Abstract
The emergence of resistance to last-resort antibiotics is a public health concern of global scale. Besides direct person-to-person propagation, environmental pathways might contribute to the dissemination of antibiotic-resistant bacteria and antibiotic resistance genes (ARGs). Here, we describe the incidence of blaNDM-1, a gene conferring resistance to carbapenems, in the wastewater of the city of Jeddah, Saudi Arabia, over a 1-year period. blaNDM-1 was detected at concentrations ranging from 104 to 105 copies/m3 of untreated wastewater during the entire monitoring period. These results indicate the ubiquity and high incidence of blaNDM-1 in the local wastewater. To track the bacteria carrying blaNDM-1, we isolated Escherichia coli PI7, a strain of sequence type 101 (ST101), from wastewater around the Hajj event in October 2013. Genome sequencing of this strain revealed an extensive repertoire of ARGs as well as virulence and invasive traits. These traits were further confirmed by antibiotic resistance profiling and in vitro cell internalization in HeLa cell cultures. Given that this strain remains viable even after a certain duration in the sewerage, and that Jeddah lacks a robust sanitary infrastructure to fully capture all generated sewage, the presence of this bacterium in the untreated wastewater represents a potential hazard to the local public health. To the best of our knowledge, this is the first report of a blaNDM-1-positive E. coli strain isolated from a nonnosocomial environment in Saudi Arabia and may set a priority concern for the need to establish improved surveillance for carbapenem-resistant E. coli in the country and nearby regions.
Highlights
King Abdullah University of Science and Technology (KAUST), Water Desalination and Reuse Center (WDRC), Biological and Environmental Sciences & Engineering Division (BESE), Thuwal, Saudi Arabiaa; King Abdullah University of Science and Technology (KAUST), Bioscience Core Labs, Thuwal, Saudi Arabiab
The combination of cultivation and molecular biology-based approaches to identify emerging microbial contaminants, especially in developing countries like Saudi Arabia, has provided an interesting outlook on the occurrence of antibioticresistant bacteria (ARB) that may be present in untreated wastewater
BlaNDM-1 genes were ubiquitously detected in untreated wastewater entering a Jeddah WWTP throughout the monitored period (Fig. 1) and at an abundance ranging from 1.6 ϫ 104 to 2 ϫ 105 copies/m3
Summary
King Abdullah University of Science and Technology (KAUST), Water Desalination and Reuse Center (WDRC), Biological and Environmental Sciences & Engineering Division (BESE), Thuwal, Saudi Arabiaa; King Abdullah University of Science and Technology (KAUST), Bioscience Core Labs, Thuwal, Saudi Arabiab. Special attention has been given to wastewater due to the high abundances of ARB and ARGs deriving from human and animal feces and the presence of subtherapeutic antibiotic and heavy metal concentrations that favor the maintenance and proliferation of antimicrobial resistance in these aquatic ecosystems [11,12,13] Other human activities, such as international tourism and pilgrimage, further contribute to the spread of these emerging biological pollutants, as visitors might carry multiresistant infectious agents that can be disseminated via the local sewage system [14]. Due to the overuse of septic tanks in many areas of Saudi Arabia, it has been estimated that partially treated
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