Urban wastewater contributes to the emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) in an urban receiving river in eastern India.

This article focuses on the emergence and characterization of carbapenem-resistant Klebsiella pneumoniae (CRKP) in the urban river system surrounding Cuttack city, Odisha, India, highlighting its public health implications. The study found high levels of CRKP exhibiting multidrug and extreme drug resistance, with 100% resistance to several β-lactam antibiotics and carbapenems, and identified key carbapenemase genes (blaNDM, blaOXA-48-like, blaKPC) and extended-spectrum β-lactamase (ESBL) genes correlated significantly with toxic metals such as arsenic, cadmium, cobalt, copper, iron, manganese, and lead in the river water. Molecular typing revealed dissemination of genetically related CRKP clones from untreated wastewater into the river, while detection of virulence factors and capsular serotypes (K1, K2, K54) indicated pathogenic potential. The findings underscore the role of anthropogenic pollution, including hospital and domestic wastewater discharge, in spreading antibiotic resistance in aquatic environments and emphasize the need for regular molecular surveillance and improved wastewater treatment to mitigate public health risks.