{"title":"超级细菌耐碳青霉烯肺炎克雷伯菌的环境贩运及其在城市人群中的无声传播：一项基于污水的研究","authors":"Saubhagini Sahoo, Anshuman Sahu, Rajesh Kumar Sahoo, Mahendra Gaur, Debadutta Bhanjadeo, Enketeswara Subudhi","doi":"10.1186/s12302-025-01187-6","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Antibiotic resistance (AR) is an imminent threat to developing nations where poor sanitation and untreated wastewater remain major risk factors. In this study, Cuttack’s raw municipal sewage effluent (RMSE) was leveraged to investigate the potential escape of carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) into the environment and its prevalence in the urban population. Their genetic relatedness with clinical CRKP isolates was evaluated using repetitive element sequence-based PCR (rep-PCR) and (GTG)<sub>5</sub>-PCR.</p><h3>Results</h3><p>Eleven (<i>n</i> = 11) CRKP isolates, exhibiting variable resistance to 15 antibiotic classes, were recovered from RMSE. These isolates harboured several clinically relevant carbapenemase genes, including <i>bla</i><sub>KPC</sub> (18.18%), <i>bla</i><sub>IMP</sub> (18.18%), <i>bla</i><sub>NDM</sub> (9.09%) with <i>bla</i><sub>VIM</sub> (54.54%) and <i>bla</i><sub>OXA-48-like</sub> (54.54%) being the most prevalent. In contrast, the clinical CRKP isolates (<i>n</i> = 14) were predominantly characterized by <i>bla</i><sub>NDM</sub> (78.5%). The co-carriage of <i>bla</i><sub>VIM</sub> + <i>bla</i><sub>OXA-48-like</sub> was the most frequent combination in RMSE-derived isolates (45.45%), while clinical isolates were dominated by <i>bla</i><sub>NDM</sub> + <i>bla</i><sub>OXA-48-like</sub> (42.85%). Notably, many clinical isolates were marked by the confluence of extensively drug-resistant (XDR) (50%) phenotype and hypervirulent markers including <i>iucA</i>, <i>iroB</i>, <i>rmpA</i>, <i>rmpA2</i> and <i>peg-344</i>. The clinical and environmental CRKP isolates clustered into two separate clades and differed significantly in their Multiple Antibiotic Resistance (MAR) Index (<i>p</i> < 0.00078), Minimum Inhibitory Concentration (MIC) of meropenem (<i>p</i> < 0.028) and imipenem (<i>p</i> < 0.019), number of β-lactamase genes (<i>p</i> < 0.0022), siderophore genes (<i>p</i> < 0.00039), and porin genes (<i>p</i> < 0.0001), as determined by the Mann–Whitney U-test. An XDR strain of the international high-risk clone ST395 harbouring a chromosomally encoded <i>bla</i><sub>NDM-5</sub> gene was also recovered from the RMSE.</p><h3>Conclusion</h3><p>These findings underscore the need for tailored strategies to mitigate community-associated and hospital-acquired CRKP infections, respectively, while identifying Cuttack’s RMSE as an escape gate for CRKP into the environment. The alarming presence of this superbug in RMSE further reflects its prevalence and ongoing cryptic transmission in Cuttack’s urban population. Our study advocates for the integration of sewage surveillance as a robust, cost-effective approach to monitor the environmental spread and current trends of pathogens in human populations.</p><h3>Graphical Abstract</h3>\n<div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>","PeriodicalId":546,"journal":{"name":"Environmental Sciences Europe","volume":"37 1","pages":""},"PeriodicalIF":6.0000,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1186/s12302-025-01187-6.pdf","citationCount":"0","resultStr":"{\"title\":\"Environmental trafficking of superbug carbapenem-resistant Klebsiella pneumoniae and its silent spread in an urban population: a sewage-based study\",\"authors\":\"Saubhagini Sahoo, Anshuman Sahu, Rajesh Kumar Sahoo, Mahendra Gaur, Debadutta Bhanjadeo, Enketeswara Subudhi\",\"doi\":\"10.1186/s12302-025-01187-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Antibiotic resistance (AR) is an imminent threat to developing nations where poor sanitation and untreated wastewater remain major risk factors. In this study, Cuttack’s raw municipal sewage effluent (RMSE) was leveraged to investigate the potential escape of carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) into the environment and its prevalence in the urban population. Their genetic relatedness with clinical CRKP isolates was evaluated using repetitive element sequence-based PCR (rep-PCR) and (GTG)<sub>5</sub>-PCR.</p><h3>Results</h3><p>Eleven (<i>n</i> = 11) CRKP isolates, exhibiting variable resistance to 15 antibiotic classes, were recovered from RMSE. These isolates harboured several clinically relevant carbapenemase genes, including <i>bla</i><sub>KPC</sub> (18.18%), <i>bla</i><sub>IMP</sub> (18.18%), <i>bla</i><sub>NDM</sub> (9.09%) with <i>bla</i><sub>VIM</sub> (54.54%) and <i>bla</i><sub>OXA-48-like</sub> (54.54%) being the most prevalent. In contrast, the clinical CRKP isolates (<i>n</i> = 14) were predominantly characterized by <i>bla</i><sub>NDM</sub> (78.5%). The co-carriage of <i>bla</i><sub>VIM</sub> + <i>bla</i><sub>OXA-48-like</sub> was the most frequent combination in RMSE-derived isolates (45.45%), while clinical isolates were dominated by <i>bla</i><sub>NDM</sub> + <i>bla</i><sub>OXA-48-like</sub> (42.85%). Notably, many clinical isolates were marked by the confluence of extensively drug-resistant (XDR) (50%) phenotype and hypervirulent markers including <i>iucA</i>, <i>iroB</i>, <i>rmpA</i>, <i>rmpA2</i> and <i>peg-344</i>. The clinical and environmental CRKP isolates clustered into two separate clades and differed significantly in their Multiple Antibiotic Resistance (MAR) Index (<i>p</i> < 0.00078), Minimum Inhibitory Concentration (MIC) of meropenem (<i>p</i> < 0.028) and imipenem (<i>p</i> < 0.019), number of β-lactamase genes (<i>p</i> < 0.0022), siderophore genes (<i>p</i> < 0.00039), and porin genes (<i>p</i> < 0.0001), as determined by the Mann–Whitney U-test. An XDR strain of the international high-risk clone ST395 harbouring a chromosomally encoded <i>bla</i><sub>NDM-5</sub> gene was also recovered from the RMSE.