Puljko, Ana (2024) Wastewater as a source for the spread of resistance to third-generation cephalosporins and carbapenems to the aquatic environment. Doctoral thesis, Institut Ruđer Bošković.
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Abstract
This dissertation aimed to investigate the removal of enterobacteria resistant to third-generation cephalosporins (3GCs) and carbapenems and the corresponding resistance genes from seven Croatian wastewater treatment plants (WWTPs) and to characterize 3GC- and carbapenem-resistant enterobacterial isolates from hospital and treated wastewater from Zagreb WWTP to reveal their epidemiology and resistance mechanisms. Culture- and quantitative PCR-based methods showed that these WWTPs only partially eliminate these enterobacteria and the resistance genes, which are then released into the environment via the treated wastewater. Phenotypic analysis of the wastewater isolates confirmed their production of extended-spectrum β-lactamases (ESBLs) and/or carbapenemases, and revealed their multidrug-resistant phenotype, while genomic analysis identified ESBL and/or carbapenemase genes as well as resistance genes to other antimicrobial classes. Molecular epidemiology revealed that most Escherichia coli, Klebsiella spp., and Enterobacter cloacae complex were human-associated clones, while ST131 and ST361 E. coli and ST101 K. pneumoniae were recognized as high-risk clones and emerging high-risk clones. These results emphasize the need to use advanced treatment technologies for municipal wastewater treatment and hospital wastewater pre-treatment to control the spread of these critical pathogens, which are resistant to clinically important antibiotics, into the environment
Item Type: | Thesis (Doctoral thesis) | ||||||||
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Uncontrolled Keywords: | Enterobacterales; extended-spectrum β-lactamases; carbapenemases; wastewater treatment plant; treated wastewater; hospital wastewater; antimicrobial resistance | ||||||||
Subjects: | BIOTECHNICAL SCIENCES BIOTECHNICAL SCIENCES > Biotechnology |
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Divisions: | Division for Marine and Enviromental Research | ||||||||
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Depositing User: | Ana Puljko | ||||||||
Date Deposited: | 18 Jun 2024 08:42 | ||||||||
URI: | http://fulir.irb.hr/id/eprint/8906 |
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