1
|
Tuamsuwan K, Chamawan P, Boonyarit P, Srisuphan V, Klaytong P, Rangsiwutisak C, Wannapinij P, Fongthong T, Stelling J, Turner P, Limmathurotsakul D. Frequency of antimicrobial-resistant bloodstream infections in 111 hospitals in Thailand, 2022. J Infect 2024; 89:106249. [PMID: 39173918 PMCID: PMC11409609 DOI: 10.1016/j.jinf.2024.106249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 08/11/2024] [Accepted: 08/12/2024] [Indexed: 08/24/2024]
Abstract
OBJECTIVES To evaluate the frequency of antimicrobial-resistant bloodstream infections (AMR BSI) in Thailand. METHODS We analyzed data from 2022, generated by 111 public hospitals in health regions 1 to 12, using the AutoMated tool for Antimicrobial resistance Surveillance System (AMASS), and submitted to the Ministry of Public Health, Thailand. Multilevel Poisson regression models were used. RESULTS The most common cause of community-origin AMR BSI was third-generation cephalosporin-resistant Escherichia coli (3GCREC, 65.6%; 5101/7773 patients) and of hospital-origin AMR BSI was carbapenem-resistant Acinetobacter baumannii (CRAB, 51.2%, 4968/9747 patients). The percentage of patients tested for BSI was negatively associated with the frequency of community-origin 3GCREC BSI and hospital-origin CRAB BSI (per 100,000 tested patients). Hospitals in health regions 4 (lower central region) had the highest frequency of community-origin 3GCREC BSI (adjusted incidence rate ratio, 2.06; 95% confidence interval: 1.52-2.97). Health regions were not associated with the frequency of hospital-origin CRAB BSI, and between-hospital variation was high, even adjusting for hospital level and size. CONCLUSION The high between-hospital variation of hospital-origin CRAB BSI suggests the importance of hospital-specific factors. Our approach and findings highlight health regions and hospitals where actions against AMR infection, including antimicrobial stewardship and infection control, should be prioritized.
Collapse
Affiliation(s)
- Krittiya Tuamsuwan
- The Office of Permanent Secretary, Ministry of Public Health, Nonthaburi, Thailand
| | - Panida Chamawan
- The Office of Permanent Secretary, Ministry of Public Health, Nonthaburi, Thailand
| | - Phairam Boonyarit
- The Office of Permanent Secretary, Ministry of Public Health, Nonthaburi, Thailand
| | - Voranadda Srisuphan
- The Office of Permanent Secretary, Ministry of Public Health, Nonthaburi, Thailand
| | - Preeyarach Klaytong
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chalida Rangsiwutisak
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Prapass Wannapinij
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Trithep Fongthong
- The Office of Permanent Secretary, Ministry of Public Health, Nonthaburi, Thailand
| | - John Stelling
- Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Paul Turner
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Cambodia-Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Direk Limmathurotsakul
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| |
Collapse
|
2
|
Garner E, Maile-Moskowitz A, Angeles LF, Flach CF, Aga DS, Nambi I, Larsson DGJ, Bürgmann H, Zhang T, Vikesland PJ, Pruden A. Metagenomic Profiling of Internationally Sourced Sewage Influents and Effluents Yields Insight into Selecting Targets for Antibiotic Resistance Monitoring. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:16547-16559. [PMID: 39229966 PMCID: PMC11411718 DOI: 10.1021/acs.est.4c03726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
It has been debated whether wastewater treatment plants (WWTPs) primarily act to attenuate or amplify antibiotic resistance genes (ARGs). However, ARGs are highly diverse with respect to their resistance mechanisms, mobilities, and taxonomic hosts and therefore their behavior in WWTPs should not be expected to be universally conserved. We applied metagenomic sequencing to wastewater influent and effluent samples from 12 international WWTPs to classify the behavior of specific ARGs entering and exiting WWTPs. In total, 1079 different ARGs originating from a variety of bacteria were detected. This included ARGs that could be mapped to assembled scaffolds corresponding to nine human pathogens. While the relative abundance (per 16S rRNA gene) of ARGs decreased during treatment at 11 of the 12 WWTPs sampled and absolute abundance (per mL) decreased at all 12 WWTPs, increases in relative abundance were observed for 40% of the ARGs detected at the 12th WWTP. Also, the relative abundance of mobile genetic elements (MGE) increased during treatment, but the fraction of ARGs known to be transmissible between species decreased, thus demonstrating that increased MGE prevalence may not be generally indicative of an increase in ARGs. A distinct conserved resistome was documented in both influent and effluent across samples, suggesting that well-functioning WWTPs generally attenuate influent antibiotic resistance loads. This work helps inform strategies for wastewater surveillance of antibiotic resistance, highlighting the utility of tracking ARGs as indicators of treatment performance and relative risk reduction.
Collapse
Affiliation(s)
- Emily Garner
- Wadsworth Department of Civil and Environmental Engineering, West Virginia University, Morgantown, West Virginia 26505, United States
| | - Ayella Maile-Moskowitz
- Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Luisa F Angeles
- Department of Chemistry, University at Buffalo, Buffalo, New York 14260, United States
| | - Carl-Fredrik Flach
- Institute of Biomedicine, Department of Infectious Diseases, Centre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, Västra Götaland, SE-405 30 Gothenburg, Sweden
| | - Diana S Aga
- Department of Chemistry, University at Buffalo, Buffalo, New York 14260, United States
| | - Indumathi Nambi
- Department of Civil Engineering, Indian Institute of Technology, Madras, Chennai 600036, India
| | - D G Joakim Larsson
- Institute of Biomedicine, Department of Infectious Diseases, Centre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, Västra Götaland, SE-405 30 Gothenburg, Sweden
| | - Helmut Bürgmann
- Eawag: Swiss Federal Institute of Aquatic Science and Technology, Kastanienbaum CH-6047, Switzerland
| | - Tong Zhang
- Department of Civil Engineering, The University of Hong Kong, Pokfulam 999077, Hong Kong
| | - Peter J Vikesland
- Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Amy Pruden
- Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia 24061, United States
| |
Collapse
|
3
|
Compaoré A, Rouamba T, Kaboré B, Jacobs J, Peeters Grietens K, Sariola S. Exploring Antibiotic Use in the Community: A Household-Based Survey Using the Drug Bag Method in Rural Burkina Faso. Antibiotics (Basel) 2024; 13:872. [PMID: 39335045 PMCID: PMC11428394 DOI: 10.3390/antibiotics13090872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/28/2024] [Accepted: 08/29/2024] [Indexed: 09/30/2024] Open
Abstract
In Burkina Faso, there is lack of awareness of antibiotic use at the community level. This study aims to generate information on the commonly used antibiotics along with the reasons for which they have been used in rural Burkina Faso. The drug bag method was employed to collect information from 423 households in the health district of Nanoro. Descriptive analyses were performed using R software version 4.2.1. Of the 33 antibiotics inventoried, amoxicillin tablets and oxytetracycline were the most recognized and used antibiotics. This study indicated that antibiotics were used for a range of health problems in the community, some of which were administered as painkillers. While primary healthcare facilities constituted the primary source of drugs for households (76.8%), informal drug sellers constituted an additional option (61.5%) for community members. This is a significant concern, given that some antibiotics classified as "Watch"-such as norfloxacin-were readily available in these outlets, despite not being included on the country's Essential Medicines List. This study underscores the necessity of considering the role played by formal providers in the inappropriate use of antibiotics and the importance of understanding the circumstances and logical reasoning underlying communities' access to and use of antibiotics.
Collapse
Affiliation(s)
- Adélaïde Compaoré
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, 11 BP 218 Ouaga CMS 11, Nanoro, Burkina Faso; (T.R.); (B.K.)
- Socio-Ecological Health Research Unit, Institute of Tropical Medicine Antwerp, 2000 Antwerpen, Belgium;
- Faculté des Sciences Économiques, Sociales, Politiques et de la Communication, UCLouvain Saint-Louis Bruxelles, 1000 Bruxelles, Belgium
| | - Toussaint Rouamba
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, 11 BP 218 Ouaga CMS 11, Nanoro, Burkina Faso; (T.R.); (B.K.)
- Centre de Recherche en Epidémiologie, Biostatistiques et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles, 1050 Brussels, Belgium
| | - Bérenger Kaboré
- Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, 11 BP 218 Ouaga CMS 11, Nanoro, Burkina Faso; (T.R.); (B.K.)
| | - Jan Jacobs
- Unit of Bacteriology, Institute of Tropical Medicine Antwerp, 2000 Antwerpen, Belgium;
| | - Koen Peeters Grietens
- Socio-Ecological Health Research Unit, Institute of Tropical Medicine Antwerp, 2000 Antwerpen, Belgium;
- School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Salla Sariola
- Sociology, Faculty of Social Sciences, University of Helsinki, 00014 Helsinki, Finland;
| |
Collapse
|
4
|
Cailleau G, Junier T, Paul C, Fatton M, Corona-Ramirez A, Gning O, Beck K, Vidal J, Bürgmann H, Junier P. Temporal and spatial changes in the abundance of antibiotic resistance gene markers in a wastewater treatment plant. WATER ENVIRONMENT RESEARCH : A RESEARCH PUBLICATION OF THE WATER ENVIRONMENT FEDERATION 2024; 96:e11104. [PMID: 39164119 DOI: 10.1002/wer.11104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 07/30/2024] [Accepted: 07/31/2024] [Indexed: 08/22/2024]
Abstract
In this study, we investigated the temporal and spatial quantitative changes in the concentration of antibiotic resistance gene (ARG) markers in a municipal wastewater treatment plant (WWTP). Four ARGs conferring resistance to different classes of antibiotics (ermB, sul1, tet[W], and blaCTXM) and a gene used as a proxy for ARG pollution (intl1) were quantified in two separate sampling campaigns covering two and half years of operation of the WWTP. First, a systematic monthly monitoring of multiple points in the inlet and the outlet revealed an absolute decrease in the concentration of all analyzed ARGs. However, the relative abundance of sul1 and intl1 genes relative to the total bacterial load (estimated using the universal marker 16S rDNA) increased in the outlet samples as compared to the inlet. To pinpoint the exact stage of removal and/or enrichment within the WWTP, a second sampling including the stages of the biological treatment was performed bimonthly. This revealed a distinct enrichment of sul1 and intl1 genes during the biological treatment phase. Moreover, the temporal and spatial variations in ARG abundance patterns within the WWTP underscored the complexity of the dynamics associated with the removal of ARGs during wastewater treatment. Understanding these dynamics is pivotal for developing efficient strategies to mitigate the dissemination of ARGs in aquatic environments. PRACTITIONER POINTS: Regular monitoring of ARG markers in WWTPs is essential to assess temporal and spatial changes, aiding in the development of effective mitigation strategies. Understanding the dynamics of ARG abundance during biological treatment is crucial for optimizing processes and minimizing dissemination in aquatic environments. Increased relative abundance of certain ARGs highlights potential enrichment during wastewater treatment, necessitating targeted interventions. Systematic monitoring of multiple points within WWTPs can provide valuable insights into the efficacy of treatment processes in reducing ARG levels over time. The complexity of ARG abundance patterns underscores the need to develop holistic approaches to tackle antibiotic resistance in wastewater systems.
Collapse
Affiliation(s)
- Guillaume Cailleau
- Laboratory of Microbiology, University of Neuchâtel, Neuchatel, Switzerland
| | | | - Christophe Paul
- Laboratory of Microbiology, University of Neuchâtel, Neuchatel, Switzerland
| | - Mathilda Fatton
- Laboratory of Microbiology, University of Neuchâtel, Neuchatel, Switzerland
| | | | - Ophelie Gning
- Laboratory of Microbiology, University of Neuchâtel, Neuchatel, Switzerland
| | - Karin Beck
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Kastanienbaum, Switzerland
| | - Jacques Vidal
- Waste Water Treatment Plant, La Chaux-de-Fonds, Switzerland
| | - Helmut Bürgmann
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Kastanienbaum, Switzerland
- Vital-IT group, Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Pilar Junier
- Laboratory of Microbiology, University of Neuchâtel, Neuchatel, Switzerland
| |
Collapse
|
5
|
Esmaeili-Khoshmardan M, Dabiri H, Rafiee M, Eslami A, Yazdanbakhsh A, Amereh F, Jahangiri-Rad M, Hashemi A. Dynamics of antimicrobial resistance and susceptibility profile in full-scale hospital wastewater treatment plants. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2024; 90:103-123. [PMID: 39007309 DOI: 10.2166/wst.2024.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 05/14/2024] [Indexed: 07/16/2024]
Abstract
Drug resistance has become a matter of great concern, with many bacteria now resist multiple antibiotics. This study depicts the occurrence of antibiotic-resistant bacteria (ARB) and resistance patterns in five full-scale hospital wastewater treatment plants (WWTPs). Samples of raw influent wastewater, as well as pre- and post-disinfected effluents, were monitored for targeted ARB and resistance genes in September 2022 and February 2023. Shifts in resistance profiles of Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii antimicrobial-resistant indicators in the treated effluent compared to that in the raw wastewater were also worked out. Ceftazidime (6.78 × 105 CFU/mL) and cefotaxime (6.14 × 105 CFU/mL) resistant species showed the highest concentrations followed by ciprofloxacin (6.29 × 104 CFU/mL), and gentamicin (4.88 × 104 CFU/mL), in raw influent respectively. WWTP-D employing a combination of biological treatment and coagulation/clarification for wastewater decontamination showed promising results for reducing ARB emissions from wastewater. Relationships between treated effluent quality parameters and ARB loadings showed that high BOD5 and nitrate levels were possibly contributing to the persistence and/or selection of ARBs in WWTPs. Furthermore, antimicrobial susceptibility tests of targeted species revealed dynamic shifts in resistance profiles through treatment processes, highlighting the potential for ARB and ARGs in hospital wastewater to persist or amplify during treatment.
Collapse
Affiliation(s)
- Maedeh Esmaeili-Khoshmardan
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Dabiri
- Department of Medical Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Mohammad Rafiee
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Air Quality and Climate Change Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran E-mail:
| | - Akbar Eslami
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Yazdanbakhsh
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Amereh
- Department of Environmental Health Engineering, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Jahangiri-Rad
- Water Purification Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Ali Hashemi
- Department of Medical Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| |
Collapse
|
6
|
Symochko L, Pereira P, Demyanyuk O, Pinheiro MC, Barcelo D. Resistome in a changing environment: Hotspots and vectors of spreading with a focus on the Russian-Ukrainian War. Heliyon 2024; 10:e32716. [PMID: 39183836 PMCID: PMC11341293 DOI: 10.1016/j.heliyon.2024.e32716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/22/2024] [Accepted: 06/07/2024] [Indexed: 08/27/2024] Open
Abstract
This work aims to shed light on the key factors contributing to the development of environmental resistance and the urgent need to address the growing problem of antibiotic resistance (AR) under the Russian-Ukrainian conflict. The article provides an overview of the main mechanisms involved in AR development and dissemination globally and the challenges posed by the ongoing war in Ukraine. The work outlines various international initiatives to reduce AR, including the concept of "One Health" and the strategies established, which are the key to reducing the effects on public health. Addressing AR globally and in conflict areas requires a comprehensive approach. This involves implementing monitoring of the microorganism's resistance levels to antibiotics, controlling the use of antimicrobial drugs, increasing public awareness of the AR, introducing educational programs to prevent the improper use of antibiotics, and adopting environmentally safe methods for the disposal of waste from medical, food, and other industries that produce or use antibiotics. Such initiatives are essential for promoting the responsible use of antibiotics, preventing the spread of AR infections, and preserving the effectiveness of existing antimicrobial drugs.
