摘要
      抗生素耐药性在细菌病原体中的传播在很大程度上是由可移动抗生素耐药性基因（ARGs）介导的。几种新发现的ARGs的流行率和地理分布，以及一些临床上重要的对最后使用的抗生素产生耐药性的ARG，在很大程度上是未知的。对废水样本进行有针对性的分析，可以估计与下水道相连的人口的携带情况以及排放到环境中的情况。在这里，我们量化了对利奈唑胺（optrA和cfr（A））和粘菌素（mcr-1、-2、-3、-4和-5）产生耐药性的ARG，以及最近在医院和城市污水以及处理过的城市污水中发现的gar（氨基糖苷类ARG）和sul4（磺酰胺类ARG。此外，通过16S rRNA测序表征的废水细菌组成的变化与ARG的变化有关，试图揭示已知或疑似细菌宿主类群的存在是否可以解释废水中ARG的存在。在所有类型的废水样本中定期检测到mcr-1、mcr-3、mcr-4、mcr-5、sul4和gar基因，而optrA和cfr（A）仅在医院废水中检测到。最丰富的基因是mcr-3和mcr-5，尤其是在城市污水中。optrA的检测在一年内被限制在一个峰值。大多数ARGs与以前被描述为细菌宿主的分类群相关，并与人类相关。尽管一些暂定宿主可能包括也在废水环境中繁殖的细菌，但废水中ARG的检测可以反映它们在贡献种群的肠道菌群中的存在。如果是这样的话，它们可能已经在今天或不久的将来阻碍了细菌感染的治疗，而目前在临床监测中很少有针对性/检测到细菌感染。
Abstract
The spread of antibiotic resistance among bacterial pathogens is to a large extent mediated by mobile antibiotic resistance genes (ARGs). The prevalence and geographic distribution of several newly discovered ARGs, as well as some clinically important ARGs conferring resistance to last resort antibiotics, are largely unknown. Targeted analysis of wastewater samples could allow estimations of carriage in the population connected to the sewers as well as release to the environment. Here we quantified ARGs conferring resistance to linezolid (optrA and cfr(A)) and colistin (mcr-1, -2, -3, -4 and -5) and the recently discovered gar (aminoglycoside ARG) and sul4 (sulphonamide ARG) in raw hospital and municipal wastewater as well as treated municipal wastewater during five years in a low antibiotic resistance prevalence setting (Gothenburg, Sweden). Additionally, variations in bacterial composition of the wastewaters characterized by 16S rRNA sequencing were related to the variations of the ARGs in an attempt to reveal if the presence of known or suspected bacterial host taxa could explain the presence of the ARGs in wastewater. The mcr-1, mcr-3, mcr-4, mcr-5, sul4 and gar genes were detected regularly in all types of wastewater samples while optrA and cfr(A) were detected only in hospital wastewater. The most abundant genes were mcr-3 and mcr-5, especially in municipal wastewater. The detection of optrA was restricted to a peak during one year. Most of the ARGs correlated with taxa previously described as bacterial hosts and associated with humans. Although some of the tentative hosts may include bacteria also thriving in wastewater environments, detection of the ARGs in the wastewaters could reflect their presence in the gut flora of the contributing populations. If so, they could already today or in the near future hinder treatment of bacterial infections in a setting where they currently are rarely targeted/detected during clinical surveillance.

https://www.sciencedirect.com/science/article/pii/S0048969721065116