Migration of Escherichia coli and Klebsiella pneumoniae Carbapenemase (KPC)-Producing Enterobacter cloacae through Wastewater Pipework and Establishment in Hospital Sink Waste Traps in a Laboratory Model System
Abstract
:1. Introduction
2. Materials and Methods
2.1. Waste Trap Installation in the Laboratory Model System
2.2. Wastewater Backflow Event
2.3. Phenotypical Characterisation of Isolates
2.4. Genotypical Characterisation of Isolates
3. Results
3.1. KPC-Producing Enterobacter cloacae Transfer Events
3.2. Escherichia coli Transfer Events
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Mehrad, B.; Clark, N.; Zhanel, G.G.; Lynch, J.P. Antimicrobial Resistance in Hospital-Acquired Gram-Negative Bacterial Infections. Chest 2015, 147, 1413–1421. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Nordmann, P.; Dortet, L.; Poirel, L. Carbapenem resistance in Enterobacteriaceae: Here is the storm! Trends Mol. Med. 2012, 18, 263–272. [Google Scholar] [CrossRef] [PubMed]
- Nordmann, P.; Naas, T.; Poirel, L. Global Spread of Carbapenemase-producingEnterobacteriaceae. Emerg. Infect. Dis. 2011, 17, 1791–1798. [Google Scholar] [CrossRef] [PubMed]
- Tacconelli, E.; Magrini, N.; Kahlmeter, G.; Singh, N. Global Priority List of Antibiotic-Resistant Bacteria to Guide Research, Discovery, and Development of New Antibiotics; World Health Organisation: Geneve, Switzerland, February 2017; Available online: http://www.who.int/medicines/publications/WHO-PPL-Short_Summary_25Feb-ET_NM_WHO.pdf (accessed on 2 September 2021).
- Lusignani, L.S.; Presterl, E.; Zatorska, B.; Nest, M.V.D.; Diab-Elschahawi, M. Infection control and risk factors for acquisition of carbapenemase-producing enterobacteriaceae. A 5 year (2011–2016) case-control study. Antimicrob. Resist. Infect. Control 2020, 9, 1–10. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- van Loon, K.; Holt, A.F.V.I.; Vos, M.C. A Systematic Review and Meta-analyses of the Clinical Epidemiology of Carbapenem-Resistant Enterobacteriaceae. Antimicrob. Agents Chemother. 2018, 62, e01730-17. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Carling, P.C. Wastewater drains: Epidemiology and interventions in 23 carbapenem-resistant organism outbreaks. Infect. Control Hosp. Epidemiol. 2018, 39, 972–979. [Google Scholar] [CrossRef] [PubMed]
- Constantinides, B.; Chau, K.K.; Quan, T.P.; Rodger, G.; Andersson, M.I.; Jeffery, K.; Lipworth, S.; Gweon, H.S.; Peniket, A.; Pike, G.; et al. Genomic surveillance of Escherichia coli and Klebsiella spp. in hospital sink drains and patients. Microb. Genom. 2020, 6, mgen000391. [Google Scholar] [CrossRef]
- Weingarten, R.A.; Johnson, R.; Conlan, S.; Ramsburg, A.M.; Dekker, J.P.; Lau, A.F.; Khil, P.; Odom, R.T.; Deming, C.; Park, M.; et al. Genomic Analysis of Hospital Plumbing Reveals Diverse Reservoir of Bacterial Plasmids Conferring Carbapenem Resistance. mBio 2018, 9, e02011-17. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Aranega-Bou, P.; George, R.; Verlander, N.; Paton, S.; Bennett, A.; Moore, G.; Aiken, Z.; Akinremi, O.; Ali, A.; Cawthorne, J.; et al. Carbapenem-resistant Enterobacteriaceae dispersal from sinks is linked to drain position and drainage rates in a laboratory model system. J. Hosp. Infect. 2018, 102, 63–69. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Kotay, S.M.; Donlan, R.M.; Ganim, C.; Barry, K.; Christensen, B.E.; Mathers, A.J. Droplet-Rather than Aerosol-Mediated Dispersion Is the Primary Mechanism of Bacterial Transmission from Contaminated Hand-Washing Sink Traps. Appl. Environ. Microbiol. 2019, 85, e01997-18. [Google Scholar] [CrossRef] [Green Version]
- Hopman, J.; Meijer, C.; Kenters, N.; Coolen, J.; Ghamati, M.R.; Mehtar, S.; Van Crevel, R.; Morshuis, W.J.; Verhagen, A.F.T.M.; Heuvel, M.M.V.D.; et al. Risk Assessment After a Severe Hospital-Acquired Infection Associated With Carbapenemase-Producing Pseudomonas aeruginosa. JAMA Netw. Open 2019, 2, e187665. [Google Scholar] [CrossRef] [Green Version]