Collapse
Affiliation(s)
- L. Symochko
- Uzhhorod National University, Uzhhorod, Ukraine
- University of Coimbra, Coimbra, Portugal
- Institute of Agroecology and Environmental Management NAAS, Kyiv, Ukraine
| | - P. Pereira
- Environmental Management Laboratory, Mykolas Romeris University, Vilnius, Lithuania
| | - O. Demyanyuk
- Institute of Agroecology and Environmental Management NAAS, Kyiv, Ukraine
| | - M.N. Coelho Pinheiro
- Polytechnic Institute of Coimbra, Coimbra Institute of Engineering, Coimbra, Portugal
| | | |
Collapse
|
7
|
Sarkar S, Anyaso-Samuel S, Qiu P, Datta S. Multiblock partial least squares and rank aggregation: Applications to detection of bacteriophages associated with antimicrobial resistance in the presence of potential confounding factors. Stat Med 2024; 43:2527-2546. [PMID: 38618705 DOI: 10.1002/sim.10058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/31/2024] [Accepted: 02/27/2024] [Indexed: 04/16/2024]
Abstract
Urban environments, characterized by bustling mass transit systems and high population density, host a complex web of microorganisms that impact microbial interactions. These urban microbiomes, influenced by diverse demographics and constant human movement, are vital for understanding microbial dynamics. We explore urban metagenomics, utilizing an extensive dataset from the Metagenomics & Metadesign of Subways & Urban Biomes (MetaSUB) consortium, and investigate antimicrobial resistance (AMR) patterns. In this pioneering research, we delve into the role of bacteriophages, or "phages"-viruses that prey on bacteria and can facilitate the exchange of antibiotic resistance genes (ARGs) through mechanisms like horizontal gene transfer (HGT). Despite their potential significance, existing literature lacks a consensus on their significance in ARG dissemination. We argue that they are an important consideration. We uncover that environmental variables, such as those on climate, demographics, and landscape, can obscure phage-resistome relationships. We adjust for these potential confounders and clarify these relationships across specific and overall antibiotic classes with precision, identifying several key phages. Leveraging machine learning tools and validating findings through clinical literature, we uncover novel associations, adding valuable insights to our comprehension of AMR development.
Collapse
Affiliation(s)
- Shoumi Sarkar
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | | | - Peihua Qiu
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Somnath Datta
- Department of Biostatistics, University of Florida, Gainesville, Florida
| |
Collapse
|
8
|
Rzymski P, Gwenzi W, Poniedziałek B, Mangul S, Fal A. Climate warming, environmental degradation and pollution as drivers of antibiotic resistance. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 346:123649. [PMID: 38402936 DOI: 10.1016/j.envpol.2024.123649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/17/2024] [Accepted: 02/22/2024] [Indexed: 02/27/2024]
Abstract
Antibiotic resistance is a major challenge to public health, but human-caused environmental changes have not been widely recognized as its drivers. Here, we provide a comprehensive overview of the relationships between environmental degradation and antibiotic resistance, demonstrating that the former can potentially fuel the latter with significant public health outcomes. We describe that (i) global warming favors horizontal gene transfer, bacterial infections, the spread of drug-resistant pathogens due to water scarcity, and the release of resistance genes with wastewater; (ii) pesticide and metal pollution act as co-selectors of antibiotic resistance mechanisms; (iii) microplastics create conditions promoting and spreading antibiotic resistance and resistant bacteria; (iv) changes in land use, deforestation, and environmental pollution reduce microbial diversity, a natural barrier to antibiotic resistance spread. We argue that management of antibiotic resistance must integrate environmental goals, including mitigation of further increases in the Earth's surface temperature, better qualitative and quantitative protection of water resources, strengthening of sewage infrastructure and improving wastewater treatment, counteracting the microbial diversity loss, reduction of pesticide and metal emissions, and plastic use, and improving waste recycling. These actions should be accompanied by restricting antibiotic use only to clinically justified situations, developing novel treatments, and promoting prophylaxis. It is pivotal for health authorities and the medical community to adopt the protection of environmental quality as a part of public health measures, also in the context of antibiotic resistance management.
Collapse
Affiliation(s)
- Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, Poznań, Poland.
| | - Willis Gwenzi
- Biosystems and Environmental Engineering Research Group, 380 New Adylin, Marlborough, Harare, Zimbabwe; Alexander von Humboldt Fellow and Guest Professor, Grassland Science and Renewable Plant Resources, Faculty of Organic Agricultural Sciences, Universität Kassel, Witzenhausen, Germany; Alexander von Humboldt Fellow and Guest Professor, Leibniz Institute for Agricultural Engineering and Bioeconomy, Potsdam, Germany
| | - Barbara Poniedziałek
- Department of Environmental Medicine, Poznan University of Medical Sciences, Poznań, Poland
| | - Serghei Mangul
- Titus Family Department of Clinical Pharmacy, USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA, USA
| | - Andrzej Fal
- Department of Allergy, Lung Diseases and Internal Medicine Central Clinical Hospital, Ministry of Interior, Warsaw, Poland; Collegium Medicum, Warsaw Faculty of Medicine, Cardinal Stefan Wyszyński University, Warsaw, Poland
| |
Collapse
|
9
|
Schachner-Groehs I, Koller M, Leopold M, Kolm C, Linke RB, Jakwerth S, Kolarević S, Kračun-Kolarević M, Kandler W, Sulyok M, Vierheilig J, Toumi M, Farkas R, Toth E, Kittinger C, Zarfel G, Farnleitner AH, Kirschner AKT. Linking antibiotic resistance gene patterns with advanced faecal pollution assessment and environmental key parameters along 2300 km of the Danube River. WATER RESEARCH 2024; 252:121244. [PMID: 38340455 DOI: 10.1016/j.watres.2024.121244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/19/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024]
Abstract
The global spread of antimicrobial resistance (AMR) in the environment is a growing health threat. Large rivers are of particular concern as they are highly impacted by wastewater discharge while being vital lifelines serving various human needs. A comprehensive understanding of occurrence, spread and key drivers of AMR along whole river courses is largely lacking. We provide a holistic approach by studying spatiotemporal patterns and hotspots of antibiotic resistance genes (ARGs) along 2311 km of the navigable Danube River, combining a longitudinal and temporal monitoring campaign. The integration of advanced faecal pollution diagnostics and environmental and chemical key parameters allowed linking ARG concentrations to the major pollution sources and explaining the observed patterns. Nine AMR markers, including genes conferring resistance to five different antibiotic classes of clinical and environmental relevance, and one integrase gene were determined by probe-based qPCR. All AMR targets could be quantified in Danube River water, with intI1 and sul1 being ubiquitously abundant, qnrS, tetM, blaTEM with intermediate abundance and blaOXA-48like, blaCTX-M-1 group, blaCTX-M-9 group and blaKPC genes with rare occurrence. Human faecal pollution from municipal wastewater discharges was the dominant factor shaping ARG patterns along the Danube River. Other significant correlations of specific ARGs were observed with discharge, certain metals and pesticides. In contrast, intI1 was not associated with wastewater but was already established in the water microbiome. Animal contamination was detected only sporadically and was correlated with ARGs only in the temporal sampling set. During temporal monitoring, an extraordinary hotspot was identified emphasizing the variability within natural waters. This study provides the first comprehensive baseline concentrations of ARGs in the Danube River and lays the foundation for monitoring future trends and evaluating potential reduction measures. The applided holistic approach proved to be a valuable methodological contribution towards a better understanding of the environmental occurrence of AMR.
Collapse
Affiliation(s)
- Iris Schachner-Groehs
- Institute of Hygiene and Applied Immunology - Water Microbiology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Kinderspitalgasse 15, Vienna 1090, Austria
| | - Michael Koller
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University Graz, Neue Stiftingtalstraße 6, Graz 8010, Austria
| | - Melanie Leopold
- Division Water Quality and Health, Department Pharmacology, Physiology and Microbiology, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, Krems an der Donau 3500, Austria
| | - Claudia Kolm
- Division Water Quality and Health, Department Pharmacology, Physiology and Microbiology, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, Krems an der Donau 3500, Austria; Institute of Chemical, Environmental and Bioscience Engineering, Research Group Microbiology and Molecular Diagnostics, Technische Universität Wien, Gumpendorfer Straße 1A/166, Vienna 1060, Austria
| | - Rita B Linke
- Institute of Chemical, Environmental and Bioscience Engineering, Research Group Microbiology and Molecular Diagnostics, Technische Universität Wien, Gumpendorfer Straße 1A/166, Vienna 1060, Austria
| | - Stefan Jakwerth
- Institute of Hygiene and Applied Immunology - Water Microbiology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Kinderspitalgasse 15, Vienna 1090, Austria
| | - Stoimir Kolarević
- Department of Hydroecology and Water Protection, Institute for Biological Research ¨Siniša Stanković¨, National Institute of the Republic of Serbia, University of Belgrade, Bulevar despota Stefana 142, Belgrade 11060, Serbia
| | - Margareta Kračun-Kolarević
- Department of Hydroecology and Water Protection, Institute for Biological Research ¨Siniša Stanković¨, National Institute of the Republic of Serbia, University of Belgrade, Bulevar despota Stefana 142, Belgrade 11060, Serbia
| | - Wolfgang Kandler
- Department of Agrotechnology (IFA-Tulln), Institute of Bioanalytics and Agro-Metabolomics, University of Natural Resources and Life Sciences, Konrad-Lorenz-Straße 20, Tulln an der Donau 3430, Austria
| | - Michael Sulyok
- Department of Agrotechnology (IFA-Tulln), Institute of Bioanalytics and Agro-Metabolomics, University of Natural Resources and Life Sciences, Konrad-Lorenz-Straße 20, Tulln an der Donau 3430, Austria
| | - Julia Vierheilig
- Institute of Water Quality and Resource Management, Technische Universität Wien, Karlsplatz 13/226-1, Wien 1040, Austria
| | - Marwene Toumi
- Department of Microbiology, Eötvös Loránd University, Pázmány Péter sétány 1/C., H-1117, Budapest, Hungary
| | - Rózsa Farkas
- Department of Microbiology, Eötvös Loránd University, Pázmány Péter sétány 1/C., H-1117, Budapest, Hungary
| | - Erika Toth
- Department of Microbiology, Eötvös Loránd University, Pázmány Péter sétány 1/C., H-1117, Budapest, Hungary
| | - Clemens Kittinger
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University Graz, Neue Stiftingtalstraße 6, Graz 8010, Austria
| | - Gernot Zarfel
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University Graz, Neue Stiftingtalstraße 6, Graz 8010, Austria
| | - Andreas H Farnleitner
- Division Water Quality and Health, Department Pharmacology, Physiology and Microbiology, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, Krems an der Donau 3500, Austria; Institute of Chemical, Environmental and Bioscience Engineering, Research Group Microbiology and Molecular Diagnostics, Technische Universität Wien, Gumpendorfer Straße 1A/166, Vienna 1060, Austria.
| | - A K T Kirschner
- Institute of Hygiene and Applied Immunology - Water Microbiology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Kinderspitalgasse 15, Vienna 1090, Austria; Division Water Quality and Health, Department Pharmacology, Physiology and Microbiology, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, Krems an der Donau 3500, Austria.
| |
Collapse
|
10
|
Bagra K, Kneis D, Padfield D, Szekeres E, Teban-Man A, Coman C, Singh G, Berendonk TU, Klümper U. Contrary effects of increasing temperatures on the spread of antimicrobial resistance in river biofilms. mSphere 2024; 9:e0057323. [PMID: 38323843 PMCID: PMC10900892 DOI: 10.1128/msphere.00573-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/10/2024] [Indexed: 02/08/2024] Open
Abstract
River microbial communities regularly act as the first barrier of defense against the spread of antimicrobial resistance genes (ARGs) that enter environmental microbiomes through wastewater. However, how the invasion dynamics of wastewater-borne ARGs into river biofilm communities will shift due to climate change with increasing average and peak temperatures remains unknown. Here, we aimed to elucidate the effects of increasing temperatures on the naturally occurring river biofilm resistome, as well as the invasion success of foreign ARGs entering through wastewater. Natural biofilms were grown in a low-anthropogenic impact river and transferred to artificial laboratory recirculation flume systems operated at three different temperatures (20°C, 25°C, and 30°C). After 1 week of temperature acclimatization, significant increases in the abundance of the naturally occurring ARGs in biofilms were detected at higher temperatures. After this acclimatization period, biofilms were exposed to a single pulse of wastewater, and the invasion dynamics of wastewater-borne ARGs were analyzed over 2 weeks. After 1 day, wastewater-borne ARGs were able to invade the biofilms successfully with no observable effect of temperature on their relative abundance. However, thereafter, ARGs were lost at a far increased rate at 30°C, with ARG levels dropping to the initial natural levels after 14 days. Contrary to the lower temperatures, ARGs were either lost at slower rates or even able to establish themselves in biofilms with stable relative abundances above natural levels. Hence, higher temperatures come with contrary effects on river biofilm resistomes: naturally occurring ARGs increase in abundance, while foreign, invading ARGs are lost at elevated speeds.IMPORTANCEInfections with bacteria that gained resistance to antibiotics are taking millions of lives annually, with the death toll predicted to increase. River microbial communities act as a first defense barrier against the spread of antimicrobial resistance genes (ARGs) that enter the environment through wastewater after enrichment in human and animal microbiomes. The global increase in temperature due to climate change might disrupt this barrier effect by altering microbial community structure and functions. We consequently explored how increasing temperatures alter ARG spread in river microbial communities. At higher temperatures, naturally occurring ARGs increased in relative abundance. However, this coincided with a decreased success rate of invading foreign ARGs from wastewater to establish themselves in the communities. Therefore, to predict the effects of climate change on ARG spread in river microbiomes, it is imperative to consider if the river ecosystem and its resistome are dominated by naturally occurring or invading foreign ARGs.
