Abstract
Emerging antimicrobial resistance is a major threat to human’s health in the 21st century. Understanding and combating this issue requires a full and unbiased assessment of the current status on the prevalence of antimicrobial resistance genes and their correlation with each other and bacterial groups. In aquatic environments that are known reservoirs for antimicrobial resistance genes, we were able to reach this goal on plasmid-mediated quinolone resistance (PMQR) genes that lead to resistance to quinolones and possibly also to the co-emergence of resistance to β-lactams. Novel findings were made that qepA and aac-(6′)-Ib genes that were previously regarded as similarly abundant with qnr genes are now dominant among PMQR genes in aquatic environments. Further statistical analysis suggested that the correlation between PMQR and β-lactam resistance genes in the environment is still weak, that the correlations between antimicrobial resistance genes could be weakened by sufficient wastewater treatment, and that the prevalence of PMQR has been implicated in environmental, pathogenic, predatory, anaerobic, and more importantly, human symbiotic bacteria. This work provides a comprehensive analysis of PMQR genes in aquatic environments in Jinan, China, and provides information with which combat with the antimicrobial resistance problem may be fought.
Highlights
PMQR prevalence in natural, clinical and community settings, is a priority in the combat with resistance against quinolones and other antibiotics such as β-lactams
The aquatic environment has been shown a reservoir for PMQR genes[24], and it has been suggested that PMQR genes originated from environmental bacteria such as Shewanella algae that primarily inhabit aquatic environments[25]
The monthly quantification of antimicrobial resistance genes carried out in this work strongly suggests that the outbreak of these genes is seasonal (Figs 4 and 5)
Summary
PMQR prevalence in natural, clinical and community settings, is a priority in the combat with resistance against quinolones and other antibiotics such as β-lactams. The majority of surveillance investigations carried out on PMQR genes used clinical or animal samples, with focus on isolated culturable clinically relevant bacteria such as Escherichia coli[23], Klebsiella pneumoniae[14], and Enterobacter cloacae[15]. While this does make sense as antimicrobial resistant pathogens are the primary focus on investigations of antimicrobial resistance genes, these investigations cannot provide information on the full picture of the prevalence of PMQR genes in the biosphere, and cannot help us on assessing the extent and characteristics of the prevalence of PMQR genes in the environment. Novel and surprising findings on these aspects were made, and the extent of PMQR prevalence in the environment was assessed
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