摘要

       抗生素抗性细菌的环境传播已被公认为日益严重的公共卫生威胁，医院在这方面发挥着重要作用。本研究的目的是调查来自越南医院废水的大肠杆菌分离株中抗生素耐药性和抗生素耐药基因 (ARG) 的流行情况。处理前后的废水样品在一年内每月连续采样。标准磁盘扩散和 E-test 用于抗生素敏感性测试。使用组合盘扩散测试了超广谱 β-内酰胺酶 (ESBL) 生产。通过聚合酶链反应检测 ARG。在 83% 的分离株中检测到对至少一种抗生素的耐药性； 32% 的患者发现多药耐药。复方新诺明耐药率最高 (70%)，亚胺培南最低 (1%)。 43% 的分离株产生 ESBL，blaTEM 基因比 blaCTX-M 更常见。在 46% 对环丙沙星耐药的分离株中发现了 blaCTX-M、blaTEM 和 qepA 基因的共同携带。医院废水中大量存在的抗生素耐药性大肠杆菌分离株与 ARGs 相结合，即使是后处理，也会对公共健康构成威胁。它强调需要为医院污水处理厂开发有效的流程，以消除抗生素耐药性细菌和 ARG。查看全文

       The environmental spread of antibiotic-resistant bacteria has been recognised as a growing public health threat for which hospitals play a significant role. The aims of this study were to investigate the prevalence of antibiotic resistance and antibiotic resistance genes (ARGs) in Escherichia coli isolates from hospital wastewater in Vietnam. Wastewater samples before and after treatment were collected using continuous sampling every month over a year. Standard disk diffusion and E-test were used for antibiotic susceptibility testing. Extended-spectrum beta-lactamase (ESBL) production was tested using combined disk diffusion. ARGs were detected by polymerase chain reactions. Resistance to at least one antibiotic was detected in 83% of isolates; multidrug resistance was found in 32%. The highest resistance prevalence was found for co-trimoxazole (70%) and the lowest for imipenem (1%). Forty-three percent of isolates were ESBL-producing, with the blaTEM gene being more common than blaCTX-M. Co-harbouring of the blaCTX-M, blaTEM and qepA genes was found in 46% of isolates resistant to ciprofloxacin. The large presence of antibiotic-resistant E. coli isolates combined with ARGs in hospital wastewater, even post-treatment, poses a threat to public health. It highlights the need to develop effective processes for hospital wastewater treatment plants to eliminate antibiotic resistant bacteria and ARGs. View Full-Text

https://www.mdpi.com/1660-4601/14/7/699