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Detection of Emerging, Clinically Relevant Antibiotic Resistance Genes in Wastewater from Treatment Plants in Urban and Rural Areas in the United States
Citation:
Rainey, A., D. Feistel, O. Shanks, AND A. Kirby. Detection of Emerging, Clinically Relevant Antibiotic Resistance Genes in Wastewater from Treatment Plants in Urban and Rural Areas in the United States. NCEZID Science Summit, Atlanta, GA, February 20, 2020.
Impact/Purpose:
Antibiotic resistant organisms are estimated to cause over 2.8 million infections and 35,870 deaths annually in the United States. Surveillance for resistance genes is currently focused on clinical illnesses that seek medical care, with limited detection of mild or asymptomatic cases. This study evaluated the potential to detect clinically relevant antibiotic resistance genes in municipal wastewater. Information covered in this manuscript presentation was prepared based on high priority research needs in the EPA Research Action Plan (SSWR Research Area 3, Output #8, Product 1).
Description:
Antibiotic resistant organisms are estimated to cause over 2.8 million infections and 35,870 deaths annually in the United States. Clinical surveillance for resistance genes is focused on clinical illnesses that seek medical care, with limited detection of mild or asymptomatic cases. This study evaluated the potential to detect clinically relevant antibiotic resistance genes (ARGs) in municipal wastewater. Raw wastewater was collected from wastewater treatment plants in urban (N=25) and rural (N=25) areas of the US. Bacteria were concentrated by filtering 10 ml volumes through 0.45 µm filters and DNA was extracted from the filters. Quantitative PCR was used to detect 12 ARG targets. Genes conferring resistance to beta-lactams (blaTEM, blaCMY-2, mecA) were detected in nearly all samples, with no appreciable difference between urban and rural wastewater. Carbapenemase genes (OXA-48, KPC, NDM, VIM) were more frequently detected in urban wastewater. KPC, OXA-48, and VIM were detected in more than half of the samples (92%, 76%, and 68%, respectively), while NDM detection was rare (8%). The emerging mobile colistin resistance gene mcr-1 was detected in 20% of wastewater samples and 9 of the 10 positive samples were collected from urban plants. Environmental indicator genes (intI1, sul1, tetW) were detected in all samples. Clinically relevant ARGs are common in municipal wastewater. Emerging ARGs (e.g. NDM and mcr-1) are more frequently detected in urban wastewater, likely due to the much larger catchment population. PCR-based surveillance of municipal wastewater is a promising approach to detect the emergence of new resistance genes.
