization and/or infection of humans, livestock and wildlife associated with exposure to contaminated water sources.

Keywords: Klebsiella pneumoniae; antimicrobial resistance; carbapenem resistance; virulence; wastewater.

Abstract

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