Routine wastewater-based monitoring of antibiotic resistance in two Finnish hospitals: focus on carbapenem resistance genes and genes associated with bacteria causing hospital-acquired infections

SummaryBackground Wastewater-based monitoring represents a useful tool for antibiotic resistance surveillance. Aim To investigate the prevalence and abundance of genes (ARGs) in hospital wastewater over time. Methods Wastewater from two hospitals Finland (HUS1 HUS2) was monitored weekly nine weeks (weeks 25–33) summer 2020. A high-throughput real-time polymerization chain reaction (HT-qPCR) system used to detect quantify 216 ARGs associated with mobile genetic elements (MGEs), integrons, bacteria causing hospital-acquired infections (HAIs), as well 16S rRNA gene. Data HT-qPCR were analysed visualized using novel digital platform, ResistApp. Eight carbapenem (blaGES, blaKPC, blaVIM, blaNDM, blaCMY, blaMOX, blaOXA48, blaOXA51) three HAIs (Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa) studied. Findings There significantly higher number at both 27–30 (174–191 genes) compared other sampling (151–171 genes). Our analyses also indicated that hospitals, which different amounts antibiotics, had gene profiles. Carbapenem more prevalent abundant HUS1 than HUS2. Across blaGES blaVIM most abundant. strong positive association between blaKPC K. pneumoniae wastewater. Conclusion Routine wastewater-based ResistApp can provide valuable information on hospitals. This helps understand spread identify potential areas intervention.