抗菌药物用量（AMC）对城市废水中抗菌药物耐药基因（ARGs）检测的影响

IF 4.4 2区医学 Q1 INFECTIOUS DISEASES

International journal of hygiene and environmental health Pub Date : 2025-07-01 DOI:10.1016/j.ijheh.2025.114621

Helena Ferreira Leal , Élise Fortin , Sarah Dorner , Dominic Frigon , Caroline Quach , Emilie Bédard

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引用次数: 0

摘要

抗生素耐药性（AMR）是一个全球性的健康威胁，每年造成127多万人死亡，并与另外495万人有关。抗菌素耐药性的传播发生在临床环境之外，废水可作为社区层面传播的哨兵。本研究利用废水监测（WS）监测加拿大魁北克省的耐药性趋势，研究了抗菌素用量（AMC）的时间变化与废水中抗菌素耐药基因（ARGs）的流行之间的关系。c数据（2019年1月- 2023年5月）由IQVIA Solutions Canada Inc.授权，从INSPQ （Institut National de sant publiclique du qubec）获得。从3个污水处理厂获得废水样本（2020年9月- 2022年9月），筛选出11种ARGs，包括blaTEM、blaSHV、blaCTX-M、blaNDM、blaxa -1/30、qnrA、qnrB、mphE和mefA。分析评估了AMC和ARGs之间的时间和空间关联。结果2019年至2020年期间，处方总数从每1000名居民537张下降到392张（- 27%），这可能是由于COVID-19大流行的影响。这种转变形成了一种对比，使我们能够通过废水成分中的噪声更好地捕获AMC的信号。β-内酰胺类、大环内酯类和氟喹诺酮类是处方最多的类别。在所有41份样本中均检测到ARGs，其中大环内酯类耐药基因最为丰富。AMC与废水中ARG的发生率之间存在很强的相关性，尤其是β-内酰胺类和氟喹诺酮类(Spearman R = 0.80和0.81,p <；0.05)。空间格局表现为均匀的AMC，不同的ARG水平。结论sour研究强调了AMC与ARG的相关性。WS显示了实时AMR监测的前景。

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Influence of antimicrobial consumption (AMC) on the detection of antimicrobial resistance genes (ARGs) in urban wastewater

Background

Antimicrobial resistance (AMR) is a global health threat, causing over 1.27 million deaths annually and linked to an additional 4.95 million. AMR transmission occurs beyond clinical settings, with wastewater serving as a sentinel of community-level spread. This study investigated how temporal changes in antimicrobial consumption (AMC) correlate with the prevalence of antimicrobial resistance genes (ARGs) in wastewater, using wastewater surveillance (WS) to monitor resistance trends in Quebec, Canada.

Methodology

AMC data (January 2019–May 2023) were obtained from the Institut National de Santé Publique du Québec (INSPQ) under a license from IQVIA Solutions Canada Inc. Wastewater samples (September 2020–September 2022) were obtained from three WWTPs and screened for 11 ARGs, including bla_TEM, bla_SHV, bla_CTX-M, bla_NDM, bla_OXA-1/30, qnrA, qnrB, mphE, and mefA. Analyses assessed temporal and spatial associations between AMC and ARGs.

Results

Total prescriptions declined from 537 to 392 per 1000 inhabitants between 2019 and 2020 (−27 %), likely due to the impact of the COVID-19 pandemic. This shift created a contrast that allowed us to better capture the signal of AMC through the noise in wastewater composition. β-lactams, macrolides, and fluoroquinolones were the most prescribed classes. ARGs were consistently detected in all 41 samples, with macrolide resistance genes being the most abundant. Strong correlations were observed between AMC and ARG prevalence in wastewater, particularly for β-lactams and fluoroquinolones (Spearman R = 0.80 and 0.81, p < 0.05). Spatial patterns showed uniform AMC but variable ARG levels.

Conclusions

Our study highlights the correlation between AMC and ARG. WS shows promise for real-time AMR monitoring.

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来源期刊

International journal of hygiene and environmental health 医学-传染病学

CiteScore

11.50

自引率

5.00%

发文量

151

审稿时长

22 days

期刊介绍： The International Journal of Hygiene and Environmental Health serves as a multidisciplinary forum for original reports on exposure assessment and the reactions to and consequences of human exposure to the biological, chemical, and physical environment. Research reports, short communications, reviews, scientific comments, technical notes, and editorials will be peer-reviewed before acceptance for publication. Priority will be given to articles on epidemiological aspects of environmental toxicology, health risk assessments, susceptible (sub) populations, sanitation and clean water, human biomonitoring, environmental medicine, and public health aspects of exposure-related outcomes.