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Chen H, Ng C, Tran NH, Haller L, Goh SG, Charles FR, Wu Z, Lim JX, Gin KYH. Removal efficiency of antibiotic residues, antibiotic resistant bacteria, and genes across parallel secondary settling tank and membrane bioreactor treatment trains in a water reclamation plant. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 924:171723. [PMID: 38492595 DOI: 10.1016/j.scitotenv.2024.171723] [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: 12/07/2023] [Revised: 02/07/2024] [Accepted: 03/12/2024] [Indexed: 03/18/2024]
Abstract
Antimicrobial resistance is recognized as a potent threat to human health. Wastewater treatment facilities are viewed as hotspots for the spread of antimicrobial resistance. This study provides comprehensive data on the occurrences of 3 different antibiotic resistant opportunistic pathogens (with resistance to up to 5 antibiotics), 13 antibiotic resistant genes and intI1, and 22 different antimicrobial residues in a large water reclamation plant (176 million gallons per day) that runs a conventional Modified Ludzack-Ettinger (MLE) reactor followed by a secondary settling tank (SST) and membrane bioreactor (MBR) in parallel. All the antibiotic resistant bacteria and most of the antibiotic resistance genes were present in the raw influent, ranging from 2.5 × 102-3.7 × 106 CFU/mL and 1.2× 10-1-6.5 × 1010 GCN/mL, respectively. MBR outperformed the SST system in terms of ARB removal as the ARB targets were largely undetected in MBR effluent, with log removals ranging from 2.7 to 6.8, while SST only had log removals ranging from 0.27 to 4.6. Most of the ARG concentrations were found to have significantly higher in SST effluent than MBR permeate, and MBR had significantly higher removal efficiency for most targets (p < 0.05) except for sul1, sul2, blaOXA48, intI1 and 16S rRNA genes (p > 0.05). As for the antibiotic residues (AR), there was no significant removal from the start to the end of the treatment process, although MBR had higher removal efficiencies for azithromycin, chloramphenicol, erythromycin, erythromycin-H2O, lincomycin, sulfamethoxazole and triclosan, compared to the SST system. In conclusion, MBR outperformed SST in terms of ARB and ARGs removal. However low removal efficiencies of most AR targets were apparent.
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Affiliation(s)
- Hongjie Chen
- Antimicrobial Resistance Interdisciplinary Research Group, Singapore-MIT Alliance for Research and Technology, 1 Create Way, Singapore 138602, Singapore
| | - Charmaine Ng
- NUS Environmental Research Institute (NERI), National University of Singapore, T-Lab Building (#02-01), 5A Engineering Drive 1, Singapore 117411, Singapore
| | - Ngoc Han Tran
- NUS Environmental Research Institute (NERI), National University of Singapore, T-Lab Building (#02-01), 5A Engineering Drive 1, Singapore 117411, Singapore
| | - Laurence Haller
- NUS Environmental Research Institute (NERI), National University of Singapore, T-Lab Building (#02-01), 5A Engineering Drive 1, Singapore 117411, Singapore
| | - Shin Giek Goh
- NUS Environmental Research Institute (NERI), National University of Singapore, T-Lab Building (#02-01), 5A Engineering Drive 1, Singapore 117411, Singapore
| | - Francis Rathinam Charles
- NUS Environmental Research Institute (NERI), National University of Singapore, T-Lab Building (#02-01), 5A Engineering Drive 1, Singapore 117411, Singapore
| | - Zhixin Wu
- NUS Environmental Research Institute (NERI), National University of Singapore, T-Lab Building (#02-01), 5A Engineering Drive 1, Singapore 117411, Singapore
| | - Jit Xin Lim
- NUS Environmental Research Institute (NERI), National University of Singapore, T-Lab Building (#02-01), 5A Engineering Drive 1, Singapore 117411, Singapore
| | - Karina Yew-Hoong Gin
- NUS Environmental Research Institute (NERI), National University of Singapore, T-Lab Building (#02-01), 5A Engineering Drive 1, Singapore 117411, Singapore; Department of Civil & Environmental Engineering, National University of Singapore, Block E1A-07-03, 1 Engineering Drive 2, 117576, Singapore.
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Wang CZ, Li XP, Zhang YJ, Zhong WC, Liu YH, Liao XP, Sun J, Zhou YF. Molecular characteristic of mcr-1 gene in Escherichia coli from aquatic products in Guangdong, China. J Glob Antimicrob Resist 2024; 36:36-40. [PMID: 38072241 DOI: 10.1016/j.jgar.2023.11.010] [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: 07/17/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 12/31/2023] Open
Abstract
OBJECTIVES Aquatic ecosystems serve as a dissemination pathway and a reservoir of both antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs). This study aimed to determine the prevalence of colistin-resistant mcr-like genes in Enterobacteriales in aquatic products, which may be contribute to the transfer of ARGs in water environments. METHODS The mcr-1-positive Escherichia coli were recovered from 123 freshwater fish and 34 cultured crocodile cecum samples from 10 farmers' markets in Guangdong, China. Minimum inhibitory concentration (MIC) was determined using the agar dilution method. Genotyping was performed using pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST). Conjugation assay was carried out to investigate the transferability of mcr-1. Genomic information was obtained by whole genome sequencing (WGS) and bioinformatic analysis. RESULTS Forty-four mcr-1 positive isolates showed co-resistance to tetracycline, trimethoprim/sulfamethoxazole, and gentamicin, while they were all sensitive to tigecycline, meropenem, and amikacin. They were typed into sixteen PFGE clusters. ST10 and ST117 were the most popular sequence types, followed by ST1114. S1-PFGE verified the presence of the mcr-1 gene on plasmids in sizes of ∼60 kb (n = 1) and ∼240 kb (n = 3). Whole genome sequencing-based analysis identified mcr-1 integrated in IncHI2 plasmid (n = 3), IncI2 plasmid (n = 2), and bacterial chromosome in two copies (n = 1). In addition to mcr-1, they carried several other antibiotic resistance genes, such as blaCTX-M-14, fosA3, and aac(6')-Ib-cr. CONCLUSION These data suggest that aquatic products are an important antibiotic resistance reservoir and highlight possible risks regarding food safety.
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Affiliation(s)
- Chang-Zhen Wang
- State Key Laboratory for Animal Disease Control and Prevention, South China Agricultural University, Guangzhou, China; Guangdong Laboratory for Lingnan Modern Agriculture, Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, South China Agricultural University, Guangzhou, China
| | - Xing-Ping Li
- Guangdong Laboratory for Lingnan Modern Agriculture, Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, South China Agricultural University, Guangzhou, China; College of Animal Science and Technology, Henan University of Science and Technology, Luoyang, China
| | - Yue-Jun Zhang
- State Key Laboratory for Animal Disease Control and Prevention, South China Agricultural University, Guangzhou, China; Guangdong Laboratory for Lingnan Modern Agriculture, Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, South China Agricultural University, Guangzhou, China
| | - Wei-Cheng Zhong
- State Key Laboratory for Animal Disease Control and Prevention, South China Agricultural University, Guangzhou, China; Guangdong Laboratory for Lingnan Modern Agriculture, Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, South China Agricultural University, Guangzhou, China
| | - Ya-Hong Liu
- State Key Laboratory for Animal Disease Control and Prevention, South China Agricultural University, Guangzhou, China; Guangdong Laboratory for Lingnan Modern Agriculture, Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, South China Agricultural University, Guangzhou, China; Jiangsu Co-Innovation Center for the Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, China
| | - Xiao-Ping Liao
- State Key Laboratory for Animal Disease Control and Prevention, South China Agricultural University, Guangzhou, China; Guangdong Laboratory for Lingnan Modern Agriculture, Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, South China Agricultural University, Guangzhou, China
| | - Jian Sun
- State Key Laboratory for Animal Disease Control and Prevention, South China Agricultural University, Guangzhou, China; Guangdong Laboratory for Lingnan Modern Agriculture, Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, South China Agricultural University, Guangzhou, China.
| | - Yu-Feng Zhou
- State Key Laboratory for Animal Disease Control and Prevention, South China Agricultural University, Guangzhou, China; Guangdong Laboratory for Lingnan Modern Agriculture, Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, South China Agricultural University, Guangzhou, China.
