Abstract

Anthropogenic inputs increase levels of antimicrobial resistance (AMR) in the environment, however, it is unknown how these inputs create this observed increase, and if anthropogenic sources impact AMR in environmental bacteria. The aim of this study was to characterise the role of waste water treatment plants (WWTPs) in the dissemination of class 1 integrons (CL1s) in the riverine environment. Using sample sites from upstream and downstream of a WWTP, we demonstrate through isolation and culture-independent analysis that WWTP effluent significantly increases both CL1 abundance and antibiotic resistance in the riverine environment. Characterisation of CL1-bearing isolates revealed that CL1s were distributed across a diverse range of bacteria, with identical complex genetic resistance determinants isolated from both human-associated and common environmental bacteria across connected sites. Over half of sequenced CL1s lacked the 3′-conserved sequence ('atypical’ CL1s); surprisingly, bacteria carrying atypical CL1s were on average resistant to more antibiotics than bacteria carrying 3′-CS CL1s. Quaternary ammonium compound (QAC) resistance genes were observed across 75% of sequenced CL1 gene cassette arrays. Chemical data analysis indicated high levels of boron (a detergent marker) downstream of the WWTP. Subsequent phenotypic screening of CL1-bearing isolates demonstrated that ~90% were resistant to QAC detergents, with in vitro experiments demonstrating that QACs could solely select for the transfer of clinical antibiotic resistance genes to a naive Escherichia coli recipient. In conclusion, this study highlights the significant impact of WWTPs on environmental AMR, and demonstrates the widespread carriage of clinically important resistance determinants by environmentally associated bacteria.

Highlights

  • Antimicrobial resistance (AMR) is a worldwide health issue, with forecasts of prevalent untreatable infections within the decade [1]

  • To investigate the impact of waste water treatment plants (WWTPs) effluent on class 1 integrons (CL1s) prevalence in the total sediment communities, quantitative PCR (qPCR) was performed on metagenomic DNA to quantify total gene prevalence for the CL1 integrase (Fig. 1)

  • There were variations in CL1 prevalence between DS sites depending on distance from the effluent source, but DS3 was still significantly higher than the mean US CL1 prevalence (χ2 = 994.993, P < 0.0001), indicating a continued impact of the WWTP on CL1 prevalence in the bacterial sediment communities ~1 km DS

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Summary

Introduction

Antimicrobial resistance (AMR) is a worldwide health issue, with forecasts of prevalent untreatable infections within the decade [1].

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