Dissemination of antibiotic resistance genes in swimming pools and implication for human skin

Assessment of risk of exposure to Campylobacter species and their antibiotic-resistant genes from selected rivers in the Eastern Cape, South Africa

Contaminated rivers play a critical role in the transmission of Campylobacter and antibiotic-resistant genes (ARGs) in many parts of the world. South Africa is a water-scarce country which relies on its freshwater systems such as rivers for recreation, irrigation, and domestic activities. This study assesses the potential human exposure to Campylobacter and its ARGs from rivers through the ingestion route in two South African rivers. The concentration of viable Campylobacter and ARGs in selected rivers was determined using quantitative PCR. The concentrations were then used to estimate the number of gene copies a person could ingest after swimming in the contaminated water for 1 h (intake burden). The human intake burden of Campylobacter 16 S rRNA copies per 1-h swimming event ranged from 7.1 × 105-3.7 × 106 copies/h for the Bloukrans River, and 9.9 × 101-2.3 × 105 copies/h for the Swartkops River. The intake burden of Campylobacter ARGs ranged from 1.64 × 104-5.8 × 105 copies/h for cmeB; 1.0 × 103-5.7 × 104 copies/h for tetO for the Bloukrans River, and 3.6 × 102-1.551 × 105 copies/h (cmeB) and 9.98 × 102-5.7 × 104 copies/h (tetO) for the Swartkops River. Ingestion of water from contaminated rivers during recreation, cultural, or religious activities may lead to human exposure to ARGs, posing a health risk. In many communities in the world, rivers play an important role in the social and cultural lives of people, and so it is important to monitor the quality of river water. Studies such as these will help prevent the spread of antibiotic-resistant genes and waterborne diseases caused by pathogens such as Campylobacter.

The spread of antibiotic resistance to humans and potential protection strategies

Antibiotic resistance is currently one of the greatest threats to human health. Widespread use and residues of antibiotics in humans, animals, and the environment can exert selective pressure on antibiotic resistance bacteria (ARB) and antibiotic resistance gene (ARG), accelerating the flow of antibiotic resistance. As ARG spreads to the population, the burden of antibiotic resistance in humans increases, which may have potential health effects on people. Therefore, it is critical to mitigate the spread of antibiotic resistance to humans and reduce the load of antibiotic resistance in humans. This review briefly described the information of global antibiotic consumption information and national action plans (NAPs) to combat antibiotic resistance and provided a set of feasible control strategies for the transmission of ARB and ARG to humans in three areas including (a) Reducing the colonization capacity of exogenous ARB, (b) Enhancing human colonization resistance and mitigating the horizontal gene transfer (HGT) of ARG, (c) Reversing ARB antibiotic resistance. With the hope of achieving interdisciplinary one-health prevention and control of bacterial resistance.

Epidermis as a Platform for Bacterial Transmission

The epidermis constitutes a continuous external layer covering the body, offering protection against bacteria, the most abundant living organisms that come into contact with this barrier. The epidermis is heavily colonized by commensal bacterial organisms that help protect against pathogenic bacteria. The highly regulated and dynamic interaction between the epidermis and commensals involves the host’s production of nutritional factors promoting bacterial growth together to chemical and immunological bacterial inhibitors. Signal trafficking ensures the system’s homeostasis; conditions that favor colonization by pathogens frequently foster commensal growth, thereby increasing the bacterial population size and inducing the skin’s antibacterial response, eliminating the pathogens and re-establishing the normal density of commensals. The microecological conditions of the epidermis favors Gram-positive organisms and are unsuitable for long-term Gram-negative colonization. However, the epidermis acts as the most important host-to-host transmission platform for bacteria, including those that colonize human mucous membranes. Bacteria are frequently shared by relatives, partners, and coworkers. The epidermal bacterial transmission platform of healthcare workers and visitors can contaminate hospitalized patients, eventually contributing to cross-infections. Epidermal transmission occurs mostly via the hands and particularly through fingers. The three-dimensional physical structure of the epidermis, particularly the fingertips, which have frictional ridges, multiplies the possibilities for bacterial adhesion and release. Research into the biology of bacterial transmission via the hands is still in its infancy; however, tribology, the science of interacting surfaces in relative motion, including friction, wear and lubrication, will certainly be an important part of it. Experiments on finger-to-finger transmission of microorganisms have shown significant interindividual differences in the ability to transmit microorganisms, presumably due to genetics, age, sex, and the gland density, which determines the physical, chemical, adhesive, nutritional, and immunological status of the epidermal surface. These studies are needed to optimize interventions and strategies for preventing the hand transmission of microorganisms.