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. 2020 Oct 30;9(1):169.
doi: 10.1186/s13756-020-00826-2.

Multidrug-resistant enterobacteriaceae in coastal water: an emerging threat

Regev Cohen  1   2 , Svetlana Paikin  3 , Assaf Rokney  4 , Maxim Rubin-Blum  5 , Peleg Astrahan  6
Affiliations

Multidrug-resistant enterobacteriaceae in coastal water: an emerging threat

Regev Cohen et al. Antimicrob Resist Infect Control. .

Abstract

Background: The environmental role of carbapenemase-producing Enterobacteriaceae (CPE) acquisition and infection in human disease has been described but not thoroughly investigated. We aimed to assess the occurrence of CPE in nearshore aquatic bodies.

Methods: Enterobacteriaceae were cultured from coastal and estuary water near Netanya, Israel in June and July of 2018. Bacteria were identified by VITEK2® and their antimicrobial susceptibility was tested according to the CLSI guidelines. Enterobacteriaceae genomes were sequenced to elucidate their resistome and carbapenemase types.

Results: Among other clinically relevant bacteria, four CPE (three Enterobacter spp and one Escherichia coli isolate) were isolated from two river estuaries (Poleg and Alexander Rivers) and coastal water at a popular recreational beach (Beit Yanai). Molecular analysis and genome sequencing revealed the persistent presence of rare beta-lactamase resistance genes, including blaIMI-2 and a previously unknown blaIMI-20 allele, which were not found among the local epidemiological strains. Genome comparisons revealed the high identity of riverine and marine CPE that were cultivated one month apart.

Conclusions: We show that CPE contamination was widespread in nearshore marine and riverine habitats. The high genome-level similarity of riverine and marine CPEs, isolated one month apart, hints at the common source of infection. We discuss the clinical implications of these findings and stress the urgent need to assess the role of the aquatic environment in CPE epidemiology.

Keywords: Carbapenemase producing enterobacteriaceae (CPE); Enterobacter spp.; Estuary; Israel; Public health; Seawater.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Map of the coastline near Netanya and areas of water samplings (red asterisks)
Fig. 2
Fig. 2
Phylogenetic tree of IMI type carbapenem-hydrolyzing class A beta-lactamases (alignment of 21 sequences of 292 amino acids). The tree is drawn to scale, with branch lengths representing the number of substitutions per site. The percentage of trees in which the associated taxa clustered together was determined based on 100 bootstrap resamples. Sequences from this study are marked in blue
See this image and copyright information in PMC

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