Cahill Niamh, Hooban Brigid, Fitzhenry Kelly, Joyce Aoife, O'Connor Louise, Miliotis Georgios, McDonagh Francesca, Burke Liam, Chueiri Alexandra, Farrell Maeve Louise, Bray James E, Delappe Niall, Brennan Wendy, Prendergast Deirdre, Gutierrez Montserrat, Burgess Catherine, Cormican Martin, Morris Dearbháile
Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Galway, Ireland.
Antimicrobial Resistance and Microbial Ecology Group, School of Medicine, University of Galway, Galway, Ireland; Centre for One Health, Ryan Institute, University of Galway, Galway, Ireland.
Sci Total Environ. 2023 Jun 10;876:162649. doi: 10.1016/j.scitotenv.2023.162649. Epub 2023 Mar 10.
The emergence and dissemination of mobile colistin resistance (mcr) genes across the globe poses a significant threat to public health, as colistin remains one of the last line treatment options for multi-drug resistant infections. Environmental samples (157 water and 157 wastewater) were collected in Ireland between 2018 and 2020. Samples collected were assessed for the presence of antimicrobial resistant bacteria using Brilliance ESBL, Brilliance CRE, mSuperCARBA and McConkey agar containing a ciprofloxacin disc. All water and integrated constructed wetland influent and effluent samples were filtered and enriched in buffered peptone water prior to culture, while wastewater samples were cultured directly. Isolates collected were identified via MALDI-TOF, were tested for susceptibility to 16 antimicrobials, including colistin, and subsequently underwent whole genome sequencing. Overall, eight mcr positive Enterobacterales (one mcr-8 and seven mcr-9) were recovered from six samples (freshwater (n = 2), healthcare facility wastewater (n = 2), wastewater treatment plant influent (n = 1) and integrated constructed wetland influent (piggery farm waste) (n = 1)). While the mcr-8 positive K. pneumoniae displayed resistance to colistin, all seven mcr-9 harbouring Enterobacterales remained susceptible. All isolates demonstrated multi-drug resistance and through whole genome sequencing analysis, were found to harbour a wide variety of antimicrobial resistance genes i.e., 30 ± 4.1 (10-61), including the carbapenemases, bla (n = 2) and bla (n = 1), which were harboured by three of the isolates. The mcr genes were located on IncHI2, IncFIIK and IncI1-like plasmids. The findings of this study highlight potential sources and reservoirs of mcr genes in the environment and illustrate the need for further research to gain a better understanding of the role the environment plays in the persistence and dissemination of antimicrobial resistance.
移动性黏菌素耐药(mcr)基因在全球范围内的出现和传播对公众健康构成了重大威胁,因为黏菌素仍是耐多药感染的最后一线治疗选择之一。2018年至2020年期间在爱尔兰采集了环境样本(157份水样本和157份废水样本)。使用含有环丙沙星纸片的 Brilliance ESBL、Brilliance CRE、mSuperCARBA 和麦康凯琼脂对采集的样本进行抗菌耐药菌检测。所有水样本以及综合人工湿地的进水和出水样本在培养前均经过过滤,并在缓冲蛋白胨水中富集,而废水样本则直接进行培养。通过基质辅助激光解吸电离飞行时间质谱(MALDI-TOF)对采集的分离株进行鉴定,检测其对包括黏菌素在内的16种抗菌药物的敏感性,随后进行全基因组测序。总体而言,从6个样本(淡水(n = 2)、医疗机构废水(n = 2)、污水处理厂进水(n = 1)和综合人工湿地进水(养猪场废水)(n = 1))中分离出8株mcr阳性肠杆菌科细菌(1株mcr-8和7株mcr-9)。虽然mcr-8阳性肺炎克雷伯菌对黏菌素耐药,但所有携带mcr-9的7株肠杆菌科细菌仍对黏菌素敏感。所有分离株均表现出多重耐药性,通过全基因组测序分析发现,它们含有多种抗菌耐药基因,即30 ± 4.1(10 - 61)个,其中包括碳青霉烯酶bla(n = 2)和bla(n = 1),有3株分离株携带这些基因。mcr基因位于IncHI2、IncFIIK和IncI1样质粒上。本研究结果突出了环境中mcr基因的潜在来源和储存库,并表明需要进一步开展研究,以更好地了解环境在抗菌耐药性的持续存在和传播中所起的作用。