Abstract
Hospital sewage plays a key role in the dissemination of antibiotic-resistant genes (ARGs) by serving as an environmental antimicrobial resistance reservoir. In this study, we aimed to characterize the cephalosporin- and carbapenem-resistant isolates from hospital sewage and receiving rivers. The results showed that ESBL (blaCTX-M) and carbapenemase genes (blaNDM and blaKPC) were widely detected in a number of different bacterial species. These resistance genes were mainly harbored in Enterobacteriaceae, followed by Acinetobacter and Aeromonas isolates. More attention should be given to these bacteria as important vectors of ARGs in the environment. Furthermore, we showed that the multidrug resistance phenotype was highly prevalent, which was found in 85.5% Enterobacteriaceae and 75% Acinetobacter strains. Notably, the presence of carbapenemase genes in isolates from treated effluents and receiving rivers indicates that the discharges of wastewater treatment plants could be an important source for high-risk resistance genes propagation to the environment. In conclusion, this study shows a high prevalence of ESBL- and carbapenemase-producing bacteria in hospital sewage and receiving rivers in China. These findings have serious implications for human health, and also suggest the need for more efforts to control the dissemination of resistant bacteria from hospital sewage into the environment.
Highlights
The emergence and rapid dissemination of antibiotic resistance is a serious and growing problem for human health [1]. β-lactam antibiotics are by far the most used antibiotics worldwide for treating infections in both humans and animals [2]
Aquatic environments are significant reservoirs of antibiotic-resistant determinants. They serve as a vehicle by which antibiotic-resistant genes (ARGs) or antibiotic-resistant bacteria (ARB) could be disseminated from one ecosystem to another, thereby increasing the risk of infection with MDR bacteria outside the hospital [31]
Analysis of the antimicrobial resistance profiles of Enterobacteriaceae and Acinetobacter isolates obtained in this study revealed a high prevalence of resistance to antimicrobial agents, and that MDR
Summary
The emergence and rapid dissemination of antibiotic resistance is a serious and growing problem for human health [1]. β-lactam antibiotics are by far the most used antibiotics worldwide for treating infections in both humans and animals [2]. The emergence and rapid dissemination of antibiotic resistance is a serious and growing problem for human health [1]. Β-lactam antibiotics are by far the most used antibiotics worldwide for treating infections in both humans and animals [2]. A significant threat to the usage of these agents is the rapid evolution of β-lactamases, mainly among Gram-negative bacteria, which makes each new drug obsolete in a very short period of time [3]. Among the β-lactams, carbapenem antibiotics are considered to be the most reliable last-resort treatment for bacterial infections caused by extended-spectrum β-lactamases (ESBLs)-producing bacteria [4]. The rapid spread of carbapenem resistance, usually caused by the production of carbapenemase, constitutes a critical public-healthcare problem worldwide [4]. Carbapenemases have the ability to hydrolyze penicillins, cephalosporins and carbapenems, thereby limiting treatment options [5].
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