Alduhaidhawi Athraa Harjan Mohsen, AlHuchaimi Sundus Nsaif, Al-Mayah Thikra Abdullah, Al-Ouqaili Mushtak T S, Alkafaas Samar Sami, Muthupandian Saravanan, Saki Morteza
Department of Biology, Faculty of Science, University of Kufa, Najaf, Iraq.
Department of Parasitology, Faculty of Medicine, University of Kufa, Najaf, Iraq.
Infect Drug Resist. 2022 Mar 19;15:1143-1154. doi: 10.2147/IDR.S358248. eCollection 2022.
This study aimed to evaluate the presence of CRISPR-Cas system genes and their possible association with antibiotic resistance patterns of and species isolated from hospital wastewater (HWW) samples of several hospitals.
HWW samples (200 mL) were collected from wastewater discharged from different hospitals from October 2020 to March 2021. The isolation and identification of enterococci species were performed by standard bacteriology tests and polymerase chain reaction (PCR). Antibiotic resistance was determined using the disc diffusion. The presence of various CRISPR-Cas systems was investigated by PCR. The association of the occurrence of CRISPR-Cas systems with antibiotic resistance was analyzed with appropriate statistical tests.
In total, 85 different enterococci species were isolated and identified using phenotypic methods. The results of PCR confirmed the prevalence of 50 (58.8%) and 35 (41.2%) , respectively. In total, 54 (63.5%) of 85 isolates showed the presence of CRISPR-Cas loci. The incidence of CRISPR-Cas was more common in . CRISPR1, CRISPR2, and CRISPR3 were present in 35 (41.2%), 47 (55.3%), and 30 (35.3%) enterococci isolates, respectively. The CRISPR-Cas positive isolates showed significant lower resistance rates against vancomycin, ampicillin, chloramphenicol, erythromycin, rifampin, teicoplanin, tetracycline, imipenem, tigecycline, and trimethoprim-sulfamethoxazole in comparison with CRISPR-Cas negative isolates. The results showed that the presence of CRISPR-Cas genes was lower in multidrug-resistant (MDR) isolates (53.1%, n = 26/49) compared to the non-MDR enterococci isolates (77.8%, n = 28/36) ( = 0.023).
This study revealed the higher prevalence of than in HWWs. Also, the lack of CRISPR-Cas genes was associated with more antibiotic resistance rates and multidrug resistance in and isolates with HWW origin.
本研究旨在评估从几家医院的医院废水（HWW）样本中分离出的肠球菌属和粪肠球菌属中CRISPR-Cas系统基因的存在情况及其与抗生素耐药模式的可能关联。
于2020年10月至2021年3月从不同医院排放的废水中收集200 mL HWW样本。通过标准细菌学检测和聚合酶链反应（PCR）对肠球菌属进行分离和鉴定。采用纸片扩散法测定抗生素耐药性。通过PCR研究各种CRISPR-Cas系统的存在情况。使用适当的统计检验分析CRISPR-Cas系统的出现与抗生素耐药性之间的关联。
总共使用表型方法分离并鉴定出85种不同的肠球菌属。PCR结果分别证实了50株（58.8%）粪肠球菌和35株（41.2%）屎肠球菌的流行情况。在85株分离株中，共有54株（63.5%）显示存在CRISPR-Cas基因座。CRISPR-Cas在粪肠球菌中更为常见。CRISPR1、CRISPR2和CRISPR3分别存在于35株（41.2%）、47株（55.3%）和30株（35.3%）肠球菌分离株中。与CRISPR-Cas阴性分离株相比，CRISPR-Cas阳性分离株对万古霉素、氨苄青霉素、氯霉素、红霉素、利福平、替考拉宁、四环素、亚胺培南、替加环素和甲氧苄啶-磺胺甲恶唑的耐药率显著更低。结果表明，与非多重耐药肠球菌分离株（77.8%，n = 28/36）相比，多重耐药（MDR）分离株中CRISPR-Cas基因的存在率较低（53.1%，n = 26/49）（P = 0.023）。
本研究揭示了医院废水中粪肠球菌的流行率高于屎肠球菌。此外，对于源自医院废水的肠球菌属和粪肠球菌属分离株，CRISPR-Cas基因的缺失与更高的抗生素耐药率和多重耐药性相关。
