- Article
18 Pages
Carbapenem-resistant bacteria (CRB) are increasingly documented in wastewater-impacted rivers, but their distribution along the entire river continuum remains poorly understood. We analysed CRB distribution in a river ecosystem, from reference river source to sites heavily affected by hospital and urban wastewater. The CRB populations cultivated at 42, 35, and 22 °C (CR42; CR35; CR22) were quantified along with heterotrophic bacteria and intestinal enterococci. CR35 and CR22 fractions were detected throughout the river continuum, including the river source, suggesting that presumably environmental CRB may form a widespread population in these rivers. CR42 fraction was absent from river source and occurred at significantly lower concentrations at low-anthropogenic-impact sites compared to wastewater-impacted locations. CRB species of public health importance, such as Acinetobacter baumannii, Klebsiella pneumoniae, Enterobacter cloacae, and Enterobacter bugandensis were predominately isolated at 42 °C and recovered only on sites downstream of hospital and wastewater treatment plant discharge. Overall, CRB of public health interest were associated with hospital and urban wastewater inputs, whereas presumably environmental CRB represented a widespread background population throughout the entire river flow. Cultivation at 42 °C, combined with species-level identification, provided a potential approach for distinguishing the wastewater-associated fraction from the environmental background.
Processes
23 October 2026


![Schematic representation of cultivable CRB populations recovered at different incubation temperatures (22, 35, and 42 °C). Circle sizes approximately reflect the relative abundance of these populations, as estimated from the results of the present study and the available literature [4,15,19]. HB = heterotrophic bacteria cultivable at 22 °C.](https://mdpi-res.com/processes/processes-14-03402/article_deploy/html/images/processes-14-03402-ag-550.jpg)




