Measuring and mitigating the release of mobile antibiotic resistance genes from wastewater treatment plants in Canada.

细菌病原体对抗生素的耐药性破坏了医生控制侵袭性细菌感染的能力，导致患者健康结局的严重后果。最近的八国集团科学部长会议强调了这一威胁的严重性，会议将抗菌素耐药性确定为二十一世纪的一项重大卫生安全挑战(英国，2013年6月12日，八国集团)。抗生素耐药性的上升与临床和农业环境中抗生素的使用增加有关。因此，最近的政策制定侧重于减少抗生素的使用。这些努力对公众健康很重要；然而，他们没有考虑其他潜在的抗生素耐药性宿主。在此背景下，研究已确定废水处理厂(WWTP)是高浓度抗生素耐药细菌(ARB)和抗生素耐药基因的全球热点。污水处理厂从含有包括ARB在内的排泄物的家庭接收人类排泄物。被要求口服抗生素进行治疗的个人将在胃肠道中增加ARB的含量。这些ARB和抗生素残留物从尿液和粪便中排泄出来，最终被输送到废水处理厂。此外，抗生素耐药性基因往往与可移动的遗传元件有关，进一步增加了这些临床相关的抗生素耐药性基因被水平动员到环境中发现的机会性病原体的可能性。污水处理厂可能是减少耐药水库的关键控制点。拟议的研究将与我们在三个省(SK、PEI)的市政污水处理合作伙伴合作进行

Antibiotic resistance in bacterial pathogens undermines a physician's ability to control invasive bacterial infections, leading to serious consequences in patient health outcomes. The magnitude of the threat was highlighted by the recent G8 Science Ministers identified antimicrobial drug resistance as a major health security challenge of the twenty first century (G8 UK, June 12, 2013). The rise in antibiotic resistance has been linked to an increased use of antibiotics in clinical and agricultural settings. Consequently, recent policy development has focused on reducing antibiotic use. These efforts are important for public health; however, they do not consider other potential reservoirs of antibiotic resistance. In this context, research efforts have identified wastewater treatment plants (WWTPs) as global hot-spots for high concentrations of antibiotic resistant bacteria (ARB) and antibiotic resistance genes. WWTPs receive human fecal wastes from households containing excreted gut bacteria including ARB. Individuals required to orally ingest antibiotics as a medical treatment will enrich for ARB in the gastrointestinal tract. These ARB and antibiotic residues are excreted in urine and feces, and are ultimately transported to wastewater treatment plants. Moreover, the antibiotic resistance genes are often associated with mobile genetic elements, furthering the potential for these clinically relevant antibiotic resistance genes to be horizontally mobilized to opportunistic pathogens found in the environment. WWTPs may represent a critical control point in the reduction of antibiotic resistance reservoirs. The proposed research will be in collaboration with our municipal WWTP partners in three provinces (SK, PEI