Antibiotic resistance patterns of Escherichia coli isolates from the clinic through the wastewater pathway

Brandon Bojar; Jennifer Sheridan; Rachelle Beattie; Caitlin Cahak; Elizabeth Liedhegner; L Silvia Munoz-Price; Krassimira R Hristova; Troy Skwor

doi:10.1016/j.ijheh.2021.113863

Antibiotic resistance patterns of Escherichia coli isolates from the clinic through the wastewater pathway

Int J Hyg Environ Health. 2021 Sep:238:113863. doi: 10.1016/j.ijheh.2021.113863. Epub 2021 Oct 16.

Authors

Brandon Bojar¹, Jennifer Sheridan¹, Rachelle Beattie², Caitlin Cahak³, Elizabeth Liedhegner¹, L Silvia Munoz-Price⁴, Krassimira R Hristova², Troy Skwor⁵

Affiliations

¹ Department of Biomedical Sciences, College of Health Sciences, University of Wisconsin - Milwaukee, Milwaukee, WI, 53211, USA.
² Department of Biological Sciences, Marquette University, Milwaukee, WI, 53233, USA.
³ Wisconsin Diagnostic Laboratories, Milwaukee, WI, 53226, USA.
⁴ Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
⁵ Department of Biomedical Sciences, College of Health Sciences, University of Wisconsin - Milwaukee, Milwaukee, WI, 53211, USA. Electronic address: skwor@uwm.edu.

PMID: 34662851
DOI: 10.1016/j.ijheh.2021.113863

Abstract

Antimicrobial resistance (AMR) remains one of the leading global health threats. This study compared antimicrobial resistance patterns among E. coli isolates from clinical uropathogenic Escherichia coli (UPEC) to hospital wastewater populations and throughout an urban wastewater treatment facility - influent, pre- and post-chlorinated effluents. Antibiotic susceptibility of 201 isolates were analyzed against eleven different antibiotics, and the presence of twelve antibiotic resistant genes and type 1 integrase were identified. AMR exhibited the following pattern: UPEC (46.8%) > hospital wastewater (37.8%) > urban post-chlorinated effluent (27.6%) > pre-chlorinated effluent (21.4%) > urban influent wastewater (13.3%). However, multi-drug resistance against three or more antimicrobial classes was more prevalent among hospital wastewater populations (29.7%) compared to other sources. E. coli from wastewaters disinfected with chlorine were significantly correlated with increased trimethoprim-sulfamethoxazole resistance in E. coli compared to raw and treated wastewater populations. bla_CTX-M-1 group was the most common extended spectrum beta-lactamase in E. coli from hospital wastewater (90%), although UPEC strains also encoded bla_CTX-M-1 group (50%) and bla_TEM (100%) genes. Among tetracycline-resistant populations, tetA and tetB were the only resistance genes identified throughout wastewater populations that were associated with increased phenotypic resistance. Further characterization of the E. coli populations identified phylogroup B2 predominating among clinical UPEC populations and correlated with the highest AMR, whereas the elevated rate of multi-drug resistance among hospital wastewater was mostly phylogroup A. Together, our findings highlight hospital wastewater as a rich source of AMR and multi-drug resistant bacterial populations.

Keywords: CTX-M; ESBL; Phylogroup; SXT; Uropathogenic; Wastewater.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents / pharmacology
Drug Resistance, Multiple, Bacterial / genetics
Escherichia coli Infections* / drug therapy
Escherichia coli Infections* / epidemiology
Escherichia coli* / genetics
Humans
Wastewater

Substances

Anti-Bacterial Agents
Waste Water