Water and sanitation: an essential battlefront in the war on antimicrobial resistance

Bürgmann, Helmut; Frigon, Dominic; Gaze, William H.; Manaia, Célia M.; Pruden, Amy; Singer, Andrew C.; Smets, Barth F.; Zhang, Tong

doi:10.1093/femsec/fiy101

Cited by 137 publications

(98 citation statements)

References 114 publications

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“…However, scientific knowledge has not yet progressed to establish the objectives for estimating the risks of ARB and ARG abundance in wastewater. Assessing the different risks to which human populations may be exposed and determining pollutants concentrations should be one of the main objectives [47]. Nonetheless, it is difficult to imagine a risk assessment framework that includes all complex gene transfer events, which may take place from environmental bacteria to human or animal pathogens [48].…”

Section: Discussionmentioning

confidence: 99%

“…Another thing that would be valuable to measure is the rates at which the horizontal gene transfer occurs in the WWTPs. However, this is still an important knowledge gap [47]. In this sense, it has been reported that conjugation is an extremely effective mechanism for dissemination of ESBLs [50].…”

Section: Discussionmentioning

confidence: 99%

“…In fact, the 4 strains with higher conjugation frequencies, contain the integrase class 1 intI1 gene and different insertion sequences (ISEcp1, IS26, IS903) ( Figures S1-S5). Nevertheless, very little is known about the health risks posed by exposure to commensal or environmental bacteria that carry mobile ARGs [47]. The conjugation process may occur in many types of ecosystems, but in food environments can have very serious consequences, due to the mobilization of virulence genes and toxins [51].…”

Section: Discussionmentioning

confidence: 99%

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The Aquatic Ecosystem, a Good Environment for the Horizontal Transfer of Antimicrobial Resistance and Virulence-Associated Factors Among Extended Spectrum β-lactamases Producing E. coli

2020

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One of the main public health problems nowadays is the increase of antimicrobial resistance, both in the hospital environment and outside it (animal environment, food and aquatic ecosystems, among others). It is necessary to investigate the virulence-associated factors and the ability of horizontal gene transfer among bacteria for a better understanding of the pathogenicity and the mechanisms of dissemination of resistant bacteria. Therefore, the objective of this work was to detect several virulence factors genes (fimA, papC, papG III, cnf1, hlyA and aer) and to determine the conjugative capacity in a wide collection of extended-spectrum β-lactamases-producing E. coli isolated from different sources (human, food, farms, rivers, and wastewater treatment plants). Regarding virulence genes, fimA, papC, and aer were distributed throughout all the studied environments, papG III was mostly related to clinical strains and wastewater is a route of dissemination for cnf1 and hlyA. Strains isolated from aquatic environments showed an average conjugation frequencies of 1.15 × 10 −1 ± 5 × 10 −1 , being significantly higher than those observed in strains isolated from farms and food (p < 0.05), with frequencies of 1.53 × 10 −4 ± 2.85 × 10 −4 and 9.61 × 10 −4 ± 1.96 × 10 −3 , respectively. The reported data suggest the importance that the aquatic environment (especially WWTPs) acquires for the exchange of genes and the dispersion of resistance. Therefore, specific surveillance programs of AMR indicators in wastewaters from animal or human origin are needed, in order to apply sanitation measures to reduce the burden of resistant bacteria arriving to risky environments as WWTPs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Aquatic Ecosystem, a Good Environment for the Horizontal Transfer of Antimicrobial Resistance and Virulence-Associated Factors Among Extended Spectrum β-lactamases Producing E. coli

2020

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“…Anthropogenic release of antibiotic resistance genes (ARGs) into environmental reservoirs has raised global public health concerns [1,2]. The importance of wastewater treatment plants (WWTP) both as a barrier for resistant bacteria and as a potential hotspot for dissemination has been highlighted, although the evaluation of the risks for human health remains unresolved [3,4]. The increasing environmental occurrence of clinically relevant ARGs and evidence for horizontal dissemination of resistance between environmental bacteria and human pathogens demonstrate the importance of environmental resistomes (collections of resistance genes in a metagenome) [1,[5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Wastewater treatment plant resistomes are shaped by bacterial composition, genetic exchange, and upregulated expression in the effluent microbiomes

