BMC microbiology · 2026
Clinically significant Klebsiella pneumoniae persistence in wastewater: co-occurrence of virulence and multidrug resistance genes.
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Abdelgalel Reham R, Ibrahem Reham Ali, Ahmed Abo Bakr F, Mohamed Doaa Safwat
Аннотация
BACKGROUND: Wastewater monitoring is an effective approach for assessing public health, providing insight into circulating pathogens and their associated antimicrobial resistance genes. Klebsiella pneumoniae, a clinically and environmentally significant opportunistic pathogen, was investigated in this study.
METHODS: 120 wastewater samples were collected from various sources, and the isolates were analyzed for antimicrobial susceptibility using the Kirby-Bauer disk diffusion method against 11 antibiotics, in addition to PCR-based detection of β-lactamase and virulence genes.
RESULTS: Among 81 K. pneumoniae isolates from different wastewater sources, 51% were resistant to at least one antibiotic, with hospital wastewater being the main source of resistant strains (74.2%), followed by community wastewater (50%), WWTP influent (35%), and effluent (21.4%). Resistance was most frequent to ampicillin/sulbactam (35.8%), whereas gentamicin showed the highest efficacy (4.9%). Multidrug resistance was observed in 53.7% of resistant isolates, primarily in samples from hospitals (69.6%) and WWTP influents (57.1%). ESBL producers accounted for 67.5% of isolates, while 32.5% co-produced ESBLs and carbapenemases. The blaSHV gene was detected in all isolates (100%), while blaOXA-48 (22.5%) was the most common carbapenemase gene. Almost all isolates (98.8%) possessed at least one virulence gene, with mrkD (96.3%) and entB (79.0%) being the most detected. Additionally, 86.5% of the isolates carried two or more virulence genes. Notably, no hypervirulent strains were observed.
CONCLUSION: Overall, wastewater from diverse sources constitutes a significant reservoir of multidrug-resistant and virulent K. pneumoniae strains. Their environmental release poses a considerable public health risk, highlighting the urgent need for improved wastewater management and continuous microbial surveillance.
METHODS: 120 wastewater samples were collected from various sources, and the isolates were analyzed for antimicrobial susceptibility using the Kirby-Bauer disk diffusion method against 11 antibiotics, in addition to PCR-based detection of β-lactamase and virulence genes.
RESULTS: Among 81 K. pneumoniae isolates from different wastewater sources, 51% were resistant to at least one antibiotic, with hospital wastewater being the main source of resistant strains (74.2%), followed by community wastewater (50%), WWTP influent (35%), and effluent (21.4%). Resistance was most frequent to ampicillin/sulbactam (35.8%), whereas gentamicin showed the highest efficacy (4.9%). Multidrug resistance was observed in 53.7% of resistant isolates, primarily in samples from hospitals (69.6%) and WWTP influents (57.1%). ESBL producers accounted for 67.5% of isolates, while 32.5% co-produced ESBLs and carbapenemases. The blaSHV gene was detected in all isolates (100%), while blaOXA-48 (22.5%) was the most common carbapenemase gene. Almost all isolates (98.8%) possessed at least one virulence gene, with mrkD (96.3%) and entB (79.0%) being the most detected. Additionally, 86.5% of the isolates carried two or more virulence genes. Notably, no hypervirulent strains were observed.
CONCLUSION: Overall, wastewater from diverse sources constitutes a significant reservoir of multidrug-resistant and virulent K. pneumoniae strains. Their environmental release poses a considerable public health risk, highlighting the urgent need for improved wastewater management and continuous microbial surveillance.