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Rodríguez-Rodríguez CE, Ramírez-Morales D, Masis-Mora M, Montiel-Mora JR, Soto-Garita C, Araya-Valverde E, Cambronero-Heinrichs JC, Sànchez-Melsió A, Briceño-Guevara S, Mendez-Rivera M, Balcázar JL. Occurrence and risk assessment of pharmaceuticals in hospital wastewater in Costa Rica. CHEMOSPHERE 2023; 339:139746. [PMID: 37549747 DOI: 10.1016/j.chemosphere.2023.139746] [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: 03/30/2023] [Revised: 07/18/2023] [Accepted: 08/04/2023] [Indexed: 08/09/2023]
Abstract
This work aims to determine the occurrence, hazard and prioritization of pharmaceuticals from hospital wastewater in Costa Rica through the monitoring of 70 compounds and assessing their environmental risk through a hazard quotient approach (HQ). Moreover, the quantification of selected antibiotic resistance genes (ARGs) was conducted for the first time in this matrix in this geographical location. Thirty-four pharmaceuticals were detected, being caffeine, 1,7-dimethylxanthine, acetaminophen, ibuprofen, naproxen, ciprofloxacin and ketoprofen the most frequent (>50% of the samples). Eighteen pharmaceuticals exhibited high hazard (HQ ≥ 1), while five more showed medium hazard (1 > HQ ≥ 0.1). Prioritization, which also included frequency parameters, revealed caffeine, lovastatin, diphenhydramine, acetaminophen, ibuprofen, ciprofloxacin, and sildenafil as the compounds of major concern. Similarly, cumulative hazard per sample (ΣHQ) estimated high hazard towards aquatic organisms in every sample. All selected ARGs, except mcr-1 (polymyxin resistance), were detected. Among genes conferring resistance to beta-lactams, blaCTX-M and blaKPC were the most abundant, related to resistance to cephalosporins and carbapenems. Ecotoxicological evaluation showed mostly low toxicity towards Daphnia magna and Vibrio fischeri, contrary to the marked effect observed towards Lactuca sativa. These findings provide relevant and novel information on the risk posed by hospital wastewater and their pharmaceutical content in the Latin American environmental context.
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Affiliation(s)
- Carlos E Rodríguez-Rodríguez
- Centro de Investigación en Contaminación Ambiental (CICA), Universidad de Costa Rica, 2060, San José, Costa Rica.
| | - Didier Ramírez-Morales
- Centro de Investigación en Contaminación Ambiental (CICA), Universidad de Costa Rica, 2060, San José, Costa Rica
| | - Mario Masis-Mora
- Centro de Investigación en Contaminación Ambiental (CICA), Universidad de Costa Rica, 2060, San José, Costa Rica
| | - José R Montiel-Mora
- Centro de Investigación en Contaminación Ambiental (CICA), Universidad de Costa Rica, 2060, San José, Costa Rica
| | - Claudio Soto-Garita
- Centro de Investigación en Contaminación Ambiental (CICA), Universidad de Costa Rica, 2060, San José, Costa Rica
| | - Emanuel Araya-Valverde
- Centro Nacional de Innovaciones Biotecnológicas (CENIBiot), CeNAT-CONARE, 1174-1200, San José, Costa Rica
| | - Juan Carlos Cambronero-Heinrichs
- Centro de Investigación en Contaminación Ambiental (CICA), Universidad de Costa Rica, 2060, San José, Costa Rica; Facultad de Microbiología, Universidad de Costa Rica, 2060, San José, Costa Rica
| | - Alexandre Sànchez-Melsió
- Catalan Institute for Water Research (ICRA-CERCA), 17003, Girona, Spain; University of Girona, 17004, Girona, Spain
| | - Susana Briceño-Guevara
- Centro de Investigación en Contaminación Ambiental (CICA), Universidad de Costa Rica, 2060, San José, Costa Rica
| | - Michael Mendez-Rivera
- Centro de Investigación en Contaminación Ambiental (CICA), Universidad de Costa Rica, 2060, San José, Costa Rica
| | - José L Balcázar
- Catalan Institute for Water Research (ICRA-CERCA), 17003, Girona, Spain; University of Girona, 17004, Girona, Spain
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Xiao C, Li X, Huang L, Cao H, Han L, Ni Y, Xia H, Yang Z. Prevalence and molecular characteristics of polymyxin-resistant Enterobacterales in a Chinese tertiary teaching hospital. Front Cell Infect Microbiol 2023; 13:1118122. [PMID: 37143741 PMCID: PMC10151768 DOI: 10.3389/fcimb.2023.1118122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/29/2023] [Indexed: 05/06/2023] Open
Abstract
Introduction Polymyxin-resistant Enterobacterales poses a significant threat to public health globally, but its prevalence and genomic diversity within a sole hospital is less well known. In this study, the prevalence of polymyxin-resistant Enterobacterales in a Chinese teaching hospital was investigated with deciphering of their genetic determinants of drug resistance. Methods Polymyxin-resistant Enterobacterales isolates identified by matrix-assisted laser desorption were collected in Ruijin Hospital from May to December in 2021. Both the VITEK 2 Compact and broth dilution methods were used to determine polymyxin B (PMB) susceptibility. Polymyxin-resistant isolates were further characterized by molecular typing using PCR, multi-locus sequence typing, and sequencing of the whole genome. Results Of the 1,216 isolates collected, 32 (2.6%) across 12 wards were polymyxin-resistant (minimum inhibitory concentration (MIC) range, PMB 4-256 mg/ml, and colistin 4 ≥ 16 mg/ ml). A total of 28 (87.5%) of the polymyxin-resistant isolates had reduced susceptibility to imipenem and meropenem (MIC ≥ 16 mg/ml). Of the 32 patients, 15 patients received PMB treatment and 20 survived before discharge. The phylogenetic tree of these isolates showed they belonged to different clones and had multiple origins. The polymyxin-resistant Klebsiella pneumoniae isolates belonged to ST-11 (85.72%), ST-15 (10.71%), and ST-65 (3.57%), and the polymyxin-resistant Escherichia coli belonged to four different sequence types, namely, ST-69 (25.00%), ST-38 (25.00%), ST-648 (25.00%), and ST-1193 (25.00%). In addition, six mgrB specific mutations (snp_ALT c.323T>C and amino acid change p.Val8Ala) were identified in 15.6% (5/32) of the isolates. mcr-1, a plasmid-mediated polymyxin-resistant gene, was found in three isolates, and non-synonymous mutations including T157P, A246T, G53V, and I44L were also observed. Discussion In our study, a low prevalence of polymyxin-resistant Enterobacterales was observed, but these isolates were also identified as multidrug resistant. Therefore, efficient infection control measures should be implemented to prevent the further spread of resistance to last-line polymyxin therapy.
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Affiliation(s)
- Chenlu Xiao
- Department of Laboratory Medicine, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Clinical Microbiology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuming Li
- Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing, China
| | - Lianjiang Huang
- Department of Clinical Laboratory, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, China
| | - Huiluo Cao
- Department of Microbiology, The University of Hongkong, Hong Kong, Hong Kong SAR, China
| | - Lizhong Han
- Department of Laboratory Medicine, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Clinical Microbiology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuxing Ni
- Department of Infection Control, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Han Xia
- Department of Scientific Affairs, Hugobiotech Co., Ltd., Beijing, China
| | - Zhitao Yang
- Department of Emergency, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Zhitao Yang,
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Xiao C, Zhu Y, Yang Z, Shi D, Ni Y, Hua L, Li J. Prevalence and Molecular Characteristics of Polymyxin-Resistant Pseudomonas aeruginosa in a Chinese Tertiary Teaching Hospital. Antibiotics (Basel) 2022; 11:antibiotics11060799. [PMID: 35740205 PMCID: PMC9219935 DOI: 10.3390/antibiotics11060799] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 12/01/2022] Open
Abstract
Polymyxin-resistant Pseudomonas aeruginosa is a major threat to public health globally. We investigated the prevalence of polymyxin-resistant P. aeruginosa in a Chinese teaching hospital and determined the genetic and drug-resistant phenotypes of the resistant isolates. P. aeruginosa isolates identified by MALDI-TOF MS were collected across a 3-month period in Ruijin Hospital. Antimicrobial susceptibility was determined by a Vitek-2 Compact system with broth dilution used to determine polymyxin B (PMB) susceptibility. Polymyxin-resistant isolates were further characterized by molecular typing using PCR, multi-locus sequence typing (MLST) and whole-genome sequencing. Phylogenetic relationships were analyzed using single nucleotide polymorphism (SNP) from the whole-genome sequencing. Of 362 P. aeruginosa isolates collected, 8 (2.2%) isolates from separate patients across six wards were polymyxin-resistant (MIC range, PMB 4–16 μg/mL and colistin 4–≥16 μg/mL). Four patients received PMB treatments (intravenous, aerosolized and/or topical) and all patients survived to discharge. All polymyxin-resistant isolates were genetically related and were assigned to five different clades (Isolate 150 and Isolate 211 being the same ST823 type). Genetic variations V51I, Y345H, G68S and R155H in pmrB and L71R in pmrA were identified, which might confer polymyxin resistance in these isolates. Six of the polymyxin-resistant isolates showed reduced susceptibility to imipenem and meropenem (MIC range ≥ 16 μg/mL), while two of the eight isolates were resistant to ceftazidime. We revealed a low prevalence of polymyxin-resistant P. aeruginosa in a Chinese teaching hospital with most polymyxin-resistant isolates being multidrug-resistant. Therefore, effective infection control measures are urgently needed to prevent further spread of resistance to the last-line polymyxins.
