Department of Microbiology, Institute of Biomedical Sciences, Universidade de São Paulo, São Paulo, Brazil.
Department of Clinical Analysis, School of Pharmacy, Universidade de São Paulo, São Paulo, Brazil.
Sci Total Environ. 2017 Nov 15;598:910-915. doi: 10.1016/j.scitotenv.2017.03.207. Epub 2017 Apr 27.
The emergence of high-risk clones of multidrug-resistant (MDR) bacteria in aquatic environments has generated an important public health problem, creating an urgent need to strengthen surveillance. This study reports the occurrence of clinically significant MDR Enterobacteriaceae and non-fermentative bacteria carrying carbapenemases (KPC-2), extended-spectrum β-lactamases (CTX-M) and plasmid-mediated quinolone resistance (PMQR) genes in urban lakes and reservoirs, in Southeastern Brazil. In this regard, the detection of hospital-associated lineages of KPC-2-producing Klebsiella pneumoniae belonging to the international clonal complex CC258 (ST11) and CTX-M-15-producing Escherichia coli belonging to the international CC10 (ST617), in an urban lake, is reported for the first time. Whole genome sequencing (WGS) analysis of KPC-2-producing K. pneumoniae ST11 revealed that bla gene was carried by an IncN plasmid on a Tn4401b element. This study support that aquatic environments with public access can act as reservoirs of clinically important MDR bacteria, constituting a potential risk to human and animal health. On the other hand, the detection of high-risk clones highlights the extra-hospital spread of clinically significant bacteria into urban aquatic environments.
水生环境中出现耐多药（MDR）细菌高危克隆，引发了重要的公共卫生问题，亟待加强监测。本研究报告了在巴西东南部城市湖泊和水库中，临床意义重大的耐多药肠杆菌科和非发酵细菌携带碳青霉烯酶（KPC-2）、广谱β-内酰胺酶（CTX-M）和质粒介导的喹诺酮耐药（PMQR）基因的情况。在这方面，首次报道了在一个城市湖泊中发现了属于国际克隆群 CC258（ST11）的产 KPC-2 肺炎克雷伯菌和属于国际 CC10（ST617）的产 CTX-M-15 大肠杆菌的医院相关株系。对产 KPC-2 的 ST11 肺炎克雷伯菌进行全基因组测序（WGS）分析表明，bla 基因由 Tn4401b 元件上的 IncN 质粒携带。本研究表明，公众可进入的水生环境可能成为临床重要的耐多药细菌的储库，对人类和动物健康构成潜在威胁。另一方面，高危克隆的检测突显了临床上重要的细菌向城市水生环境的医院外传播。
