Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein, Christian Albrecht University of Kiel, Campus Kiel, Rosalind-Franklin-Straße 12, 24105, Kiel, Germany.
Pharmaceutical Institute, Department of Clinical Pharmacy, Christian Albrecht University of Kiel, Kiel, Germany.
Microbiome. 2018 Feb 20;6(1):37. doi: 10.1186/s40168-018-0414-7.
Multidrug-resistant bacteria represent a substantial global burden for human health, potentially fuelled by migration waves: in 2015, 476,649 refugees applied for asylum in Germany mostly as a result of the Syrian crisis. In Arabic countries, multiresistant bacteria cause significant problems for healthcare systems. Currently, no data exist describing antibiotic resistances in healthy refugees. Here, we assess the microbial landscape and presence of antibiotic resistance genes (ARGs) in refugees and German controls. To achieve this, a systematic study was conducted in 500 consecutive refugees, mainly from Syria, Iraq, and Afghanistan and 100 German controls. Stool samples were subjected to PCR-based quantification of 42 most relevant ARGs, 16S ribosomal RNA gene sequencing-based microbiota analysis, and culture-based validation of multidrug-resistant microorganisms.
The fecal microbiota of refugees is substantially different from that of resident Germans. Three categories of resistance profiles were found: (i) ARGs independent of geographic origin of individuals comprising BIL/LAT/CMA, ErmB, and mefE; (ii) vanB with a high prevalence in Germany; and (iii) ARGs showing substantially increased prevalences in refugees comprising CTX-M group 1, SHV, vanC1, OXA-1, and QnrB. The majority of refugees carried five or more ARGs while the majority of German controls carried three or less ARGs, although the observed ARGs occurred independent of signatures of potential pathogens.
Our results, for the first time, assess antibiotic resistance genes in refugees and demonstrate a substantially increased prevalence for most resistances compared to German controls. The antibiotic resistome in refugees may thus require particular attention in the healthcare system of host countries.
耐多药细菌对人类健康构成了重大的全球性负担，可能因移民潮而加剧：2015 年，476649 名难民因叙利亚危机主要在德国申请避难。在阿拉伯国家，耐多药细菌对医疗保健系统造成了重大问题。目前，尚无描述健康难民中抗生素耐药性的数据。在这里，我们评估了难民和德国对照者中的微生物景观和抗生素耐药基因（ARGs）的存在。为此，对 500 名连续的难民（主要来自叙利亚、伊拉克和阿富汗）和 100 名德国对照者进行了系统研究。对粪便样本进行了基于 PCR 的 42 种最相关 ARGs 的定量、16S 核糖体 RNA 基因测序的微生物组分析以及多药耐药微生物的基于培养的验证。
难民的粪便微生物群与常驻德国人的粪便微生物群有很大的不同。发现了三种耐药谱类别：（i）个体地理起源无关的 ARGs 包括 BIL/LAT/CMA、ErmB 和 mefE；（ii）在德国流行率很高的 vanB；（iii）在难民中表现出显着增加流行率的 ARGs 包括 CTX-M 组 1、SHV、vanC1、OXA-1 和 QnrB。大多数难民携带五个或更多的 ARGs，而大多数德国对照者携带三个或更少的 ARGs，尽管观察到的 ARGs 独立于潜在病原体的特征。
我们的研究结果首次评估了难民中的抗生素耐药基因，并与德国对照者相比，大多数耐药性的发生率明显增加。因此，难民中的抗生素耐药组可能需要在宿主国家的医疗保健系统中特别关注。
