Department of Environment and Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
Department of Environment and Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, China.
Environ Pollut. 2022 Mar 15;297:118800. doi: 10.1016/j.envpol.2022.118800. Epub 2022 Jan 7.
The emergence and dissemination of carbapenem-resistant Enterobacteriaceae (CRE) constitute a major global health problem. The environment plays an important role in the dissemination of CRE, but large-scale studies on CRE in groundwater environments in animal breeding areas are scarce. The aim of this study was to investigate CRE occurrence and environmental transmission of carbapenem resistance genes in large animal breeding areas in northern China. In total, 280 well water and 102 animal feces samples in large animal breeding areas in six counties from the two provinces Inner Mongolia and Shandong in China, were screened for CRE. A total of 39 CRE were isolated and characterized with next-generation sequencing. 5.3% of well water samples were contaminated with CRE. The well water in chicken farms had the highest number of detections of CRE (15.9%). More than half of the isolates carried closely related, conjugative IncX3 plasmids with bla-genes from multiple geographic areas, indicating that this kind of plasmid plays an important role in dissemination of carbapenem resistance determinants. The clonal expansion of various CRE isolates in well water and animal feces were demonstrated; clonally related CRE were isolated from different wells within the same county, from different counties in the same province, and even from different provinces. In addition to harboring various ARGs, two closely related K. pneumoniae belonging to ST11 isolated from well water carried genetic hypervirulence determinants on a virulence plasmid, highlighting the potential health risk posed by further dissemination of this strain. These findings suggest that groundwater may be an underappreciated reservoir and source of dissemination of CRE, from which resistance genes may disseminate among different bacterial strains and over large geographic distances. Further research and multi-sectorial monitoring, with a "One health" perspective, is urgently needed to investigate the need for interventions aimed at preventing CRE dissemination.
产碳青霉烯类耐药肠杆菌科（CRE）的出现和传播是一个主要的全球健康问题。环境在 CRE 的传播中起着重要作用，但在动物养殖区地下水环境中进行的大规模 CRE 研究很少。本研究旨在调查中国北方两个省份内蒙古和山东六个县的大型动物养殖区 CRE 的发生情况和环境传播。共筛选了中国内蒙古和山东两个省份六个县的 280 份井水和 102 份动物粪便样本，以检测 CRE。共分离并鉴定了 39 株 CRE，采用下一代测序技术。有 5.3%的井水样本受到 CRE 的污染。鸡场的井水 CRE 检出率最高（15.9%）。超过一半的分离株携带来自多个地理区域的 bla 基因的密切相关的可接合 IncX3 质粒，表明这种质粒在传播碳青霉烯类耐药决定因素方面起着重要作用。在井水和动物粪便中，各种 CRE 分离株的克隆扩张得到了证明；从同一县内不同水井、同一省内不同县甚至不同省份分离到了具有克隆相关性的 CRE。除了携带各种 ARG 外，从井水分离到的两个密切相关的肺炎克雷伯菌属于 ST11，它们在一个毒力质粒上携带遗传超毒力决定因素，突出了该菌株进一步传播所带来的潜在健康风险。这些发现表明，地下水可能是 CRE 的一个未被充分认识的储存库和传播源，其中的耐药基因可能在不同细菌菌株之间以及在较大的地理距离上传播。需要从“同一健康”的角度出发，进一步进行研究和多部门监测，以调查是否需要采取干预措施来防止 CRE 的传播。
