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Population-level surveillance of antibiotic resistance in Escherichia coli through sewage analysis.

ABSTRACT: IntroductionThe occurrence of antibiotic resistance in faecal bacteria in sewage is likely to reflect the current local clinical resistance situation.AimThis observational study investigated the relationship between Escherichia coli resistance rates in sewage and clinical samples representing the same human populations.MethodsE. coli were isolated from eight hospital (n?=?721 isolates) and six municipal (n?=?531 isolates) sewage samples, over 1?year in Gothenburg, Sweden. An inexpensive broth screening method was validated against disk diffusion and applied to determine resistance against 11 antibiotics in sewage isolates. Resistance data on E. coli isolated from clinical samples from corresponding local hospital and primary care patients were collected during the same year and compared with those of the sewage isolates by linear regression.ResultsE. coli resistance rates derived from hospital sewage and hospital patients strongly correlated (r2?=?0.95 for urine and 0.89 for blood samples), as did resistance rates in E. coli from municipal sewage and primary care urine samples (r2?=?0.82). Resistance rates in hospital sewage isolates were close to those in hospital clinical isolates while resistance rates in municipal sewage isolates were about half of those measured in primary care isolates. Resistance rates in municipal sewage isolates were more stable between sampling occasions than those from hospital sewage.ConclusionOur findings provide support for development of a low-cost, sewage-based surveillance system for antibiotic resistance in E. coli, which could complement current monitoring systems and provide clinically relevant antibiotic resistance data for countries and regions where surveillance is lacking.

SUBMITTER: Hutinel M

PROVIDER: S-EPMC6749774 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Population-level surveillance of antibiotic resistance in Escherichia coli through sewage analysis.

Hutinel Marion M Huijbers Patricia Maria Catharina PMC Fick Jerker J Åhrén Christina C Larsson Dan Göran Joakim DGJ Flach Carl-Fredrik CF

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 20190901 37

IntroductionThe occurrence of antibiotic resistance in faecal bacteria in sewage is likely to reflect the current local clinical resistance situation.AimThis observational study investigated the relationship between Escherichia coli resistance rates in sewage and clinical samples representing the same human populations.MethodsE. coli were isolated from eight hospital (n = 721 isolates) and six municipal (n = 531 isolates) sewage samples, over 1 year in Gothenburg, Sweden. An inexpe ...[more]

PMID: 31530345

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Project description:Objective Increasing rates of antimicrobial resistance among E. coli is a growing concern worldwide. We aimed to assess the changing antibiotic sensitivity pattern in Uropathogenic E. coli over a period of 12 years with special emphasis on ESBL-producing E. coli. Methods A retrospective study was done on the population of Islamabad from 1st Jan 2005 to Dec 2010 and then continued from 1st Jan 2016 to 31st May 2021. A total of 12000 samples were analyzed for isolation and identification of bacteria and antimicrobial susceptibility testing, from patients having uncomplicated urinary tract infections. Our primary was to find the antibiotics with the highest sensitivity against E. Coli in 2021, while our secondary outcome was to find the overall sensitivity pattern of E. Coli to antibiotics from 2005 to 2021. Results There was a decrease in susceptibility rates of E. coli to Amoxicillin-Clavulanic Acid 47%, Trimethoprim-Sulfamethoxazole (TMP-SMX) 27%, Fluoroquinolones 24% & Cephalosporins 38%. There was a significant increase in the use of Nitrofurantoin and Fosfomycin. High resistance rates to Fluoroquinolones (76%), TMP-SMX (73%), Cephalosporins (62%), and Amoxicillin (53%) were documented. However, significantly high degree of sensitivity rates to Fosfomycin (92%), Aminoglycosides (90%) & Nitrofurantoin (80%) were recorded. Conclusions Uropathogenic E. coli shows the highest sensitivity to Fosfomycin and Aminoglycosides in the year 2021, followed by Nitrofurantoin and Sulbactam. Cephalosporins, Amoxicillin/Cluvalanic acid, TMP-SMX, and Fluoroquinolones show a declining sensitivity pattern. UTIs can be prevented well by lifestyle changes, taking vitamins, trace elements, and carbohydrates. Highlights • This article is discussing the antibiotic sensitivity pattern in Uro-pathogenic E. coli over a period of 12 years having a special emphasis on ESBL-producing E. coli• Uropathogenic Ecoli have the highest sensitivity to Fosfomycin and Aminoglycosides in the year 2021, followed by nitrofurantoin and Sulbactam.• Dietary recommendations could be a first step toward prevention of UTI recurrence because eating habits appear to be a key risk factor.• UTIs can be prevented well by taking vitamins, trace elements, and/or carbohydrates. These antibacterial agents work well when combined. Antibiotic overuse and the prevalence of antibiotic-resistant microbes pose a serious danger to the use of probiotics.• Further monitoring of antimicrobial susceptibility is recommended in the upcoming years for effective treatment.

Project description:Biofilms are considered to be highly resistant to antimicrobial agents. Several mechanisms have been proposed to explain this high resistance of biofilms, including restricted penetration of antimicrobial agents into biofilms, slow growth owing to nutrient limitation, expression of genes involved in the general stress response, and emergence of a biofilm-specific phenotype. However, since combinations of these factors are involved in most biofilm studies, it is still difficult to fully understand the mechanisms of biofilm resistance to antibiotics. In this study, the antibiotic susceptibility of Escherichia coli cells in biofilms was investigated with exclusion of the effects of the restricted penetration of antimicrobial agents into biofilms and the slow growth owing to nutrient limitation. Three different antibiotics, ampicillin (100 microg/ml), kanamycin (25 microg/ml), and ofloxacin (10 microg/ml), were applied directly to cells in the deeper layers of mature biofilms that developed in flow cells after removal of the surface layers of the biofilms. The results of the antibiotic treatment analyses revealed that ofloxacin and kanamycin were effective against biofilm cells, whereas ampicillin did not kill the cells, resulting in regrowth of the biofilm after the ampicillin treatment was discontinued. LIVE/DEAD staining revealed that a small fraction of resistant cells emerged in the deeper layers of the mature biofilms and that these cells were still alive even after 24 h of ampicillin treatment. Furthermore, to determine which genes in the biofilm cells are induced, allowing increased resistance to ampicillin, global gene expression was analyzed at different stages of biofilm formation, the attachment, colony formation, and maturation stages. The results showed that significant changes in gene expression occurred during biofilm formation, which were partly induced by rpoS expression. Based on the experimental data, it is likely that the observed resistance of biofilms can be attributed to formation of ampicillin-resistant subpopulations in the deeper layers of mature biofilms but not in young colony biofilms and that the production and resistance of the subpopulations were aided by biofilm-specific phenotypes, like slow growth and induction of rpoS-mediated stress responses.

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Population-level surveillance of antibiotic resistance in Escherichia coli through sewage analysis.

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Population-level surveillance of antibiotic resistance in <i>Escherichia coli</i> through sewage analysis.

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