Drug resistant bacteria in non carbonated mineral waters

Bacterial diversity and antibiotic resistance in water habitats: searching the links with the human microbiome

Water is one of the most important bacterial habitats on Earth. As such, water represents also a major way of dissemination of bacteria between different environmental compartments. Human activities led to the creation of the so-called urban water cycle, comprising different sectors (waste, surface, drinking water), among which bacteria can hypothetically be exchanged. Therefore, bacteria can be mobilized between unclean water habitats (e.g. wastewater) and clean or pristine water environments (e.g. disinfected and spring drinking water) and eventually reach humans. In addition, bacteria can also transfer mobile genetic elements between different water types, other environments (e.g. soil) and humans. These processes may involve antibiotic resistant bacteria and antibiotic resistance genes. In this review, the hypothesis that some bacteria may share different water compartments and be also hosted by humans is discussed based on the comparison of the bacterial diversity in different types of water and with the human-associated microbiome. The role of such bacteria as potential disseminators of antibiotic resistance and the inference that currently only a small fraction of the clinically relevant antibiotic resistome may be known is discussed.

Bottled mineral water as a potential source of antibiotic resistant bacteria

The antibiotic resistance phenotypes of the cultivable bacteria present in nine batches of two Portuguese and one French brands of commercially available mineral waters were examined. Most of the 238 isolates recovered on R2A, Pseudomonas Isolation agar or on these culture media supplemented with amoxicillin or ciprofloxacin, were identified (based on 16S rRNA gene sequence analysis) as Proteobacteria of the divisions Beta, Gamma and Alpha. Bacteria resistant to more than three distinct classes of antibiotics were detected in all the batches of the three water brands in counts up to 10² CFU/ml. In the whole set of isolates, it was observed resistance against all the 22 antimicrobials tested (ATB, bioMérieux and disc diffusion), with most of the bacteria showing resistance to three or more classes of antibiotics. Bacteria with the highest multi-resistance indices were members of the genera Variovorax, Bosea, Ralstonia, Curvibacter, Afipia and Pedobacter. Some of these bacteria are related with confirmed or suspected nosocomial agents. Presumable acquired resistance may be suggested by the observation of bacteria taxonomically related but isolated from different brands, exhibiting distinct antibiotic resistance profiles. Bottled mineral water was confirmed as a possible source of antibiotic resistant bacteria, with the potential to be transmitted to humans.

Diversity and antibiotic resistance in Pseudomonas spp. from drinking water

Pseudomonas spp. are common inhabitants of aquatic environments, including drinking water. Multi-antibiotic resistance in clinical isolates of P. aeruginosa is widely reported and deeply characterized. However, the information regarding other species and environmental isolates of this genus is scant. This study was designed based on the hypothesis that members of the genus Pseudomonas given their high prevalence, wide distribution in waters and genetic plasticity can be important reservoirs of antibiotic resistance in drinking water. With this aim, the diversity and antibiotic resistance phenotypes of Pseudomonas isolated from different drinking water sources were evaluated. The genotypic diversity analyses were based on six housekeeping genes (16S rRNA, rpoD, rpoB, gyrB, recA and ITS) and on pulsed field gel electrophoresis. Susceptibility to 21 antibiotics of eight classes was tested using the ATB PSE EU (08) and disk diffusion methods. Pseudomonas spp. were isolated from 14 of the 32 sampled sites. A total of 55 non-repetitive isolates were affiliated to twenty species. Although the same species were isolated from different sampling sites, identical genotypes were never observed in distinct types of water (water treatment plant/distribution system, tap water, cup fillers, biofilm, and mineral water). In general, the prevalence of antibiotic resistance was low and often the resistance patterns were related with the species and/or the strain genotype. Resistance to ticarcillin, ticarcillin with clavulanic acid, fosfomycin and cotrimoxazol were the most prevalent (69-84%). No resistance to piperacillin, levofloxacin, ciprofloxacin, tetracycline, gentamicin, tobramycin, amikacin, imipenem or meropenem was observed. This study demonstrates that Pseudomonas spp. are not so widespread in drinking water as commonly assumed. Nevertheless, it suggests that water Pseudomonas can spread acquired antibiotic resistance, preferentially via vertical transmission.

Risk assessment of heterotrophic bacteria from bottled drinking water sold in Indian markets

One hundred and five samples of bottled drinking water belonging to 30 different brands, collected from six different states of India have been analysed for total heterotrophic bacterial (THB) load and coliforms. Almost all bottlers used multiple treatment procedures such as microfiltration, reverse osmosis and ozonization to treat the water. Around 40% of the samples exceeded the limit of 100 cfu/ml set by the department of health as well as Bureau of Indian Standards (BIS), Government of India. Fourteen percent and 44% of the samples with THB loads between 100 and 1000 cfu/ml or 1000 cfu/ml tested positive for coliforms indicating a linear relationship between THB and coliform bacteria. Gram-positive genera such as Kurthia and Corynebacterium were found to be dominant genera, while members of the family enterobacteriaceae contributed to 7%. Risk assessment of the heterotrophic bacteria revealed that the majority of the strains acquired resistance against ampicillin, nalidixic acid, novobiocin and oxytetracycline. As bottled drinking water is a ready to drink commodity, the high load of heterotrophic bacteria with multiple drug resistance poses significant health hazards to the consumers, especially to immunocompromised individuals.