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Affiliation(s)
- Chenlu Xiao
- Department of Laboratory Medicine, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
- Department of Clinical Microbiology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yan Zhu
- Monash Biomedicine Discovery Institute, Infection Program and Department of Microbiology, Monash University, Melbourne 3800, Australia;
| | - Zhitao Yang
- Department of Emergency, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
| | - Dake Shi
- Department of Infection Control, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (D.S.); (Y.N.)
| | - Yuxing Ni
- Department of Infection Control, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (D.S.); (Y.N.)
| | - Li Hua
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- Correspondence: (L.H.); (J.L.)
| | - Jian Li
- Monash Biomedicine Discovery Institute, Infection Program and Department of Microbiology, Monash University, Melbourne 3800, Australia;
- Correspondence: (L.H.); (J.L.)
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Zhu L, Shuai X, Xu L, Sun Y, Lin Z, Zhou Z, Meng L, Chen H. Mechanisms underlying the effect of chlorination and UV disinfection on VBNC state Escherichia coli isolated from hospital wastewater. JOURNAL OF HAZARDOUS MATERIALS 2022; 423:127228. [PMID: 34547689 DOI: 10.1016/j.jhazmat.2021.127228] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 09/10/2021] [Accepted: 09/11/2021] [Indexed: 06/13/2023]
Abstract
The occurrence of viable but non-culturable (VBNC) bacteria in the wastewater system poses a huge threat to environmental and public health, in particular in hospital wastewater treatment system (HWTS). HWTS-oriented studies have been conducted to assess the effectiveness of chlorination and UV disinfection using indigenous bacteria. Results revealed that the VBNC Escherichia coli and ARGs remained persistent even at high chlorination (12 mg/L for 2.5 h) and UV doses (1000 mJ/cm2). The molecular mechanisms underlying chlorination-/UV-induced VBNC state in E. coli were explored through the transcriptomics and results suggested that most energy-dependent physiological activities (e.g., metabolism) have been suppressed in VBNC E. coli, while the pathogenicity-related genes varied insignificantly compared to the culturable cells, indicating that the VBNC E. coli could potentially display pathogenicity. Further Galleria mellonella model experiment has confirmed that although the disinfection-induced VBNC state made cells less infectious, these cells could regain their pathogenicity after resuscitation. This in vitro study can be used as a reference for studies on infections from VBNC bacteria and highlights the health risk due to VBNC pathogens in hospital effluents. There is a need to develop effluent standards specifically for healthcare facilities, and a stricter downstream disinfection strategy should be considered for the removal of VBNC cells and ARGs in the effluent.
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Affiliation(s)
- Lin Zhu
- Department of Environmental Engineering, College of Environmental and Resource Sciences; Zhejiang University, Hangzhou 310058, China
| | - Xinyi Shuai
- Department of Environmental Engineering, College of Environmental and Resource Sciences; Zhejiang University, Hangzhou 310058, China
| | - Like Xu
- Department of Chemistry, University of Bath, Claverton Down, Bath BA2 7AY, UK
| | - Yujie Sun
- Department of Environmental Engineering, College of Environmental and Resource Sciences; Zhejiang University, Hangzhou 310058, China
| | - Zejun Lin
- Department of Environmental Engineering, College of Environmental and Resource Sciences; Zhejiang University, Hangzhou 310058, China
| | - Zhenchao Zhou
- Department of Environmental Engineering, College of Environmental and Resource Sciences; Zhejiang University, Hangzhou 310058, China
| | - Lingxuan Meng
- Department of Environmental Engineering, College of Environmental and Resource Sciences; Zhejiang University, Hangzhou 310058, China
| | - Hong Chen
- Department of Environmental Engineering, College of Environmental and Resource Sciences; Zhejiang University, Hangzhou 310058, China.
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Molecular Methods for Pathogenic Bacteria Detection and Recent Advances in Wastewater Analysis. WATER 2021. [DOI: 10.3390/w13243551] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
With increasing concerns about public health and the development of molecular techniques, new detection tools and the combination of existing approaches have increased the abilities of pathogenic bacteria monitoring by exploring new biomarkers, increasing the sensitivity and accuracy of detection, quantification, and analyzing various genes such as functional genes and antimicrobial resistance genes (ARG). Molecular methods are gradually emerging as the most popular detection approach for pathogens, in addition to the conventional culture-based plate enumeration methods. The analysis of pathogens in wastewater and the back-estimation of infections in the community, also known as wastewater-based epidemiology (WBE), is an emerging methodology and has a great potential to supplement current surveillance systems for the monitoring of infectious diseases and the early warning of outbreaks. However, as a complex matrix, wastewater largely challenges the analytical performance of molecular methods. This review synthesized the literature of typical pathogenic bacteria in wastewater, types of biomarkers, molecular methods for bacterial analysis, and their recent advances in wastewater analysis. The advantages and limitation of these molecular methods were evaluated, and their prospects in WBE were discussed to provide insight for future development.
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Cherak Z, Loucif L, Moussi A, Rolain JM. Epidemiology of mobile colistin resistance (mcr) genes in aquatic environments. J Glob Antimicrob Resist 2021; 27:51-62. [PMID: 34438108 DOI: 10.1016/j.jgar.2021.07.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/11/2021] [Accepted: 07/25/2021] [Indexed: 02/05/2023] Open
Abstract
Colistin is one of the last-line therapies against multidrug-resistant Gram-negative pathogens, especially carbapenemase-producing isolates, making resistance to this compound a major global public-health crisis. Until recently, colistin resistance in Gram-negative bacteria was known to arise only by chromosomal mutations. However, a plasmid-mediated colistin resistance mechanism was described in late 2015. This mechanism is encoded by different mobile colistin resistance (mcr) genes that encode phosphoethanolamine (pEtN) transferases. These enzymes catalyse the addition of a pEtN moiety to lipid A in the bacterial outer membrane leading to colistin resistance. MCR-producing Gram-negative bacteria have been largely disseminated worldwide. However, their environmental dissemination has been underestimated. Indeed, water environments act as a connecting medium between different environments, allowing them to play a crucial role in the spread of antibiotic resistance between the natural environment and humans and other animals. For a better understanding of the role of such environments as reservoirs and/or dissemination routes of mcr genes, this review discusses primarily the various water habitats contributing to the spread of antibiotic resistance. Thereafter, we provide an overview of existing knowledge regarding the global epidemiology of mcr genes in water environments. This review confirms the global distribution of mcr genes in several water environments, including wastewater from different origins, surface water and tap water, making these environments reservoirs and dissemination routes of concern for this resistance mechanism.
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Affiliation(s)
- Zineb Cherak
- Laboratoire de Génétique, Biotechnologie et Valorisation des Bio-ressources (GBVB), Faculté des Sciences Exactes et des Sciences de la Nature et de la Vie, Université Mohamed Khider, Biskra, Algeria
| | - Lotfi Loucif
- Laboratoire de Biotechnologie des Molécules Bioactives et de la Physiopathologie Cellulaire (LBMBPC), Département de Microbiologie et de Biochimie, Faculté des Sciences de la Nature et de la Vie, Université de Batna 2, Batna, Algeria.
| | - Abdelhamid Moussi
- Laboratoire de Génétique, Biotechnologie et Valorisation des Bio-ressources (GBVB), Faculté des Sciences Exactes et des Sciences de la Nature et de la Vie, Université Mohamed Khider, Biskra, Algeria
| | - Jean-Marc Rolain
- Aix-Marseille Université, IRD, MEPHI, Faculté de Médecine et de Pharmacie, Marseille, France; IHU Méditerranée Infection, Marseille, France; Assistance Publique des Hôpitaux de Marseille, Marseille, France
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Antibiotic Resistance in Wastewater and Its Impact on a Receiving River: A Case Study of WWTP Brno-Modřice, Czech Republic. WATER 2021. [DOI: 10.3390/w13162309] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Antibiotic resistance has become a global threat in which the anthropogenically influenced aquatic environment represents not only a reservoir for the spread of antibiotic resistant bacteria (ARB) among humans and animals but also an environment where resistance genes are introduced into natural microbial ecosystems. Wastewater is one of the sources of antibiotic resistance. The aim of this research was the evaluation of wastewater impact on the spread of antibiotic resistance in the water environment. In this study, qPCR was used to detect antibiotic resistance genes (ARGs)—blaCTX-M-15, blaCTX-M-32, ampC, blaTEM, sul1, tetM and mcr-1 and an integron detection primer (intl1). Detection of antibiotic resistant Escherichia coli was used as a complement to the observed qPCR results. Our results show that the process of wastewater treatment significantly reduces the abundances of ARGs and ARB. Nevertheless, treated wastewater affects the ARGs and ARB number in the receiving river.