Collapse
Affiliation(s)
- Kenyum Bagra
- Institute for Hydrobiology, Technische Universität Dresden, Dresden, Germany
- Indian Institute of Technology, Roorkee, Uttarakhand, India
| | - David Kneis
- Institute for Hydrobiology, Technische Universität Dresden, Dresden, Germany
| | - Daniel Padfield
- Environment and Sustainability Institute, University of Exeter, Exeter, United Kingdom
| | - Edina Szekeres
- Institute of Biological Research Cluj, NIRDBS, Cluj-Napoca, Romania
| | - Adela Teban-Man
- Institute of Biological Research Cluj, NIRDBS, Cluj-Napoca, Romania
| | - Cristian Coman
- Institute of Biological Research Cluj, NIRDBS, Cluj-Napoca, Romania
| | - Gargi Singh
- Indian Institute of Technology, Roorkee, Uttarakhand, India
| | - Thomas U. Berendonk
- Institute for Hydrobiology, Technische Universität Dresden, Dresden, Germany
| | - Uli Klümper
- Institute for Hydrobiology, Technische Universität Dresden, Dresden, Germany
| |
Collapse
|
11
|
Hem S, Cummins ML, Wyrsch ER, Drigo B, Hoye BJ, Maute K, Sanderson-Smith M, Gorman J, Bogema DR, Jenkins C, Deutscher AT, Yam J, Hai F, Donner E, Jarocki VM, Djordjevic SP. Genomic analysis of Citrobacter from Australian wastewater and silver gulls reveals novel sequence types carrying critically important antibiotic resistance genes. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 909:168608. [PMID: 37977387 DOI: 10.1016/j.scitotenv.2023.168608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023]
Abstract
Antimicrobial resistance (AMR) is a major public health concern, and environmental bacteria have been recognized as important reservoirs of antimicrobial resistance genes (ARGs). Citrobacter, a common environmental bacterium and opportunistic pathogen in humans and other animals, has been largely understudied in terms of its diversity and AMR potential. Whole-genome (short-read) sequencing on a total of 77 Citrobacter isolates obtained from Australian silver gull (Chroicocephalus novaehollandiae) (n = 17) and influent wastewater samples (n = 60) was performed, revealing a diverse Citrobacter population, with seven different species and 33 sequence types, 17 of which were novel. From silver gull using non-selective media we isolated a broader range of species with little to no mobilised ARG carriage. Wastewater isolates (selected using Carbapenem- Resistant Enterobacterales (CRE) selective media) carried a heavy burden of ARGs (up to 21 ARGs, conferring resistance to nine classes of antibiotics), with several novel multidrug-resistant (MDR) lineages identified, including C. braakii ST1110, which carried ARGs conferring resistance to eight to nine classes of antibiotics, and C. freundii ST1105, which carried two carbapenemase genes, blaIMP-4 in class 1 integron structure, and blaKPC-2. Additionally, we identified an MDR C. portucalensis isolate carrying blaNDM-1, blaSHV-12, and mcr-9. We identified IncC, IncM2, and IncP6 plasmids as the likely vectors for many of the critically important mobilised ARGs. Phylogenetic analyses were performed to assess any epidemiological linkages between isolation sources, demonstrating low relatedness across sources beyond the ST level. However, these analyses did reveal some closer relationships between strains from disparate wastewater sources despite their collection some 13,000 km apart. These findings support the need for future surveillance of Citrobacter populations in wastewater and wildlife populations to monitor for potential opportunistic human pathogens.
Collapse
Affiliation(s)
- Sopheak Hem
- Australian Institute for Microbiology and Infection, University of Technology Sydney, Ultimo, Australia; The Australian Centre for Genomic Epidemiological Microbiology, University of Technology Sydney, Ultimo, Australia
| | - Max L Cummins
- Australian Institute for Microbiology and Infection, University of Technology Sydney, Ultimo, Australia; The Australian Centre for Genomic Epidemiological Microbiology, University of Technology Sydney, Ultimo, Australia
| | - Ethan R Wyrsch
- Australian Institute for Microbiology and Infection, University of Technology Sydney, Ultimo, Australia; The Australian Centre for Genomic Epidemiological Microbiology, University of Technology Sydney, Ultimo, Australia
| | - Barbara Drigo
- UniSA STEM, University of South Australia, Adelaide, SA, Australia
| | - Bethany J Hoye
- School of Earth, Atmospheric and Life Sciences, University of Wollongong NSW, Australia; Environmental Futures Research Centre, University of Wollongong NSW, Australia
| | - Kimberly Maute
- School of Earth, Atmospheric and Life Sciences, University of Wollongong NSW, Australia; Environmental Futures Research Centre, University of Wollongong NSW, Australia
| | - Martina Sanderson-Smith
- School of Chemistry and Molecular Bioscience and Molecular Horizons, University of Wollongong, NSW, Australia
| | - Jody Gorman
- School of Chemistry and Molecular Bioscience and Molecular Horizons, University of Wollongong, NSW, Australia
| | - Daniel R Bogema
- Elizabeth Macarthur Agricultural Institute, NSW Department of Primary Industries, Menangle, NSW, Australia
| | - Cheryl Jenkins
- Elizabeth Macarthur Agricultural Institute, NSW Department of Primary Industries, Menangle, NSW, Australia
| | - Ania T Deutscher
- Elizabeth Macarthur Agricultural Institute, NSW Department of Primary Industries, Menangle, NSW, Australia
| | - Jerald Yam
- Elizabeth Macarthur Agricultural Institute, NSW Department of Primary Industries, Menangle, NSW, Australia
| | - Faisal Hai
- School of Civil, Mining, Environmental and Architectural Engineering, University of Wollongong, NSW, Australia
| | - Erica Donner
- Cooperative Research Centre for Solving Antimicrobial resistance in Agribusiness, Food, and Environments (CRC SAAFE), Adelaide, South Australia, Australia; Future Industries Institute, University of South Australia, Adelaide, South Australia, Australia
| | - Veronica M Jarocki
- Australian Institute for Microbiology and Infection, University of Technology Sydney, Ultimo, Australia; The Australian Centre for Genomic Epidemiological Microbiology, University of Technology Sydney, Ultimo, Australia.
| | - Steven P Djordjevic
- Australian Institute for Microbiology and Infection, University of Technology Sydney, Ultimo, Australia; The Australian Centre for Genomic Epidemiological Microbiology, University of Technology Sydney, Ultimo, Australia.
| |
Collapse
|
12
|
Saibu S, Uhanie Perera I, Suzuki S, Rodó X, Fujiyoshi S, Maruyama F. Resistomes in freshwater bioaerosols and their impact on drinking and recreational water safety: A perspective. ENVIRONMENT INTERNATIONAL 2024; 183:108377. [PMID: 38103344 DOI: 10.1016/j.envint.2023.108377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 12/07/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
Antibiotic resistance genes (ARGs) are widespread environmental pollutants of biological origin that pose a significant threat to human, animal, and plant health, as well as to ecosystems. ARGs are found in soil, water, air, and waste, and several pathways for global dissemination in the environment have been described. However, studies on airborne ARG transport through atmospheric particles are limited. The ARGs in microorganisms inhabiting an environment are referred to as the "resistome". A global search was conducted of air-resistome studies by retrieving bioaerosol ARG-related papers published in the last 30 years from PubMed. We found that there is no dedicated methodology for isolating ARGs in bioaerosols; instead, conventional methods for microbial culture and metagenomic analysis are used in combination with standard aerosol sampling techniques. There is a dearth of information on the bioaerosol resistomes of freshwater environments and their impact on freshwater sources used for drinking and recreational activities. More studies of aerobiome freshwater environments are needed to ensure the safe use of water and sanitation. In this review we outline and synthesize the few studies that address the freshwater air microbiome (from tap water, bathroom showers, rivers, lakes, and swimming pools) and their resistomes, as well as the likely impacts on drinking and recreational waters. We also discuss current knowledge gaps for the freshwater airborne resistome. This review will stimulate new investigations of the atmospheric microbiome, particularly in areas where both air and water quality are of public health concern.
Collapse
Affiliation(s)
- Salametu Saibu
- Department of Microbiology, Lagos State University of Ojo, Lagos, Nigeria
| | - Ishara Uhanie Perera
- Section of Microbial Genomics and Ecology, Planetary Health and Innovation Science Center (PHIS), The IDEC Institute, Hiroshima University, Japan
| | - Satoru Suzuki
- Graduate School of Science and Engineering, Center for Marine Environmental Studies, Ehime University, Japan
| | - Xavier Rodó
- ICREA and CLIMA Program, Barcelona Institute for Global Health (-ISGlobal), Barcelona, Spain
| | - So Fujiyoshi
- Section of Microbial Genomics and Ecology, Planetary Health and Innovation Science Center (PHIS), The IDEC Institute, Hiroshima University, Japan
| | - Fumito Maruyama
- Section of Microbial Genomics and Ecology, Planetary Health and Innovation Science Center (PHIS), The IDEC Institute, Hiroshima University, Japan.
| |
Collapse
|
13
|
Castañeda-Barba S, Top EM, Stalder T. Plasmids, a molecular cornerstone of antimicrobial resistance in the One Health era. Nat Rev Microbiol 2024; 22:18-32. [PMID: 37430173 DOI: 10.1038/s41579-023-00926-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 07/12/2023]
Abstract
Antimicrobial resistance (AMR) poses a substantial threat to human health. The widespread prevalence of AMR is, in part, due to the horizontal transfer of antibiotic resistance genes (ARGs), typically mediated by plasmids. Many of the plasmid-mediated resistance genes in pathogens originate from environmental, animal or human habitats. Despite evidence that plasmids mobilize ARGs between these habitats, we have a limited understanding of the ecological and evolutionary trajectories that facilitate the emergence of multidrug resistance (MDR) plasmids in clinical pathogens. One Health, a holistic framework, enables exploration of these knowledge gaps. In this Review, we provide an overview of how plasmids drive local and global AMR spread and link different habitats. We explore some of the emerging studies integrating an eco-evolutionary perspective, opening up a discussion about the factors that affect the ecology and evolution of plasmids in complex microbial communities. Specifically, we discuss how the emergence and persistence of MDR plasmids can be affected by varying selective conditions, spatial structure, environmental heterogeneity, temporal variation and coexistence with other members of the microbiome. These factors, along with others yet to be investigated, collectively determine the emergence and transfer of plasmid-mediated AMR within and between habitats at the local and global scale.
Collapse
Affiliation(s)
- Salvador Castañeda-Barba
- Department of Biological Sciences, University of Idaho, Moscow, ID, USA
- Bioinformatics and Computational Biology Graduate Program, University of Idaho, Moscow, ID, USA
- Institute for Interdisciplinary Data Sciences, University of Idaho, Moscow, ID, USA
| | - Eva M Top
- Department of Biological Sciences, University of Idaho, Moscow, ID, USA
- Bioinformatics and Computational Biology Graduate Program, University of Idaho, Moscow, ID, USA
- Institute for Interdisciplinary Data Sciences, University of Idaho, Moscow, ID, USA
- Institute for Modelling Collaboration and Innovation, University of Idaho, Moscow, ID, USA
| | - Thibault Stalder
- Department of Biological Sciences, University of Idaho, Moscow, ID, USA.
- Institute for Interdisciplinary Data Sciences, University of Idaho, Moscow, ID, USA.
- Institute for Modelling Collaboration and Innovation, University of Idaho, Moscow, ID, USA.
| |
Collapse
|
14
|
Keneh NK, Kenmoe S, Bowo-Ngandji A, Tatah Kihla Akoachere JF, Gonsu Kamga H, Ndip RN, Ebogo-Belobo JT, Kengne-Ndé C, Mbaga DS, Tendongfor N, Ndip LM, Esemu SN. A mapping review of methicillin-resistant Staphylococcus aureus proportions, genetic diversity, and antimicrobial resistance patterns in Cameroon. PLoS One 2023; 18:e0296267. [PMID: 38134014 PMCID: PMC10745167 DOI: 10.1371/journal.pone.0296267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND The emergence of methicillin-resistant Staphylococcus aureus (MRSA) has increased and poses a significant threat to human and animal health in Cameroon and the world at large. MRSA strains have infiltrated various settings, including hospitals, communities, and livestock, contributing to increased morbidity, treatment costs, and mortality. This evidence synthesis aims to understand MRSA prevalence, resistance patterns, and genetic characterization in Cameroon. METHODS The methodology was consistent with the PRISMA 2020 guidelines. Studies of any design containing scientific data on MRSA prevalence, genetic diversity, and antimicrobial resistance patterns in Cameroon were eligible for inclusion, with no restrictions on language or publication date. The search involved a comprehensive search strategy in several databases including Medline, Embase, Global Health, Web of Science, African Index Medicus, and African Journal Online. The risk of bias in the included studies was assessed using the Hoy et al tool, and the results were synthesized and presented in narrative synthesis and/or tables and graphs. RESULTS The systematic review analyzed 24 studies, mostly conducted after 2010, in various settings in Cameroon. The studies, characterized by moderate to low bias, revealed a wide prevalence of MRSA ranging from 1.9% to 46.8%, with considerable variation based on demographic and environmental factors. Animal (0.2%), food (3.2% to 15.4%), and environmental samples (0.0% to 34.6%) also showed a varied prevalence of MRSA. The genetic diversity of MRSA was heterogeneous, with different virulence gene profiles and clonal lineages identified in various populations and sample types. Antimicrobial resistance rates showed great variability in the different regions of Cameroon, with notable antibiotic resistance recorded for the beta-lactam, fluoroquinolone, glycopeptide, lincosamide, and macrolide families. CONCLUSION This study highlights the significant variability in MRSA prevalence, genetic diversity, and antimicrobial resistance patterns in Cameroon, and emphasizes the pressing need for comprehensive antimicrobial stewardship strategies in the country.
Collapse
Affiliation(s)
- Nene Kaah Keneh
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Laboratory for Emerging Infectious Diseases, University of Buea, Buea, South West Region, Cameroon
| | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | | | - Hortense Gonsu Kamga
- Faculty of Medicine and Biomedical Sciences, The University of Yaounde I, Yaoundé, Cameroon
| | - Roland Ndip Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Jean Thierry Ebogo-Belobo
- Center for Research in Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Cyprien Kengne-Ndé
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala, Cameroon
| | | | | | - Lucy Mande Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Laboratory for Emerging Infectious Diseases, University of Buea, Buea, South West Region, Cameroon
| | - Seraphine Nkie Esemu
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Laboratory for Emerging Infectious Diseases, University of Buea, Buea, South West Region, Cameroon
| |
Collapse
|
15
|
Bagra K, Bellanger X, Merlin C, Singh G, Berendonk TU, Klümper U. Environmental stress increases the invasion success of antimicrobial resistant bacteria in river microbial communities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 904:166661. [PMID: 37652387 DOI: 10.1016/j.scitotenv.2023.166661] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/02/2023]
Abstract
Environmental microbiomes are constantly exposed to invasion events through foreign, antibiotic resistant bacteria that were enriched in the anthropic sphere. However, the biotic and abiotic factors, as well as the natural barriers that determine the invasion success of these invader bacteria into the environmental microbiomes are poorly understood. A great example of such invasion events are river microbial communities constantly exposed to resistant bacteria originating from wastewater effluents. Here, we aim at gaining comprehensive insights into the key factors that determine their invasion success with a particular focus on the effects of environmental stressors, regularly co-released in wastewater effluents. Understanding invasion dynamics of resistant bacteria is crucial for limiting the environmental spread of antibiotic resistance. To achieve this, we grew natural microbial biofilms on glass slides in rivers for one month. The biofilms were then transferred to laboratory, recirculating flume systems and exposed to a single pulse of a model resistant invader bacterium (Escherichia coli) either in presence or absence of stress induced by Cu2+. The invasion dynamics of E. coli into the biofilms were then monitored for 14 days. Despite an initially successful introduction of E. coli into the biofilms, independent of the imposed stress, over time the invader perished in absence of stress. However, under stress the invading strain successfully established and proliferated in the biofilms. Noteworthy, the increased establishment success of the invader coincided with a loss in microbial community diversity under stress conditions, likely due to additional niche space becoming available for the invader.
