Abstract：
Antimicrobial resistance (AMR) is a global health threat requiring urgent attention and effective strategies for containment. AMR is fueled by wastewater mismanagement and global mobility, disseminating multidrug-resistant (MDR) strains worldwide. While global estimates of AMR burden have been informative, community-level understanding has received little attention despite reports of high AMR prevalence in healthy communities. We assessed the \"invasion\" of antibiotic resistance genes (ARGs) into the normal human flora by characterizing AMR Escherichia coli in local wastewaters contributed by a healthy youth population. This study estimated 26% (out of 300 isolates) resistant and 59% plasmid-bearing E. coli in local wastewater. Of the 78 AMR isolates, the frequency of mono-resistance was higher against tetracycline (32%), followed by kanamycin (17%) and chloramphenicol (9%). Five isolates were potentially MDR. We further sequenced four MDRs and four sensitive strains to comprehend the genome and resistome diversity in comparison to the global wastewater E. coli (genomes from the PATRIC database). The whole-genome analysis revealed extensive genome similarity among global isolates, suggesting global dissemination and colonization of E. coli. Global wastewater resistome majorly comprised ARGs against aminoglycosides (26%), beta-lactam (17%), sulfonamide (11%), and trimethoprim (8%). Resistance to colistin, a last-resort antibiotic, was prevalent in MDRs of European and South Asian isolates. A systems approach is required to address the AMR crisis on a global scale, reduce antibiotic usage, and increase the efficiency of wastewater management and disinfection.
摘要：
抗菌素耐药性（AMR）是一种全球性的健康威胁，需要紧急关注和有效的遏制策略。废水管理不善和全球流动性助长了AMR，在全球传播多药耐药（MDR）菌株。虽然全球对AMR负担的估计提供了信息，尽管有健康社区中AMR患病率较高的报道,但社区层面的理解很少受到关注.我们通过表征健康青年人口贡献的当地废水中的AMR大肠杆菌，评估了抗生素抗性基因（ARG）对正常人类菌群的“入侵”。这项研究估计，在当地废水中，有26％（300个分离株中）的耐药性和59％的携带质粒的大肠杆菌。在78个AMR分离物中,对四环素的单抗频率较高(32%)，其次是卡那霉素（17％）和氯霉素（9％）。五个分离株是潜在的MDR。我们进一步测序了四个MDR和四个敏感菌株，以了解与全球废水大肠杆菌（来自PATRIC数据库的基因组）相比的基因组和抗性组多样性。全基因组分析揭示了全球分离株之间广泛的基因组相似性，表明大肠杆菌的全球传播和定植。全球废水抗性主要包括抗氨基糖苷类的ARGs（26％），β-内酰胺（17%），磺胺(11%),和甲氧苄啶(8%)。对粘菌素的抗性，最后的抗生素,在欧洲和南亚分离株的MDR中普遍存在。需要一种系统方法来解决全球范围内的AMR危机，减少抗生素的使用，并提高废水管理和消毒的效率。