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Reichert G, Hilgert S, Alexander J, Rodrigues de Azevedo JC, Morck T, Fuchs S, Schwartz T. Determination of antibiotic resistance genes in a WWTP-impacted river in surface water, sediment, and biofilm: Influence of seasonality and water quality. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 768:144526. [PMID: 33450684 DOI: 10.1016/j.scitotenv.2020.144526] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/11/2020] [Accepted: 12/11/2020] [Indexed: 05/28/2023]
Abstract
Many pathogenic bacteria are adapted to live in aquatic habitats, which makes rivers possible sources and spread pathways of antibiotic resistance, since they usually receive effluents from wastewater treatment plants (WWTP), possibly containing antibiotic residues and also antibiotic-resistant bacteria. This study investigates different monitoring strategies to identify the occurrence of antibiotic-resistant bacteria in rivers. We analyzed the presence of 13 antibiotic resistance genes (ARGs) and seven gene markers for facultative pathogenic bacteria (FPB) with qPCR in sampling sites upstream and downstream of a small WWTP in Southern Germany. Five sampling campaigns were conducted from February to June 2019. Surface water, sediment, and biofilm samples were analyzed. The biofilm was collected from an artificial sampler placed in the river. blaTEM, ermB, tetM, and sul1 genes were detected in all samples analyzed. The results showed there was a previous background in the river, but the WWTP and the water quality of the river influenced the concentration and occurrence of ARGs and FPB. Genes representing resistance against strong or last-resort antibiotics, such as mecA, blaCMY-2, blaKPC-3, and mcr-1, and multidrug resistance were also detected, mainly in samples collected downstream of the WWTP. Downstream of the WWTP, the occurrence of ARG and FPB correlated with ammoniacal nitrogen, while upstream of the WWTP correlated with turbidity, suspended solids, and seasonal factors such as UVA radiation and the presence of macrophytes. Biofilm samples presented higher abundances of ARGs and FPB. The biofilm sampler was efficient and allowed to collect biofilms from specific periods, which helped to identify seasonal patterns.
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Affiliation(s)
- Gabriela Reichert
- Department of Hydraulics and Sanitation, Federal University of Parana (UFPR), Brazil; Institute for Water and River Basin Management, Karlsruhe Institute of Technology (KIT), Germany.
| | - Stephan Hilgert
- Institute for Water and River Basin Management, Karlsruhe Institute of Technology (KIT), Germany
| | - Johannes Alexander
- Institute of Functional Interfaces, Karlsruhe Institute of Technology (KIT), Germany
| | - Júlio César Rodrigues de Azevedo
- Department of Hydraulics and Sanitation, Federal University of Parana (UFPR), Brazil; Department of Chemistry and Biology, Federal Technology University of Paraná (UTFPR), Brazil
| | - Tobias Morck
- Department of Environmental Engineering, University of Kassel, Germany
| | - Stephan Fuchs
- Institute for Water and River Basin Management, Karlsruhe Institute of Technology (KIT), Germany
| | - Thomas Schwartz
- Institute of Functional Interfaces, Karlsruhe Institute of Technology (KIT), Germany
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11
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Nagy Á, Székelyhidi R, Hanczné Lakatos E, Kapcsándi V. Review on the occurrence of the mcr-1 gene causing colistin resistance in cow's milk and dairy products. Heliyon 2021; 7:e06800. [PMID: 33898852 PMCID: PMC8060599 DOI: 10.1016/j.heliyon.2021.e06800] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/25/2021] [Accepted: 04/10/2021] [Indexed: 01/17/2023] Open
Abstract
Both livestock farmers and the clinic use significant amount of antibiotics worldwide, in many cases the same kind. Antibiotic resistance is not a new phenomenon, however, it is a matter of concern that resistance genes (mcr - Mobilized Colistin Resistance - genes) that render last-resort drugs (Colistin) ineffective, have already evolved. Nowadays, there is a significant consumption of milk and dairy products, which, if not treated properly, can contain bacteria (mainly Gram-negative bacteria). We collected articles and reviews in which Gram-negative bacteria carrying the mcr-1 gene have been detected in milk, dairy products, or cattle. Reports have shown that although the incidence is still low, unfortunately the gene has been detected in some dairy products on almost every continent. In the interest of our health, the use of colistin in livestock farming must be banned as soon as possible, and new treatments should be applied so that we can continue to have a chance in fighting multidrug-resistant bacteria in human medicine.
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12
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Nikkhahi F, Robatjazi S, Niazadeh M, Javadi A, Shahbazi G, Aris P, Marashi S, Emam N. First detection of mobilized colistin resistance mcr-1 gene in Escherichia coli isolated from livestock and sewage in Iran. New Microbes New Infect 2021; 41:100862. [PMID: 33996103 PMCID: PMC8086131 DOI: 10.1016/j.nmni.2021.100862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/17/2021] [Accepted: 03/04/2021] [Indexed: 11/23/2022] Open
Abstract
Currently, few studies have investigated the mechanisms of resistance to colistin in Iran. The aim of this study was to investigate mcr-harbouring Escherichia coli dissemination in livestock and sewage in Iran. A total of 115 samples from cows (n = 38), chickens (n = 47) and urban sewage samples (n = 30) were collected. The presence of genes including mcr1–6 and ampC β-lactamase (blaMOX, blaCIT, blaDHA, blaACC, blaEBC, blaFOX) for colistin-resistant isolates was investigated by multiplex PCR method. Genetic association of colistin-resistant strains was also evaluated by ERIC PCR. Sixty-five isolates were identified as E. coli. Meaningless were resistant to colistin. The highest (26.1%) and lowest (3.07%) resistance were shown to ampicillin and meropenem respectively. Among the three colistin-resistant isolates, 2 (66%) were multidrug resistant, with one of them being mcr-1 positive and the other one positive for DHA ampC β-lactamase gene. No mcr2–6 genes were found. Minimum inhibitory concentration of mcr-producing isolate was 4 mg/L by microbroth dilution. This study reports, first the detection of mcr-1 in E. coli from farm animals in Iran, a finding that is indicative of a global distribution of this plasmidic element and threatning the use of colistin as a last resort antibiotic. No clonal relationship was observed between the colistin-resistant E. coli isolates by ERIC-PCR. Monitoring the presence of these strains in animal sources help as to controlling the spread of resistance genes from animal to human is vital.
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Affiliation(s)
- F. Nikkhahi
- Medical Microbiology Research Center, Iran
- Corresponding author: F. Nikkhahi, Medical Microbiology Research Center, Qazvin University of Medical Sciences, PO Box 34199, 15315, Qazvin, Iran.
| | | | | | - A. Javadi
- Department of Biostatics, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - P. Aris
- Medical Microbiology Research Center, Iran
| | | | - N. Emam
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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13
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Next generation sequencing reveals limitation of qPCR methods in quantifying emerging antibiotic resistance genes (ARGs) in the environment. Appl Microbiol Biotechnol 2021; 105:2925-2936. [PMID: 33738553 DOI: 10.1007/s00253-021-11202-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/28/2021] [Accepted: 02/26/2021] [Indexed: 01/04/2023]
Abstract
Occurrence of emerging antibiotic resistance genes (ARGs) in the environment, especially those conferring resistance to the last resort antibiotic carbapenems (blaKPC) and colistin (mcr-1), has become an important environmental issue. Real-time polymerase chain reaction (qPCR) methods were commonly used to quantify emerging ARGs in the environment, with some studies reporting high abundance. Due to the high diversity of DNA templates and complexity in environmental samples, overestimation or even false-positive detection of target genes may occur due to potential non-specific amplification. This study compared the performance of dye-based qPCR and probe-based qPCR assays for the detection of blaKPC and mcr-1 in activated sludge (AS) samples, which showed that the detection of blaKPC and mcr-1 by the dye-based qPCR assays was likely false-positive when compared with probe-based qPCR results. Next generation sequencing (NGS) of the qPCR reactions identified primer dimers and non-specific amplicons as the primary causes for the false-positive detection. NGS also detected target amplicons in the negative reactions, indicating potential false-negative detection by the probe-based qPCR assays. Testing of spiked samples showed false-positive detection and overestimation by the dye-based qPCR assays primarily occurred at low concentrations of target DNA, while false-negative detection by probe-based qPCR was caused primarily by reduced amplification efficiencies in the environmental samples. Together, the results identified the limitations of the qPCR methods in complex environmental samples and demonstrated the remedial utility of NGS in quantifying emerging ARGs by qPCR. KEY POINTS: • Dye-based qPCR assays are prone to false-positive and overestimation at low substrate concentration. • Probe-based qPCR assays can experience false-negative detection due to environmental interference. • The combination of qPCR with NGS provides improved sensitivity and reliability in detecting low level ARGs in complex environmental matrices.