Collapse
Affiliation(s)
- Kenyum Bagra
- Technische Universität Dresden, Institute of Hydrobiology, Dresden, Germany; Department of Civil Engineering, Indian Institute of Technology, Roorkee, Uttarakhand, India
| | - Xavier Bellanger
- Université de Lorraine, CNRS, LCPME, UMR 7564, Villers-lès-Nancy, France
| | - Christophe Merlin
- Université de Lorraine, CNRS, LCPME, UMR 7564, Villers-lès-Nancy, France
| | - Gargi Singh
- Department of Civil Engineering, Indian Institute of Technology, Roorkee, Uttarakhand, India
| | - Thomas U Berendonk
- Technische Universität Dresden, Institute of Hydrobiology, Dresden, Germany
| | - Uli Klümper
- Technische Universität Dresden, Institute of Hydrobiology, Dresden, Germany.
| |
Collapse
|
16
|
Lee J, Ju F, Beck K, Bürgmann H. Differential effects of wastewater treatment plant effluents on the antibiotic resistomes of diverse river habitats. THE ISME JOURNAL 2023; 17:1993-2002. [PMID: 37684524 PMCID: PMC10579368 DOI: 10.1038/s41396-023-01506-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/18/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023]
Abstract
Wastewater treatment plants (WWTPs) are key sources of antimicrobial resistance genes (ARGs) that could influence the resistomes of microbial communities in various habitats of the receiving river ecosystem. However, it is currently unknown which habitats are most impacted and whether ARGs, like certain chemical contaminants, could be accumulated or enriched in the river ecosystem. We conducted a systematic metagenomic survey on the antibiotic resistomes of WWTP effluent, four riverine habitats (water, suspended particles, sediment, epilithic biofilm), and freshwater amphipod gut microbiomes. The impact of WWTP effluent on the downstream habitats was assessed in nine Swiss rivers. While there were significant differences in resistomes across habitats, the wastewater resistome was more similar to the resistome of receiving river water than to the resistomes of other habitats, and river water was the habitat most strongly impacted by the WWTPs effluent. The sulfonamide, beta-lactam, and aminoglycoside resistance genes were among the most abundant ARGs in the WWTP effluents, and especially aadA, sul1, and class A beta-lactamase genes showed significantly increased abundance in the river water of downstream compared to upstream locations (p < 0.05). However, this was not the case for the sediment, biofilm, and amphipod gut habitats. Accordingly, evidence for accumulation or enrichment of ARGs through the riverine food web was not identified. Our study suggests that monitoring riverine antimicrobial resistance determinants could be conducted using "co-occurrence" of aadA, sul1, and class A beta-lactamase genes as an indicator of wastewater-related pollution and should focus on the water as the most affected habitat.
Collapse
Affiliation(s)
- Jangwoo Lee
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, 6047, Kastanienbaum, Switzerland
- Department of Environmental Systems Science, ETH Zurich, Swiss Federal Institute of Technology, Zurich, Switzerland
- Departments of Microbiology, Immunology & Infectious Diseases, Cumming School of Medicine, and Biological Sciences, Faculty of Science, University of Calgary, Calgary, AB, Canada
| | - Feng Ju
- Key Laboratory of Coastal Environment and Resources of Zhejiang Province, School of Engineering, Westlake University, 310030, Hangzhou, Zhejiang, China.
- Westlake Laboratory of Life Sciences and Biomedicine, 310024, Hangzhou, Zhejiang, China.
| | - Karin Beck
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, 6047, Kastanienbaum, Switzerland
| | - Helmut Bürgmann
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, 6047, Kastanienbaum, Switzerland.
| |
Collapse
|
17
|
Leão I, Khalifa L, Gallois N, Vaz-Moreira I, Klümper U, Youdkes D, Palmony S, Dagai L, Berendonk TU, Merlin C, Manaia CM, Cytryn E. Microbiome and Resistome Profiles along a Sewage-Effluent-Reservoir Trajectory Underline the Role of Natural Attenuation in Wastewater Stabilization Reservoirs. Appl Environ Microbiol 2023; 89:e0017023. [PMID: 37199629 PMCID: PMC10304787 DOI: 10.1128/aem.00170-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/24/2023] [Indexed: 05/19/2023] Open
Abstract
Antibiotic-resistant bacteria and antibiotic resistance gene (ARGs) loads dissipate through sewage treatment plants to receiving aquatic environments, but the mechanisms that mitigate the spread of these ARGs are not well understood due to the complexity of full-scale systems and the difficulty of source tracking in downstream environments. To overcome this problem, we targeted a controlled experimental system comprising a semicommercial membrane-aerated bioreactor (MABR), whose effluents fed a 4,500-L polypropylene basin that mimicked effluent stabilization reservoirs and receiving aquatic ecosystems. We analyzed a large set of physicochemical measurements, concomitant with the cultivation of total and cefotaxime-resistant Escherichia coli, microbial community analyses, and quantitative PCR (qPCR)/digital droplet PCR (ddPCR) quantification of selected ARGs and mobile genetic elements (MGEs). The MABR removed most of the sewage-derived organic carbon and nitrogen, and simultaneously, E. coli, ARG, and MGE levels dropped by approximately 1.5- and 1.0-log unit mL-1, respectively. Similar levels of E. coli, ARGs, and MGEs were removed in the reservoir, but interestingly, unlike in the MABR, the relative abundance (normalized to 16S rRNA gene-inferred total bacterial abundance) of these genes also decreased. Microbial community analyses revealed the substantial shifts in bacterial and eukaryotic community composition in the reservoir relative to the MABR. Collectively, our observations lead us to conclude that the removal of ARGs in the MABR is mainly a consequence of treatment-facilitated biomass removal, whereas in the stabilization reservoir, mitigation is linked to natural attenuation associated with ecosystem functioning, which includes abiotic parameters, and the development of native microbiomes that prevent the establishment of wastewater-derived bacteria and associated ARGs. IMPORTANCE Wastewater treatment plants are sources of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs), which can contaminate receiving aquatic environments and contribute to antibiotic resistance. We focused on a controlled experimental system comprising a semicommercial membrane-aerated bioreactor (MABR) that treated raw sewage, whose effluents fed a 4,500-L polypropylene basin that mimicked effluent stabilization reservoirs. We evaluated ARB and ARG dynamics across the raw-sewage-MABR-effluent trajectory, concomitant with evaluation of microbial community composition and physicochemical parameters, in an attempt to identify mechanisms associated with ARB and ARG dissipation. We found that removal of ARB and ARGs in the MABR was primarily associated with bacterial death or sludge removal, whereas in the reservoir it was attributed to the inability of ARBs and associated ARGs to colonize the reservoir due to a dynamic and persistent microbial community. The study demonstrates the importance of ecosystem functioning in removing microbial contaminants from wastewater.
Collapse
Affiliation(s)
- Inês Leão
- Universidade Católica Portuguesa, Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
| | - Leron Khalifa
- Institute of Soil, Water and Environmental Sciences, Volcani Institute, Agricultural Research Organization, Rishon-Lezion, Israel
| | | | - Ivone Vaz-Moreira
- Universidade Católica Portuguesa, Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
| | - Uli Klümper
- Technische Universität Dresden, Institute of Hydrobiology, Dresden, Germany
| | - Daniel Youdkes
- Institute of Soil, Water and Environmental Sciences, Volcani Institute, Agricultural Research Organization, Rishon-Lezion, Israel
| | | | | | | | | | - Célia M. Manaia
- Universidade Católica Portuguesa, Centro de Biotecnologia e Química Fina, Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
| | - Eddie Cytryn
- Institute of Soil, Water and Environmental Sciences, Volcani Institute, Agricultural Research Organization, Rishon-Lezion, Israel
| |
Collapse
|
18
|
Pulami D, Schwabe L, Blom J, Schwengers O, Wilharm G, Kämpfer P, Glaeser SP. Genomic plasticity and adaptive capacity of the quaternary alkyl-ammonium compound and copper tolerant Acinetobacter bohemicus strain QAC-21b isolated from pig manure. Antonie Van Leeuwenhoek 2023; 116:327-342. [PMID: 36642771 PMCID: PMC10024671 DOI: 10.1007/s10482-022-01805-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/26/2022] [Indexed: 01/17/2023]
Abstract
Here, we present the genomic characterization of an Acinetobacter bohemicus strain QAC-21b which was isolated in the presence of a quaternary alky-ammonium compound (QAAC) from manure of a conventional German pig farm. The genetic determinants for QAAC, heavy metal and antibiotic resistances are reported based of the whole genome shotgun sequence and physiological growth tests. A. bohemicus QAC-21b grew in a species typical manner well at environmental temperatures but not at 37 °C. The strain showed tolerance to QAACs and copper but was susceptible to antibiotics relevant for Acinetobacter treatments. The genome of QAC-21b contained several Acinetobacter typical QAAC and heavy metal transporting efflux pumps coding genes, but no key genes for acquired antimicrobial resistances. The high genomic content of transferable genetic elements indicates that this bacterium can be involved in the transmission of antimicrobial resistances, if it is released with manure as organic fertilizer on agricultural fields. The genetic content of the strain was compared to that of two other A. bohemicus strains, the type strain ANC 3994T, isolated from forest soil, and KCTC 42081, originally described as A. pakistanensis, a metal resistant strain isolated from a wastewater treatment pond. In contrast to the forest soil strain, both strains from anthropogenically impacted sources showed genetic features indicating their evolutionary adaptation to the anthropogenically impacted environments. Strain QAC-21b will be used as model strain to study the transmission of antimicrobial resistance to environmentally adapted Acinetobacter in agricultural environments receiving high content of pollutants with organic fertilizers from livestock husbandry.
Collapse
Affiliation(s)
- Dipen Pulami
- Institute of Applied Microbiology, Justus-Liebig University Giessen, 35392, Giessen, Germany
| | - Lina Schwabe
- Institute of Applied Microbiology, Justus-Liebig University Giessen, 35392, Giessen, Germany
| | - Jochen Blom
- Bioinformatics and Systems Biology, Justus-Liebig University Giessen, 35392, Giessen, Germany
| | - Oliver Schwengers
- Bioinformatics and Systems Biology, Justus-Liebig University Giessen, 35392, Giessen, Germany
| | - Gottfried Wilharm
- Project Group P2, Robert Koch Institute, Wernigerode Branch, 38855, Wernigerode, Germany
| | - Peter Kämpfer
- Institute of Applied Microbiology, Justus-Liebig University Giessen, 35392, Giessen, Germany
| | - Stefanie P Glaeser
- Institute of Applied Microbiology, Justus-Liebig University Giessen, 35392, Giessen, Germany.
| |
Collapse
|
19
|
Huang X, Lee CS, Zhang K, Alhamzani AG, Hsiao BS. Sodium Alginate-Aldehyde Cellulose Nanocrystal Composite Hydrogel for Doxycycline and Other Tetracycline Removal. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:1161. [PMID: 37049257 PMCID: PMC10096764 DOI: 10.3390/nano13071161] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/14/2023] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
A novel composite hydrogel bead composed of sodium alginate (SA) and aldehyde cellulose nanocrystal (DCNC) was developed for antibiotic remediation through a one-step cross-linking process in a calcium chloride bath. Structural and physical properties of the hydrogel bead, with varying composition ratios, were analyzed using techniques such as BET analysis, SEM imaging, tensile testing, and rheology measurement. The optimal composition ratio was found to be 40% (SA) and 60% (DCNC) by weight. The performance of the SA-DCNC hydrogel bead for antibiotic remediation was evaluated using doxycycline (DOXY) and three other tetracyclines in both single- and multidrug systems, yielding a maximum adsorption capacity of 421.5 mg g-1 at pH 7 and 649.9 mg g-1 at pH 11 for DOXY. The adsorption mechanisms were investigated through adsorption studies focusing on the effects of contact time, pH, concentration, and competitive contaminants, along with X-ray photoelectron spectroscopy analysis of samples. The adsorption of DOXY was confirmed to be the synergetic effects of chemical reaction, electrostatic interaction, hydrogen bonding, and pore diffusion/surface deposition. The SA-DCNC composite hydrogel demonstrated high reusability, with more than 80% of its adsorption efficiency remaining after five cycles of the adsorption-desorption test. The SA-DCNC composite hydrogel bead could be a promising biomaterial for future antibiotic remediation applications in both pilot and industrial scales because of its high adsorption efficiency and ease of recycling.
Collapse
Affiliation(s)
- Xiangyu Huang
- Department of Chemistry, Stony Brook University, 100 Nicolls Road, Stony Brook, NY 11794, USA
| | - Cheng-Shiuan Lee
- New York State Center for Clean Water Technology, Stony Brook University, Stony Brook, NY 11794, USA
- Research Center for Environmental Changes, Academia Sinica, Taipei 115, Taiwan
| | - Katherine Zhang
- Department of Chemistry, Stony Brook University, 100 Nicolls Road, Stony Brook, NY 11794, USA
| | | | - Benjamin S. Hsiao
- Department of Chemistry, Stony Brook University, 100 Nicolls Road, Stony Brook, NY 11794, USA
| |
Collapse
|
20
|
Al-Eitan L, Sendyani S, Alnimri M. Applications of the One Health concept: Current Status in the Middle East. JOURNAL OF BIOSAFETY AND BIOSECURITY 2023. [DOI: 10.1016/j.jobb.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
|
21
|
Pillay S, Calderón-Franco D, Urhan A, Abeel T. Metagenomic-based surveillance systems for antibiotic resistance in non-clinical settings. Front Microbiol 2022; 13:1066995. [PMID: 36532424 PMCID: PMC9755710 DOI: 10.3389/fmicb.2022.1066995] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/09/2022] [Indexed: 08/12/2023] Open
Abstract
The success of antibiotics as a therapeutic agent has led to their ineffectiveness. The continuous use and misuse in clinical and non-clinical areas have led to the emergence and spread of antibiotic-resistant bacteria and its genetic determinants. This is a multi-dimensional problem that has now become a global health crisis. Antibiotic resistance research has primarily focused on the clinical healthcare sectors while overlooking the non-clinical sectors. The increasing antibiotic usage in the environment - including animals, plants, soil, and water - are drivers of antibiotic resistance and function as a transmission route for antibiotic resistant pathogens and is a source for resistance genes. These natural compartments are interconnected with each other and humans, allowing the spread of antibiotic resistance via horizontal gene transfer between commensal and pathogenic bacteria. Identifying and understanding genetic exchange within and between natural compartments can provide insight into the transmission, dissemination, and emergence mechanisms. The development of high-throughput DNA sequencing technologies has made antibiotic resistance research more accessible and feasible. In particular, the combination of metagenomics and powerful bioinformatic tools and platforms have facilitated the identification of microbial communities and has allowed access to genomic data by bypassing the need for isolating and culturing microorganisms. This review aimed to reflect on the different sequencing techniques, metagenomic approaches, and bioinformatics tools and pipelines with their respective advantages and limitations for antibiotic resistance research. These approaches can provide insight into resistance mechanisms, the microbial population, emerging pathogens, resistance genes, and their dissemination. This information can influence policies, develop preventative measures and alleviate the burden caused by antibiotic resistance.
Collapse
Affiliation(s)
- Stephanie Pillay
- Delft Bioinformatics Lab, Delft University of Technology, Delft, Netherlands
| | | | - Aysun Urhan
- Delft Bioinformatics Lab, Delft University of Technology, Delft, Netherlands
- Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, MA, United States
| | - Thomas Abeel
- Delft Bioinformatics Lab, Delft University of Technology, Delft, Netherlands
- Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, MA, United States
| |
Collapse
|
22
|
Muurinen J, Muziasari WI, Hultman J, Pärnänen K, Narita V, Lyra C, Fadlillah LN, Rizki LP, Nurmi W, Tiedje JM, Dwiprahasto I, Hadi P, Virta MPJ. Antibiotic Resistomes and Microbiomes in the Surface Water along the Code River in Indonesia Reflect Drainage Basin Anthropogenic Activities. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:14994-15006. [PMID: 35775832 PMCID: PMC9631996 DOI: 10.1021/acs.est.2c01570] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Water and sanitation are important factors in the emergence of antimicrobial resistance in low- and middle-income countries. Drug residues, metals, and various wastes foster the spread of antibiotic resistance genes (ARGs) with the help of mobile genetic elements (MGEs), and therefore, rivers receiving contaminants and effluents from multiple sources are of special interest. We followed both the microbiome and resistome of the Code River in Indonesia from its pristine origin at the Merapi volcano through rural and then city areas to the coast of the Indian Ocean. We used a SmartChip quantitative PCR with 382 primer pairs for profiling the resistome and MGEs and 16S rRNA gene amplicon sequencing to analyze the bacterial communities. The community structure explained the resistome composition in rural areas, while the city sampling sites had lower bacterial diversity and more ARGs, which correlated with MGEs, suggesting increased mobility potential in response to pressures from human activities. Importantly, the vast majority of ARGs and MGEs were no longer detectable in marine waters at the ocean entrance. Our work provides information on the impact of different influents on river health as well as sheds light on how land use contributes to the river resistome and microbiome.
