Plasmid-mediated antimicrobial resistance in drinking water

Abstract

The natural environment has been identified as a hotspot for the proliferation and dissemination of antimicrobial resistance (AMR). Plasmids are central to the persistence and rapid dispersal of antimicrobial resistance genes (ARGs) in the environment. Drinking water sourced from the natural environment and contaminated by anthropogenic activities may harbour antimicrobial resistant bacteria and ARGs. This review evaluates the global occurrence of plasmid-mediated AMR (PMRs) in drinking water and identifies a gap in plasmid research. We demonstrate that AMR in drinking water is a universal issue, irrespective of socio-economic background. The beta-lactamase blaOXA-, KPC- and NDM-type genes are some of the genes that were identified in drinking water around the globe. These genes encode enzymes capable of hydrolysing carbapenem antibiotics giving rise to resistance against antimicrobials of last resort. Other genes included extended spectrum beta lactamase (ESBL) genes, blaTEM, blaSHV, blaCTX-M which encode resistance against third generation cephalosporins; as well as the colistin resistance mcr-1 gene. We highlight an urgent need for standardised methods for detecting PMRs to gain a better insight into the scale of AMR in drinking water and a one health approach to tackle global AMR. We suggest a potential methodology for the initial global analysis of PMR in drinking water.

Keywords

• Antimicrobial resistance genes
• Transmission
• Drinking water
• Co-selection
• One-health