Matthew-Bernard Makeda, Farmer-Diaz Karla, Dolphin-Bond Grace, Matthew-Belmar Vanessa, Cheetham Sonia, Mitchell Kerry, Macpherson Calum N L, Ramos-Nino Maria E
Department of Microbiology, Immunology, and Pharmacology, School of Medicine, St. George's University, St. George's P.O. Box 7, Grenada.
Department of Pathobiology, School of Veterinary Medicine, St. George's University, St. George's P.O. Box 7, Grenada.
Int J Environ Res Public Health. 2025 Jan 12;22(1):97. doi: 10.3390/ijerph22010097.
Antimicrobial resistance (AMR) is a growing global health threat. This study investigated antibiotic resistance in isolates from municipal wastewater (86 isolates) and clinical urinary tract infection (UTI) cases (34 isolates) in a Grenadian community, using data from January 2022 to October 2023. Antibiogram data, assessed per WHO guidelines for Critically Important antimicrobials (CIA), showed the highest resistance levels in both clinical and wastewater samples for ampicillin, followed by amoxicillin/clavulanic acid and nalidixic acid, all classified as Critically Important. Similar resistance was observed for sulfamethoxazole-trimethoprim (highly important) in both groups, with nitrofurantoin showing resistance in the important category. According to the WHO AWaRe classification, ampicillin (ACCESS group) had the highest resistance, while nitrofurantoin had the lowest across all samples. The WATCH group antibiotics, cefuroxime and cefoxitin, showed comparable resistance levels, whereas aztreonam from the RESERVE group (tested only in wastewater) was 100% sensitive. Multiple Antibiotic Resistance (MAR) index analysis revealed that 7% of wastewater and 38.2% of clinical samples had MAR values over 0.2, indicating prior antibiotic exposure in clinical isolates. These parallel patterns in wastewater and clinical samples highlight wastewater monitoring as a valuable tool for AMR surveillance, supporting antibiotic stewardship through ongoing environmental and clinical assessment.
抗菌药物耐药性（AMR）是一个日益严重的全球健康威胁。本研究利用2022年1月至2023年10月的数据，调查了格林纳达一个社区的城市污水分离株（86株）和临床尿路感染（UTI）病例分离株（34株）中的抗生素耐药性。根据世界卫生组织（WHO）对极其重要的抗菌药物（CIA）的指南进行评估的抗菌谱数据显示，氨苄西林在临床和污水样本中的耐药水平最高，其次是阿莫西林/克拉维酸和萘啶酸，所有这些都被归类为极其重要的抗菌药物。两组中磺胺甲恶唑-甲氧苄啶（非常重要）也观察到类似的耐药情况，呋喃妥因在重要类别中显示出耐药性。根据WHO的AWaRe分类，氨苄西林（ACCESS组）在所有样本中的耐药性最高，而呋喃妥因的耐药性最低。WATCH组抗生素头孢呋辛和头孢西丁显示出相当的耐药水平，而RESERVE组的氨曲南（仅在污水中检测）100%敏感。多重耐药（MAR）指数分析显示，7%的污水样本和38.2%的临床样本的MAR值超过0.2，表明临床分离株先前有抗生素暴露。污水和临床样本中的这些平行模式突出了污水监测作为AMR监测的一个有价值工具，通过持续的环境和临床评估来支持抗生素管理。