Collapse
Affiliation(s)
- Johanna Muurinen
- Department
of Microbiology, University of Helsinki, Viikinkaari 9, 00014 Helsinki, Finland
| | - Windi I. Muziasari
- Department
of Microbiology, University of Helsinki, Viikinkaari 9, 00014 Helsinki, Finland
- Resistomap
Oy, Viikinkaari 4, 00790 Helsinki, Finland
| | - Jenni Hultman
- Department
of Microbiology, University of Helsinki, Viikinkaari 9, 00014 Helsinki, Finland
| | - Katariina Pärnänen
- Department
of Microbiology, University of Helsinki, Viikinkaari 9, 00014 Helsinki, Finland
| | - Vanny Narita
- PT.
AmonRa, Jalan Panti Asuhan
37, 13330 Jakarta
Timur, Indonesia
| | - Christina Lyra
- Department
of Microbiology, University of Helsinki, Viikinkaari 9, 00014 Helsinki, Finland
| | - Lintang N. Fadlillah
- Center
for Environmental Studies (PSLH), Universitas
Gadjah Mada, Jalan Kuningan, 55281 Yogyakarta, Indonesia
- Faculty
of Geography, Universitas Gadjah Mada, Jalan Kaliurang, 55281 Yogyakarta, Indonesia
| | - Ludhang P. Rizki
- Center
for Environmental Studies (PSLH), Universitas
Gadjah Mada, Jalan Kuningan, 55281 Yogyakarta, Indonesia
- Faculty of
Medicine, Universitas Gadjah Mada, Jalan Farmako, 55281 Yogyakarta, Indonesia
| | - William Nurmi
- Resistomap
Oy, Viikinkaari 4, 00790 Helsinki, Finland
| | - James M. Tiedje
- Center
for Microbial Ecology, Department of Plant, Soil and Microbial Sciences, Michigan State University, East Lansing, Michigan 48824, United States
| | - Iwan Dwiprahasto
- Faculty of
Medicine, Universitas Gadjah Mada, Jalan Farmako, 55281 Yogyakarta, Indonesia
| | - Pramono Hadi
- Center
for Environmental Studies (PSLH), Universitas
Gadjah Mada, Jalan Kuningan, 55281 Yogyakarta, Indonesia
- Faculty
of Geography, Universitas Gadjah Mada, Jalan Kaliurang, 55281 Yogyakarta, Indonesia
| | - Marko P. J. Virta
- Department
of Microbiology, University of Helsinki, Viikinkaari 9, 00014 Helsinki, Finland
| |
Collapse
|
23
|
Prieto Riquelme M, Garner E, Gupta S, Metch J, Zhu N, Blair MF, Arango-Argoty G, Maile-Moskowitz A, Li AD, Flach CF, Aga DS, Nambi IM, Larsson DGJ, Bürgmann H, Zhang T, Pruden A, Vikesland PJ. Demonstrating a Comprehensive Wastewater-Based Surveillance Approach That Differentiates Globally Sourced Resistomes. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:14982-14993. [PMID: 35759608 PMCID: PMC9631994 DOI: 10.1021/acs.est.1c08673] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Wastewater-based surveillance (WBS) for disease monitoring is highly promising but requires consistent methodologies that incorporate predetermined objectives, targets, and metrics. Herein, we describe a comprehensive metagenomics-based approach for global surveillance of antibiotic resistance in sewage that enables assessment of 1) which antibiotic resistance genes (ARGs) are shared across regions/communities; 2) which ARGs are discriminatory; and 3) factors associated with overall trends in ARGs, such as antibiotic concentrations. Across an internationally sourced transect of sewage samples collected using a centralized, standardized protocol, ARG relative abundances (16S rRNA gene-normalized) were highest in Hong Kong and India and lowest in Sweden and Switzerland, reflecting national policy, measured antibiotic concentrations, and metal resistance genes. Asian versus European/US resistomes were distinct, with macrolide-lincosamide-streptogramin, phenicol, quinolone, and tetracycline versus multidrug resistance ARGs being discriminatory, respectively. Regional trends in measured antibiotic concentrations differed from trends expected from public sales data. This could reflect unaccounted uses, captured only by the WBS approach. If properly benchmarked, antibiotic WBS might complement public sales and consumption statistics in the future. The WBS approach defined herein demonstrates multisite comparability and sensitivity to local/regional factors.
Collapse
Affiliation(s)
| | - Emily Garner
- Department
of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia24061, United States
- Department
of Civil and Environmental Engineering, West Virginia University, Morgantown, West Virginia26506, United States
| | - Suraj Gupta
- Department
of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia24061, United States
- The
Interdisciplinary PhD Program in Genetics, Bioinformatics, and Computational
Biology, Virginia Tech, Blacksburg, Virginia24061, United States
| | - Jake Metch
- Department
of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia24061, United States
| | - Ni Zhu
- Department
of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia24061, United States
| | - Matthew F. Blair
- Department
of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia24061, United States
| | - Gustavo Arango-Argoty
- Department
of Computer Science, Virginia Tech, Blacksburg, Virginia24061, United States
| | - Ayella Maile-Moskowitz
- Department
of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia24061, United States
| | - An-dong Li
- Department
of Civil Engineering, The University of
Hong Kong, Pokfulam, Hong Kong
| | - Carl-Fredrik Flach
- Centre for
Antibiotic Resistance Research (CARe), University
of Gothenburg, 405 30Göteborg, Sweden
- Department
of Infectious Diseases, University of Gothenburg, 405 30Göteborg, Sweden
| | - Diana S. Aga
- Department
of Chemistry, University at Buffalo, Buffalo, New York14260, United States
| | - Indumathi M. Nambi
- Department
of Civil Engineering, Indian Institute of
Technology, Madras,
Chennai600036, India
| | - D. G. Joakim Larsson
- Centre for
Antibiotic Resistance Research (CARe), University
of Gothenburg, 405 30Göteborg, Sweden
- Department
of Infectious Diseases, University of Gothenburg, 405 30Göteborg, Sweden
| | - Helmut Bürgmann
- Eawag:
Swiss Federal Institute of Aquatic Science and Technology, CH-6047Kastanienbaum, Switzerland
| | - Tong Zhang
- Department
of Civil Engineering, The University of
Hong Kong, Pokfulam, Hong Kong
| | - Amy Pruden
- Department
of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia24061, United States
| | - Peter J. Vikesland
- Department
of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia24061, United States
| |
Collapse
|
24
|
Antibiotic-Resistant Bacteria and Resistance Genes in Isolates from Ghanaian Drinking Water Sources. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:2850165. [PMID: 36246472 PMCID: PMC9560817 DOI: 10.1155/2022/2850165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/04/2022] [Accepted: 09/10/2022] [Indexed: 11/17/2022]
Abstract
The control of infectious diseases is seriously threatened by the increase in the number of microorganisms resistant to antimicrobial agents. Antibiotic-resistant bacteria have also been identified in the water environment. A field study was performed sampling drinking water sources in seven districts of southern Ghana targeting boreholes, dams, hand-dug wells, and streams during baseflow conditions. Bacteria were isolated (N = 110) from a total of 67 water samples to investigate their antimicrobial susceptibility and to determine their carriage of select antibiotic resistance genes. Bacterial identification was performed using conventional selective media methods and the analytical profile index (API) method. Antibiotic susceptibility tests were carried out using the Kirby–Bauer method. Results indicated that all water sources tested were of poor quality based on the presence of fecal indicator organisms. The most commonly occurring bacterium isolated from water was Klebsiella spp. (N = 24, 21.8%), followed by E. coli (N = 23, 20.9%). Gram-negative bacteria isolates were most commonly resistant to cefuroxime (24.5%), while the Gram-positives were most commonly resistant to meropenem (21.3%). The highest rates of bacterial resistances to more than one antibiotic were observed in Klebsiella spp. (30.0%) followed by E. coli (27.8%). PCR was used to detect the presence of a select antibiotic resistance genes in the Gram-negative isolates. The presence of blaNDM-1, sull, tet(O), and tet(W) were observed in isolates from all water sources. In contrast, ermF was not detected in any of the Gram-negative isolates from any water source. Most (28.7%) of the resistance genes were observed in E. coli isolates. Reducing microbial contamination of the various water sources is needed to protect public health and to ensure the sustainability of this resource. This further calls for education of the citizenry.
Collapse
|
25
|
Lepper HC, Woolhouse MEJ, van Bunnik BAD. The Role of the Environment in Dynamics of Antibiotic Resistance in Humans and Animals: A Modelling Study. Antibiotics (Basel) 2022; 11:1361. [PMID: 36290019 PMCID: PMC9598675 DOI: 10.3390/antibiotics11101361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/29/2022] [Accepted: 10/01/2022] [Indexed: 11/17/2022] Open
Abstract
Antibiotic resistance is transmitted between animals and humans either directly or indirectly, through transmission via the environment. However, little is known about the contribution of the environment to resistance epidemiology. Here, we use a mathematical model to study the effect of the environment on human resistance levels and the impact of interventions to reduce antibiotic consumption in animals. We developed a model of resistance transmission with human, animal, and environmental compartments. We compared the model outcomes under different transmission scenarios, conducted a sensitivity analysis, and investigated the impacts of curtailing antibiotic usage in animals. Human resistance levels were most sensitive to parameters associated with the human compartment (rate of loss of resistance from humans) and with the environmental compartment (rate of loss of environmental resistance and rate of environment-to-human transmission). Increasing environmental transmission could lead to increased or reduced impact of curtailing antibiotic consumption in animals on resistance in humans. We highlight that environment-human sharing of resistance can influence the epidemiology of resistant bacterial infections in humans and reduce the impact of interventions that curtail antibiotic consumption in animals. More data on resistance in the environment and frequency of human-environment transmission is crucial to understanding antibiotic resistance dynamics.
Collapse
Affiliation(s)
- Hannah C. Lepper
- Usher Institute, Ashworth Laboratories, University of Edinburgh, Edinburgh EH9 3FL, UK
| | - Mark E. J. Woolhouse
- Usher Institute, Ashworth Laboratories, University of Edinburgh, Edinburgh EH9 3FL, UK
| | - Bram A. D. van Bunnik
- Usher Institute, Ashworth Laboratories, University of Edinburgh, Edinburgh EH9 3FL, UK
- Roslin Institute, University of Edinburgh, Edinburgh EH25 9RG, UK
| |
Collapse
|
26
|
Effects of varying flux and transmembrane pressure conditions during ceramic ultrafiltration on the infectivity and retention of MS2 bacteriophages. Sep Purif Technol 2022. [DOI: 10.1016/j.seppur.2022.121709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
27
|
Liguori K, Keenum I, Davis BC, Calarco J, Milligan E, Harwood VJ, Pruden A. Antimicrobial Resistance Monitoring of Water Environments: A Framework for Standardized Methods and Quality Control. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:9149-9160. [PMID: 35732277 DOI: 10.1080/10643389.2021.2024739] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Antimicrobial resistance (AMR) is a grand societal challenge with important dimensions in the water environment that contribute to its evolution and spread. Environmental monitoring could provide vital information for mitigating the spread of AMR; this includes assessing antibiotic resistance genes (ARGs) circulating among human populations, identifying key hotspots for evolution and dissemination of resistance, informing epidemiological and human health risk assessment models, and quantifying removal efficiencies by domestic wastewater infrastructure. However, standardized methods for monitoring AMR in the water environment will be vital to producing the comparable data sets needed to address such questions. Here we sought to establish scientific consensus on a framework for such standardization, evaluating the state of the science and practice of AMR monitoring of wastewater, recycled water, and surface water, through a literature review, survey, and workshop leveraging the expertise of academic, governmental, consulting, and water utility professionals.
Collapse
Affiliation(s)
- Krista Liguori
- The Charles Edward Via, Jr., Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia 24060, United States
| | - Ishi Keenum
- The Charles Edward Via, Jr., Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia 24060, United States
| | - Benjamin C Davis
- The Charles Edward Via, Jr., Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia 24060, United States
| | - Jeanette Calarco
- Department of Integrative Biology, University of South Florida, Tampa, Florida 33620, United States
| | - Erin Milligan
- The Charles Edward Via, Jr., Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia 24060, United States
| | - Valerie J Harwood
- Department of Integrative Biology, University of South Florida, Tampa, Florida 33620, United States
| | - Amy Pruden
- The Charles Edward Via, Jr., Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia 24060, United States
| |
Collapse
|
28
|
Liguori K, Keenum I, Davis BC, Calarco J, Milligan E, Harwood VJ, Pruden A. Antimicrobial Resistance Monitoring of Water Environments: A Framework for Standardized Methods and Quality Control. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:9149-9160. [PMID: 35732277 PMCID: PMC9261269 DOI: 10.1021/acs.est.1c08918] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Antimicrobial resistance (AMR) is a grand societal challenge with important dimensions in the water environment that contribute to its evolution and spread. Environmental monitoring could provide vital information for mitigating the spread of AMR; this includes assessing antibiotic resistance genes (ARGs) circulating among human populations, identifying key hotspots for evolution and dissemination of resistance, informing epidemiological and human health risk assessment models, and quantifying removal efficiencies by domestic wastewater infrastructure. However, standardized methods for monitoring AMR in the water environment will be vital to producing the comparable data sets needed to address such questions. Here we sought to establish scientific consensus on a framework for such standardization, evaluating the state of the science and practice of AMR monitoring of wastewater, recycled water, and surface water, through a literature review, survey, and workshop leveraging the expertise of academic, governmental, consulting, and water utility professionals.
