Detection of vancomycin-resistant Enterococcus faecium hospital-adapted lineages in municipal wastewater treatment plants indicates widespread distribution and release into the environment

Research output: Contribution to journalArticlepeer-review

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Detection of vancomycin-resistant Enterococcus faecium hospital-adapted lineages in municipal wastewater treatment plants indicates widespread distribution and release into the environment. / Gouliouris, Theodore; Raven, Kathy E; Moradigaravand, Danesh; Ludden, Catherine; Coll, Francesc; Blane, Beth; Naydenova, Plamena; Horner, Carolyne; Brown, Nicholas M; Corander, Jukka; Limmathurotsakul, Direk; Parkhill, Julian; Peacock, Sharon J.

In: Genome Research, Vol. 29, No. 4, 01.04.2019, p. 626-634.

Research output: Contribution to journalArticlepeer-review

Harvard

Gouliouris, T, Raven, KE, Moradigaravand, D, Ludden, C, Coll, F, Blane, B, Naydenova, P, Horner, C, Brown, NM, Corander, J, Limmathurotsakul, D, Parkhill, J & Peacock, SJ 2019, 'Detection of vancomycin-resistant Enterococcus faecium hospital-adapted lineages in municipal wastewater treatment plants indicates widespread distribution and release into the environment', Genome Research, vol. 29, no. 4, pp. 626-634. https://doi.org/10.1101/gr.232629.117

APA

Gouliouris, T., Raven, K. E., Moradigaravand, D., Ludden, C., Coll, F., Blane, B., Naydenova, P., Horner, C., Brown, N. M., Corander, J., Limmathurotsakul, D., Parkhill, J., & Peacock, S. J. (2019). Detection of vancomycin-resistant Enterococcus faecium hospital-adapted lineages in municipal wastewater treatment plants indicates widespread distribution and release into the environment. Genome Research, 29(4), 626-634. https://doi.org/10.1101/gr.232629.117

Vancouver

Author

Gouliouris, Theodore ; Raven, Kathy E ; Moradigaravand, Danesh ; Ludden, Catherine ; Coll, Francesc ; Blane, Beth ; Naydenova, Plamena ; Horner, Carolyne ; Brown, Nicholas M ; Corander, Jukka ; Limmathurotsakul, Direk ; Parkhill, Julian ; Peacock, Sharon J. / Detection of vancomycin-resistant Enterococcus faecium hospital-adapted lineages in municipal wastewater treatment plants indicates widespread distribution and release into the environment. In: Genome Research. 2019 ; Vol. 29, No. 4. pp. 626-634.

Bibtex

@article{d0714ba21e4142189e6545fbc25dbb05,
title = "Detection of vancomycin-resistant Enterococcus faecium hospital-adapted lineages in municipal wastewater treatment plants indicates widespread distribution and release into the environment",
abstract = "Vancomycin-resistant Enterococcus faecium (VREfm) is a leading cause of healthcare-associated infection. Reservoirs of VREfm are largely assumed to be nosocomial although there is a paucity of data on alternative sources. Here, we describe an integrated epidemiological and genomic analysis of E. faecium associated with bloodstream infection and isolated from wastewater. Treated and untreated wastewater from 20 municipal treatment plants in the East of England, United Kingdom was obtained and cultured to isolate E. faecium, ampicillin-resistant E. faecium (AREfm), and VREfm. VREfm was isolated from all 20 treatment plants and was released into the environment by 17/20 plants, the exceptions using terminal ultraviolet light disinfection. Median log10 counts of AREfm and VREfm in untreated wastewater from 10 plants in direct receipt of hospital sewage were significantly higher than 10 plants that were not. We sequenced and compared the genomes of 423 isolates from wastewater with 187 isolates associated with bloodstream infection at five hospitals in the East of England. Among 481 E. faecium isolates belonging to the hospital-adapted clade, we observed genetic intermixing between wastewater and bloodstream infection, with highly related isolates shared between a major teaching hospital in the East of England and 9/20 plants. We detected 28 antibiotic resistance genes in the hospital-adapted clade, of which 23 were represented in bloodstream, hospital sewage, and municipal wastewater isolates. We conclude that our findings are consistent with widespread distribution of hospital-adapted VREfm beyond acute healthcare settings with extensive release of VREfm into the environment in the East of England.",
keywords = "Anti-Bacterial Agents/toxicity, Cross Infection/microbiology, Drug Resistance, Bacterial, England, Enterococcus faecium/drug effects, Genome, Bacterial, Vancomycin/toxicity, Waste Water/microbiology",
author = "Theodore Gouliouris and Raven, {Kathy E} and Danesh Moradigaravand and Catherine Ludden and Francesc Coll and Beth Blane and Plamena Naydenova and Carolyne Horner and Brown, {Nicholas M} and Jukka Corander and Direk Limmathurotsakul and Julian Parkhill and Peacock, {Sharon J}",
note = "{\textcopyright} 2019 Gouliouris et al.; Published by Cold Spring Harbor Laboratory Press.",
year = "2019",
month = apr,
day = "1",
doi = "10.1101/gr.232629.117",
language = "English",
volume = "29",
pages = "626--634",
journal = "Genome Research",
issn = "1088-9051",
publisher = "Cold Spring Harbor Laboratory Press",
number = "4",

