Antimicrobial resistance gene persistence in waste water treatment systems, the natural environment and patient samples in the Lothians

抗菌素耐药性在全球范围内对卫生服务构成重大威胁。虽然已知携带抗菌素耐药(AMR)基因的细菌在医用抗生素使用之前就存在于环境中，但它们的大量使用已导致AMR基因多样性和流行率的迅速增加。目前，关于不同环境因素如何影响AMR基因的流行和传播缺乏相关知识。重要的是更好地了解这些因素，因为这将使制定拦截和防止AMR传播来源的战略成为可能。抗生素的广泛使用导致人类粪便中抗药性细菌水平的增加，使废水处理厂(WWTP)成为耐药细菌的热点。向周围环境排放污水以及在农地上使用生物固体作为肥料，是耐药细菌及其AMR基因进入环境的重要切入点。目前的项目旨在提高我们对污水处理厂和环境中AMR基因流行和持久性的贡献因素的了解。已经编制了一份针对已知抗药性基因的引物清单，该研究将测试并用于聚合酶链式反应(PCR)，以调查各种AMR基因在一系列样本中的丰度。除污水处理厂外，还将从包括农田和城乡地区在内的不同环境中采集土壤和水样本，以评估人类活动对AMR流行的影响。这项研究还将利用实验室规模的生物反应器和微型宇宙，反映真实世界的污水处理厂和环境，以调查影响选定数量的临床相关AMR基因随时间的持久性以及它们在不同条件下在微生物群落中的流行率的因素。这可能包括污水处理厂使用的操作条件。该项目将探索的另一个领域旨在增加我们对环境在将临床相关的AMR基因传递给人类群体中的作用的理解。这个问题将通过对从爱丁堡健康人类志愿者那里收集的粪便样本进行聚合酶链式反应来解决。AMR基因的丰度将与环境样本中观察到的AMR基因进行比较，以确定是否存在任何相关性。这将有助于建立一幅更清晰的图景，详细说明环境中AMR基因对人类人口的影响程度。

Antimicrobial resistance poses a major threat to health services on a global scale. Whilst bacteria harbouring antimicrobial resistant (AMR) genes are known to have existed in the environment preceding the medical use of antibiotics, their intensive use has resulted in a rapid increase in AMR gene diversity and prevalence. Currently, there is a lack of knowledge surrounding how different environmental factors influence the prevalence and dispersal of AMR genes. It is important to gain greater understanding these factors as it will enable the development of strategies to intercept and prevent sources of AMR spread. The extensive therapeutic use of antibiotics has resulted in an increase in the level of antimicrobial resistant bacteria found in human faeces, making waste water treatment plants (WWTPs) a "hotspot" of resistant bacteria. The release of effluent into the surrounding environment and the use of biosolids as a fertiliser on agricultural land act as a significant point of entry for resistant bacteria and their AMR genes into the environment. The current project aims to improve our understanding of the contributing factors to the prevalence and persistence of AMR genes in WWTPs and in the environment. A list of primers targeting known resistance genes has been compiled, which the study will test and use in polymerase chain reaction (PCR) to investigate the abundance of a variety of AMR genes in a range of samples. Alongside the WWTP, soil and water samples will be taken from a diverse set of environments including agricultural land and rural/ urban areas, in order to assess the impact of human activity on AMR prevalence. The study will also utilize lab-scale bioreactors and microcosms, reflecting real-world WWTPs and environments to investigate factors influencing the persistence of a select number of clinically relevant AMR genes over time and their prevalence amongst microbial communities under differing conditions. This may include operating conditions used in WWTPs. Another area the project will explore aims to increase our understanding regarding the role of the environment in the transmission of clinically relevant AMR genes to the human population. This will be addressed by performing PCR on faecal samples collected from healthy human volunteers in Edinburgh. The abundance of AMR genes will be compared to those observed in the environmental samples, in order to establish whether there is any correlation. This will help build a clearer picture detailing the extent to which AMR genes in the environment impact the human population.