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14
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Nguyen NT, Liu M, Katayama H, Takemura T, Kasuga I. Association of the colistin resistance gene mcr-1 with faecal pollution in water environments in Hanoi, Vietnam. Lett Appl Microbiol 2020; 72:275-282. [PMID: 33099779 DOI: 10.1111/lam.13421] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/30/2020] [Accepted: 10/20/2020] [Indexed: 11/29/2022]
Abstract
Colistin is one of the antibiotics of last resort for human health. However, the dissemination of the plasmid-mediated colistin resistance gene mcr-1 is of great concern globally. In the One Health framework, the environment is an important component for managing antimicrobial resistance. However, little information is available concerning the prevalence of mcr-1 in water environments. We aimed to reveal the prevalence of mcr-1 in different water environments in Hanoi, Vietnam. Quantitative PCR was applied to detect mcr-1 in four urban drainages receiving untreated domestic wastewater, three rivers, five lakes and two groundwater samples. Urban drainages contained higher concentrations of mcr-1, suggesting that urban residents carry the gene. The class 1 integron-integrase gene was identified as a good surrogate of antibiotic resistance genes including mcr-1. A significant correlation was found between the levels of mcr-1 and the human-specific cross-assembly phage, which is an indicator of human faecal pollution. These results indicated that the primary source of mcr-1 in urban water environments is human faeces, which is consistent with the fact that most domestic wastewater is untreated in Hanoi. The control of untreated wastewater is critical for alleviating the spread of mcr-1 in water environments in Vietnam.
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Affiliation(s)
- N T Nguyen
- Vietnam Research Station, Center for Infectious Disease Research in Asia and Africa, Institute of Tropical Medicine, Nagasaki University, Hanoi, Vietnam.,Master's Program in Environmental Engineering, VNU Vietnam Japan University, Hanoi, Vietnam
| | - M Liu
- Department of Urban Engineering, School of Engineering, The University of Tokyo, Tokyo, Japan
| | - H Katayama
- Department of Urban Engineering, School of Engineering, The University of Tokyo, Tokyo, Japan
| | - T Takemura
- Vietnam Research Station, Center for Infectious Disease Research in Asia and Africa, Institute of Tropical Medicine, Nagasaki University, Hanoi, Vietnam
| | - I Kasuga
- Master's Program in Environmental Engineering, VNU Vietnam Japan University, Hanoi, Vietnam.,Department of Urban Engineering, School of Engineering, The University of Tokyo, Tokyo, Japan
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15
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Xiaomin S, Yiming L, Yuying Y, Zhangqi S, Yongning W, Shaolin W. Global impact of mcr-1-positive Enterobacteriaceae bacteria on "one health". Crit Rev Microbiol 2020; 46:565-577. [PMID: 33044874 DOI: 10.1080/1040841x.2020.1812510] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Polymyxins, especially polymyxin B and polymyxin E (colistin), are considered to be the last line of defence against infections caused by multi-drug-resistant (MDR) gram-negative bacteria such as carbapenem-resistant Enterobacteriaceae (CRE). However, the recent emergence and dissemination of the plasmid-mediated colistin resistance gene mcr-1 and its variants pose a serious challenge to public health and the livestock industry. This review describes the prevalence and dissemination of mcr-1-positive isolates from different sources, including animals (food animals, pet animals and wildlife), humans (healthy populations and patients) and the environment (farms, urban and rural communities and natural environments) based on existing epidemiological studies of mcr-1 and MCR-1-producing Enterobacteriaceae bacteria around the world. The major mechanisms of mcr-1 transmission across humans, animals and the environment are discussed.
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Affiliation(s)
- Shi Xiaomin
- Beijing Advance Innovation Center for Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing, China, P.R. China
| | - Li Yiming
- Beijing Advance Innovation Center for Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing, China, P.R. China
| | - Yang Yuying
- Beijing Advance Innovation Center for Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing, China, P.R. China
| | - Shen Zhangqi
- Beijing Advance Innovation Center for Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing, China, P.R. China
| | - Wu Yongning
- Beijing Advance Innovation Center for Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing, China, P.R. China.,NHC Key Laboratory of Food Safety Risk Assessment, Food Safety Research Unit (2019RU014) of Chinese Academy of Medical Science, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Wang Shaolin
- Beijing Advance Innovation Center for Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing, China, P.R. China
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16
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Jebri S, Rahmani F, Hmaied F. Bacteriophages as antibiotic resistance genes carriers in agro-food systems. J Appl Microbiol 2020; 130:688-698. [PMID: 32916015 DOI: 10.1111/jam.14851] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/04/2020] [Indexed: 12/14/2022]
Abstract
Antibiotic resistance genes (ARGs) are a global health concern. Antibiotic resistance occurs naturally, but misuse of antibiotics in humans and animals is accelerating the process of antibiotic resistance emergency, which has been aggravated by exposure to molecules of antibiotics present in clinical and agricultural settings and the engagement of many countries in water reuse especially in Middle East and North Africa region. Bacteriophages have the potential to be significant actors in ARGs transmission through the transduction process. These viruses have been detected along with ARGs in non impacted habitats and in anthropogenic impacted environments like wastewater, reclaimed water and manure amended soil as well as minimally processed food and ready to eat vegetables. The ubiquity of bacteriophages and their persistence in the environment raises concern about their involvement in ARGs transmission among different biomes and the generation of pathogenic-resistant bacteria that pose a great threat to human health. The aim of this review is to give an overview of the potential role of bacteriophages in the dissemination and the transfer of ARGs to pathogens in food production and processing and the consequent contribution to antibiotic resistance transmission through faecal oral route carrying ARGs to our dishes.
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Affiliation(s)
- S Jebri
- Laboratoire de Biotechnologies et Technologie Nucléaire (LR16CNSTN01), Centre National des Sciences et Technologie Nucléaire, Sidi Thabet, Tunisia
| | - F Rahmani
- Laboratoire de Biotechnologies et Technologie Nucléaire (LR16CNSTN01), Centre National des Sciences et Technologie Nucléaire, Sidi Thabet, Tunisia
| | - F Hmaied
- Laboratoire de Biotechnologies et Technologie Nucléaire (LR16CNSTN01), Centre National des Sciences et Technologie Nucléaire, Sidi Thabet, Tunisia
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17
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Occurrence and Characteristics of Mobile Colistin Resistance ( mcr) Gene-Containing Isolates from the Environment: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031028. [PMID: 32041167 PMCID: PMC7036836 DOI: 10.3390/ijerph17031028] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 01/09/2020] [Accepted: 01/20/2020] [Indexed: 01/04/2023]
Abstract
The emergence and spread of mobile colistin (COL) resistance (mcr) genes jeopardize the efficacy of COL, a last resort antibiotic for treating deadly infections. COL has been used in livestock for decades globally. Bacteria have mobilized mcr genes (mcr-1 to mcr-9). Mcr-gene-containing bacteria (MGCB) have disseminated by horizontal/lateral transfer into diverse ecosystems, including aquatic, soil, botanical, wildlife, animal environment, and public places. The mcr-1, mcr-2, mcr-3, mcr-5, mcr-7, and mcr-8 have been detected in isolates from and/or directly in environmental samples. These genes are harboured by Escherichia coli, Enterobacter, Klebsiella, Proteus, Salmonella, Citrobacter, Pseudomonas, Acinetobacter, Kluyvera, Aeromonas, Providencia, and Raulotella isolates. Different conjugative and non-conjugative plasmids form the backbones for mcr in these isolates, but mcr have also been integrated into the chromosome of some strains. Insertion sequences (IS) (especially ISApl1) located upstream or downstream of mcr, class 1–3 integrons, and transposons are other drivers of mcr in the environment. Genes encoding multi-/extensive-drug resistance and virulence are often co-located with mcr on plasmids in environmental isolates. Transmission of mcr to/among environmental strains is clonally unrestricted. Contact with the mcr-containing reservoirs, consumption of contaminated animal-/plant-based foods or water, international animal-/plant-based food trades and travel, are routes for transmission of MGCB.
