Evidence for selection of multi-resistant E. coli by hospital effluent.

Anti-Bacterial Agents / pharmacology Escherichia coli Hospitals Sweden Wastewater
Antibiotic resistance Hospital effluent Resistance selection

Journal

Environment international
ISSN: 1873-6750
Titre abrégé: Environ Int
Pays: Netherlands
ID NLM: 7807270

Informations de publication

Date de publication:
05 2021
Historique:
received: 22 12 2020
revised: 28 01 2021
accepted: 29 01 2021
pubmed: 17 2 2021
medline: 27 4 2021
entrez: 16 2 2021
Statut: ppublish

Résumé

There is a risk that residues of antibiotics and other antimicrobials in hospital and municipal wastewaters could select for resistant bacteria. Still, direct experimental evidence for selection is lacking. Here, we investigated if effluent from a large Swedish hospital, as well as influent and effluent from the connected municipal wastewater treatment plant (WWTP) select for antibiotic resistant Escherichia coli in three controlled experimental setups. Exposure of sterile-filtered hospital effluent to a planktonic mix of 149 different E. coli wastewater isolates showed a strong selection of multi-resistant strains. Accordingly, exposure to a complex wastewater community selected for strains resistant to several antibiotic classes. Exposing individual strains with variable resistance patterns revealed a rapid bactericidal effect of hospital effluent on susceptible, but not multi-resistant E. coli. No selection was observed after exposure to WWTP effluent, while exposure to WWTP influent indicated a small selective effect for ceftazidime and cefadroxil resistant strains, and only in the E. coli mix assay. An analysis of commonly used antibiotics and non-antibiotic pharmaceuticals in combination with growth and resistance pattern of individual E. coli isolates suggested a possible contribution of ciprofloxacin and β-lactams to the selection by hospital effluent. However, more research is needed to clarify the contribution from different selective agents. While this study does not indicate selection by the studied WWTP effluent, there is some indications of selective effects by municipal influent on β-lactam-resistant strains. Such effects may be more pronounced in countries with higher antibiotic use than Sweden. Despite the limited antibiotic use in Sweden, the hospital effluent strongly and consistently selected for multi-resistance, indicating widespread risks. Hence, there is an urgent need for further evaluation of risks for resistance selection in hospital sewers, as well as for strategies to remove selective agents and resistant bacteria.

Identifiants

DOI: 10.1016/j.envint.2021.106436 PMID: 33592450
pubmed: 33592450
pii: S0160-4120(21)00061-1
doi: 10.1016/j.envint.2021.106436
pii:
doi:

Substances chimiques

Anti-Bacterial Agents 0
Waste Water 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

106436

Informations de copyright

Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Auteurs

Nadine Kraupner (N)

Centre for Antibiotic Resistance Research (CARe) at the University of Gothenburg, Gothenburg, Sweden; Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.

Marion Hutinel (M)

Centre for Antibiotic Resistance Research (CARe) at the University of Gothenburg, Gothenburg, Sweden; Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.

Kilian Schumacher (K)

Centre for Antibiotic Resistance Research (CARe) at the University of Gothenburg, Gothenburg, Sweden; Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Department of Biology I, Microbiology, Ludwig-Maximilians-Universität München, Martinsried, Germany(1).

Declan A Gray (DA)

Centre for Antibiotic Resistance Research (CARe) at the University of Gothenburg, Gothenburg, Sweden; Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.

Maja Genheden (M)

Centre for Antibiotic Resistance Research (CARe) at the University of Gothenburg, Gothenburg, Sweden; Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.

Jerker Fick (J)

Department of Chemistry, Umea University, Sweden.

Carl-Fredrik Flach (CF)

Centre for Antibiotic Resistance Research (CARe) at the University of Gothenburg, Gothenburg, Sweden; Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.

D G Joakim Larsson (DGJ)

Centre for Antibiotic Resistance Research (CARe) at the University of Gothenburg, Gothenburg, Sweden; Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden. Electronic address: joakim.larsson@fysiologi.gu.se.

Articles similaires

Vancomycin-associated DRESS demonstrates delay in AST abnormalities.

Ahmed Hussein, Kateri L Schoettinger, Jourdan Hydol-Smith et al.
1.00
Humans Drug Hypersensitivity Syndrome Vancomycin Female Male

Management of the infected total elbow arthroplasty.

Joaquin Sanchez-Sotelo
1.00
Humans Arthroplasty, Replacement, Elbow Prosthesis-Related Infections Debridement Anti-Bacterial Agents

Sex differences in the impact of lower respiratory tract infections on older adults' health trajectories: a population-based cohort study.

Ahmad Abbadi, Giorgi Beridze, Eleana Tsoumani et al.
1.00
Humans Female Male Aged Respiratory Tract Infections

Survival rate changes in children with congenital diaphragmatic hernia over the past three decades: a nationwide, population-based prospective nested case-control study.

B Kutasy, C M Burgos
1.00
Humans Hernias, Diaphragmatic, Congenital Case-Control Studies Prospective Studies Sweden

Classifications MeSH

questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Anti-infectieux › Antibactériens › Evidence for selection of multi-resistant E....
questionsmedicales.fr › Bactéries › Proteobacteria › Gammaproteobacteria › Enterobacteriaceae › Escherichia › Escherichia coli › Evidence for selection of multi-resistant E....
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Établissements de santé › Hôpitaux › Evidence for selection of multi-resistant E....
questionsmedicales.fr › Régions géographiques › Europe › Pays nordiques et scandinaves › Suède › Evidence for selection of multi-resistant E....
questionsmedicales.fr › Environnement et santé publique › Santé publique › Pollution de l'environnement › Déchets › Eaux usées › Evidence for selection of multi-resistant E....