engleski

Extended-spectrum β-lactamase producing Enterobacterales from hospital wastewater in Croatia

Hospital wastewater is a source for transmission of extended-spectrum β-lactamase (ESBL)-producing Enterobacterales into the municipal sewage system and further into the environment. Here, we describe the occurrence of ESBL-producing enterobacteria, and their resistance genes from wastewater of two major hospitals in Zagreb, Croatia. Chromogenic medium RAPID’E. coli2 agar (Bio-Rad) supplemented with cefotaxime (4 mg/L) was used for the isolation of presumptive ESBL- producing enterobacteria. Identification was done with MALDI-TOF MS. Antibiotic susceptibility profiles and ESBL production was assessed. ESBL and carbapenemase genes were detected using PCR. Out of 100 presumptive ESBL producing enterobacteria, the most dominant taxa were Escherichia coli (48 %), Citrobacter spp. (14 %), Enterobacter spp. (13 %) and Klebsiella spp. (8 %). The 69 isolates were ESBL-producing enterobacteria with multi-drug resistance. The predominant ESBL genes detected with PCR were blaTEM (95 %) and blaCTX-M-1 (87 %). The blaSHV and blaGES-7 were detected sporadically. Moreover, more than 50 % of ESBL producing isolates were resistant to carbapenems, and blaKPC-2 and blaOXA- 48 genes were the most detected carbapenemase genes. The occurrence of ESBL-producing isolates indicates that hospital wastewater is the source of multi-drug resistant enterobacteria and is evidence of a need for pretreatment of hospital wastewater before discharge into the municipal sewer system.

Enterobacterales ; extended-spectrum β-lactamase ; carbapenemase ; hospital wastewater

nije evidentirano