University of Utah, Salt Lake City, UT, USA.
VA Salt Lake City Healthcare System, Salt Lake City, UT, USA.
Sci Rep. 2019 Mar 8;9(1):3938. doi: 10.1038/s41598-019-40420-0.
Community-associated acquisition of extended-spectrum beta-lactamase- (ESBL) and carbapenemase-producing Enterobacteriaceae has significantly increased in recent years, necessitating greater inquiry into potential exposure routes, including food and water sources. In high-income countries, drinking water is often neglected as a possible source of community exposure to antibiotic-resistant organisms. We screened coliform-positive tap water samples (n = 483) from public and private water systems in six states of the United States for bla, bla, bla, bla, bla, and bla-type genes by multiplex PCR. Positive samples were subcultured to isolate organisms harboring ESBL or carbapenemase genes. Thirty-one samples (6.4%) were positive for bla, ESBL-type bla or bla, or bla-type carbapenemase genes, including at least one positive sample from each state. ESBL and bla-type Enterobacteriaceae isolates included E. coli, Kluyvera, Providencia, Klebsiella, and Citrobacter species. The bla-type genes were also found in non-fermenting Gram-negative species, including Shewanella, Pseudomonas and Acinetobacter. Multiple isolates were phenotypically non-susceptible to third-generation cephalosporin or carbapenem antibiotics. These findings suggest that tap water in high income countries could serve as an important source of community exposure to ESBL and carbapenemase genes, and that these genes may be disseminated by non-Enterobacteriaceae that are not detected as part of standard microbiological water quality testing.
近年来，社区获得性产超广谱β-内酰胺酶（ESBL）和碳青霉烯酶肠杆菌科的数量显著增加，这就需要更深入地研究潜在的暴露途径，包括食物和水源。在高收入国家，饮用水通常被忽视为社区接触抗生素耐药菌的可能来源。我们通过多重 PCR 筛查了来自美国六个州的公共和私人供水系统中含有大肠菌群的自来水样本（n=483），以检测 bla、bla、bla、bla、bla 和 bla 型基因。对阳性样本进行传代培养以分离携带 ESBL 或碳青霉烯酶基因的细菌。31 个样本（6.4%）对 bla、ESBL 型 bla 或 bla、或 bla 型碳青霉烯酶基因呈阳性，包括每个州至少有一个阳性样本。ESBL 和 bla 型肠杆菌科细菌包括大肠埃希菌、克氏柠檬酸杆菌、普罗威登斯菌、克雷伯菌和柠檬酸杆菌属。bla 型基因也存在于非发酵革兰氏阴性菌中，包括希瓦氏菌属、假单胞菌属和不动杆菌属。多种分离株对第三代头孢菌素或碳青霉烯类抗生素表现出表型耐药。这些发现表明，高收入国家的自来水可能是社区接触 ESBL 和碳青霉烯酶基因的重要来源，这些基因可能通过非肠杆菌科细菌传播，而这些细菌在标准微生物水质检测中无法被检测到。