</p><h3>Conclusion</h3><p>These findings underscore the need for tailored strategies to mitigate community-associated and hospital-acquired CRKP infections, respectively, while identifying Cuttack’s RMSE as an escape gate for CRKP into the environment. The alarming presence of this superbug in RMSE further reflects its prevalence and ongoing cryptic transmission in Cuttack’s urban population. Our study advocates for the integration of sewage surveillance as a robust, cost-effective approach to monitor the environmental spread and current trends of pathogens in human populations.</p><h3>Graphical Abstract</h3>\\n<div><figure><div><div><picture><source><img></source></picture></div></div></figure></div></div>\",\"PeriodicalId\":546,\"journal\":{\"name\":\"Environmental Sciences Europe\",\"volume\":\"37 1\",\"pages\":\"\"},\"PeriodicalIF\":6.0000,\"publicationDate\":\"2025-07-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://link.springer.com/content/pdf/10.1186/s12302-025-01187-6.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Environmental Sciences Europe\",\"FirstCategoryId\":\"93\",\"ListUrlMain\":\"https://link.springer.com/article/10.1186/s12302-025-01187-6\",\"RegionNum\":3,\"RegionCategory\":\"环境科学与生态学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENVIRONMENTAL SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Environmental Sciences Europe","FirstCategoryId":"93","ListUrlMain":"https://link.springer.com/article/10.1186/s12302-025-01187-6","RegionNum":3,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENVIRONMENTAL SCIENCES","Score":null,"Total":0}
Environmental trafficking of superbug carbapenem-resistant Klebsiella pneumoniae and its silent spread in an urban population: a sewage-based study
Background
Antibiotic resistance (AR) is an imminent threat to developing nations where poor sanitation and untreated wastewater remain major risk factors. In this study, Cuttack’s raw municipal sewage effluent (RMSE) was leveraged to investigate the potential escape of carbapenem-resistant Klebsiella pneumoniae (CRKP) into the environment and its prevalence in the urban population. Their genetic relatedness with clinical CRKP isolates was evaluated using repetitive element sequence-based PCR (rep-PCR) and (GTG)5-PCR.
Results
Eleven (n = 11) CRKP isolates, exhibiting variable resistance to 15 antibiotic classes, were recovered from RMSE. These isolates harboured several clinically relevant carbapenemase genes, including blaKPC (18.18%), blaIMP (18.18%), blaNDM (9.09%) with blaVIM (54.54%) and blaOXA-48-like (54.54%) being the most prevalent. In contrast, the clinical CRKP isolates (n = 14) were predominantly characterized by blaNDM (78.5%). The co-carriage of blaVIM + blaOXA-48-like was the most frequent combination in RMSE-derived isolates (45.45%), while clinical isolates were dominated by blaNDM + blaOXA-48-like (42.85%). Notably, many clinical isolates were marked by the confluence of extensively drug-resistant (XDR) (50%) phenotype and hypervirulent markers including iucA, iroB, rmpA, rmpA2 and peg-344. The clinical and environmental CRKP isolates clustered into two separate clades and differed significantly in their Multiple Antibiotic Resistance (MAR) Index (p < 0.00078), Minimum Inhibitory Concentration (MIC) of meropenem (p < 0.028) and imipenem (p < 0.019), number of β-lactamase genes (p < 0.0022), siderophore genes (p < 0.00039), and porin genes (p < 0.0001), as determined by the Mann–Whitney U-test. An XDR strain of the international high-risk clone ST395 harbouring a chromosomally encoded blaNDM-5 gene was also recovered from the RMSE.
Conclusion
These findings underscore the need for tailored strategies to mitigate community-associated and hospital-acquired CRKP infections, respectively, while identifying Cuttack’s RMSE as an escape gate for CRKP into the environment. The alarming presence of this superbug in RMSE further reflects its prevalence and ongoing cryptic transmission in Cuttack’s urban population. Our study advocates for the integration of sewage surveillance as a robust, cost-effective approach to monitor the environmental spread and current trends of pathogens in human populations.
期刊介绍：
ESEU is an international journal, focusing primarily on Europe, with a broad scope covering all aspects of environmental sciences, including the main topic regulation.
ESEU will discuss the entanglement between environmental sciences and regulation because, in recent years, there have been misunderstandings and even disagreement between stakeholders in these two areas. ESEU will help to improve the comprehension of issues between environmental sciences and regulation.
ESEU will be an outlet from the German-speaking (DACH) countries to Europe and an inlet from Europe to the DACH countries regarding environmental sciences and regulation.
Moreover, ESEU will facilitate the exchange of ideas and interaction between Europe and the DACH countries regarding environmental regulatory issues.
Although Europe is at the center of ESEU, the journal will not exclude the rest of the world, because regulatory issues pertaining to environmental sciences can be fully seen only from a global perspective.
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