Inactivation of carbapenem-resistant Klebsiella pneumoniae by photo-Fenton: Residual effect, gene evolution and modifications with citric acid and persulfate

Abstract The photo-Fenton process application to eliminate carbapenem-resistant Klebsiella pneumoniae, an antibiotic-resistant priority pathogen, was evaluated. Initially, reagents concentration effect was tested and under suitable conditions (5 mg L −1 of Fe 2+ and 50 mg L −1 of H 2 O 2 ) complete bacteria inactivation by action of hydroxyl radical and UVA plus hydrogen peroxide was achieved at 120 min. The process presented a strong residual disinfecting effect when light was turned off at only 20 min. Besides, the cultivability of treated K. pneumoniae in a selective medium containing carbapenem antibiotics was considered. bla-KPC , gene responsible for the resistance, evolution was also assessed. The bacteria response to carbapenem antibiotics was higher as the treatment time increased. In turn, bla-KPC gene remained when K. pneumoniae was completely inactivated (120 min); nevertheless, treatment times longer than 120 min diminished bla -KPC presence. Finally, the photo-Fenton process and its modifications (citric acid addition or persulfate anion instead hydrogen peroxide) were applied to a real hospital wastewater in Colombia. In such complex matrix, the conventional photo-Fenton system reached a moderate disinfection (∼3.5 log-units at 300 min). Meanwhile, in presence of citric acid total inactivation was completed at the same time. Interestingly, the H 2 O 2 substitution by persulfate strongly accelerated the microorganism elimination, achieving the 6-log-units reduction after only 60 min of process action. Thus, the effective elimination of K. pneumoniae from water by the modified photo-Fenton evidenced the potential applicability of this process to limit the proliferation of antibiotic resistant bacteria.