Laboratório ALERTA, Divisão de Infectologia do Departamento de Medicina da Universidade Federal de São Paulo, São Paulo, Brazil.
Diagn Microbiol Infect Dis. 2013 May;76(1):80-5. doi: 10.1016/j.diagmicrobio.2013.02.001. Epub 2013 Mar 9.
We investigated the antimicrobial resistance profile and the occurrence of Klebsiella pneumoniae carbapenemase (KPC)-producing Gram-negative rods in sewage samples obtained from a Brazilian teaching hospital and from the wastewater treatment plant (WWTP) that receives it for treatment. We identified multidrug-resistant bacteria as well as KPC-2-producing Aeromonas spp. and several Enterobacteriaceae species, including Kluyvera spp., in the hospital effluent and in different sites of the WWTP. Most isolates showed the blaKPC-2 gene harbored on a transposon that was carried by conjugative plasmids. The presence of KPC production among Aeromonas spp., Kluyvera spp., and other Enterobacteriaceae indicates the adaptability of such isolates to aquatic environments, not only in the hospital effluent but also throughout the WWTP. Although secondary treatment seems to decrease the amount of KPC producers in sewage, multidrug-resistant isolates are continually disposed in the urban river. Thus, sewage treatment regulations are urgently needed to decelerate the evolution of antimicrobial resistance beyond hospitals.
我们调查了从巴西一所教学医院和接收其进行处理的污水处理厂 (WWTP) 获得的污水样本中的抗微生物药物耐药性概况和产碳青霉烯酶肺炎克雷伯菌 (KPC) 的革兰氏阴性杆菌的发生情况。我们在医院污水和 WWTP 的不同地点发现了耐多药细菌以及产 KPC-2 的气单胞菌属和几种肠杆菌科物种，包括克吕沃尔氏菌属。大多数分离株显示 blaKPC-2 基因位于转座子上，该转座子由可接合的质粒携带。气单胞菌属、克吕沃尔氏菌属和其他肠杆菌科中 KPC 的产生表明这些分离株对水生环境具有适应性，不仅在医院污水中，而且在整个 WWTP 中均如此。尽管二级处理似乎减少了污水中 KPC 产生菌的数量，但仍有耐药性分离株不断排入城市河流。因此，迫切需要制定污水处理法规，以减缓医院以外的抗微生物药物耐药性的演变。
