Prevalence, Characterization, and Epidemiological Relationships between ESBL and Carbapenemase-Producing Escherichia coli , Klebsiella pneumoniae, and Acinetobacter spp. Isolated from Humans and the Kitchen Environment of Two Greek Hospitals

Extended-spectrum-β-lactamase (ESBL) and carbapenemase-producing Enterobacterales and spp. pose significant challenges as nosocomial pathogens, demonstrating resistance against various antimicrobials. Their presence in food suggests that hospital kitchens could serve as antibiotic resistance reservoirs leading to patients' infection. The aim of this study was to assess the prevalence and characteristics of β-lactam-resistant strains of , , and spp. isolated from the kitchen environment and from the staff of two Greek hospitals. Strains were recovered after selective isolation with β-lactams and were identified with MALDI-TOF MS. Antimicrobial susceptibility and presence of common β-lactamase genes were evaluated. Protein profiles were examined to analyze potential relationships of the strain with those from hospital patients. strains were further categorized into phylogenetic groups. The overall prevalence in the kitchen environment was 4.5%, 1.5%, and 15.0% for , and spp., respectively, whereas the prevalence of spp. in human skin was 4.0%. Almost all strains were multidrug-resistant. All strains were ESBL producers and belonged to phylogroups A and B1. All and seven strains were carbapenemase-producers. A protein profile analysis showed relatedness between chicken and kitchen environment strains, as well as between kitchen environment and patient strains originated either from the same or from different hospitals. The results suggest that hospital kitchens may act as important pathogen hotspots contributing to the circulation of resistant strains in the hospital environment.