AUTHOR=Sung Gyung-Hye , Kim Si Hyun , Park Eun Hee , Hwang Suk Nam , Kim Jea-Dong , Kim Gyu Ri , Kim Eun-Young , Jeong Joseph , Kim Sunjoo , Shin Jeong Hwan 

TITLE=Association of Carbapenemase-Producing Enterobacterales Detected in Stream and Clinical Samples

JOURNAL=Frontiers in Microbiology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2022.923979

DOI=10.3389/fmicb.2022.923979

ISSN=1664-302X

ABSTRACT=<sec><title>Background</title><p>The spread of carbapenem-resistant <italic>Enterobacterales</italic> (CRE) strains has caused treatment failure and is a worldwide threat to public health. However, there are limited reports on the prevalence of carbapenemase-producing <italic>Enterobacterales</italic> (CPE) in aquatic environments and its association with clinical isolates. This study aimed to investigate the prevalence of CPE in a stream environment and its genetic relationship with clinical isolates in Korea.</p></sec><sec><title>Methods</title><p>A total of 4,582 water samples were collected from 94 streams. Multiplex PCR and sequencing were used to detect and identify six carbapenemase genes. Multi-locus sequence typing (MLST) was performed to investigate the genetic relatedness between the environmental strains and clinical isolates.</p></sec><sec><title>Results</title><p>A total of 133 CRE strains were isolated from the streams. <italic>Klebsiella pneumoniae</italic> was the most common CRE (45.9%), followed by <italic>Enterobacter cloacae</italic> complex (29.3%), <italic>Escherichia coli</italic> (13.5%), <italic>Raoultella ornithinolytica</italic> (5.3%), and <italic>Citrobacter freundii</italic> (2.3%). Ninety (67.7%) isolates carried carbapenemase genes. <italic>K. pneumoniae</italic> carbapenemase-2 (36.7%) and New Delhi metallo-β-lactamase-5 (32.2%) were the common carbapenemases detected. Sequence type (ST)307 and ST11 <italic>K. pneumoniae</italic> strains harboring the <italic>bla</italic><sub>KPC-2</sub> gene were the most prevalent in stream and patient samples.</p></sec><sec><title>Conclusion</title><p>CPE was highly prevalent in streams and closely related to the isolates obtained from patients. Therefore, continuous monitoring of stream environments is required to control the spread of carbapenem resistance.</p></sec>