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18
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Kneis D, Berendonk TU, Heß S. High prevalence of colistin resistance genes in German municipal wastewater. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 694:133454. [PMID: 31398645 DOI: 10.1016/j.scitotenv.2019.07.260] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 07/05/2019] [Accepted: 07/16/2019] [Indexed: 05/23/2023]
Abstract
Bacterial resistance against the last-resort antibiotic colistin is of increasing concern on a global scale. Wastewater is suspected to be one of the pathways by which resistant bacteria and the respective genes are disseminated. We employed a metagenomics approach to detect and quantify colistin resistance genes in raw municipal wastewater sampled at 9 locations all over Germany (14 samples in total, collected in 2016/2017). Our data support the findings of earlier studies according to which the prevalence of the colistin resistance gene mcr-1 is still low. However, we were able to demonstrate that the total prevalence of colistin resistance genes is dramatically underestimated if the focus is put on that specific gene alone. In comparison to mcr-1, other gene variants like mcr-3 and mcr-7 proved to be 10 to 100 times more abundant in samples of untreated wastewater. The average relative abundances expressed as copies per 16S rRNA gene copies were 2.3×10-3 for mcr-3, 2.2×10-4 for mcr-4, 3.0×10-4 for mcr-5, and 4.4×10-4 for mcr-7. While these four gene variants were ubiquitous in all 14 samples, mcr-1 was detected only once at a relative abundance of 1.4×10-5. Our results suggest a high risk of increasing incidence of colistin resistance as large amounts of mcr genes are continuously disseminated to diverse microbial communities via the wastewater path.
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Affiliation(s)
- David Kneis
- Institute of Hydrobiology, TU Dresden, Germany; Helmholtz Centre for Environmental Research - UFZ, Magdeburg, Germany.
| | | | - Stefanie Heß
- Institute of Hydrobiology, TU Dresden, Germany; Dept. of Microbiology, University of Helsinki, Finland
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19
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Cacace D, Fatta-Kassinos D, Manaia CM, Cytryn E, Kreuzinger N, Rizzo L, Karaolia P, Schwartz T, Alexander J, Merlin C, Garelick H, Schmitt H, de Vries D, Schwermer CU, Meric S, Ozkal CB, Pons MN, Kneis D, Berendonk TU. Antibiotic resistance genes in treated wastewater and in the receiving water bodies: A pan-European survey of urban settings. WATER RESEARCH 2019; 162:320-330. [PMID: 31288142 DOI: 10.1016/j.watres.2019.06.039] [Citation(s) in RCA: 172] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/14/2019] [Accepted: 06/15/2019] [Indexed: 05/05/2023]
Abstract
There is increasing public concern regarding the fate of antibiotic resistance genes (ARGs) during wastewater treatment, their persistence during the treatment process and their potential impacts on the receiving water bodies. In this study, we used quantitative PCR (qPCR) to determine the abundance of nine ARGs and a class 1 integron associated integrase gene in 16 wastewater treatment plant (WWTP) effluents from ten different European countries. In order to assess the impact on the receiving water bodies, gene abundances in the latter were also analysed. Six out of the nine ARGs analysed were detected in all effluent and river water samples. Among the quantified genes, intI1 and sul1 were the most abundant. Our results demonstrate that European WWTP contribute to the enrichment of the resistome in the receiving water bodies with the particular impact being dependent on the effluent load and local hydrological conditions. The ARGs concentrations in WWTP effluents were found to be inversely correlated to the number of implemented biological treatment steps, indicating a possible option for WWTP management. Furthermore, this study has identified blaOXA-58 as a possible resistance gene for future studies investigating the impact of WWTPs on their receiving water.
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Affiliation(s)
- Damiano Cacace
- Environmental Sciences Technische Universität Dresden, Institute of Hydrobiology, 01062, Dresden, Zellescher Weg 40, Germany
| | - Despo Fatta-Kassinos
- Department of Civil and Environmental Engineering and Nireas-International Water Research Center, School of Engineering, University of Cyprus, P.O. Box 20537, 1678, Nicosia, Cyprus
| | - Celia M Manaia
- Universidade Católica Portuguesa, CBQF - Centro de Biotecnologia e Química Fina - Laboratório Associado, Escola Superior de Biotecnologia, Portugal
| | - Eddie Cytryn
- The Institute of Soil, Water and Environmental Sciences, The Volcani Center, Agricultural Research Organization, Bet-Dagan, Israel
| | - Norbert Kreuzinger
- Institute for Water Quality and Resource Management, Vienna University of Technology, Karlsplatz 13, 1040, Vienna, Austria
| | - Luigi Rizzo
- Department of Civil Engineering, University of Salerno, Via Ponte Don Melillo 1, 84084, Fisciano (SA), Italy
| | - Popi Karaolia
- Department of Civil and Environmental Engineering and Nireas-International Water Research Center, School of Engineering, University of Cyprus, P.O. Box 20537, 1678, Nicosia, Cyprus
| | - Thomas Schwartz
- Karlsruhe Institute of Technology (KIT) - Campus North, Institute of Functional Interfaces (IFG), P.O. Box 3640, 76021, Karlsruhe, Germany
| | - Johannes Alexander
- Karlsruhe Institute of Technology (KIT) - Campus North, Institute of Functional Interfaces (IFG), P.O. Box 3640, 76021, Karlsruhe, Germany
| | - Christophe Merlin
- Laboratoire de Chimie Physique et Microbiologie pour Les Matériaux et L'Environnement (LCPME), UMR 7564, CNRS-Université de Lorraine, Vandoeuvre-lès-Nancy F, 54500, France
| | - Hemda Garelick
- Department of Natural Science, Faculty of Science and Technology, Middlesex University, The Burroughs, London, NW4 4BT, UK
| | - Heike Schmitt
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584, CM Utrecht, the Netherlands
| | - Daisy de Vries
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584, CM Utrecht, the Netherlands
| | - Carsten U Schwermer
- Norwegian Institute for Water Research (NIVA), Gaustadalléen 21, 0349, Oslo, Norway
| | - Sureyya Meric
- Corlu Engineering Faculty, Environmental Engineering Department, Namık Kemal Üniversitesi, Çorlu, 59860, Tekirdağ, Turkey
| | - Can Burak Ozkal
- Corlu Engineering Faculty, Environmental Engineering Department, Namık Kemal Üniversitesi, Çorlu, 59860, Tekirdağ, Turkey
| | - Marie-Noelle Pons
- Laboratoire Réactions et Génie des Procédés, CNRS-Université de Lorraine, 1, Rue Grandville, BP 20451, 54001, Nancy Cedex, France
| | - David Kneis
- Environmental Sciences Technische Universität Dresden, Institute of Hydrobiology, 01062, Dresden, Zellescher Weg 40, Germany
| | - Thomas U Berendonk
- Environmental Sciences Technische Universität Dresden, Institute of Hydrobiology, 01062, Dresden, Zellescher Weg 40, Germany.
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20
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Yang F, Gu Y, Zhou J, Zhang K. Swine waste: A reservoir of high-risk bla NDM and mcr-1. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 683:308-316. [PMID: 31132710 DOI: 10.1016/j.scitotenv.2019.05.251] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/05/2019] [Accepted: 05/17/2019] [Indexed: 06/09/2023]
Abstract
Multidrug resistance associated with pigs not only affects pig production but also threatens human health by influencing the farm surrounding and contaminating the food chain. This paper focused on the occurrence and prevalence of high-risk resistance genes (using blaNDM and mcr-1 as marker genes) in two Chinese swine farms, and investigated their fate and seasonal changes in piggery wastewater treatment systems (PWWTSs). Results revealed that blaNDM and mcr-1 were prevalent in both confined swine farms, and even prevailed through various processing stages of PWWTSs. Moreover, the abundance of blaNDM and mcr-1 in winter was higher than that in summer, with 0.01-1.01 logs variation in piggery wastewater. Of concern is that considerable amounts of blaNDM and mcr-1 were present in final effluent that is applied to farmland (up to 102-104copies/mL), raising the risk of propagation to indigenous bacteria. Worse still, those pig-derived isolates harboring the blaNDM/mcr-1 gene were confirmed to spread multidrug resistance to other bacteria, which further increased their dissemination potential in agricultural environment. This study highlights the prevalence of blaNDM and mcr-1 in swine farms, meanwhile, also emphasizes the necessary to mitigate the release and propagation of these high-risk genes from swine farms following land fertilization and wastewater usage.