- Kotay, S.; Chai, W.; Guilford, W.; Barry, K.; Mathers, A.J. Spread from the Sink to the Patient: In Situ Study Using Green Fluorescent Protein (GFP)-Expressing Escherichia coli To Model Bacterial Dispersion from Hand-Washing Sink-Trap Reservoirs. Appl. Environ. Microbiol. 2017, 83, e03327-16. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bankevich, A.; Nurk, S.; Antipov, D.; Gurevich, A.; Dvorkin, M.; Kulikov, A.; Lesin, V.M.; Nikolenko, S.; Pham, S.; Prjibelski, A.D.; et al. SPAdes: A New Genome Assembly Algorithm and Its Applications to Single-Cell Sequencing. J. Comput. Biol. 2012, 19, 455–477. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ondov, B.D.; Treangen, T.J.; Melsted, P.; Mallonee, A.B.; Bergman, N.H.; Koren, S.; Phillippy, A.M. Mash: Fast genome and metagenome distance estimation using MinHash. Genome Biol. 2016, 17, 1–14. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Tewolde, R.; Dallman, T.; Schaefer, U.; Sheppard, C.L.; Ashton, P.; Pichon, B.; Ellington, M.; Swift, C.; Green, J.; Underwood, A. MOST: A modified MLST typing tool based on short read sequencing. PeerJ 2016, 4, e2308. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Breathnach, A.; Cubbon, M.; Karunaharan, R.; Pope, C.; Planche, T. Multidrug-resistant Pseudomonas aeruginosa outbreaks in two hospitals: Association with contaminated hospital waste-water systems. J. Hosp. Infect. 2012, 82, 19–24. [Google Scholar] [CrossRef] [PubMed]
- Buchan, B.W.; Graham, M.B.; Lindmair-Snell, J.; Arvan, J.; Ledeboer, N.A.; Nanchal, R.; Munoz-Price, L.S. The relevance of sink proximity to toilets on the detection of Klebsiella pneumoniae carbapenemase inside sink drains. Am. J. Infect. Control 2018, 47, 98–100. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Moloney, E.; Deasy, E.; Swan, J.; Brennan, G.; O’Donnell, M.; Coleman, D. Whole-genome sequencing identifies highly related Pseudomonas aeruginosa strains in multiple washbasin U-bends at several locations in one hospital: Evidence for trafficking of potential pathogens via wastewater pipes. J. Hosp. Infect. 2020, 104, 484–491. [Google Scholar] [CrossRef] [PubMed]
January 2018 (Pre-Installation) | February 2018 (Pre-Backflow) | February 2018 (Post-Backflow) | April 2018 | May 2018 | August 2018 | September 2018 | October 2018 | |
---|---|---|---|---|---|---|---|---|
SINK 1 | E. cloacae ST501 (Isolate A) | E. cloacae ST501 (Isolate B) | ||||||
SINK 2 | ||||||||
SINK 3 | E. cloacae ST31 (Isolate G) | E. cloacae ST31 (Isolate H) | E. coli ST5295 (Isolate L) | E. coli ST5295 (Isolate N) | ||||
SINK 4 | E. coli ST5295 (Isolate J) | E. cloacae ST501 (Isolate D) | E. coli ST5295 (Isolate K) | |||||
SINK 5 | E. cloacae ST501 (Isolate C) E. cloacae ST31 (Isolate I) | E. cloacae ST501 (Isolate E) E. coli ST5295 (Isolate M) | E. cloacae ST501 (Isolate F) E. coli ST5295 (Isolate O) | E. coli ST5295 (Isolate P) | E. coli ST5295 (Isolate Q) |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Aranega-Bou, P.; Ellaby, N.; Ellington, M.J.; Moore, G. Migration of Escherichia coli and Klebsiella pneumoniae Carbapenemase (KPC)-Producing Enterobacter cloacae through Wastewater Pipework and Establishment in Hospital Sink Waste Traps in a Laboratory Model System. Microorganisms 2021, 9, 1868. https://doi.org/10.3390/microorganisms9091868
Aranega-Bou P, Ellaby N, Ellington MJ, Moore G. Migration of Escherichia coli and Klebsiella pneumoniae Carbapenemase (KPC)-Producing Enterobacter cloacae through Wastewater Pipework and Establishment in Hospital Sink Waste Traps in a Laboratory Model System. Microorganisms. 2021; 9(9):1868. https://doi.org/10.3390/microorganisms9091868
Chicago/Turabian StyleAranega-Bou, Paz, Nicholas Ellaby, Matthew J. Ellington, and Ginny Moore. 2021. "Migration of Escherichia coli and Klebsiella pneumoniae Carbapenemase (KPC)-Producing Enterobacter cloacae through Wastewater Pipework and Establishment in Hospital Sink Waste Traps in a Laboratory Model System" Microorganisms 9, no. 9: 1868. https://doi.org/10.3390/microorganisms9091868
APA StyleAranega-Bou, P., Ellaby, N., Ellington, M. J., & Moore, G. (2021). Migration of Escherichia coli and Klebsiella pneumoniae Carbapenemase (KPC)-Producing Enterobacter cloacae through Wastewater Pipework and Establishment in Hospital Sink Waste Traps in a Laboratory Model System. Microorganisms, 9(9), 1868. https://doi.org/10.3390/microorganisms9091868