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Hospital wastewater effluent: hot spot for antibiotic resistant bacteria
Journal of Water, Sanitation & Hygiene for Development ( IF 1.7 ) Pub Date : 2020-06-01 , DOI: 10.2166/washdev.2020.086
Urška Rozman 1 , Darja Duh 1 , Mojca Cimerman 1 , Sonja Šostar Turk 1
Affiliation  

Hospital wastewaters are highly complex effluents acting as a hotspot for antibiotic resistant bacteria. Especially, Gram-negative bacteria bearing multiple antibiotic resistant genes are increasingly found in hospital wastewaters. The aim of this study was to evaluate the presence of extended spectrum beta-lactamases (ESBL) and carbapenemase producing Enterobacteriaceae in hospital wastewaters from one Slovenian and two Austrian hospitals, as well as the occurrence of antibiotic resistant genes encoding for VIM, KPC, NDM, CTXM and OXA beta-lactamases in isolates from hospital wastewater. The results indicated high levels of ESBL producing Enterobacteriaceae in ranges up to 107 cfu/mL. Carbapenemase producing Enterobacteriaceae and OXA 48-type CPE were present in ranges up to 105 cfu/mL. Out of 89 multiplied polymerase chain reaction (PCR) amplicons, only 36 were positive for different β-lactamase gene families, among those only three isolates were identified as multiresistant. The dominant ESBL family was CTXM in 19 different isolates. This was followed by 10 OXA-48 positive isolates and 10 VIM positive isolates. KPC or NDM carbapenemases were not identified with PCR screening of the isolates. Hospital wastewaters serve as a reservoir for nearly all clinically important antibiotic resistances. The importance of evaluating such potential environmental reservoirs is especially evident when outbreak cases could not be linked to an epidemiological source.



中文翻译:

医院废水:抗生素耐药菌的热点

医院废水是高度复杂的废水,是抗生素耐药细菌的热点。特别是,在医院废水中越来越多地发现带有多种抗生素抗性基因的革兰氏阴性细菌。这项研究的目的是评估斯洛文尼亚和两家奥地利医院的医院废水中存在产生超广谱β-内酰胺酶(ESBL)和产碳青霉烯酶的肠杆菌科细菌,以及编码VIM,KPC,NDM的抗生素抗性基因的发生情况,医院污水分离物中的CTXM和OXAβ-内酰胺酶。结果表明,产生ESBL的肠杆菌科细菌水平很高,最高可达10 7 cfu / mL。产生碳青霉烯酶的肠杆菌科细菌和OXA 48型CPE的存在范围高达10 5cfu / mL。在89个多重聚合酶链反应(PCR)扩增子中,只有36个对不同的β-内酰胺酶基因家族呈阳性,其中只有3个分离株被鉴定为多重耐药。ESBL家族的主要成员是19种不同菌株中的CTXM。其次是10个OXA-48阳性分离株和10个VIM阳性分离株。PCR分离株未鉴定出KPC或NDM碳青霉烯酶。医院废水可作为几乎所有临床上重要的抗生素耐药性的储存库。当暴发病例不能与流行病学来源联系在一起时,评估此类潜在环境储层的重要性尤其明显。

更新日期:2020-06-01
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