Abstract
Due to the global progress of antimicrobial resistance, the World Health Organization (WHO) published the list of the antibiotic-resistant “priority pathogens” in order to promote research and development of new antibiotics to the families of bacteria that cause severe and often deadly infections. In the framework of the One Health approach, the surveillance of these pathogens in different environments should be implemented in order to analyze their spread and the potential risk of transmission of antibiotic resistances by food and water. Therefore, the objective of this work was to determine the presence of high and critical priority pathogens included in the aforementioned list in different aquatic environments in the POCTEFA area (North Spain–South France). In addition to these pathogens, detection of colistin-resistant Enterobacteriaceae was included due its relevance as being the antibiotic of choice to treat infections caused by multidrug resistant bacteria (MDR). From the total of 80 analyzed samples, 100% of the wastewater treatment plants (WWTPs) and collectors (from hospitals and slaughterhouses) and 96.4% of the rivers, carried antibiotic resistant bacteria (ARB) against the tested antibiotics. Fifty-five (17.7%) of the isolates were identified as target microorganisms (high and critical priority pathogens of WHO list) and 58.2% (n = 32) of them came from WWTPs and collectors. Phenotypic and genotypic characterization showed that 96.4% were MDR and resistance to penicillins/cephalosporins was the most widespread. The presence of bla genes, KPC-type carbapenemases, mcr-1 and vanB genes has been confirmed. In summary, the presence of clinically relevant MDR bacteria in the studied aquatic environments demonstrates the need to improve surveillance and treatments of wastewaters from slaughterhouses, hospitals and WWTPs, in order to minimize the dispersion of resistance through the effluents of these areas.
Highlights
One of the highest public health challenges worldwide is the increase in the number and types of antimicrobial resistances (AMR) [1]
The use and misuse of antimicrobials in human medicine is one of the main causes of this increasing problem, but inappropriate practices in intensive livestock farms have contributed to the alarming increase in antibiotic resistant bacteria (ARB) [2,3]
Regarding vancomycin resistant enterococci (VRE), the presence of these bacteria seems to be related to small wild mammals, rabbits and birds [20,21], some authors described the presence of E. faecium vanA and vanB in wastewater and surface waters [22,23]
Summary
One of the highest public health challenges worldwide is the increase in the number and types of antimicrobial resistances (AMR) [1]. Β-lactam antibiotics have been the most extended therapeutic choice for the treatment of human and animal infections worldwide, and bacteria have developed different β-lactam resistance mechanisms, such as the production of extended spectrum β-lactamases (ESBLs) and carbapenemases [14]. Colistin sulfate is used for the control of Enterobacteriaceae infections in pig production in some countries [25,26], contributing to the spread of colistin resistances mediated by the transferable plasmid mcr-1 [27]. In this context, it would be very interesting to search for this type of resistance in different aquatic environments, such as rivers, WWTPs and collectors
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