Open AccessPopulation Screening Using Sewage Reveals Pan-Resistant Bacteria in Hospital and Community Samples
Author(s) -
Lital Meir-Gruber,
Yossi Manor,
Shiraz Gefen-Halevi,
Musa Hindiyeh,
Fernando Mileguir,
Roberto Azar,
Gill Smollan,
Natasha Belausov,
Galia Rahav,
Ari Shamiss,
Ella Mendelson,
Nathan Keller
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0164873
Subject(s) - sewage , enterobacter cloacae , enterobacter , klebsiella pneumonia , microbiology and biotechnology , bacteria , citrobacter , klebsiella , biology , population , veterinary medicine , medicine , klebsiella pneumoniae , escherichia coli , staphylococcus aureus , environmental science , environmental health , environmental engineering , biochemistry , genetics , gene
The presence of pan-resistant bacteria worldwide possesses a threat to global health. It is difficult to evaluate the extent of carriage of resistant bacteria in the population. Sewage sampling is a possible way to monitor populations. We evaluated the presence of pan-resistant bacteria in Israeli sewage collected from all over Israel, by modifying the pour plate method for heterotrophic plate count technique using commercial selective agar plates. This method enables convenient and fast sewage sampling and detection. We found that sewage in Israel contains multiple pan-resistant bacteria including carbapenemase resistant Enterobacteriacae carrying bla KPC and bla NDM-1 , MRSA and VRE. bla KPC carrying Klebsiella pneumonia and Enterobacter cloacae were the most common Enterobacteriacae drug resistant bacteria found in the sewage locations we sampled. Klebsiella pneumonia , Enterobacter spp., Escherichia coli and Citrobacter spp. were the 4 main CRE isolated from Israeli sewage and also from clinical samples in our clinical microbiology laboratory. Hospitals and Community sewage had similar percentage of positive samplings for bla KPC and bla NDM-1 . VRE was found to be more abundant in sewage in Israel than MRSA but there were more locations positive for MRSA and VRE bacteria in Hospital sewage than in the Community. Therefore, our upgrade of the pour plate method for heterotrophic plate count technique using commercial selective agar plates can be a useful tool for routine screening and monitoring of the population for pan-resistant bacteria using sewage.