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Affiliation(s)
- Fengxia Yang
- Agro-Environmental Protection Institute, Ministry of Agriculture, Tianjin 300191, China
| | - Yanru Gu
- College of Resources and Environment, Northeast Agricultural University, Harbin 150036, China
| | - Jing Zhou
- College of Resources and Environment, Northeast Agricultural University, Harbin 150036, China
| | - Keqiang Zhang
- Agro-Environmental Protection Institute, Ministry of Agriculture, Tianjin 300191, China.
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21
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Valenzuela-Valderrama M, González IA, Palavecino CE. Photodynamic treatment for multidrug-resistant Gram-negative bacteria: Perspectives for the treatment of Klebsiella pneumoniae infections. Photodiagnosis Photodyn Ther 2019; 28:256-264. [PMID: 31505296 DOI: 10.1016/j.pdpdt.2019.08.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 08/09/2019] [Indexed: 12/25/2022]
Abstract
The emergence of multi-drug resistance for pathogenic bacteria is one of the most pressing global threats to human health in the 21st century. Hence, the availability of new treatment becomes indispensable to prevent morbidity and mortality caused by infectious agents. This article reviews the antimicrobial properties of photodynamic therapy (PDT), which is based on the use of photosensitizers compounds (PSs). The PSs are non-toxic small molecules, which induce oxidative stress only under excitation with light. Then, the PDT has the advantage to be locally activated using phototherapy devices. We focus on PDT for the Klebsiella pneumoniae, as an example of Gram-negative bacteria, due to its relevance as an agent of health-associated infections (HAI) and a multi-drug resistant bacteria. K. pneumoniae is a fermentative bacillus, member of the Enterobacteriaceae family, which is most commonly associated with producing infection of the urinary tract (UTI) and pneumonia. K. pneumoniae infections may occur in deep organs such as bladder or lungs tissues; therefore, activating light must get access or penetrate tissues with sufficient power to produce effective PDT. Consequently, the rationale for selecting the most appropriate PSs, as well as photodynamic devices and photon fluence doses, were reviewed. Also, the mechanisms by which PDT activates the immune system and its importance to eradicate the infection successfully, are discussed.
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Affiliation(s)
- Manuel Valenzuela-Valderrama
- Laboratorio de Microbiología Celular, Instituto de Investigación e Innovación en Salud, Facultad de Ciencias de la Salud, Universidad Central de Chile, Chile; Centro de Estudios Avanzados en Enfermedades Crónicas (ACCDiS), Independencia, Santiago 8380000, Chile.
| | - Iván Alonzo González
- Instituto de Investigación e Innovación en Salud, Facultad de Ciencias de la Salud, Universidad Central de Chile, Chile.
| | - Christian Erick Palavecino
- Laboratorio de Microbiología Celular, Instituto de Investigación e Innovación en Salud, Facultad de Ciencias de la Salud, Universidad Central de Chile, Chile.
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22
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Li Z, Cao Y, Yi L, Liu JH, Yang Q. Emergent Polymyxin Resistance: End of an Era? Open Forum Infect Dis 2019; 6:5550895. [PMID: 31420655 PMCID: PMC6767968 DOI: 10.1093/ofid/ofz368] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Indexed: 12/03/2022] Open
Abstract
Until recently, the polymyxin antibiotics were used sparingly due to dose limiting toxicities. However, the lack of therapeutic alternatives for infections caused by highly resistant Gram-negative bacteria has led to the increased use of the polymyxins. Unfortunately, the world has witnessed increased rates of polymyxin resistance in the last decade, which is likely in part due to its irrational use in human and veterinary medicine. The spread of polymyxin resistance has been aided by the dissemination of the transferable polymyxin-resistance gene, mcr, in humans and the environment. The mortality of colistin-resistant bacteria (CoRB) infections varies in different reports. However, poor clinical outcome was associated with prior colistin treatment, illness severity, complications, and multidrug resistance. Detection of polymyxin resistance in the clinic is possible through multiple robust and practical tests, including broth microdilution susceptibility testing, chromogenic agar testing, and molecular biology assays. There are multiple risk factors that increase a person’s risk for infection with a polymyxin-resistant bacteria, including age, prior colistin treatment, hospitalization, and ventilator support. For patients that are determined to be infected by polymyxin-resistant bacteria, various antibiotic treatment options currently exist. The rising trend of polymyxin resistance threatens patient care and warrants effective control.
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Affiliation(s)
- Zekun Li
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China.,Department of Laboratory Medicine, Xiangya School of Medicine, Central South University, Changsha, China
| | - Yuping Cao
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Lingxian Yi
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Jian-Hua Liu
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Qiwen Yang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Beijing, China
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23
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Lalaoui R, Djukovic A, Bakour S, Sanz J, Gonzalez-Barbera EM, Salavert M, López-Hontangas JL, Sanz MA, Xavier KB, Kuster B, Debrauwer L, Ubeda C, Rolain JM. Detection of plasmid-mediated colistin resistance, mcr-1 gene, in Escherichia coli isolated from high-risk patients with acute leukemia in Spain. J Infect Chemother 2019; 25:605-609. [PMID: 31023570 DOI: 10.1016/j.jiac.2019.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/07/2019] [Accepted: 03/12/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Bacterial infections in immunocompromised patients are associated with a high mortality and morbidity rate. In this high-risk group, the presence of multidrug-resistant (MDR) bacteria, particularly bacteria that harbor a transferable antibiotic resistance gene, complicates the management of bacterial infections. In this study, we investigated the presence of the transferable colistin resistance mcr genes in patients with leukemia in Spain. METHODS 217 fecal samples collected in 2013-2015 from 56 patients with acute leukemia and colonized with MDR Enterobacteriaceae strains, were screened on September 2017 for the presence of the colistin resistance mcr genes (mcr-1 to -5) by multiplex PCR. mcr positive strains selected on LBJMR and MacConkey supplemented with colistin (2 μg/ml) media were phenotypically and molecularly characterized by antimicrobial susceptibility testing, minimum inhibitory concentration, multilocus sequence typing and plasmid characterization. RESULTS Among 217 fecal samples, 5 samples collected from 3 patients were positive for the presence of the mcr-1 colistin-resistance gene. Four Escherichia coli strains were isolated and exhibited resistance to colistin with MIC = 4 μg/ml. Other genes conferring the resistance to β-lactam antibiotics have also been identified in mcr-1 positive strains, including blaTEM-206 and blaTEM-98. Three different sequence types were identified, including ST1196, ST140 and ST10. Plasmid characterization allowed us to detect the mcr-1 colistin resistance gene on conjugative IncP plasmid type. CONCLUSION To the best of our knowledge, we have identified the mcr-1 gene for the first time in leukemia patients in Spain. In light of these results, strict measures have been implemented to prevent its dissemination.
