Antibiotic Resistance in Enterobacteriaceae from Surface Waters in Urban Brazil Highlights the Risks of Poor Sanitation
Antibiotic Resistance in Enterobacteriaceae from Surface Waters in Urban Brazil Highlights the Risks of Poor Sanitation
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DOI：
10.4269/ajtmh.18-0726
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发表时间：
2019-01-01
影响因子：
3.3
通讯作者：
Perez, Federico
中科院分区：
文献类型：
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作者：
Bartley, Patricia S.;Domitrovic, T. Nicholas;Perez, Federico
地表水是一个未被重视的抗菌素耐药性（AMR）水库。恶劣的卫生条件使不同种类的环境细菌接触，促进了水平基因转移。为了研究地表水作为AMR潜在储存库的作用，我们研究了巴西东北部城市湖泊和农村河流系统中粪便污染、AMR基因和肠杆菌科的点流行情况，并与美国俄亥俄州东北部的湖泊和下水道系统进行了比较。利用微生物来源追踪技术检查地表水样本，寻找人类粪便污染的证据，并筛选质粒介导的氟喹诺酮类药物耐药性和碳青霉烯酶基因。采用选择性琼脂法检测肠杆菌科细菌，然后进行药敏试验和基因芯片检测AMR基因，采用重复序列聚合酶链反应和多位点序列分型进行分类。在巴西城市湖泊和俄亥俄州东北部的污水中，人类粪便细菌的浓度也同样很高。然而，来自巴西城市湖泊的过滤水样显示存在bla(OXA-48), bla(KPC), bla(VIM-2)， qnrS和aac(6')-lb-cr，而来自俄亥俄州东北部的原始污水中仅鉴定出bla（VIM-2）。在巴西城市湖泊中，85%培养的肠杆菌科（n = 40）至少对一种临床重要抗生素耐药，包括ST131大肠杆菌，其中含有广谱β -内酰胺酶CTX-M。虽然两株菌株表现出多粘菌素耐药，但未检测到mcr-1/2。我们的研究结果表明，巴西城市地表水可以作为AMR的环境水库，改善废水处理和卫生设施通常可以改善AMR的传播。
Surface waters are an unappreciated reservoir of antimicrobial resistance (AMR). Poor sanitation brings different species of environmental bacteria into contact, facilitating horizontal gene transfer. To investigate the role of surface waters as potential reservoirs of AMR, we studied the point prevalence of fecal contamination, AMR genes, and Enterobacteriaceae in an urban lake and rural river system in Northeast Brazil in comparison with a lake and sewer system in Northeast Ohio in the United States. Surface water samples were examined for evidence of human fecal contamination using microbial source tracking and screened for plasmid-mediated fluoroquinolone resistance and carbapenemase genes. Enterobacteriaceae were detected using selective agar followed by antimicrobial susceptibility testing and detection of AMR genes by microarray, and classified by repetitive sequence-based polymerase chain reaction and multilocus sequence typing. Concentrations of human fecal bacteria in the Brazilian urban lake and sewage in Northeast Ohio were similarly high. Filtered water samples from the Brazilian urban lake, however, showed the presence of bla(OXA-48), bla(KPC), bla(VIM-2), qnrS, and aac(6')-lb-cr, whereas only bla(VIM-2) was identified in raw sewage from Northeast Ohio. From the Brazilian urban lake, 85% of the Enterobacteriaceae (n = 40) cultured were resistant to at least one clinically important antibiotic, including ST131 Escherichia coli harboring the extended-spectrum beta-lactamase CTX-M. Although two isolates demonstrated polymyxin resistance, mcr-1/2 was not detected. Our findings indicate that surface waters in an urban Brazilian site can serve as an environmental reservoir of AMR and that improving wastewater treatment and sanitation generally may ameliorate AMR dissemination.