Antibiotic resistance and antibacterial activity in heterotrophic bacteria of mineral water origin

Antibiotic resistance and antibacterial activity were determined on heterotrophic bacteria isolated from mineral waters. Of the 120 isolates Pseudomonas spp. (55.8%) was the predominant group followed by Acinetobacter spp. (14.17%), Flavobacterium spp. (10.83%), Achromobacter spp. (10%), Burkholderia cepacia (3.3%), Agrobacterium/radiobacter (2.5%), Moraxella spp. (1.7%), Aeromonas hydrophila (1.7%). Over 80% of the isolates were resistant to one or more antibiotics and the highest resistance was found for chloramphenicol, ampicillin, colistin and sulfamethizole (60%, 55%, 50% and 47.5%, respectively). Strains with multiple antibiotic resistance (MAR) represented 55% of isolates and the most resistant organism belonged to the genus Pseudomonas. Of 40 randomly selected strains, 27 (67.5%) had antibacterial activity towards one or more indicators. This activity, found in a high percentage in the genus Pseudomonas (92%), emerged mainly against closely related microorganisms. Several producers were active also against Escherichia coli, Salmonella, Listeria monocytogenes and Staphylococcus aureus. Forty-six percent of the isolates harboured 1 to 5 plasmids with molecular weights ranging from 2.1 to 41.5 MDa.

Incidence of antibiotic-resistant Klebsiella pneumoniae and Enterobacter species in freshwater wetlands

AIMS

The aim of this study was to assess the incidence of Enterobacteriaceae (potential human and animal pathogens) in wetlands.

METHODS

Enterobacteriaceae, selected from the sediments and rhizosphere of wetland plant Juncus effusus L., were analysed using classical microbiological methods, API20E, API20NE, fatty acid analyses, and 16S rRNA sequencing. Assessed virulence factors include antibiotic resistance, presence of plasmids and capsules.

RESULTS

Klebsiella pneumoniae, Enterobacter cloacae and Enterobacter asburiae, known human pathogens, were identified. K. pneumoniae 16S rRNA gene sequence showed the significant hit (E < 0.001) with the unculturable bacteria obtained from faeces of elderly individuals (accession number AB099804) when Genbank database was used. Ent. asburiae 16S rRNA gene sequence showed the significant hit with (E < 0.001) with the unculturable bacteria obtained from the pig gastrointestinal tract (accession number AF371852). The rate of antibiotic resistance (<50 microg ml(-1)) was high for ampicillin and cephalosporins for the most strains (75.7%) yet low (>10 to 20 microg ml(-1)) for kanamycin, tetracycline and chloramphenicol for all strains tested. Capsules were detected in all investigated strains. PCR detected membrane protein but not chromosomally encoded beta-lactamase.

SIGNIFICANCE AND IMPACT OF THE STUDY

The antibiotic resistance of tested strains and presence of capsules (protect micro-organisms from phagocytosis) suggest that wetland sediments and rhizosphere present a potential reservoirs for enteric human and animal pathogens.

Arming the enemy: the evolution of resistance to self-proteins

A remarkable range of novel antibiotics is attracting increasing interest as a major new weapon in the campaign against bacterial infection. They are based on the toxic peptides that provide the innate immune system of animals, and it is claimed that bacteria will be unable to evolve resistance to them because they attack the 'Achilles' heel' of bacterial membrane structure. Both experimental evidence and theoretical arguments suggest that this claim is doubtful. If so, the introduction of these substances into general use may provoke the evolution of resistance to our own defence proteins and thus compromise our natural defences against infection.

Enumeration and characterization of bacteria in mineral water by improved direct viable count method

Fifteen strains from two emergent mineral waters were isolated and tentatively identified with API 20NE and BIOLOG GN systems. These strains were screened for their sensitivities to seven replication-inhibiting antibiotics of the (fluoro)quinolone group (nalidixic and pipemidic acid, flumequine, norfloxacin, ofloxacin, pefloxacin and ciprofloxacin). It was shown that the direct viable count (DVC) procedure could be improved by using certain antibiotic cocktails, which were active against the isolates. Geometric bacterial features were successfully determined with image analysis and adapted software (ICONIX, Perfect Image). Elongations were significant and allowed rapid discrimination of antibiotic inhibited and non-inhibited strains. Particular isolates in a mixed culture were characterized and enumerated after only 14 h exposure with the appropriate antibiotic cocktail. This method can also be applied to other communities, such as mixed cultures in bio-fermentors or in food with known microflora.