}

RIS

TY - JOUR

T1 - Detection of vancomycin-resistant Enterococcus faecium hospital-adapted lineages in municipal wastewater treatment plants indicates widespread distribution and release into the environment

AU - Gouliouris, Theodore

AU - Raven, Kathy E

AU - Moradigaravand, Danesh

AU - Ludden, Catherine

AU - Coll, Francesc

AU - Blane, Beth

AU - Naydenova, Plamena

AU - Horner, Carolyne

AU - Brown, Nicholas M

AU - Corander, Jukka

AU - Limmathurotsakul, Direk

AU - Parkhill, Julian

AU - Peacock, Sharon J

N1 - © 2019 Gouliouris et al.; Published by Cold Spring Harbor Laboratory Press.

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Vancomycin-resistant Enterococcus faecium (VREfm) is a leading cause of healthcare-associated infection. Reservoirs of VREfm are largely assumed to be nosocomial although there is a paucity of data on alternative sources. Here, we describe an integrated epidemiological and genomic analysis of E. faecium associated with bloodstream infection and isolated from wastewater. Treated and untreated wastewater from 20 municipal treatment plants in the East of England, United Kingdom was obtained and cultured to isolate E. faecium, ampicillin-resistant E. faecium (AREfm), and VREfm. VREfm was isolated from all 20 treatment plants and was released into the environment by 17/20 plants, the exceptions using terminal ultraviolet light disinfection. Median log10 counts of AREfm and VREfm in untreated wastewater from 10 plants in direct receipt of hospital sewage were significantly higher than 10 plants that were not. We sequenced and compared the genomes of 423 isolates from wastewater with 187 isolates associated with bloodstream infection at five hospitals in the East of England. Among 481 E. faecium isolates belonging to the hospital-adapted clade, we observed genetic intermixing between wastewater and bloodstream infection, with highly related isolates shared between a major teaching hospital in the East of England and 9/20 plants. We detected 28 antibiotic resistance genes in the hospital-adapted clade, of which 23 were represented in bloodstream, hospital sewage, and municipal wastewater isolates. We conclude that our findings are consistent with widespread distribution of hospital-adapted VREfm beyond acute healthcare settings with extensive release of VREfm into the environment in the East of England.

AB - Vancomycin-resistant Enterococcus faecium (VREfm) is a leading cause of healthcare-associated infection. Reservoirs of VREfm are largely assumed to be nosocomial although there is a paucity of data on alternative sources. Here, we describe an integrated epidemiological and genomic analysis of E. faecium associated with bloodstream infection and isolated from wastewater. Treated and untreated wastewater from 20 municipal treatment plants in the East of England, United Kingdom was obtained and cultured to isolate E. faecium, ampicillin-resistant E. faecium (AREfm), and VREfm. VREfm was isolated from all 20 treatment plants and was released into the environment by 17/20 plants, the exceptions using terminal ultraviolet light disinfection. Median log10 counts of AREfm and VREfm in untreated wastewater from 10 plants in direct receipt of hospital sewage were significantly higher than 10 plants that were not. We sequenced and compared the genomes of 423 isolates from wastewater with 187 isolates associated with bloodstream infection at five hospitals in the East of England. Among 481 E. faecium isolates belonging to the hospital-adapted clade, we observed genetic intermixing between wastewater and bloodstream infection, with highly related isolates shared between a major teaching hospital in the East of England and 9/20 plants. We detected 28 antibiotic resistance genes in the hospital-adapted clade, of which 23 were represented in bloodstream, hospital sewage, and municipal wastewater isolates. We conclude that our findings are consistent with widespread distribution of hospital-adapted VREfm beyond acute healthcare settings with extensive release of VREfm into the environment in the East of England.

KW - Anti-Bacterial Agents/toxicity

KW - Cross Infection/microbiology

KW - Drug Resistance, Bacterial

KW - England

KW - Enterococcus faecium/drug effects

KW - Genome, Bacterial

KW - Vancomycin/toxicity

KW - Waste Water/microbiology

U2 - 10.1101/gr.232629.117

DO - 10.1101/gr.232629.117

M3 - Article

C2 - 30898881

VL - 29

SP - 626

EP - 634

JO - Genome Research

JF - Genome Research

SN - 1088-9051

IS - 4

ER -