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In a clinical setting it seems to be normal these days that a relevant proportion or even the majority of different bacterial species has already one or more acquired antibiotic resistances. Unfortunately, the overuse of antibiotics for livestock breeding and medicine has also altered the wild-type resistance profiles of many bacterial species in different environmental settings. As a matter of fact, getting in contact with resistant bacteria is no longer restricted to hospitals. Beside food and food production, the aquatic environment might also play an important role as reservoir and carrier. The aim of this study was the assessment of the resistance patterns of  Escherichia coli  and  Klebsiella  spp. out of surface water without prior enrichment and under non-selective culture conditions (for antibiotic resistance). In addition, the presence of clinically important extended spectrum beta lactamase (ESBL) and carbapenmase harboring  Enterobacteriaceae  should be investigated. During Joint Danube Survey 3 (2013), water samples were taken over the total course of the River Danube. Resistance testing was performed for 21 different antibiotics. Samples were additionally screened for ESBL or carbapenmase harboring  Enterobacteriaceae . 39% of all isolated  Escherichia coli  and 15% of all  Klebsiella  spp. from the river Danube had at least one acquired resistance. Resistance was found against all tested antibiotics except tigecycline. Taking a look on the whole stretch of the River Danube the proportion of multiresistances did not differ significantly. In total, 35 ESBL harboring  Enterobacteriaceae , 17  Escherichia coli , 13  Klebsiella pneumoniae  and five  Enterobacter  spp. were isolated. One  Klebsiella pneumoniae  harboring NMD-1 carbapenmases and two  Enterobacteriaceae  with KPC-2 could be identified. Human generated antibiotic resistance is very common in  E .  coli  and  Klebsiella  spp. in the River Danube. Even isolates with resistance patterns normally associated with intensive care units are present.

Enterobacteriaceae Isolated from the River Danube: Antibiotic Resistances, with a Focus on the Presence of ESBL and Carbapenemases