Collapse
Affiliation(s)
- Krista Liguori
- The
Charles Edward Via, Jr., Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia 24060, United States
| | - Ishi Keenum
- The
Charles Edward Via, Jr., Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia 24060, United States
| | - Benjamin C. Davis
- The
Charles Edward Via, Jr., Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia 24060, United States
| | - Jeanette Calarco
- Department
of Integrative Biology, University of South
Florida, Tampa, Florida 33620, United States
| | - Erin Milligan
- The
Charles Edward Via, Jr., Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia 24060, United States
| | - Valerie J. Harwood
- Department
of Integrative Biology, University of South
Florida, Tampa, Florida 33620, United States
| | - Amy Pruden
- The
Charles Edward Via, Jr., Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, Virginia 24060, United States
| |
Collapse
|
29
|
Calderón-Franco D, Sarelse R, Christou S, Pronk M, van Loosdrecht MCM, Abeel T, Weissbrodt DG. Metagenomic profiling and transfer dynamics of antibiotic resistance determinants in a full-scale granular sludge wastewater treatment plant. WATER RESEARCH 2022; 219:118571. [PMID: 35576763 DOI: 10.1016/j.watres.2022.118571] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/04/2022] [Accepted: 05/07/2022] [Indexed: 05/25/2023]
Abstract
In the One Health context, wastewater treatment plants (WWTPs) are central to safeguarding water resources. Nonetheless, many questions remain about their effectiveness in preventing antimicrobial resistance (AMR) dissemination. Most surveillance studies monitor the levels and removal of selected antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs) in intracellular DNA (iDNA) extracted from WWTP influents and effluents. The role of extracellular free DNA (exDNA) in wastewater is mostly overlooked. This study analyzed the transfer of ARGs and MGEs in a full-scale Nereda® reactor removing nutrients with aerobic granular sludge. We tracked the composition and fate of the iDNA and exDNA pools of influent, sludge, and effluent samples. Metagenomics was used to profile the microbiome, resistome, and mobilome signatures of iDNA and exDNA extracts. Selected ARGs and MGEs were analyzed by qPCR. From 2,840 ARGs identified, the genes arr-3 (2%), tetC (1.6%), sul1 (1.5%), oqxB (1.2%), and aph(3")-Ib (1.2%) were the most abundant among all sampling points and bioaggregates. Pseudomonas, Acinetobacter, Aeromonas, Acidovorax, Rhodoferax, and Streptomyces populations were the main potential hosts of ARGs in the sludge. In the effluent, 478 resistance determinants were detected, of which 89% were from exDNA potentially released by cell lysis during aeration in the reactor. MGEs and multiple ARGs were co-localized on the same extracellular genetic contigs. Total intracellular ARGs decreased 3-42% due to wastewater treatment. However, the ermB and sul1 genes increased by 2 and 1 log gene copies mL-1, respectively, in exDNA from influent to effluent. The exDNA fractions need to be considered in AMR surveillance, risk assessment, and mitigation strategies.
Collapse
Affiliation(s)
- David Calderón-Franco
- Department of Biotechnology, Weissbrodt Group for Environmental Life Science Engineering, Environmental Biotechnology Section, Delft University of Technology, van der Maasweg 9, Delft 2629 HZ, the Netherlands
| | - Roel Sarelse
- Department of Biotechnology, Weissbrodt Group for Environmental Life Science Engineering, Environmental Biotechnology Section, Delft University of Technology, van der Maasweg 9, Delft 2629 HZ, the Netherlands
| | - Stella Christou
- Department of Biotechnology, Weissbrodt Group for Environmental Life Science Engineering, Environmental Biotechnology Section, Delft University of Technology, van der Maasweg 9, Delft 2629 HZ, the Netherlands
| | - Mario Pronk
- Department of Biotechnology, Weissbrodt Group for Environmental Life Science Engineering, Environmental Biotechnology Section, Delft University of Technology, van der Maasweg 9, Delft 2629 HZ, the Netherlands; Royal HaskoningDHV, Amersfoort, the Netherlands
| | - Mark C M van Loosdrecht
- Department of Biotechnology, Weissbrodt Group for Environmental Life Science Engineering, Environmental Biotechnology Section, Delft University of Technology, van der Maasweg 9, Delft 2629 HZ, the Netherlands
| | - Thomas Abeel
- Delft Bioinformatics Lab, Delft University of Technology, Delft, the Netherlands; Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, USA
| | - David G Weissbrodt
- Department of Biotechnology, Weissbrodt Group for Environmental Life Science Engineering, Environmental Biotechnology Section, Delft University of Technology, van der Maasweg 9, Delft 2629 HZ, the Netherlands.
| |
Collapse
|
30
|
Konopka JK, Chatterjee P, LaMontagne C, Brown J. Environmental impacts of mass drug administration programs: exposures, risks, and mitigation of antimicrobial resistance. Infect Dis Poverty 2022; 11:78. [PMID: 35773680 PMCID: PMC9243877 DOI: 10.1186/s40249-022-01000-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/09/2022] [Indexed: 01/05/2023] Open
Abstract
Mass drug administration (MDA) of antimicrobials has shown promise in the reduction and potential elimination of a variety of neglected tropical diseases (NTDs). However, with antimicrobial resistance (AMR) becoming a global crisis, the risks posed by widespread antimicrobial use need to be evaluated. As the role of the environment in AMR emergence and dissemination has become increasingly recognized, it is likewise crucial to establish the role of MDA in environmental AMR pollution, along with the potential impacts of such pollution. This review presents the current state of knowledge on the antimicrobial compounds, resistant organisms, and antimicrobial resistance genes in MDA trials, routes of these determinants into the environment, and their persistence and ecological impacts, particularly in low and middle-income countries where these trials are most common. From the few studies directly evaluating AMR outcomes in azithromycin MDA trials, it is becoming apparent that MDA efforts can increase carriage and excretion of resistant pathogens in a lasting way. However, research on these outcomes for other antimicrobials used in MDA trials is sorely needed. Furthermore, while paths of AMR determinants from human waste to the environment and their persistence thereafter are supported by the literature, quantitative information on the scope and likelihood of this is largely absent. We recommend some mitigative approaches that would be valuable to consider in future MDA efforts. This review stands to be a valuable resource for researchers and policymakers seeking to evaluate the impacts of MDA.
Collapse
Affiliation(s)
- Joanna K Konopka
- The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
| | - Pranab Chatterjee
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Connor LaMontagne
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7431, USA
| | - Joe Brown
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7431, USA
| |
Collapse
|
31
|
Review of Antimicrobial Resistance in Wastewater in Japan: Current Challenges and Future Perspectives. Antibiotics (Basel) 2022; 11:antibiotics11070849. [PMID: 35884103 PMCID: PMC9312076 DOI: 10.3390/antibiotics11070849] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/14/2022] [Accepted: 06/22/2022] [Indexed: 12/18/2022] Open
Abstract
Antimicrobial resistance (AMR) circulates through humans, animals, and the environments, requiring a One Health approach. Recently, urban sewage has increasingly been suggested as a hotspot for AMR even in high-income countries (HICs), where the water sanitation and hygiene infrastructure are well-developed. To understand the current status of AMR in wastewater in a HIC, we reviewed the epidemiological studies on AMR in the sewage environment in Japan from the published literature. Our review showed that a wide variety of clinically important antibiotic-resistant bacteria (ARB), antibiotic resistance genes (ARGs), and antimicrobial residues are present in human wastewater in Japan. Their concentrations are lower than in low- and middle-income countries (LMICs) and are further reduced by sewage treatment plants (STPs) before discharge. Nevertheless, the remaining ARB and ARGs could be an important source of AMR contamination in river water. Furthermore, hospital effluence may be an important reservoir of clinically important ARB. The high concentration of antimicrobial agents commonly prescribed in Japan may contribute to the selection and dissemination of AMR within wastewater. Our review shows the importance of both monitoring for AMR and antimicrobials in human wastewater and efforts to reduce their contamination load in wastewater.
Collapse
|
32
|
Ghabalo AP, Safarkar R. Monitoring and Evaluation of Antibiotic Resistance Pattern of Escherichia coli Isolated from Drinking Water Sources in Ardabil Province of Iran. Open Microbiol J 2022. [DOI: 10.2174/18742858-v16-e2203100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background and Objective:
Antibiotic resistance is rapidly spreading among bacteria, such as Escherichia coli, which have been discharged into water sources by humans and animals, in part due to genes carried by integrons. The goal of this study was to track and assess the pattern of antibiotic resistance among Escherichia coli strains isolated from drinking water sources in Iran’s Ardabil province.
Methods:
Escherichia coli strains were isolated and identified using standard biochemical and microbiological techniques from Ardabil province’s water supply sources in 2019 and 2020. The class 1 integron gene was detected using the polymerase chain reaction (PCR). The disk diffusion method was used to determine antibiotic resistance and sensitivity.
Results:
The Int I gene was found in 47 out of 200 isolates (23.5%). The antibiotic streptomycin had the highest resistance (100%), whereas gentamycin, ciprofloxacin, tobramycin, tetracycline, cefipime, imipenem, meropenem, chloramphenicol, and trimethoprim-sulfamethoxamide had the lowest resistance. Gentamycin, ciprofloxacin, tobramycin, tetracycline, cefipime, imipenem, meropenem, and trimethoprim-sulfamethoxazole, on the other hand, had the highest sensitivity of 100%, while streptomycin had the lowest (0%). Also, the highest level of pollution of Escherichia coli in drinking water supply sources in the province is in Parsabad city (42.86%), and the lowest level of pollution is in Kosar city (6.67%).
Conclusion:
According to the findings of this study, the high prevalence of Escherichia coli strains resistant to the antibiotic streptomycin circulating in water sources should be considered a major problem in terms of antibiotic resistance spreading among bacteria in water.
Collapse
|
33
|
Sanchez-Cid C, Guironnet A, Keuschnig C, Wiest L, Vulliet E, Vogel TM. Gentamicin at sub-inhibitory concentrations selects for antibiotic resistance in the environment. ISME COMMUNICATIONS 2022; 2:29. [PMID: 37938295 PMCID: PMC9723587 DOI: 10.1038/s43705-022-00101-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/24/2022] [Accepted: 02/01/2022] [Indexed: 06/01/2023]
Abstract
Antibiotics released into the environment at low (sub-inhibitory) concentrations could select for antibiotic resistance that might disseminate to the human microbiome. In this case, low-level anthropogenic sources of antibiotics would have a significant impact on human health risk. In order to provide data necessary for the evaluation of this risk, we implemented river water microcosms at both sub-inhibitory and inhibitory concentrations of gentamicin as determined previously based on bacterial growth in enriched media. Using metagenomic sequencing and qPCR/RT-qPCR, we assessed the effects of gentamicin on water bacterial communities and their resistome. A change in the composition of total and active communities, as well as a gentamicin resistance gene selection identified via mobile genetic elements, was observed during a two-day exposure. We demonstrated the effects of sub-inhibitory concentrations of gentamicin on bacterial communities and their associated resistome in microcosms (simulating in situ conditions). In addition, we established relationships between antibiotic dose and the magnitude of the community response in the environment. The scope of resistance selection under sub-inhibitory concentrations of antibiotics and the mechanisms underlying this process might provide the basis for understanding resistance dispersion and associated risks in relatively low impacted ecosystems.
Collapse
Affiliation(s)
- Concepcion Sanchez-Cid
- Environmental Microbial Genomics, Laboratoire Ampère, Ecole Centrale de Lyon, Université de Lyon, Ecully, France.
- Promega France, 69100, Charbonnières-les-Bains, France.
| | - Alexandre Guironnet
- Univ Lyon, CNRS, Université Claude Bernard Lyon 1, Institut des Sciences Analytiques, UMR 5280, 5 Rue de la Doua, F-69100, Villeurbanne, France
| | - Christoph Keuschnig
- Environmental Microbial Genomics, Laboratoire Ampère, Ecole Centrale de Lyon, Université de Lyon, Ecully, France
| | - Laure Wiest
- Univ Lyon, CNRS, Université Claude Bernard Lyon 1, Institut des Sciences Analytiques, UMR 5280, 5 Rue de la Doua, F-69100, Villeurbanne, France
| | - Emmanuelle Vulliet
- Univ Lyon, CNRS, Université Claude Bernard Lyon 1, Institut des Sciences Analytiques, UMR 5280, 5 Rue de la Doua, F-69100, Villeurbanne, France
| | - Timothy M Vogel
- Environmental Microbial Genomics, Laboratoire Ampère, Ecole Centrale de Lyon, Université de Lyon, Ecully, France
| |
Collapse
|
34
|
Velazquez-Meza ME, Galarde-López M, Carrillo-Quiróz B, Alpuche-Aranda CM. Antimicrobial resistance: One Health approach. Vet World 2022; 15:743-749. [PMID: 35497962 PMCID: PMC9047147 DOI: 10.14202/vetworld.2022.743-749] [Citation(s) in RCA: 92] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/10/2022] [Indexed: 11/19/2022] Open
Abstract
In this research, a review of antimicrobial resistance (AMR) is conducted as part of the One Health approach. A review of publications, which included “antimicrobial resistance” and “One Health,” was conducted. Among the global health problems, AMR is the one that most clearly illustrates the One Health approach. AMR is a critical global problem affecting humans, the environment, and animals. This is related to each of these three components due to the irresponsible and excessive use of antimicrobials in various sectors (agriculture, livestock, and human medicine). Improper management of antimicrobials, inadequate control of infections, agricultural debris, pollutants in the environment, and migration of people and animals infected with resistant bacteria facilitate the spread of resistance. The study aimed to analyze the problem of AMR from a health perspective to analyze the different actors involved in One Health.
Collapse
Affiliation(s)
- Maria Elena Velazquez-Meza
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Miguel Galarde-López
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Berta Carrillo-Quiróz
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Celia Mercedes Alpuche-Aranda
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| |
Collapse
|
35
|
Schwaller C, Fokkens K, Helmreich B, Drewes JE. CFD simulations of flow fields during ultrafiltration: Effects of hydrodynamic strain rates with and without a particle cake layer on the permeation of mobile genetic elements. Chem Eng Sci 2022. [DOI: 10.1016/j.ces.2022.117606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
36
|
Booth A, Wester AL. A multivariable analysis of the contribution of socioeconomic and environmental factors to blood culture Escherichia Coli resistant to fluoroquinolones in high- and middle-income countries. BMC Public Health 2022; 22:354. [PMID: 35183144 PMCID: PMC8857829 DOI: 10.1186/s12889-022-12776-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 02/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) is a public health concern. We wanted to determine if various environmental and socioeconomic variables as well as markers of antimicrobial use impacted on the level of AMR in countries of different income levels. METHODS We performed cross-national univariate and multivariable analyses using the national proportion of quinolone-resistant Escherichia coli (QREC) in blood culture as the dependent variable. Access to safe water and sanitation, other socioeconomic variables, and human and animal antimicrobial consumption were analysed. RESULTS In middle-income countries, unsafely managed sanitation, corruption and healthcare access and quality were significantly associated with the national proportion of blood culture QREC (%) in univariate analyses, whereas no variables remained significant in the multivariable models. For the multivariable high-income country model, corruption and healthcare access and quality were significantly associated with blood culture QREC (%) levels. For the model including all countries, human fluoroquinolone use, corruption level, livestock and crop production index were significantly associated with blood culture QREC (%) levels in the univariate analyses. CONCLUSION Corruption is a strong predictor of AMR, likely reflecting a multitude of socioeconomic factors. Sanitation quality contributed to increased blood culture QREC (%) levels in middle-income countries, although was not an independent factor, highlighting the need to also focus on infrastructure such as sanitation services in the context of AMR.
