摘要
      破坏临床相关抗生素耐药性基因（ARGs）的传播是“一个健康”战略成功的关键组成部分之一。虽然废水处理厂（WWTP）代表了抗生素抗性基因（ARGs）每天向水生环境排放的最终控制点，但已经对选定城市排水区的废水进料进行了分散的上游监测，其中blaCTX-M32、blaCTX-M15、blaOXA48、blaCMY-2、mecA、blaNDM-1、blaKPC3、vanA和mcr-1代表了临床相关的ARGs。除了医院，与住房区的下水道系统相比，养老院也要对高水平的ARG排放负责。监测结合了基于qPCR的定量分析、基于流量的分析和分离株的多种抗生素耐药性分析。研究结果表明，在确定的关键控制点采取的地方行动有助于防止大量废水受到污染。与WWTP的中心行动相比，这一策略将支持更具成本效益的治疗。这一监测战略应适用污染者付费原则。
Abstract
Disrupting the spread of clinically relevant antibiotic resistance genes (ARGs) is one of the key components for the success of the One Health strategy. While waste water treatment plants (WWTPs) represent a final control point for daily discharges of antibiotic resistance genes (ARGs) to the aquatic environment, a decentralized upstream monitoring of wastewater feeds of selected urban drainage areas for blaCTX-M32, blaCTX-M15, blaOXA48, blaCMY-2, mecA, blaNDM-1, blaKPC3, vanA, and mcr-1 representing clinically relevant ARGs has been performed. Besides hospitals, also retirement homes were found to be responsible for high levels of ARG discharges compared to housing area sewer systems. The monitoring combines qPCR-based quantifications, flow volume-based analyses, and multiple antibiotic resistance analyses of isolates. As result of the study, local actions at identified critical control points could help to prevent contaminations of larger volumes of wastewaters. This strategy will support a more cost-effective treatment compared to central actions at WWTPs, only. A polluter-pays principle should be applied by this monitoring strategy.

https://www.sciencedirect.com/science/article/pii/S0048969722002765