Abstract
The World Health Organization has identified antibiotic resistance as one of the largest threats to human health and food security. In this study, we compared antibiotic resistance patterns between ESBL-producing Escherichia coli from human clinical diseases and cefotaxime-resistant environmental strains, as well as their potential to be pathogenic. Antibiotic susceptibility was tested amongst clinical isolates (n = 11), hospital wastewater (n = 22), and urban wastewater (n = 36, both influent and treated effluents). Multi-drug resistance predominated (>70%) among hospitalwastewater and urban wastewater influent isolates. Interestingly, isolates from clinical and urban treated effluents showed similar multi-drug resistance rates (~50%). Most hospital wastewater isolates were Phylogroup A, while clinical isolates were predominately B2, with a more diverse phylogroup population in urban wastewater. ESBL characterization of cefotaxime-resistant populations identified blaCTX-M-1 subgroup as the most common, whereby blaKPC was more associated with ceftazidime and ertapenem resistance. Whole-genome sequencing of a carbapenemase-producing hospital wastewater E. coli strain revealed plasmid-mediated blaKPC-2. Among cefotaxime-resistant populations, over 60% of clinical and 30% of treated effluent E. coli encoded three or more virulence genes exhibiting a pathogenic potential. Together, the similarity among treated effluent E. coli populations and clinical strains suggest effluents could serve as a reservoir for future multi-drug resistant E. coli clinical infections.
Highlights
Antimicrobial resistance (AMR) is a serious global health concern
AMR is frequently associated with the overuse and misuse of antibiotics in clinical settings, resistant bacteria and their genes are widespread within human, animal, and environmental settings, indicating the need for a One Health approach [2]
We examined extended spectrum beta-lactamase (ESBLs)-producing E. coli isolates from a variety of clinical sources
Summary
Antimicrobial resistance (AMR) is a serious global health concern. In the United States alone, over 2 million AMR infections are reported annually, resulting in approximately23,000 deaths [1]. AMR is frequently associated with the overuse and misuse of antibiotics in clinical settings, resistant bacteria and their genes are widespread within human, animal, and environmental settings, indicating the need for a One Health approach [2]. Wastewaters are ideal for the study of AMR as they serve as a bridge between human, animal, and environmental settings and have been frequently implicated in the acquisition and dissemination of AMR bacteria and genes [3,4]. Bacterial populations that survive the WW treatment process, whether pathogenic or not, serve as a health risk in downstream receiving waters by increasing the dissemination of AMR bacteria and their genes
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