Collapse
Affiliation(s)
- Amy Booth
- Faculty of Health Sciences, University of Cape Town, Rondebosch, Cape Town, 7700, South Africa.
| | - Astrid Louise Wester
- Centre for Antimicrobial Resistance Research, and Division of Infection Control, Norwegian Institute of Public Health, Lovisenberggata 8, 0456, Oslo, Norway
| |
Collapse
|
37
|
Che Y, Xu X, Yang Y, Břinda K, Hanage W, Yang C, Zhang T. High-resolution genomic surveillance elucidates a multilayered hierarchical transfer of resistance between WWTP- and human/animal-associated bacteria. MICROBIOME 2022; 10:16. [PMID: 35078531 PMCID: PMC8790882 DOI: 10.1186/s40168-021-01192-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 11/05/2021] [Indexed: 05/10/2023]
Abstract
BACKGROUND Our interconnected world and the ability of bacteria to quickly swap antibiotic resistance genes (ARGs) make it particularly important to establish the epidemiological links of multidrug resistance (MDR) transfer between wastewater treatment plant (WWTP)- and human/animal-associated bacteria, under the One Health framework. However, evidence of ARGs exchange and potential factors that contribute to this transfer remain limited. RESULTS Here, by combining culture-based population genomics and genetic comparisons with publicly available datasets, we reconstructed the complete genomes of 82 multidrug-resistant isolates from WWTPs and found that most WWTP-associated isolates were genetically distinct from their closest human/animal-associated relatives currently available in the public database. Even in the minority of lineages that were closely related, WWTP-associated isolates were characterized by quite different plasmid compositions. We identified a high diversity of circular plasmids (264 in total, of which 141 were potentially novel), which served as the main source of resistance, and showed potential horizontal transfer of ARG-bearing plasmids between WWTP- and humans/animal-associated bacteria. Notably, the potentially transferred ARGs and virulence factors (VFs) with different genetic backgrounds were closely associated with flanking insertion sequences (ISs), suggesting the importance of synergy between plasmids and ISs in mediating a multilayered hierarchical transfer of MDR and potentiating the emergence of MDR-hypervirulent clones. CONCLUSION Our findings advance the current efforts to establish potential epidemiological links of MDR transmission between WWTP- and human/animal-associated bacteria. Plasmids play an important role in mediating the transfer of ARGs and the IS-associated ARGs that are carried by conjugative plasmids should be prioritized to tackle the spread of resistance. Video Abstract.
Collapse
Affiliation(s)
- You Che
- Environmental Microbiome Engineering and Biotechnology Laboratory, Center for Environmental Engineering Research, Department of Civil Engineering, The University of Hong Kong, Pok Fu Lam, Hong Kong, China
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA USA
| | - Xiaoqing Xu
- Environmental Microbiome Engineering and Biotechnology Laboratory, Center for Environmental Engineering Research, Department of Civil Engineering, The University of Hong Kong, Pok Fu Lam, Hong Kong, China
| | - Yu Yang
- Environmental Microbiome Engineering and Biotechnology Laboratory, Center for Environmental Engineering Research, Department of Civil Engineering, The University of Hong Kong, Pok Fu Lam, Hong Kong, China
| | - Karel Břinda
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA USA
- Department of Biomedical Informatics, Harvard Medical School, MA Boston, USA
| | - William Hanage
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA USA
| | - Chao Yang
- Key Laboratory of Molecular Microbiology and Technology for Ministry of Education, Nankai University, 300071 Tianjin, China
| | - Tong Zhang
- Environmental Microbiome Engineering and Biotechnology Laboratory, Center for Environmental Engineering Research, Department of Civil Engineering, The University of Hong Kong, Pok Fu Lam, Hong Kong, China
| |
Collapse
|
38
|
Kaiser RA, Taing L, Bhatia H. Antimicrobial Resistance and Environmental Health: A Water Stewardship Framework for Global and National Action. Antibiotics (Basel) 2022; 11:antibiotics11010063. [PMID: 35052940 PMCID: PMC8773023 DOI: 10.3390/antibiotics11010063] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/14/2021] [Accepted: 12/28/2021] [Indexed: 01/09/2023] Open
Abstract
Antimicrobial resistance (AMR) is a global health crisis that affects all life on Earth. In 2015, the World Health Organization developed guidance to combat AMR in accordance with a One Health framework considering human, animal, and environment sectors of planetary health. This study reviewed global guidance and 25 National Action Plans to evaluate thematic priorities in One Health AMR approaches using a novel framework that additionally facilitated the identification of water-related stewardship gaps, as water resources are recognized as the primary environmental AMR reservoir and dissemination pathway. This review found that global and national stewardship primarily focuses on mitigating antibiotic use in the human and animal sectors, overlooking environmental drivers, particularly diverse environmental waters. The findings of this study highlight the need to broaden the scope of water-related AMR concerns beyond water, sanitation, and hygiene (WASH) infrastructure for water supply and wastewater treatment, and account for environmental waters in AMR development and dissemination, particularly in low-income countries where half a billion people rely on environmental waters to meet daily needs. Equitably accounting for water environments, supplies, and waste in AMR prevention, mitigation, surveillance, and innovation can significantly enhance the integration of environmental objectives in One Health AMR stewardship.
Collapse
Affiliation(s)
- Rachel A. Kaiser
- School of Environmental Studies, College of Interdisciplinary Studies, Tennessee Technological University, 1 William L Jones Drive, Cookeville, TN 38505, USA
- United Nations University Institute for Water, Environment and Health (UNU-INWEH), 204-175 Longwood Rd. S, Hamilton, ON L8P 0A1, Canada; (L.T.); (H.B.)
- Correspondence:
| | - Lina Taing
- United Nations University Institute for Water, Environment and Health (UNU-INWEH), 204-175 Longwood Rd. S, Hamilton, ON L8P 0A1, Canada; (L.T.); (H.B.)
- School of Geography and Earth Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
| | - Himesh Bhatia
- United Nations University Institute for Water, Environment and Health (UNU-INWEH), 204-175 Longwood Rd. S, Hamilton, ON L8P 0A1, Canada; (L.T.); (H.B.)
| |
Collapse
|
39
|
Lee J, Beck K, Bürgmann H. Wastewater bypass is a major temporary point-source of antibiotic resistance genes and multi-resistance risk factors in a Swiss river. WATER RESEARCH 2022; 208:117827. [PMID: 34794019 DOI: 10.1016/j.watres.2021.117827] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 06/13/2023]
Abstract
Untreated combined sewage (bypass) is often discharged by wastewater treatment plants to receiving rivers during stormwater events, where it may contribute to increased levels of antibiotic resistance genes (ARGs) and multi-resistance risk factors (multi-resistant bacteria and multi-resistance genomic determinants (MGDs)) in the receiving water. Other contamination sources, such as soil runoff and resuspended river sediment could also play a role during stormwater events. Here we report on stormwater event-based sampling campaigns to determine temporal dynamics of ARGs and multi-resistance risk factors in bypass, treated effluent, and the receiving river, as well as complimentary data on catchment soils and surface sediments. Both indicator ARGs (qPCR) and resistome (ARG profiles revealed by metagenomics) indicated bypass as the main contributor to the increased levels of ARGs in the river during stormwater events. Furthermore, we showed for the first time that the risk of exposure to bypass-borne multi-resistance risk factors increase under stormwater events and that many of these MGDs were plasmid associated and thus potentially mobile. In addition, elevated resistance risk factors persisted for some time (up to 22 h) in the receiving water after stormwater events, likely due to inputs from distributed overflows in the catchment. This indicates temporal dynamics should be considered when interpreting the risks of exposure to resistance from event-based contamination. We propose that reducing bypass from wastewater treatment plants may be an important intervention option for reducing dissemination of antibiotic resistance.
Collapse
Affiliation(s)
- Jangwoo Lee
- Department of Surface Waters Research and Management, Eawag, Swiss Federal Institute of Aquatic Science and Technology, Kastanienbaum, Switzerland; Department of Environmental Systems Science, Swiss Federal Institute of Technology, ETH Zurich, Zurich, Switzerland
| | - Karin Beck
- Department of Surface Waters Research and Management, Eawag, Swiss Federal Institute of Aquatic Science and Technology, Kastanienbaum, Switzerland
| | - Helmut Bürgmann
- Department of Surface Waters Research and Management, Eawag, Swiss Federal Institute of Aquatic Science and Technology, Kastanienbaum, Switzerland.
| |
Collapse
|
40
|
Flores-Vargas G, Bergsveinson J, Lawrence JR, Korber DR. Environmental Biofilms as Reservoirs for Antimicrobial Resistance. Front Microbiol 2022; 12:766242. [PMID: 34970233 PMCID: PMC8713029 DOI: 10.3389/fmicb.2021.766242] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 11/22/2021] [Indexed: 12/17/2022] Open
Abstract
Characterizing the response of microbial communities to a range of antibiotic concentrations is one of the strategies used to understand the impact of antibiotic resistance. Many studies have described the occurrence and prevalence of antibiotic resistance in microbial communities from reservoirs such as hospitals, sewage, and farm feedlots, where bacteria are often exposed to high and/or constant concentrations of antibiotics. Outside of these sources, antibiotics generally occur at lower, sub-minimum inhibitory concentrations (sub-MICs). The constant exposure to low concentrations of antibiotics may serve as a chemical "cue" that drives development of antibiotic resistance. Low concentrations of antibiotics have not yet been broadly described in reservoirs outside of the aforementioned environments, nor is the transfer and dissemination of antibiotic resistant bacteria and genes within natural microbial communities fully understood. This review will thus focus on low antibiotic-concentration environmental reservoirs and mechanisms that are important in the dissemination of antibiotic resistance to help identify key knowledge gaps concerning the environmental resistome.
Collapse
Affiliation(s)
| | | | - John R Lawrence
- Environment and Climate Change Canada, Saskatoon, SK, Canada
| | - Darren R Korber
- Food and Bioproduct Sciences, University of Saskatchewan, Saskatoon, SK, Canada
| |
Collapse
|
41
|
Tan L, Zhang C, Liu F, Chen P, Wei X, Li H, Yi G, Xu Y, Zheng X. Three-compartment septic tanks as sustainable on-site treatment facilities? Watch out for the potential dissemination of human-associated pathogens and antibiotic resistance. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2021; 300:113709. [PMID: 34547574 DOI: 10.1016/j.jenvman.2021.113709] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/05/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
Improved sanitation is critical important to reduce the spread of human deposited pathogens and antibiotic resistance genes (ARGs). In the China's rural "Toilet Revolution", three-compartment septic tanks (SPTs) are widely used as household domestic sewage treatment facilities. The effluents of SPTs are encouraged to be used as fertilizer in agriculture. However, whether SPT could eliminate fecal pathogens and ARGs is still unrevealed which is crucial in risk assessment of SPT effluent utilization. Herein, we employed metagenomic sequencing to investigate the pathogens and ARGs in rural household SPTs from Tianjin, China. We found that rural household SPT effluents conserved pathogens comparable to that of the influents. A total of 441 ARGs conferring resistance to 26 antibiotic classes were observed in rural household SPTs, with the relative abundance ranging from 709 to 1800 ppm. Results of metagenomic assembly indicated that some ARG-MGE-carrying contigs were carried by pathogens, which may pose risk to human and animal health after being introduced to the environment. This study raises the question of SPTs as sustainable on-site treatment facilities for rural domestic sewage and underscores the need for more attention to the propagation and dissemination of antibiotic-resistant pathogens from SPT to the environments, animals, and humans.
Collapse
Affiliation(s)
- Lu Tan
- Agro-Environmental Protection Institute, Ministry of Agriculture and Rural Affairs, Tianjin, 300191, China
| | - Chunxue Zhang
- Agro-Environmental Protection Institute, Ministry of Agriculture and Rural Affairs, Tianjin, 300191, China
| | - Fang Liu
- Agro-Environmental Protection Institute, Ministry of Agriculture and Rural Affairs, Tianjin, 300191, China
| | - Peizhen Chen
- Agro-Environmental Protection Institute, Ministry of Agriculture and Rural Affairs, Tianjin, 300191, China
| | - Xiaocheng Wei
- Agro-Environmental Protection Institute, Ministry of Agriculture and Rural Affairs, Tianjin, 300191, China
| | - Houyu Li
- Agro-Environmental Protection Institute, Ministry of Agriculture and Rural Affairs, Tianjin, 300191, China
| | - Gao Yi
- Agro-Environmental Protection Institute, Ministry of Agriculture and Rural Affairs, Tianjin, 300191, China
| | - Yan Xu
- Agro-Environmental Protection Institute, Ministry of Agriculture and Rural Affairs, Tianjin, 300191, China.
| | - Xiangqun Zheng
- Agro-Environmental Protection Institute, Ministry of Agriculture and Rural Affairs, Tianjin, 300191, China.
| |
Collapse
|
42
|
Denny L. BSAC Vanguard Series: Clean water-the world's best medicine for disease and drug-resistant infection. J Antimicrob Chemother 2021; 77:279-280. [PMID: 34849983 DOI: 10.1093/jac/dkab414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
As stated by the WHO, without urgent action we are heading for a 'post-antibiotic era', in which common infections and minor injuries will again prove fatal, as they did in the past. How do we get millions of people to change their use of antimicrobials to avoid this terrifying outcome? There is one very effective measure that we can take: making access to clean water and sanitation universal. Billions of the world's population still lack access to clean drinking water and adequate sanitation. Some of the statistics regarding this lack of access are truly shocking. Global health organizations and policymakers must move from prioritizing treating disease to preventing it. This takes capital investment but will pay dividends in reductions in infections and antimicrobial resistance.
Collapse
Affiliation(s)
- Lindsay Denny
- Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA
| |
Collapse
|
43
|
Antibiotic Resistance Genes and Potentially Pathogenic Bacteria in the Central Adriatic Sea: Are They Connected to Urban Wastewater Inputs? WATER 2021. [DOI: 10.3390/w13233335] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Despite last decades’ interventions within local and communitarian programs, the Mediterranean Sea still receives poorly treated urban wastewater (sewage). Wastewater treatment plants (WWTPs) performing primary sewage treatments have poor efficiency in removing microbial pollutants, including fecal indicator bacteria, pathogens, and mobile genetic elements conferring resistance to antimicrobials. Using a combination of molecular tools, we investigated four urban WWTPs (i.e., two performing only mechanical treatments and two performing a subsequent conventional secondary treatment by activated sludge) as continuous sources of microbial pollution for marine coastal waters. Sewage that underwent only primary treatments was characterized by a higher content of traditional and alternative fecal indicator bacteria, as well as potentially pathogenic bacteria (especially Acinetobacter, Coxiella, Prevotella, Streptococcus, Pseudomonas, Vibrio, Empedobacter, Paracoccus, and Leptotrichia), than those subjected to secondary treatment. However, seawater samples collected next to the discharging points of all the WWTPs investigated here revealed a marked fecal signature, despite significantly lower values in the presence of secondary treatment of the sewage. WWTPs in this study represented continuous sources of antibiotic resistance genes (ARGs) ermB, qnrS, sul2, tetA, and blaTEM (the latter only for three WWTPs out of four). Still, no clear effects of the two depuration strategies investigated here were detected. Some marine samples were identified as positive to the colistin-resistance gene mcr-1, an ARG that threatens colistin antibiotics’ clinical utility in treating infections with multidrug-resistant bacteria. This study provides evidence that the use of sole primary treatments in urban wastewater management results in pronounced inputs of microbial pollution into marine coastal waters. At the same time, the use of conventional treatments does not fully eliminate ARGs in treated wastewater. The complementary use of molecular techniques could successfully improve the evaluation of the depuration efficiency and help develop novel solutions for the treatment of urban wastewater.
Collapse
|
44
|
Role of pollution on the selection of antibiotic resistance and bacterial pathogens in the environment. Curr Opin Microbiol 2021; 64:117-124. [PMID: 34700125 DOI: 10.1016/j.mib.2021.10.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/28/2021] [Accepted: 10/06/2021] [Indexed: 02/02/2023]
Abstract
There is evidence that human activity causes pollution that contributes to an enhanced selection of bacterial pathogens in the environment. In this review, we consider how environmental pollution can favour the selection of bacterial pathogens in the environment. We specifically discuss pollutants released into the environment by human activities (mainly human waste) that are associated with the selection for genetic features in environmental bacterial populations that lead to the emergence of bacterial pathogens. Finally, we also identify key pollutants that are associated with antibiotic resistance and discuss possibilities of how to prevent their release into the environment.
