摘要
      污水处理通过限制抗微生物耐药性（AMR）的传播，对环境安全至关重要。然而，在评估治疗效果的基因组指导方法上，尤其是在细菌耐药性和移动性方面，仍然没有达成共识。在这里，我们提出了第一个全面的宏基因组证据，证明了厌氧-缺氧-好氧（A2/O）工艺处理前后医院污水中细菌耐药性和移动性的AMR相关变化。通过宏基因组和生物信息学方法分析了AMR传播的关键因素，包括未处理和处理污水中微生物群落的多样性、抗生素抗性基因（ARGs）和可移动遗传元件（MGE）。最常见的20种细菌中有16种减少，其中粪肠球菌的清除率最高（88.46%）。在发生率最高的20种ARGs中，有5种类型的ARGs显著下降（p<0.01），包括crp、tetQ、ermF、aadA24和catB3，而其他ARGs如aac、aph、VEB-3、mphE、msrE、sul1、GES-6、qacH、OXA-3，在前20个MGE中，只有5种类型的MGE减少，而其他MGE因处理而增加（p<0.01）。网络分析进一步表明，在A2/O条件下，细菌与ARGs之间的连接以及MGE与ARGs。总的来说，我们的工作证明了耐药性和流动性作为AMR监测小组的评估标准的相关性和实用性，以更全面地评估污水处理对AMR传播的有效性。
Abstract
Sewage treatment is crucial to environmental security by restricting the spread of antimicrobial resistance (AMR). However, there remains little consensus on genome-guided approaches to evaluating treatment efficacy, particularly with respect to the bacterial resistome and mobilome. Here, we present the first comprehensive metagenomic evidence for AMR-related changes in the bacterial resistome and mobilome in hospital sewage before and after treatment as modified by an anaerobic-anoxic-oxic (A2/O) process. Key factors involved in AMR dissemination including diversities of microbial communities, antibiotic resistance genes (ARGs), and mobile genetic elements (MGEs) in untreated and treated sewage were analyzed by metagenomic and bioinformatic methods. Sixteen out of the most common 20 bacterial species were reduced, with Enterococcus faecalis showing the highest clearance rate (88.46%). Of the highest occurring 20 ARGs, five types of ARGs significantly declined (p < 0.01), including crp, tetQ, ermF, aadA24, and catB3, whereas the other ARGs such as aac, aph, VEB-3, mphE, msrE, sul1, GES-6, qacH, OXA-3, and ereA increased in the treated sewage (p < 0.01). Of the top 20 MGEs, only five types were reduced, while the other MGEs were increased by treatment (p < 0.01). Network analysis further reveals that connections between bacteria and ARGs, and connections between MGEs and ARGs were weakened significantly under A2/O. Overall, our work demonstrates the relevance and utility of resistome and mobilome as assessment criteria in AMR monitoring panels for more comprehensive evaluation of the effectiveness of sewage treatment against the spread of AMR.

https://www.sciencedirect.com/science/article/abs/pii/S2213343722020899