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Waste water effluent contributes to the dissemination of CTX-M-15 in the natural environment.

Amos, G C A and Hawkey, P M and Gaze, W H and Wellington, E M (2014) Waste water effluent contributes to the dissemination of CTX-M-15 in the natural environment. The Journal of antimicrobial chemotherapy, 69 (7). pp. 1785-91. ISSN 1460-2091. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login Ids

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Official URL: http://jac.oxfordjournals.org/content/69/7/1785.lo...

Abstract

OBJECTIVES

Multidrug-resistant Enterobacteriaceae pose a significant threat to public health. We aimed to study the impact of sewage treatment effluent on antibiotic resistance reservoirs in a river.

METHODS

River sediment samples were taken from downstream and upstream of a waste water treatment plant (WWTP) in 2009 and 2011. Third-generation cephalosporin (3GC)-resistant Enterobacteriaceae were enumerated. PCR-based techniques were used to elucidate mechanisms of resistance, with a new two-step PCR-based assay developed to investigate bla(CTX-M-15) mobilization. Conjugation experiments and incompatibility replicon typing were used to investigate plasmid ecology.

RESULTS

We report the first examples of bla(CTX-M-15) in UK river sediment; the prevalence of bla(CTX-M-15) was dramatically increased downstream of the WWTP. Ten novel genetic contexts for this gene were identified, carried in pathogens such as Escherichia coli ST131 as well as indigenous aquatic bacteria such as Aeromonas media. The bla(CTX-M-15) -gene was readily transferable to other Gram-negative bacteria. We also report the first finding of an imipenem-resistant E. coli in a UK river.

CONCLUSIONS

The high diversity and host range of novel genetic contexts proves that evolution of novel combinations of resistance genes is occurring at high frequency and has to date been significantly underestimated. We have identified a worrying reservoir of highly resistant enteric bacteria in the environment that poses a threat to human and animal health.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login Ids
Subjects: QW Microbiology. Immunology
Divisions: Clinical Support > Infection Control
Related URLs:
Depositing User: Mr Philip O'Reilly
Date Deposited: 05 Sep 2014 13:12
Last Modified: 05 Sep 2014 13:12
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/723

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