Environmental, Safety Technology and Health Program, School of Public Health, Walailak University, Thaiburi, Thasala, Nakhon Si Thammarat 80160, Thailand.
Department of Environmental Health and Technology, School of Public Health, Walailak University, Nakhon Si Thammarat 80160, Thailand; One Health Research Center, Walailak University, Nakhon Si Thammarat 80160, Thailand.
Sci Total Environ. 2023 Oct 20;896:165229. doi: 10.1016/j.scitotenv.2023.165229. Epub 2023 Jun 30.
Antimicrobial resistance has been a serious and complex issue for over a decade. Although research on antimicrobial resistance (AMR) has mainly focused on clinical and animal samples as essential for treatment, the AMR situation in aquatic environments may vary and have complicated patterns according to geographical area. Therefore, this study aimed to examine recent literature on the current situation and identify gaps in the AMR research on freshwater, seawater, and wastewater in Southeast Asia. The PubMed, Scopus, and ScienceDirect databases were searched for relevant publications published from January 2013 to June 2023 that focused on antimicrobial resistance bacteria (ARB) and antimicrobial resistance genes (ARGs) among water sources. Based on the inclusion criteria, the final screening included 41 studies, with acceptable agreement assessed using Cohen's inter-examiner kappa equal to 0.866. This review found that 23 out of 41 included studies investigated ARGs and ARB reservoirs in freshwater rather than in seawater and wastewater, and it frequently found that Escherichia coli was a predominant indicator in AMR detection conducted by both phenotypic and genotypic methods. Different ARGs, such as bla, sul1, and tetA genes, were found to be at a high prevalence in wastewater, freshwater, and seawater. Existing evidence highlights the importance of wastewater management and constant water monitoring in preventing AMR dissemination and strengthening effective mitigation strategies. This review may be beneficial for updating current evidence and providing a framework for spreading ARB and ARGs, particularly region-specific water sources. Future AMR research should include samples from various water systems, such as drinking water or seawater, to generate contextually appropriate results. Robust evidence regarding standard detection methods is required for prospective-era work to raise practical policies and alerts for developing microbial source tracking and identifying sources of contamination-specific indicators in aquatic environment markers.
抗生素耐药性已经是一个严重且复杂的问题，已经存在了十余年。虽然抗生素耐药性（AMR）的研究主要集中在临床和动物样本上，这些样本对于治疗至关重要，但水生环境中的 AMR 情况可能因地理位置而异，具有复杂的模式。因此，本研究旨在考察最近关于东南亚淡水、海水和废水的 AMR 现状的文献，并确定 AMR 研究中的空白。使用 PubMed、Scopus 和 ScienceDirect 数据库，检索了 2013 年 1 月至 2023 年 6 月期间发表的与水源中抗生素耐药细菌（ARB）和抗生素耐药基因（ARGs）相关的相关出版物。根据纳入标准，最终筛选出 41 项研究，采用 Cohen 检验者间kappa 相等 0.866 来评估可接受的一致性。本综述发现，41 项纳入研究中有 23 项研究调查了淡水而不是海水和废水的 ARG 和 ARB 库，并且经常发现，表型和基因型方法检测到的 AMR 中，大肠杆菌是主要的指示菌。在废水、淡水和海水中，bla、sul1 和 tetA 等不同的 ARG 被发现具有高流行率。现有证据强调了废水管理和持续的水质监测在防止 AMR 传播和加强有效缓解策略方面的重要性。本综述可能有助于更新当前证据，并为传播 ARB 和 ARGs 提供框架，特别是针对特定地区的水源。未来的 AMR 研究应包括来自各种水系统的样本，如饮用水或海水，以生成具有上下文意义的结果。需要有关于标准检测方法的有力证据，以便为前瞻性工作提供实用的政策和警报，以提高微生物源追踪能力，并确定水生环境标志物中特定污染来源的指示物。
