{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:56:47Z","timestamp":1787029007707,"version":"build-2736575974"},"reference-count":19,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T00:00:00Z","timestamp":1630627200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Sink waste traps and drains are a reservoir for multi-drug resistant Gram-negative bacteria in the hospital environment. It has been suggested that these bacteria can migrate through hospital plumbing. Hospital waste traps were installed in a laboratory model system where sinks were connected through a common wastewater pipe. Enterobacterales populations were monitored using selective culture, MALDI-TOF identification and antibiotic resistance profiling before and after a wastewater backflow event. When transfer between sinks was suspected, isolates were compared using whole-genome sequencing. Immediately after the wastewater backflow, two KPC-producing Enterobacter cloacae were recovered from a waste trap in which Carbapenemase-producing Enterobacterales (CPE) had not been detected previously. The isolates belonged to ST501 and ST31 and were genetically indistinguishable to those colonising sinks elsewhere in the system. Following inter-sink transfer, KPC-producing E. cloacae ST501 successfully integrated into the microbiome of the recipient sink and was detected in the waste trap water at least five months after the backflow event. Seven weeks and three months after the backflow, other inter-sink transfers involving Escherichia coli ST5295 and KPC-producing E. cloacae ST501 were also observed.<\/jats:p>","DOI":"10.3390\/microorganisms9091868","type":"journal-article","created":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T13:18:26Z","timestamp":1630934306000},"page":"1868","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Migration of Escherichia coli and Klebsiella pneumoniae Carbapenemase (KPC)-Producing Enterobacter cloacae through Wastewater Pipework and Establishment in Hospital Sink Waste Traps in a Laboratory Model System"],"prefix":"10.3390","volume":"9","author":[{"given":"Paz","family":"Aranega-Bou","sequence":"first","affiliation":[{"name":"Biosafety, Air and Water Microbiology Group, National Infection Service, Public Health England, Manor Farm Rd, Porton Down, Salisbury SP4 0JG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Ellaby","sequence":"additional","affiliation":[{"name":"Antimicrobial Resistance and Health Care Associated Infections, National infection Service, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Ellington","sequence":"additional","affiliation":[{"name":"National Infection Service Laboratories, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ginny","family":"Moore","sequence":"additional","affiliation":[{"name":"Biosafety, Air and Water Microbiology Group, National Infection Service, Public Health England, Manor Farm Rd, Porton Down, Salisbury SP4 0JG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1378\/chest.14-2171","article-title":"Antimicrobial Resistance in Hospital-Acquired Gram-Negative Bacterial Infections","volume":"147","author":"Mehrad","year":"2015","journal-title":"Chest"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.molmed.2012.03.003","article-title":"Carbapenem resistance in Enterobacteriaceae: Here is the storm!","volume":"18","author":"Nordmann","year":"2012","journal-title":"Trends Mol. 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Control"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e01730-17","DOI":"10.1128\/AAC.01730-17","article-title":"A Systematic Review and Meta-analyses of the Clinical Epidemiology of Carbapenem-Resistant Enterobacteriaceae","volume":"62","author":"Holt","year":"2018","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1017\/ice.2018.138","article-title":"Wastewater drains: Epidemiology and interventions in 23 carbapenem-resistant organism outbreaks","volume":"39","author":"Carling","year":"2018","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_8","first-page":"mgen000391","article-title":"Genomic surveillance of Escherichia coli and Klebsiella spp. in hospital sink drains and patients","volume":"6","author":"Constantinides","year":"2020","journal-title":"Microb. 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Infect."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/9\/9\/1868\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:55:28Z","timestamp":1760165728000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/9\/9\/1868"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,3]]},"references-count":19,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["microorganisms9091868"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms9091868","relation":{"has-preprint":[{"id-type":"doi","id":"10.20944\/preprints202107.0236.v1","asserted-by":"object"}]},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,3]]}}}