Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, 515041, China; Guangdong Province Center for Disease Control and Prevention, Guangzhou, 511400, China.
Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, 515041, China.
Environ Pollut. 2023 Jun 15;327:121539. doi: 10.1016/j.envpol.2023.121539. Epub 2023 Apr 4.
Overconsumption of antibiotics is an immediate cause for the emergence of antimicrobial resistance (AMR) and antibiotic resistant bacteria (ARB), though its environmental impact remains inadequately clarified. There is an urgent need to dissect the complex links underpinning the dynamic co-evolution of ARB and their resistome and mobilome in hospital sewage. Metagenomic and bioinformatic methods were employed to analyze the microbial community, resistome and mobilome in hospital sewage, in relation to data on clinical antibiotic use collected from a tertiary-care hospital. In this study, resistome (1,568 antibiotic resistance genes, ARGs, corresponding to 29 antibiotic types/subtypes) and mobilome (247 types of mobile genetic elements, MGEs) were identified. Networks connecting co-occurring ARGs with MGEs encompass 176 nodes and 578 edges, in which over 19 types of ARGs had significant correlations with MGEs. Prescribed dosage and time-dependent antibiotic consumption were associated with the abundance and distributions of ARGs, and conjugative transfer of ARGs via MGEs. Variation partitioning analyses show that effects of conjugative transfer were most likely the main contributors to transient propagation and persistence of AMR. We have presented the first evidence supporting idea that use of clinical antibiotics is a potent driving force for the development of co-evolving resistome and mobilome, which in turn supports the growth and evolution of ARB in hospital sewage. The use of clinical antibiotics calls for greater attention in antibiotic stewardship and management.
抗生素的过度使用是抗菌药物耐药性（AMR）和抗生素耐药菌（ARB）出现的直接原因，尽管其对环境的影响仍未得到充分阐明。迫切需要剖析医院污水中 ARB 及其耐药组和可移动组动态协同进化背后的复杂联系。本研究采用宏基因组学和生物信息学方法分析了医院污水中的微生物群落、耐药组和可移动组，并结合从一家三级医院收集的临床抗生素使用数据进行了分析。在这项研究中，鉴定出了耐药组（1568 种抗生素耐药基因，对应 29 种抗生素类型/亚型）和可移动组（247 种移动遗传元件，MGEs）。连接共存 ARGs 和 MGEs 的网络包含 176 个节点和 578 个边，其中超过 19 种 ARGs 与 MGEs 存在显著相关性。规定剂量和时间依赖性抗生素消耗与 ARGs 的丰度和分布以及通过 MGEs 的 ARG 转移有关。变异分组分析表明，转移的共轭作用的影响很可能是 AMR 瞬时传播和持续存在的主要原因。我们首次提出了这样的观点，即临床抗生素的使用是耐药组和可移动组协同进化的强大驱动力，这反过来又支持了医院污水中 ARB 的生长和进化。在抗生素管理方面，临床抗生素的使用需要引起更多关注。
