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Public health risk assessment of the presence of ESKAPE pathogens in environmental samples

Georgiou Anna

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Summary

The growing threat of antimicrobial resistance represents a critical challenge for global public health. This study focuses on the risk assessment posed by the presence of ESKAPE pathogens in environmental samples, with a particular emphasis on Klebsiella pneumoniae, Staphylococcus aureus, and Enterobacter sp. These opportunistic pathogens are known for their capacity to resist multiple classes of antibiotics and are responsible for a significant portion of healthcare-associated infections (HAIs). Their increasing detection in environmental matrices raises serious concerns about their potential dissemination from environmental reservoirs to human populations.Environmental water samples were collected from coastal, freshwater, and wastewater treatment sites in the region of Chania, Crete, between November 2023 and April 2024. Isolation of bacterial strains was achieved using filtration methods, while antimicrobial susceptibility was assessed through Minimum Inhibitory Concentration (MIC) testing against a panel of commonly used antibiotics. Additionally, the efficacy of UVC irradiation was evaluated as a disinfection method to reduce microbial load and potentially deactivate resistant strains.Results revealed widespread occurrence of the targeted pathogens across all sampling points, with several isolates demonstrating high resistance levels to critical antibiotics such as methicillin, vancomycin, and ciprofloxacin. Notably, both methicillin-resistant S. aureus (MRSA) and carbapenem-resistant K. pneumoniae were detected, underlining the environmental presence of clinically significant multidrug-resistant organisms. Although UVC treatment significantly reduced bacterial counts, complete inactivation was not always achieved, especially in samples with higher turbidity or microbial loads.The findings confirm the role of aquatic environments as reservoirs and potential transmission routes for antimicrobial resistance. They also highlight the limitations of current wastewater treatment technologies in eliminating resistant bacteria and support the need for integrated monitoring strategies and advanced disinfection approaches.This study contributes valuable insights into the environmental dimension of antimicrobial resistance and supports the development of targeted public health strategies. The integration of innovative technologies such as UVC irradiation and routine environmental surveillance may help mitigate the dissemination of resistant pathogens, thereby enhancing overall public health preparedness and resilience.

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