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Affiliation(s)
- Rym Lalaoui
- Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Ana Djukovic
- Centro Superior de Investigación en Salud Pública - FISABIO, Valencia, Spain
| | - Sofiane Bakour
- Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France; IHU-Méditerranée Infection, Marseille, France
| | - Jaime Sanz
- Department of Medicine, Hospital Universitari i Politecnic La Fe, University of Valencia, and Centro de Investigación Biomédica en Red de Cáncer, Instituto Carlos III, Valencia, Spain
| | | | | | | | - Miguel A Sanz
- Department of Medicine, Hospital Universitari i Politecnic La Fe, University of Valencia, and Centro de Investigación Biomédica en Red de Cáncer, Instituto Carlos III, Valencia, Spain
| | | | - Bernhard Kuster
- Chair of Proteomics and Bioanalytics, Technical University of Munich, Munich, Germany; Bavarian Center for Biomolecular Mass Spectrometry (BayBioMS), Technische Universität München, Gregor-Mendel-Strasse 4, 85354 Freising, Germany
| | - Laurent Debrauwer
- Toxalim, Université de Toulouse, INRA, INP-ENVT, INP-EI-Purpan, Université de Toulouse 3 Paul Sabatier, F-31027, Toulouse, France; Axiom Platform, UMR 1331 Toxalim, MetaToul-MetaboHUB, National Infrastructure of Metabolomics and Fluxomics, F-31027, Toulouse, France
| | - Carles Ubeda
- Centro Superior de Investigación en Salud Pública - FISABIO, Valencia, Spain; Centers of Biomedical Research Network (CIBER) in Epidemiology and Public Health, Madrid, Spain
| | - Jean-Marc Rolain
- Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
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24
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Bardet L, Rolain JM. Development of New Tools to Detect Colistin-Resistance among Enterobacteriaceae Strains. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2018; 2018:3095249. [PMID: 30631384 PMCID: PMC6305056 DOI: 10.1155/2018/3095249] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 01/11/2018] [Indexed: 12/27/2022]
Abstract
The recent discovery of the plasmid-mediated mcr-1 gene conferring resistance to colistin is of clinical concern. The worldwide screening of this resistance mechanism among samples of different origins has highlighted the urgent need to improve the detection of colistin-resistant isolates in clinical microbiology laboratories. Currently, phenotypic methods used to detect colistin resistance are not necessarily suitable as the main characteristic of the mcr genes is the low level of resistance that they confer, close to the clinical breakpoint recommended jointly by the CLSI and EUCAST expert systems (S ≤ 2 mg/L and R > 2 mg/L). In this context, susceptibility testing recommendations for polymyxins have evolved and are becoming difficult to implement in routine laboratory work. The large number of mechanisms and genes involved in colistin resistance limits the access to rapid detection by molecular biology. It is therefore necessary to implement well-defined protocols using specific tools to detect all colistin-resistant bacteria. This review aims to summarize the current clinical microbiology diagnosis techniques and their ability to detect all colistin resistance mechanisms and describe new tools specifically developed to assess plasmid-mediated colistin resistance. Phenotyping, susceptibility testing, and genotyping methods are presented, including an update on recent studies related to the development of specific techniques.
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Affiliation(s)
- Lucie Bardet
- Aix-Marseille Université, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Jean-Marc Rolain
- Aix-Marseille Université, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, Marseille, France
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25
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Drali R, Berrazeg M, Zidouni LL, Hamitouche F, Abbas AA, Deriet A, Mouffok F. Emergence of mcr-1 plasmid-mediated colistin-resistant Escherichia coli isolates from seawater. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 642:90-94. [PMID: 29894885 DOI: 10.1016/j.scitotenv.2018.05.387] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 05/30/2018] [Accepted: 05/31/2018] [Indexed: 06/08/2023]
Abstract
Colistin is currently regarded as one of the 'last-resort' antibiotics used for the treatment of critical infections caused by multidrug-resistant Gram-negative pathogens. Recently, there have been numerous reports of the emergence of a transferable plasmid-mediated colistin resistance gene, mcr-1 in patients, animals, food, and environment. Here, we characterize the support of colistin resistance among environmental isolates collected from seawater of Algiers coast. Our study was carried out on 246 isolates resistant to colistin (MIC > 2 μg/L). The mcr-1 gene was identified in only two isolates; M49 and M78. The two strains were identified as Escherichia coli and were non-susceptible to amoxicillin, ticarcillin, piperacillin, gentamicin, nalidixic acid, tigecycline, tetracycline, trimethoprim-sulfamethoxazole and colistin. For the latter, isolates M49 and M78 showed MIC values of 4 μg/mL and 8 μg/mL, respectively. Only the strain M78 was intermediary resistant to tobramycin. The two E. coli strains belonged to two different sequence types (STs): ST23 for M49 and ST115 for M78. The mcr-1 gene was present on a non-conjugative plasmid in the two strains.
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Affiliation(s)
- Rezak Drali
- Unité Environnement, Institut Pasteur d'Algérie, Alger 16000, Algeria.
| | - Meryem Berrazeg
- Unité de Microbiologie, Institut Pasteur d'Algérie, Antenne d'Oran 31000, Algeria; Département de Biologie, Faculté des Sciences de la Nature et de la vie, Université Oran1, 31000, Algeria
| | | | - Fella Hamitouche
- Unité Environnement, Institut Pasteur d'Algérie, Alger 16000, Algeria
| | - Amina Aicha Abbas
- Dépar tement de Biologie, Faculté des Sciences Biologiques, Université des Sciences et de la Technologie Houari Boumediene, Alger 16000, Algeria
| | - Abdelhamid Deriet
- Unité Environnement, Institut Pasteur d'Algérie, Alger 16000, Algeria
| | - Fawzia Mouffok
- Unité Environnement, Institut Pasteur d'Algérie, Alger 16000, Algeria
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26
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Li B, Chai Z, Yan X, Liu C, Situ B, Zhang Y, Pan W, Luo S, Liu J, Zheng L. An enzyme-free homogenous electrochemical assay for sensitive detection of the plasmid-mediated colistin resistance gene mcr-1. Anal Bioanal Chem 2018; 410:4885-4893. [DOI: 10.1007/s00216-018-1130-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/29/2018] [Accepted: 05/04/2018] [Indexed: 01/17/2023]
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27
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Lainhart W, Yarbrough ML, Jean S, Burnham CAD. New Bugs and New Drugs: Updates in Clinical Microbiology. J Appl Lab Med 2018; 2:925-940. [PMID: 33636835 DOI: 10.1373/jalm.2017.023101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 02/05/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND The landscape of clinical microbiology laboratories is changing. As new technologies are introduced, we are better able to detect and identify pathogens and to recognize and characterize emerging antimicrobial resistance mechanisms. CONTENT In this review, a selected cross-section of current hot topics in clinical microbiology is discussed. These topics include (a) diagnostics for urinary tract and sexually transmitted infections; (b) phenotypic and genotypic methods of detecting carbapenem resistance and discussion of newly approved anti-infective agents for these multi-drug resistant organisms; and (c) the significance, epidemiology, and identification of the emerging pathogens Mycobacterium chimaera and Candida auris. SUMMARY Communication between clinical microbiologists and their clinical colleagues is imperative to convey the significance of emerging pathogens and resistance determinants, as well as the performance characteristics of new diagnostic methods. Additionally, as antimicrobial resistance is surging, it is important to comprehensively evaluate the resistance profiles of clinical isolates to facilitate antimicrobial stewardship and inform infection prevention measures. Although antimicrobial resistance is a global public health crisis, it is encouraging that new anti-infective agents are in the pipeline and being approved for use in patients.
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Affiliation(s)
- William Lainhart
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO
| | - Melanie L Yarbrough
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO
| | - Sophonie Jean
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO
| | - Carey-Ann D Burnham
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO
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28
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Feng Y. Transferability of MCR-1/2 Polymyxin Resistance: Complex Dissemination and Genetic Mechanism. ACS Infect Dis 2018; 4:291-300. [PMID: 29397687 DOI: 10.1021/acsinfecdis.7b00201] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Polymyxins, a group of cationic antimicrobial polypeptides, act as a last-resort defense against lethal infections by carbapenem-resistant Gram-negative pathogens. Recent emergence and fast spread of mobilized colistin resistance determinant mcr-1 argue the renewed interest of colistin in clinical therapies, threatening global public health and agriculture production. This mini-review aims to present an updated overview of mcr-1, covering its global dissemination, the diversity of its hosts/plasmid reservoirs, the complexity in the genetic environment adjacent to mcr-1, the appearance of new mcr-like genes, and the molecular mechanisms for mobilized colistin resistance determinant 1/2 (MCR-1/2).
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Affiliation(s)
- Youjun Feng
- Department of Medical Microbiology and Parasitology, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
- College of Animal Sciences, Zhejiang University, Hangzhou, Zhejiang 310058, China
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29
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Detection of mcr-1 Gene among Escherichia coli Isolates from Farmed Fish and Characterization of mcr-1-Bearing IncP Plasmids. Antimicrob Agents Chemother 2018; 62:AAC.02378-17. [PMID: 29311062 DOI: 10.1128/aac.02378-17] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 01/03/2018] [Indexed: 12/19/2022] Open
Abstract
The presence of the mcr-1 gene in Escherichia coli isolated from retail freshwater fish was investigated. Seven (3.65%) clonally unrelated original E. coli isolates from grass carp were positive for mcr-1 The mcr-1 genes were encoded by either chromosomes (n = 2) or conjugative plasmids (2 IncI2, 2 IncP, and 1 IncX4). The IncP plasmids were similar to other mcr-1-harboring IncP plasmids from China, though the insertion sites varied. Our report warrants further surveillance of resistance genes in aquaculture.
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