基因组和元基因组分析揭示了从医院病人和医院废水中分离出的大肠杆菌和克雷伯氏菌属在菌种内和菌种间共享的抗性基因和移动遗传因子

IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES International journal of hygiene and environmental health Pub Date : 2024-07-21 DOI:10.1016/j.ijheh.2024.114423
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引用次数: 0

摘要

抗菌药耐药性(AMR)是一个令人严重关切的全球性问题。医院废水(HWW)是连接临床环境和自然环境的重要纽带,也是导致医院感染(包括尿路感染)的病原体的逃逸通道。埃希氏菌属和克雷伯氏菌属细菌是尿路感染(尤其是儿童尿路感染)的常见病原体,它们既可引起短期感染,也可导致慢性病。产 ESBL 的埃希氏菌和克雷伯氏菌也已成为估计环境条件下抗菌药耐药性负担以及 AMR 在临床环境和自然环境之间传播的潜在指标。本研究采用全基因组测序和纳米孔技术分析了产ESBL大肠杆菌和克雷伯氏菌的全基因组以及HWW元基因组,并对AMR的机制进行了描述。分析了临床分离菌株(导致UTI)和环境菌株(从HWW和HWW元基因组中分离)AMR编码机制的异同。研究特别关注了抗生素耐药基因(ARGs)的遗传背景和流动性,以确定这些基因的共同来源和潜在传播途径。这项研究的结果表明,耐药性通过医院污水从医疗机构传播并不局限于通常在临床环境中发现的耐药性克隆菌株的直接传播,它还涉及携带 ARGs 的移动元素在定植于各种环境的细菌之间的间接转移。医院废水可通过插入新的 ARGs(包括典型的染色体区域)为质粒进化提供支持性环境。这些结果表明,应密切监测交错环境(医院病人-HWW),以评估细菌耐药性的潜在传播途径。
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Genomic and metagenomic analysis reveals shared resistance genes and mobile genetic elements in E. coli and Klebsiella spp. isolated from hospital patients and hospital wastewater at intra- and inter-genus level

Antimicrobial resistance (AMR) is a global problem that gives serious cause for concern. Hospital wastewater (HWW) is an important link between the clinical setting and the natural environment, and an escape route for pathogens that cause hospital infections, including urinary tract infections (UTI). Bacteria of the genera Escherichia and Klebsiella are common etiological factors of UTI, especially in children, and they can cause short-term infections, as well as chronic conditions. ESBL-producing Escherichia and Klebsiella have also emerged as potential indicators for estimating the burden of antimicrobial resistance under environmental conditions and the spread of AMR between clinical settings and the natural environment. In this study, whole-genome sequencing and the nanopore technology were used to analyze the complete genomes of ESBL-producing E. coli and Klebsiella spp. and the HWW metagenome, and to characterize the mechanisms of AMR. The similarities and differences in the encoded mechanisms of AMR in clinical isolates (causing UTI) and environmental strains (isolated from HWW and the HWW metagenome) were analyzed. Special attention was paid to the genetic context and the mobility of antibiotic resistance genes (ARGs) to determine the common sources and potential transmission of these genes. The results of this study suggest that the spread of drug resistance from healthcare facilities via HWW is not limited to the direct transmission of resistant clonal lines that are typically found in the clinical setting, but it also involves the indirect transfer of mobile elements carrying ARGs between bacteria colonizing various environments. Hospital wastewater could offer a supportive environment for plasmid evolution through the insertion of new ARGs, including typical chromosomal regions. These results indicate that interlined environments (hospital patients – HWW) should be closely monitored to evaluate the potential transmission routes of drug resistance in bacteria.

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来源期刊
CiteScore
11.50
自引率
5.00%
发文量
151
审稿时长
22 days
期刊介绍: The International Journal of Hygiene and Environmental Health serves as a multidisciplinary forum for original reports on exposure assessment and the reactions to and consequences of human exposure to the biological, chemical, and physical environment. Research reports, short communications, reviews, scientific comments, technical notes, and editorials will be peer-reviewed before acceptance for publication. Priority will be given to articles on epidemiological aspects of environmental toxicology, health risk assessments, susceptible (sub) populations, sanitation and clean water, human biomonitoring, environmental medicine, and public health aspects of exposure-related outcomes.
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