Recycled wastewater is vital for the circular economy, especially on water-scarce islands. This study explored the presence of Carbapenem-Resistant Enterobacterales and other emerging pathogens in irrigation water on four Canarian Islands, applying a One Health perspective. Using membrane filtration and MALDI-TOF mass spectrometry, 69 bacterial isolates were identified. The findings revealed that 78% were Gram-negative bacilli like Pseudomonas aeruginosa, Acinetobacter spp., Enterobacteriaceae, etc., while 22% were Gram-positive bacteria, including Enterococcus spp. The main mechanisms of carbapenem resistance in Pseudomonas spp. and Acinetobacter spp. were oxacillinases, followed by metallo-β-lactamases (MBL). In Enterobacteriaceae, characterization of carbapenemase types was less frequent, with oxacillinase 48 (OXA-48) being the most prevalent. The detection of multidrug-resistant organisms in recycled wastewater highlights an urgent need for routine microbiological monitoring in water management to protect both public health and agricultural sustainability.

C. difficile is a major cause of antibiotic-associated diarrhea and hospital-acquired infections, although increasing community-acquired cases suggest alternative transmission routes. Livestock, particularly pigs, have been proposed as potential reservoirs. This study aimed to investigate the presence of zoonotic ribotypes in piglets from Tenerife (Spain) and to assess their pathogenic potential by detecting toxin genes. A total of 140 samples were analyzed, including 58 fecal samples from slaughtered piglets (4–8 weeks old) and 82 rectal swabs from piglets aged 2–25 days. Samples were cultured, identified by MALDI-TOF MS, and characterized by PCR ribotyping and toxin gene detection. No isolates were obtained from fecal samples collected at slaughter, whereas 14 (17%) rectal swabs were positive. Colonization was strongly age-dependent, with the highest prevalence at 2 days of age (100%), decreasing by day 9 (10.7%), and absent after 21 days (p < 0.05). All isolates were ribotype RT033 with a tcdA⁺/tcdB⁻/cdtA⁺/cdtB⁺ profile. The exclusive detection of RT033, a clade V lineage linked to animal reservoirs and occasional human infections, suggests a potential zoonotic risk, especially for farm workers. These findings reinforce the need for integrated C. difficile surveillance under a One Health framework to monitor emerging ribotypes and their role in community-acquired infections.

A Recycled wastewater is vital for circular economy, especially on water-scarce islands. This study explored the presence of Carbapenem-Resistant Enterobacterales and other emerging pathogens in irrigation water on four Canarian Islands, applying a One Health perspective. Using membrane filtration and MALDI-TOF mass spectrometry, 69 bacterial isolates were identified. The finding reveals that 50% were gram-negative bacilli like Pseudomonas aeruginosa and Acinetobacter spp., while 30% were Enterobacteriaceae, including Klebsiella pneumoniae and Escherichia coli. The main mechanisms of carbapenem resistance in Pseudomonas and Acinetobacter were oxacillinases, followed by metallo-β-lactamases (MBL). In Enterobacteriaceae, characterization of carbapenemase types was less frequent, with OXA-48 being the most prevalent. The detection of multidrug-resistant organisms in recycled wastewater highlights an urgent need for routine microbiological monitoring in water management protecting public health and agricultural sustainability.

Background/Objectives: Clostridioides difficile colonization is common among hospitalized onco-hematological patients, yet its clinical significance and risk factors in this population remain incompletely characterized. This study aimed to determine the prevalence, risk factors, and genomic characteristics of C. difficile colonization among oncology and hematology inpatients, and to assess its relationship with progression to symptomatic infection. Methods: We conducted a prospective cohort study of patients admitted to the oncology and hematology departments of a tertiary-care hospital in the Canary Islands, Spain, between March and October 2025. Weekly active screening for C. difficile colonization was performed on stool samples throughout hospitalization. Risk factors were assessed using multivariable logistic regression, and whole-genome sequencing was performed on 16 of the 23 recovered isolates (after excluding 3 non-recoverable and 4 contaminated isolates) to characterize sequence types, ribotypes, and antimicrobial resistance determinants. Results: Among 215 patients (262 admission episodes), colonization was detected in 23 episodes (8.8%), with higher rates in oncology (10.9%) than hematology (7.2%; adjusted OR 0.37, 95% CI 0.14–0.96, p = 0.042). Chemotherapy administered during hospitalization was the strongest independent risk factor for colonization (adjusted OR 4.16, 95% CI 1.56–11.10, p = 0.004). Only 4.3% of colonizations were classified as truly community-associated, with 95.7% of patients showing documented healthcare contact. Sequencing of 16 isolates identified nine sequence types, including ST11 (ribotype 078, of zoonotic origin) and rare ribotypes (RT010, RT451); four isolates (36%) exhibited moxifloxacin resistance linked to gyrA/gyrB mutations, while all remained susceptible to vancomycin and metronidazole. No colonized patient progressed to symptomatic infection; the single CDI case in the cohort occurred in a non-colonized patient. Conclusions: These findings support current recommendations against isolating or treating asymptomatically colonized patients, while underscoring the need for continued genomic surveillance and reinforced environmental hygiene and antimicrobial stewardship in this high-risk population.