Collapse
|
45
|
Webster TM, McFarland A, Gebert MJ, Oliverio AM, Nichols LM, Dunn RR, Hartmann EM, Fierer N. Structure and Functional Attributes of Bacterial Communities in Premise Plumbing Across the United States. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:14105-14114. [PMID: 34606240 DOI: 10.1021/acs.est.1c03309] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Microbes that thrive in premise plumbing can have potentially important effects on human health. Yet, how and why plumbing-associated microbial communities vary across broad spatial scales remain undetermined. We characterized the bacterial communities in 496 showerheads collected from across the continental United States. The overall community structure, determined by 16S rRNA gene amplicon sequencing, revealed high levels of bacterial diversity. Although a large fraction of the observed variation in community composition could not be explained, differences in bacterial community composition were associated with water supply (private well water vs public municipal water), water source (groundwater vs surface water), and associated differences in water chemistry (pH and chlorine). Most notably, showerheads in homes supplied with public water had higher abundances of Blastomonas, Mycobacterium, and Porphyrobacter, while Pseudorhodoplanes, Novosphingobium, and Nitrospira were more abundant in those receiving private well water. We conducted shotgun metagenomic analyses on 92 of these samples to assess differences in genomic attributes. Public water-sourced showerheads had communities enriched in genes related to lipid and xenobiotic metabolisms, virulence factors, and antibiotic resistance. In contrast, genes associated with oxidative stress and membrane transporters were over-represented in communities from private well water-sourced showerheads compared to those supplied by public water systems. These results highlight the broad diversity of bacteria found in premise plumbing across the United States and the role of the water source and treatment in shaping the microbial community structure and functional potential.
Collapse
Affiliation(s)
- Tara M Webster
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, Colorado 80309, United States
| | - Alexander McFarland
- Department of Civil and Environmental Engineering, Northwestern University, 2145 Sheridan Road, Evanston, Illinois 60208, United States
| | - Matthew J Gebert
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, Colorado 80309, United States
- Department of Ecology and Evolutionary Biology, University of Colorado, Boulder, Colorado 80302, United States
| | - Angela M Oliverio
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, Colorado 80309, United States
- Department of Ecology and Evolutionary Biology, University of Colorado, Boulder, Colorado 80302, United States
| | - Lauren M Nichols
- Department of Applied Ecology, North Carolina State University, Raleigh, North Carolina 27607, United States
| | - Robert R Dunn
- Department of Applied Ecology, North Carolina State University, Raleigh, North Carolina 27607, United States
- Center for Evolutionary Hologenomics, University of Copenhagen, Copenhagen 1050, Denmark
| | - Erica M Hartmann
- Department of Civil and Environmental Engineering, Northwestern University, 2145 Sheridan Road, Evanston, Illinois 60208, United States
| | - Noah Fierer
- Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder, Colorado 80309, United States
- Department of Ecology and Evolutionary Biology, University of Colorado, Boulder, Colorado 80302, United States
| |
Collapse
|
46
|
Garner E, Organiscak M, Dieter L, Shingleton C, Haddix M, Joshi S, Pruden A, Ashbolt NJ, Medema G, Hamilton KA. Towards risk assessment for antibiotic resistant pathogens in recycled water: a systematic review and summary of research needs. Environ Microbiol 2021; 23:7355-7372. [PMID: 34632683 DOI: 10.1111/1462-2920.15804] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/30/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022]
Abstract
Risk assessment is critical for identifying target concentrations of antibiotic resistant pathogens necessary for mitigating potential harmful exposures associated with water reuse. However, there is currently limited available data characterizing the concentrations of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in recycled water to support robust efforts at risk assessment. The objective of this systematic review was to identify and synthesize the existing literature documenting the presence and abundance of ARB and ARGs in recycled water. In addition, this review identifies best practices and explores monitoring targets for studying ARB and ARGs in recycled water to guide future work and identifies key research needs aimed at better supporting quantitative microbial risk assessment focused on recycled water and antibiotic resistance. Future efforts to collect data about ARB and ARG prevalence in recycled water should report concentration data per unit volume. Sample metadata should also be provided, including a description of treatment approach, a description of planned water uses (e.g., potable, irrigation), methods for conveyance to the point of use, and available physicochemical water quality data. Additional research is needed aimed at identifying recommended ARB and ARG monitoring targets and for developing approaches to incorporate metagenomic data into risk assessment.
Collapse
Affiliation(s)
- Emily Garner
- Wadsworth Department of Civil and Environmental Engineering, West Virginia University, Morgantown, WV, 26506, USA
| | - Marisa Organiscak
- Wadsworth Department of Civil and Environmental Engineering, West Virginia University, Morgantown, WV, 26506, USA
| | - Lucien Dieter
- School of Sustainable Engineering and the Built Environment, Arizona State University, 660 S College Ave, Tempe, AZ, 85281, USA.,The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, 1001 S McAllister Ave, Tempe, AZ, 85281, USA
| | - Carley Shingleton
- Wadsworth Department of Civil and Environmental Engineering, West Virginia University, Morgantown, WV, 26506, USA
| | - Madison Haddix
- Wadsworth Department of Civil and Environmental Engineering, West Virginia University, Morgantown, WV, 26506, USA
| | - Sayalee Joshi
- School of Sustainable Engineering and the Built Environment, Arizona State University, 660 S College Ave, Tempe, AZ, 85281, USA.,The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, 1001 S McAllister Ave, Tempe, AZ, 85281, USA
| | - Amy Pruden
- Via Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Nicholas J Ashbolt
- Faculty of Science and Engineering, Southern Cross University, Lismore, Australia
| | - Gertjan Medema
- KWR Water Research Institute, 7 3433PE, Nieuwegein, The Netherlands.,Sanitary Engineering, Delft University of Technology, Stevinweg 1 2628 CN Delft, Nieuwegein, The Netherlands
| | - Kerry A Hamilton
- School of Sustainable Engineering and the Built Environment, Arizona State University, 660 S College Ave, Tempe, AZ, 85281, USA.,The Biodesign Institute Center for Environmental Health Engineering, Arizona State University, 1001 S McAllister Ave, Tempe, AZ, 85281, USA
| |
Collapse
|
47
|
Perry MR, Lepper HC, McNally L, Wee BA, Munk P, Warr A, Moore B, Kalima P, Philip C, de Roda Husman AM, Aarestrup FM, Woolhouse MEJ, van Bunnik BAD. Secrets of the Hospital Underbelly: Patterns of Abundance of Antimicrobial Resistance Genes in Hospital Wastewater Vary by Specific Antimicrobial and Bacterial Family. Front Microbiol 2021; 12:703560. [PMID: 34566912 PMCID: PMC8461093 DOI: 10.3389/fmicb.2021.703560] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/10/2021] [Indexed: 01/05/2023] Open
Abstract
Background: Hospital wastewater is a major source of antimicrobial resistance (AMR) outflow into the environment. This study uses metagenomics to study how hospital clinical activity impacts antimicrobial resistance genes (ARGs) abundances in hospital wastewater. Methods: Sewage was collected over a 24-h period from multiple wastewater collection points (CPs) representing different specialties within a tertiary hospital site and simultaneously from community sewage works. High throughput shotgun sequencing was performed using Illumina HiSeq4000. ARG abundances were correlated to hospital antimicrobial usage (AMU), data on clinical activity and resistance prevalence in clinical isolates. Results: Microbiota and ARG composition varied between CPs and overall ARG abundance was higher in hospital wastewater than in community influent. ARG and microbiota compositions were correlated (Procrustes analysis, p=0.014). Total antimicrobial usage was not associated with higher ARG abundance in wastewater. However, there was a small positive association between resistance genes and antimicrobial usage matched to ARG phenotype (IRR 1.11, CI 1.06-1.16, p<0.001). Furthermore, analyzing carbapenem and vancomycin resistance separately indicated that counts of ARGs to these antimicrobials were positively associated with their increased usage [carbapenem rate ratio (RR) 1.91, 95% CI 1.01-3.72, p=0.07, and vancomycin RR 10.25, CI 2.32-49.10, p<0.01]. Overall, ARG abundance within hospital wastewater did not reflect resistance patterns in clinical isolates from concurrent hospital inpatients. However, for clinical isolates of the family Enterococcaceae and Staphylococcaceae, there was a positive relationship with wastewater ARG abundance [odds ratio (OR) 1.62, CI 1.33-2.00, p<0.001, and OR 1.65, CI 1.21-2.30, p=0.006 respectively]. Conclusion: We found that the relationship between hospital wastewater ARGs and antimicrobial usage or clinical isolate resistance varies by specific antimicrobial and bacterial family studied. One explanation, we consider is that relationships observed from multiple departments within a single hospital site will be detectable only for ARGs against parenteral antimicrobials uniquely used in the hospital setting. Our work highlights that using metagenomics to identify the full range of ARGs in hospital wastewater is a useful surveillance tool to monitor hospital ARG carriage and outflow and guide environmental policy on AMR.
Collapse
Affiliation(s)
- Meghan R. Perry
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
- NHS Lothian Infection Service, Edinburgh Clinical Infection Research Group, Edinburgh, United Kingdom
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| | - Hannah C. Lepper
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Luke McNally
- Centre for Synthetic and Systems Biology, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
- School of Biological Sciences, Institute of Evolutionary Biology, University of Edinburgh, Edinburgh, United Kingdom
| | - Bryan A. Wee
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Patrick Munk
- National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Amanda Warr
- Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Barbara Moore
- NHS Lothian Infection Service, Edinburgh Clinical Infection Research Group, Edinburgh, United Kingdom
| | - Pota Kalima
- NHS Lothian Infection Service, Edinburgh Clinical Infection Research Group, Edinburgh, United Kingdom
| | - Carol Philip
- NHS Lothian Infection Service, Edinburgh Clinical Infection Research Group, Edinburgh, United Kingdom
| | | | - Frank M. Aarestrup
- National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | | | | |
Collapse
|
48
|
Taviani E, Pedro O. Impact of the aquatic pathobiome in low-income and middle-income countries (LMICs) quest for safe water and sanitation practices. Curr Opin Biotechnol 2021; 73:220-224. [PMID: 34492621 DOI: 10.1016/j.copbio.2021.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/10/2021] [Accepted: 08/18/2021] [Indexed: 11/03/2022]
Abstract
Microbial contamination of surface waters is of particular relevance in low-income and middle-income countries (LMICs) since they often represent the only available source of water for drinking and domestic use. In the recent years, a growing urbanization, profound demographic shifts and drastic climate events have greatly affected LMICs capacity to reach access to safe drinking water and sanitation practices, and to protect citizens' health from risks associated to the exposure and use of contaminated water. Detailed phylogenetic and microbiological information on the exact composition of pathogenic organisms in urban and peri-urban water is scarce, especially in rapidly changing settings of sub-Saharan Africa. In this review we aim to highlight how large-scale water pathobiome studies can support the LMICs challenge to global access to safe water and sanitation practices.
Collapse
Affiliation(s)
- Elisa Taviani
- Center for Biotechnology, University Eduardo Mondlane, Maputo, Mozambique.
| | - Olivia Pedro
- Center for Biotechnology, University Eduardo Mondlane, Maputo, Mozambique
| |
Collapse
|
49
|
Molecular Diversity of Methicillin-Resistant and -Susceptible Staphylococcus aureus Detected in Animals: A Focus on Aquatic Animals. DIVERSITY 2021. [DOI: 10.3390/d13090417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Staphylococcus aureus (S. aureus) are one of the best-known opportunistic pathogens capable of causing different types of infections in animals. Furthermore, it has the ability to acquire resistance to various antibiotics very easily. Methicillin-resistant S. aureus (MRSA) are currently of great concern as they are the leading cause of infections in humans and animals, with a major impact on health and the economy. Several studies already demonstrate that the spread of MRSA is constantly increasing due to its ability to form reservoirs in humans, animals and the environment. In fact, several works have already identified the presence of these bacteria in animals, including domestic animals, farm animals and even wild animals. Furthermore, the incidence of various S. aureus strains in aquatic animals has also been reported by different authors, although it is still a rarely discussed topic. Some of these strains have previously been associated with humans and other animals. Strain 398 is the strain that manages to infect a wider spectrum of hosts, having been identified in several different species. Aside from this strain, many others have yet to be identified. In addition, many of these strains have virulence factors and antibiotic resistance genes that worsen the situation. The present work is a review of studies that intend to investigate the epidemiology of this agent in samples of aquatic animals from different origins, in order to better understand its distribution, prevalence and the molecular lineages associated with these species.
Collapse
|
50
|
Ott A, O'Donnell G, Tran NH, Mohd Haniffah MR, Su JQ, Zealand AM, Gin KYH, Goodson ML, Zhu YG, Graham DW. Developing Surrogate Markers for Predicting Antibiotic Resistance "Hot Spots" in Rivers Where Limited Data Are Available. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:7466-7478. [PMID: 34000189 DOI: 10.1021/acs.est.1c00939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Pinpointing environmental antibiotic resistance (AR) hot spots in low-and middle-income countries (LMICs) is hindered by a lack of available and comparable AR monitoring data relevant to such settings. Addressing this problem, we performed a comprehensive spatial and seasonal assessment of water quality and AR conditions in a Malaysian river catchment to identify potential "simple" surrogates that mirror elevated AR. We screened for resistant coliforms, 22 antibiotics, 287 AR genes and integrons, and routine water quality parameters, covering absolute concentrations and mass loadings. To understand relationships, we introduced standardized "effect sizes" (Cohen's D) for AR monitoring to improve comparability of field studies. Overall, water quality generally declined and environmental AR levels increased as one moved down the catchment without major seasonal variations, except total antibiotic concentrations that were higher in the dry season (Cohen's D > 0.8, P < 0.05). Among simple surrogates, dissolved oxygen (DO) most strongly correlated (inversely) with total AR gene concentrations (Spearman's ρ 0.81, P < 0.05). We suspect this results from minimally treated sewage inputs, which also contain AR bacteria and genes, depleting DO in the most impacted reaches. Thus, although DO is not a measure of AR, lower DO levels reflect wastewater inputs, flagging possible AR hot spots. DO measurement is inexpensive, already monitored in many catchments, and exists in many numerical water quality models (e.g., oxygen sag curves). Therefore, we propose combining DO data and prospective modeling to guide local interventions, especially in LMIC rivers with limited data.
Collapse
Affiliation(s)
- Amelie Ott
- School of Engineering, Newcastle University, NE1 7RU Newcastle upon Tyne, United Kingdom
| | - Greg O'Donnell
- School of Engineering, Newcastle University, NE1 7RU Newcastle upon Tyne, United Kingdom
| | - Ngoc Han Tran
- Department of Civil and Environmental Engineering, National University of Singapore, 117576 Singapore
| | | | - Jian-Qiang Su
- Chinese Academy of Science, Institute of Urban Environment, 1799 Xiamen, China
| | - Andrew M Zealand
- School of Engineering, Newcastle University, NE1 7RU Newcastle upon Tyne, United Kingdom
| | - Karina Yew-Hoong Gin
- Department of Civil and Environmental Engineering, National University of Singapore, 117576 Singapore
| | - Michaela L Goodson
- Newcastle University Malaysia, Educity@Iskandar, 79200 Iskandar Puteri, Johor, Malaysia
| | - Yong-Guan Zhu
- Chinese Academy of Science, Institute of Urban Environment, 1799 Xiamen, China
| | - David W Graham
- School of Engineering, Newcastle University, NE1 7RU Newcastle upon Tyne, United Kingdom
| |
Collapse
|