Fig. 1
Clustering analysis using Jaccard similarity based on distinctive traits of the 3rd generation cephalosporin-resistant K. pneumoniae isolates. Antibiotic classes tested: β-lactams and carbapenems (AMC-Amoxicillin+Clavulanate (20/10 μg); MEM-Meropenem (10 μg)); aminoglycosides (CN-Gentamicin (10 μg)); AK-Amikacin (30 μg)); quinolones (CIP-Ciprofloxacin (5 μg)); sulfonamides (SXT-Sulfamethoxazole/Trimethoprim (1.25/23.75 μg); RL-Sulfamethoxazole (25 μg); W–Trimethoprim (5 μg)); and tetracyclines (TE-Tetracycline(30 μg)). ARGs blaIMP, blaVIM and mcr were also screened and were not detected in none of the isolates. All the isolates showed a resistance phenotype against amoxicillin and aztreonam. Red, green and blue symbols in the dendrogram refer to isolates obtained from patients, wastewater and clinical settings, respectively. Colors in the table refer to the trait presence and different colors refer to different sequence types. A to F letters in the dendrogram refer to the main clusters identified. C-P – clinical isolate obtained from patients; C-E – isolate obtained from clinical environment; HE – hospital effluent; RWW – raw influent wastewater; sTWW – secondary treatment effluent wastewater; tTWW – tertiary treatment effluent wastewater; N.D. - not determined; LB - Luria-Bertani; mLB - modified Luria-Bertani; ST – sequence type; CKP – clinical K. pneumoniae; EKP – environmental K. pneumoniae; CEKP – clinical environment K. pneumoniae