Department of Biochemical Engineering and Biotechnology, Indian Institute of Technology Delhi, Hauz Khas, New Delhi, India.
School of Engineering, Newcastle University, Newcastle upon Tyne, United Kingdom.
Environ Int. 2018 Oct;119:302-308. doi: 10.1016/j.envint.2018.07.004. Epub 2018 Jul 7.
Antimicrobial resistance (AMR) is a major global concern, especially in India where the burden of infectious diseases is high and health care spending is low. Here we quantified total coliform, faecal coliforms (FC), carbapenem-resistant enteric bacteria (CRE), bla, and three integron genes in samples collected from wastewater effluent of 12 hospitals, 12 sewage treatment plants (STPs), 20 sewer drains, and five locations along the Yamuna River in New Delhi over two seasons. Significant correlations were found between FC levels, CRE (r = 0.903, p = 0.004, n = 49) and bla (r = 0.787, p = 0.003, n = 49) concentrations across all samples. Concentrations of coliforms, CRE, bla, int1, and int3 were highest in hospital effluents compared to other locations in both seasons. Although absolute concentration data indicate greater abundances of CRE and bla in the winter, normalised data indicates greater carriage of bla per cell in summer samples. In general, observed CRE levels were highest in surface water downstream of areas with higher population densities. Among CRE isolates (n = 4077), 82%, 75%, 71% and 43% of the strains from hospitals, sewer drains, river samples, and STPs, respectively, contained bla, implying STPs have relatively fewer bla positive CRE in their effluents. The most common CRE isolates in the drains were Pseudomonas putida (39%) followed by Acinetobacter baumanni (20%) and Pseudomonas montelli (19%). The present scenario in New Delhi highlights the urgent need for increased coverage of appropriate waste treatment facilities across the city to reduce CRE exposures from polluted surface waters.
抗微生物药物耐药性（AMR）是一个全球性的重大问题，在印度尤其如此，因为印度的传染病负担很重，而医疗保健支出却很低。在这里，我们在两个季节中从 12 家医院、12 家污水处理厂（STP）、20 个下水道和新德里亚穆纳河的五个地点采集的废水处理厂的污水样本中量化了总大肠菌群、粪便大肠菌群（FC）、碳青霉烯类耐药肠杆菌科细菌（CRE）、bla 和三个整合子基因。在所有样本中，FC 水平、CRE（r = 0.903，p = 0.004，n = 49）和 bla（r = 0.787，p = 0.003，n = 49）浓度之间存在显著相关性。在两个季节中，与其他地点相比，医院污水中的大肠菌群、CRE、bla、int1 和 int3 浓度均最高。尽管绝对浓度数据表明冬季 CRE 和 bla 的丰度更高，但归一化数据表明夏季样本中 bla 每细胞的携带量更高。一般来说，观察到的 CRE 水平在人口密度较高的地区下游的地表水最高。在 CRE 分离株中（n = 4077），分别有 82%、75%、71%和 43%的菌株来自医院、下水道、河流样本和 STP，含有 bla，这意味着 STP 的污水中 bla 阳性 CRE 相对较少。下水道中最常见的 CRE 分离株是铜绿假单胞菌（39%），其次是鲍曼不动杆菌（20%）和蒙氏假单胞菌（19%）。新德里的现状突显了需要在全市范围内增加适当的废物处理设施的覆盖范围，以减少受污染地表水对 CRE 的暴露。
