Distribution and quantification of antibiotic resistance genes in a large subalpine lake (Lugano Lake) and tributary rivers.

OBJECTIVES: Antibiotic resistance genes (ARGs) are causing increasing problems, especially in clinical settings. Nowadays, they are considered important environmental contaminants, but little is known about their fate in the environment or how they affect natural microbial populations. In the environment, especially in water affected by anthropic activities such as discharge of hospital, urban, and industrial wastewater treatment plant (WWTP) and agricultural runoff, antibiotic determinants may become part of the environmental gene pool, spread horizontally, and be ingested by humans and animals via contaminated food and drinking water. The aim of this work was to monitor long-term the presence of antibiotic resistance determinants in water samples collected from a subalpine lake and some tributary rivers located in the southern part of Switzerland, and to assess if anthropic activities could influence the distribution of antibiotic resistance genes present in water environments. METHODS: We analysed water samples by qPCR to quantify five antibiotic resistance genes that confer resistance to the major classes of antibiotics used in clinical and veterinary settings (ß-lactams, macrolides, tetracycline, quinolones, and sulphonamides). Water samples were collected from January 2016 to December 2021, from three rivers located in south Switzerland and from five different sites of Lugano Lake. RESULTS: The most abundant genes were sulII, followed by ermB, qnrS, and tetA; they were found especially in the river influenced by wastewater treatment plants and in the lake near the potable water uptake plant. We observed an overall decrease in the number of resistance genes during the three years. CONCLUSIONS: Our results indicate that the aquatic ecosystems monitored in this study are a reservoir of ARGs and could potentially be a setting for the transmission of resistance from the environment to humans.

Characterization of genetic determinants involved in antibiotic resistance in Aeromonas spp. and fecal coliforms isolated from different aquatic environments.

Aeromonas spp. and fecal coliforms, two abundant and cultivable bacterial populations that can be found in water ecosystems, might substantially contribute to the spread of antibiotic resistance. We investigated the presence and spread of transposons (elements that can move from one location to another in the genome), integrons (structures able to capture and incorporate gene cassettes) and resistance plasmids in strains isolated from polluted and unpolluted water. We recovered 231 Aeromonas and 250 fecal coliforms from water samplings with different degrees of pollution (hospital sewage, activated sludge of a wastewater treatment plant, river water before and after treatment and water from an alpine lake). Sixteen Aeromonas spp. and 22 fecal coliforms carried intI, coding for the site-specific integrase of class 1 integrons, while 22 Aeromonas spp. and 14 fecal coliforms carried tnpA, the transposase gene of the Tn3-family of replicative transposons. The majority of intI and tnpA-positive strains were phenotypically resistant to at least four antibiotics. Integrons and transposons were mainly located on mobilizable plasmids. Our results did not detect common mobile structures in the two populations and therefore relativize the role played by Aeromonas spp. as vectors of antimicrobial resistance determinants between water and commensal gut bacteria.

Toxigenic Clostridium difficile PCR ribotypes from wastewater treatment plants in southern Switzerland.

The occurrence of Clostridium difficile in nine wastewater treatment plants in the Ticino Canton (southern Switzerland) was investigated. The samples were collected from raw sewage influents and from treated effluents. Forty-seven out of 55 characterized C. difficile strains belonged to 13 different reference PCR ribotypes (009, 010, 014, 015, 039, 052, 053, 066, 070, 078, 101, 106, and 117), whereas 8 strains did not match any of those available in our libraries. The most frequently isolated ribotype (40%) was 078, isolated from six wastewater treatment plants, whereas ribotype 066, a toxigenic emerging ribotype isolated from patients admitted to hospitals in Europe and Switzerland, was isolated from the outgoing effluent of one plant. The majority of the isolates (85%) were toxigenic. Forty-nine percent of them produced toxin A, toxin B, and the binary toxin (toxigenic profile A(+) B(+) CDT(+)), whereas 51% showed the profile A(+) B(+) CDT(-). Interestingly, eight ribotypes (010, 014, 015, 039, 066, 078, 101, and 106) were among the riboprofiles isolated from symptomatic patients admitted to the hospitals of the Ticino Canton in 2010. Despite the limitation of sampling, this study highlights that toxigenic ribotypes of C. difficile involved in human infections may occur in both incoming and outgoing biological wastewater treatment plants. Such a finding raises concern about the possible contamination of water bodies that receive wastewater treatment plant effluents and about the safe reuse of treated wastewater.