Hospital effluent: A reservoir for carbapenemase-producing Enterobacterales?

Niamh Cahill (1) , Louise O'Connor (1) , Bláthnaid Mahon (1) , Áine Varley (1) , Elaine Mcgrath (2) , Phelim Ryan (1) , Martin Cormican (1, 2) , Carina Brehony (1) , Keith A. Jolley (3) , Martin C. Maiden (3) , Sylvain Brisse (4) , Dearbháile Morris (1)

1 NUI Galway - National University of Ireland [Galway]
2 University Hospital Galway
3 University of Oxford
4 Biodiversité et Epidémiologie des Bactéries pathogènes - Biodiversity and Epidemiology of Bacterial Pathogens

Antimicrobial resistance is a major public health concern. Carbapenemase-producing Enterobacterales (CPE) represent a significant health threat as some strains are resistant to almost all available antibiotics. The aim of this research was to examine hospital effluent and municipal wastewater in an urban area in Ireland for CPE. Samples of hospital effluent (n = 5), municipal wastewater before (n = 5) and after (n = 4) the hospital effluent stream joined the municipal wastewater stream were collected over a nine-week period (May-June 2017). All samples were examined for CPE by direct plating onto Brilliance CRE agar. Isolates were selected for susceptibility testing to 15 antimicrobial agents in accordance with EUCAST criteria. Where relevant, isolates were tested for carbapenemase-encoding genes by real-time PCR. CPE were detected in five samples of hospital effluent, one sample of pre-hospital wastewater and three samples of post-hospital wastewater. Our findings suggest hospital effluent is a major contributor to CPE in municipal wastewater. Monitoring of hospital effluent for CPE could have important applications in detection and risk management of unrecognised dissemination of CPE in both the healthcare setting and the environment.

Mots clés: Antimicrobial resistant bacteria; Carbapenem resistance; Carbapenemase-encoding genes; Hospital wastewater; Municipal wastewater

Domaines: Biochimie, Biologie Moléculaire; Biodiversité; Santé publique et épidémiologie

Niamh Cahill, Louise O'Connor, Bláthnaid Mahon, Áine Varley, Elaine Mcgrath, et al.. Hospital effluent: A reservoir for carbapenemase-producing Enterobacterales?. Science of the Total Environment, 2019, 672, pp.618-624. ⟨10.1016/j.scitotenv.2019.03.428⟩. ⟨pasteur-03329713⟩