et al. 2018

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Wastewater treatment plants (WWTPs) are implicated as hotspots for the dissemination of antibacterial resistance into the environment. However, the in situ processes governing removal, persistence, and evolution of resistance genes during wastewater treatment remain poorly understood. Here, we used quantitative metagenomic and metatranscriptomic approaches to achieve a broad-spectrum view of the flow and expression of genes related to antibacterial resistance to over 20 classes of antibiotics, 65 biocides, and 22 metals. All compartments of 12 WWTPs share persistent resistance genes with detectable transcriptional activities that were comparatively higher in the secondary effluent, where mobility genes also show higher relative abundance and expression ratios. The richness and abundance of resistance genes vary greatly across metagenomes from different treatment compartments, and their relative and absolute abundances correlate with bacterial community composition and biomass concentration. No strong drivers of resistome composition could be identified among the chemical stressors analyzed, although the sub-inhibitory concentration (hundreds of ng/L) of macrolide antibiotics in wastewater correlates with macrolide and vancomycin resistance genes. Contig-based analysis shows considerable colocalization between resistance and mobility genes and implies a history of substantial horizontal resistance transfer involving human bacterial pathogens. Based on these findings, we propose future inclusion of mobility incidence (M%) and host pathogenicity of antibiotic resistance genes in their quantitative health risk ranking models with an ultimate goal to assess the biological significance of wastewater resistomes with regard to disease control in humans or domestic livestock.

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“…Although there are several studies assessing multidrug resistance (MDR) in E. coli populations of animal origin, not much work has been done on the ecology of MDR [13, 14]. The spread of MDR into environments where antibiotics are not used is a possibility that has not yet been well researched, although it has been postulated that water could disseminate antimicrobial resistance [15].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Multidrug-ResistantEscherichia coliIsolated from Drinking Water Sources

Odonkor

Addo

2018

International Journal of Microbiology

109

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The control of infectious diseases is badly endangered by the rise in the number of microorganisms that are resistant to antimicrobial agents. This is because infections caused by resistant microorganisms often fail to respond to conventional treatment, resulting in prolonged illness and greater risk of death. Antimicrobial-resistant bacteria are also present in various water sources. This study therefore sought to document the microbiological quality and antibiograms of bacterial isolates (E. coli strains) from six different water sources in order to determine their safety for human consumption and to provide updated antibiotic data for pragmatic treatment of patients. Bacteria isolation and identification was done using API and conventional methods. Antibiotic susceptibility testing was conducted using the Kirby–Bauer method. Results obtained indicated that all the water sources tested were of poor quality. Bacteria isolated included E. coli, Enterobacter spp., Klebsiella spp., Salmonella typhi, Streptococcus spp., Proteus vulgaris, Vibrio cholera, Shigella spp., Pseudomonas aeruginosa, and Enterococcus faecalis. The prevalence of multidrug-resistant E. coli was 49.48%. E. coli isolates showed high resistance patterns to the tested antibiotics. They were most resistant to penicillin (32.99%), cefuroxime (28.87%), erythromycin (23.71%), and tetracycline (21.45%). In contrast, they were susceptible to nitrofurantoin (93.8%), cefotaxime and amikacin (91.75%), gentamicin (90.7%), nalidixic acid (89.65%), ciprofloxacin (74.2%), chloramphenicol (69.07%), pipemidic acid (65.97%), and cefuroxime (52.58%). Sixty-three percent (63%) of the multidrug-resistant E. coli strains recorded a multiple antibiotic resistance (MAR) index value >0.2. The susceptible antibiotics, especially the nitrofurantoin, are hence recommended in the practical treatment of waterborne bacterial diseases.

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Water and sanitation: an essential battlefront in the war on antimicrobial resistance

Cited by 137 publications

References 114 publications

The Aquatic Ecosystem, a Good Environment for the Horizontal Transfer of Antimicrobial Resistance and Virulence-Associated Factors Among Extended Spectrum β-lactamases Producing E. coli

The Aquatic Ecosystem, a Good Environment for the Horizontal Transfer of Antimicrobial Resistance and Virulence-Associated Factors Among Extended Spectrum β-lactamases Producing E. coli

Wastewater treatment plant resistomes are shaped by bacterial composition, genetic exchange, and upregulated expression in the effluent microbiomes

Prevalence of Multidrug-ResistantEscherichia coliIsolated from Drinking Water Sources

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