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European Journal of Clinical Microbiology & Infectious Diseases

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Open Access 01-12-2018 | Original Article

Related carbapenemase-producing Klebsiella isolates detected in both a hospital and associated aquatic environment in Sweden

Authors: Faisal Ahmad Khan, Bengt Hellmark, Ralf Ehricht, Bo Söderquist, Jana Jass

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 12/2018

Abstract

Carbapenem antibiotics are one of the last-resort agents against multidrug-resistant (MDR) bacteria. The occurrence of carbapenemase-producing Enterobacteriaceae (CPE) in wastewater and aquatic environments is an indication of MDR bacteria in the community. This study evaluated CPE in aquatic environments and compared them to the local hospital isolates in Sweden. Phenotypic and genotypic analyses of antibiotic resistance of environmental and clinical CPE were performed. The relatedness of the isolates and possible clonal dissemination was evaluated using phylogenetic and phyloproteomic analysis. Klebsiella oxytoca carrying carbapenemase genes (bla_VIM-1, bla_IMP-29) were isolated from wastewater and the recipient river, while K. oxytoca (bla_VIM-1) and Klebsiella pneumoniae (bla_VIM-1, bla_OXA-48, bla_NDM-1, bla_KPC-3) were isolated from patients at the local clinics or hospital. The K. oxytoca classified as sequence type 172 (ST172) isolated from the river was genotypically related to two clinical isolates recovered from patients. The similarity between environmental and clinical isolates suggests the dispersion of bla_VIM-1 producing K. oxytoca ST172 from hospital to aquatic environment and the likelihood of its presence in the community. This is the first report of CPE in aquatic environments in Sweden; therefore, surveillance of aquatic and hospital environments for CPE in other urban areas is important to determine the major transfer routes in order to formulate strategies to prevent the spread of MDR bacteria.

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Title: Related carbapenemase-producing Klebsiella isolates detected in both a hospital and associated aquatic environment in Sweden
Authors: Faisal Ahmad Khan
Bengt Hellmark
Ralf Ehricht
Bo Söderquist
Jana Jass
Publication date: 01-12-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Clinical Microbiology & Infectious Diseases / Issue 12/2018
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI: https://doi.org/10.1007/s10096-018-3365-9

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