摘要

       对新加坡两家医院的临床隔离病房和普通病房排放的废水进行了检查，以确定抗生素耐药性 (AR) 的新趋势。我们通过使用液相色谱-串联质谱 (LC-MS/MS)、抗生素抗性细菌 (ARB)、1 类整合酶基因 (intI1) 和 16 个抗生素抗性基因 (ARG) 进行分析，量化了 12 种抗生素化合物的浓度赋予对 10 种不同临床相关抗生素的抗性。对 119 个抗生素耐药菌株的子集进行了系统发育分类，并测试了编码对 β-内酰胺抗生素（blaNDM、blaKPC、blaSHV、blaCTX-M）、阿米卡星 [aac(6')-Ib]、co-三恶唑（sul1、sul2、dfrA）、环丙沙星（qnrA、qnrB）和 intI1 基因。在这些抗性分离株中，80.7% 被检测到 intI1，66.4% 被发现携带至少 1 个测试的 ARG。在 3 个采样位置中，临床隔离病房的 ARB 浓度最高，与对 β-内酰胺 (blaKPC)、复方新诺明 (sul1、sul2、dfrA)、阿米卡星 [aac(6') -Ib]、环丙沙星 (qnrA) 和 intI1。我们发现对美罗培南、头孢他啶、阿米卡星、复方新诺明和环丙沙星耐药的细菌浓度与 blaKPC、aac(6')-Ib、sul1、sul2、dfrA、qnrA 和intI1 基因。

       Wastewater discharged from clinical isolation and general wards at two hospitals in Singapore was examined to determine the emerging trends of antibiotic resistance (AR). We quantified the concentrations of 12 antibiotic compounds by analysis using liquid chromatography-tandem mass spectrometry (LC-MS/MS), antibiotic-resistant bacteria (ARB), the class 1 integrase gene (intI1), and 16 antibiotic resistance genes (ARGs) that confer resistance to 10 different clinically relevant antibiotics. A subset of 119 antibiotic-resistant isolates were phylogenetically classified and tested for the presence of ARGs encoding resistance to β-lactam antibiotics (blaNDM, blaKPC, blaSHV, blaCTX-M), amikacin [aac(6′)-Ib], co-trimoxazole (sul1, sul2, dfrA), ciprofloxacin (qnrA, qnrB), and the intI1 gene. Among these resistant isolates, 80.7% were detected with intI1 and 66.4% were found to carry at least 1 of the tested ARGs. Among 3 sampled locations, the clinical isolation ward had the highest concentrations of ARB and the highest levels of ARGs linked to resistance to β-lactam (blaKPC), co-trimoxazole (sul1, sul2, dfrA), amikacin [aac(6′)-Ib], ciprofloxacin (qnrA), and intI1. We found strong positive correlations (P < 0.05) between concentrations of bacteria resistant to meropenem, ceftazidime, amikacin, co-trimoxazole, and ciprofloxacin and abundances of blaKPC, aac(6′)-Ib, sul1, sul2, dfrA, qnrA, and intI1 genes.

https://journals.asm.org/doi/full/10.1128/AAC.01556-16