[论文解读] Tracking Carbapenem-Resistant Pathogens in Hospital Wastewater: the focus on Acinetobacter baumannii and Pseudomonas aeruginosa

Magdalena Męcik, Kornelia Stefaniak+6 more|arXiv (Cornell University)|Mar 15, 2026

Antibiotic Resistance in Bacteria被引用 0

一句话总结

该研究对波兰医院废水进行调查，以绘制克雷巴氏脓样铜绿假单胞菌（CRPA）和铜绿假单胞菌属拟杆菌相关的耐 carbapenem药物的分布图，揭示CRPA普遍存在、CRAB基因型多样，以及耐药基因、废水理化性质与抗生素浓度之间的关联。

ABSTRACT

Carbapenem-resistant Pseudomonas aeruginosa (CRPA) and Acinetobacter baumannii (CRAB) represent a major clinical and epidemiological challenge and pose a growing threat to public health and the environment. Accordingly, CRPA and CRAB were investigated in hospital wastewater (HWW) collected during winter and summer 2024 from 64 healthcare facilities across all 16 Polish voivodeships. To our knowledge, this study constitutes the first nationwide, large-scale assessment in Poland of carbapenem resistance in these high-risk pathogens in hospital wastewater. The study aimed to determine the prevalence of carbapenem-resistant bacteria (CRB) in HWW discharged into the public sewer system and municipal wastewater treatment plants (WWTPs). In addition, associations between CRB prevalence, hospital geographic location, and sampling season were analyzed to identify spatial and temporal patterns of carbapenem resistance (CR). Carbapenem-resistant P. aeruginosa were predominant in all studied regions. Carbapenem-resistant A. baumannii were identified in a smaller percentage of samples and were characterized by greater genotypic diversity. The ERIC-PCR assay confirmed the presence of both closely related strains and unique genetic profiles, which suggests that CRB emissions into the environment have a complex character. The statistical analysis revealed significant relationships between CRB counts, the physicochemical parameters of HWW, and antibiotic concentrations in HWW samples. In addition, the tested samples harbored many antibiotic resistance genes (ARGs), which confirms that HWW is a significant reservoir of mobile genetic elements (MGEs) involved in the spread of antibiotic resistance. The results of the study indicate that HWW should be rigorously monitored and managed to minimize risks to public health and environment.

研究动机与目标

• 评估跨波兰公共下水道系统和市政废水处理厂排放的医院废水中克雷巴耐药细菌的普遍性。
• 表征物种分布（CRPA和CRAB）并评估地理与季节（2024年冬季与夏季）的模式。
• 评估CRB计数与废水理化参数及抗生素浓度之间的关联。
• 通过分子分型和ARG/MGE的存在来识别遗传多样性和易位性，以推断环境传播潜力。

提出的方法

• 在波兰16个省辖市的64家医疗机构的医院废水中采集样本，时间覆盖2024年冬季和夏季。
• 使用合适的微生物学和分子方法（ERIC-PCR做分型）来检测和表征CRPA和CRAB。
• 分析CRB流行与地理位置、季节以及废水理化参数之间的关联。
• 筛选样本中的抗生素耐药基因（ARGs）和移动遗传元件（MGEs）。

实验结果

研究问题

• RQ1 克雷巴耐药铜绿假单胞菌和鲍氏不动杆菌在波兰医院废水中的普遍性如何？
• RQ2 CRB计数是否与医院地理位置和采样季节相关？
• RQ3 废水理化参数和抗生素浓度是否与CRB流行相关？
• RQ4 医院废水中CRB菌株的基因型多样性及ARGs/MGEs的存在情况如何？

主要发现

• CRPA在波兰所有研究区域占主导地位。
• CRAB在样本中所占比例较小，但表现出更高的基因型多样性。
• ERIC-PCR显示CRB型谱既有高度相关也存在独特性，表明环境排放复杂。
• 统计分析显示CRB计数与废水理化参数及抗生素浓度之间存在显著关系。
• 样本中存在大量ARGs，确认医院废水是涉及耐药传播的MGEs的储库。
• 结果支持对医院废水进行严格监测与管理，以降低对公共健康和环境的风险。