Nahum Yanina, Muhvich Johnathan, Morones-Ramirez José Rubén, Casillas-Vega Nestor G, Zaman Muhammad H
Department of Biomedical Engineering, Boston University, Boston, MA, United States.
Center on Forced Displacement, Boston University, Boston, MA, United States.
Front Public Health. 2025 Mar 21;13:1568463. doi: 10.3389/fpubh.2025.1568463. eCollection 2025.
Antimicrobial resistance is a major global health threat, characterized by the ability of microorganisms to withstand the effects of antimicrobial agents. Biofilms, as unique microbial communities, significantly contribute to this threat. They provide a protective environment for pathogens, facilitate horizontal gene transfer, and create an ideal setting for the persistence and evolution of resistant bacteria. This issue can be particularly important in low-income settings and vulnerable communities, such as formal and informal refugee and migrant camps. These settings usually have limited access to healthcare resources and appropriate treatments, contributing to the selective pressure that promotes the survival and proliferation of resistant bacteria. Thus, biofilms formed in wastewater in these areas can play a critical role in spreading antimicrobial resistance or acting as hidden reservoirs for future outbreaks. While emerging efforts focus on detecting antibiotic resistance genes and planktonic bacteria in wastewater, biofilms may be a source of under-appreciated antimicrobial resistance, creating a significant gap in our understanding of resistance dynamics in wastewater systems. Incorporating biofilm surveillance into wastewater monitoring strategies in vulnerable settings can help develop a more comprehensive understanding of resistance transmission and more effective intervention measures in these settings.
抗菌耐药性是全球主要的健康威胁，其特征是微生物具有抵抗抗菌药物作用的能力。生物膜作为独特的微生物群落，对这一威胁有显著影响。它们为病原体提供了一个保护环境，促进水平基因转移，并为耐药细菌的持续存在和进化创造了理想条件。在低收入环境以及脆弱社区，如正规和非正规的难民及移民营地，这个问题可能尤为重要。这些环境通常获得医疗资源和适当治疗的机会有限，从而形成了促进耐药细菌生存和繁殖的选择压力。因此，在这些地区废水中形成的生物膜在传播抗菌耐药性或充当未来疫情的隐藏源头方面可能发挥关键作用。虽然新出现的努力集中在检测废水中的抗生素耐药基因和浮游细菌，但生物膜可能是未得到充分重视的抗菌耐药性来源，这在我们对废水系统中耐药动态的理解上造成了重大差距。将生物膜监测纳入脆弱环境中的废水监测策略有助于更全面地了解耐药性传播情况，并在这些环境中制定更有效的干预措施。
