摘要
      抗微生物耐药性（AMR）是世界范围内对人类健康的最大威胁之一。瑞士日内瓦世界卫生组织（WHO）推出了“一个健康”方法，该方法鼓励评估人体-动物-微生物共享环境中的抗生素耐药基因（ARG），以限制和缓解AMR的发展。气溶胶作为传播ARGs的媒介，受到的关注很少。在本研究中，我们调查了从科威特城市和三家医院内部收集的室内和室外气溶胶中ARGs的分布和丰度。高通量定量聚合酶链式反应（HT-qPCR）方法用于此目的。结果表明，气溶胶中存在氨基糖苷类、β-内酰胺类、氟喹诺酮类、四环素类、大环内酯类林可酰胺链脲菌素B（MLSB）、多药耐药（MDR）和万古霉素耐药基因。在城市非临床环境中，最主要的药物类别是β-内酰胺，基因为IMP-2组（0.85）、Per-2组（0.65）、OXA-54（0.57）、QnrS（0.50）和OXA-55（0.55）。与室外相比，室内气溶胶具有更丰富的ARGs多样性（观察到的Chao1、Shannon’s和Pielou’s均匀度）。还记录了ARGs相对丰度和类型的季节变化（秋季与冬季）（R2为0.132，p＜0.08）。在医院气溶胶中的可吸入（2.1µm、1.1µm、0.7µm和＜0.3µm）和可吸入（＞9.0µm、5.8µm、4.7µm和3.3µm）粒级都存在ARGs。所有ARGs都起源于致病性细菌，并由致病性形式宿主。这些发现提供了基线数据，并支持了对气溶胶作为ARG在人类和非人类陆地生物群中传播的载体进行详细调查的必要性。
Abstract
Antimicrobial resistance (AMR) is one of the biggest threats to human health worldwide. The World Health Organization (WHO, Geneva, Switzerland) has launched the “One-Health” approach, which encourages assessment of antibiotic-resistant genes (ARGs) within environments shared by human-animals-plants-microbes to constrain and alleviate the development of AMR. Aerosols as a medium to disseminate ARGs, have received minimal attention. In the present study, we investigated the distribution and abundance of ARGs in indoor and outdoor aerosols collected from an urban location in Kuwait and the interior of three hospitals. The high throughput quantitative polymerase chain reaction (HT-qPCR) approach was used for this purpose. The results demonstrate the presence of aminoglycoside, beta-lactam, fluoroquinolone, tetracycline, macrolide-lincosamide-streptogramin B (MLSB), multidrug-resistant (MDR) and vancomycin-resistant genes in the aerosols. The most dominant drug class was beta-lactam and the genes were IMP-2-group (0.85), Per-2 group (0.65), OXA-54 (0.57), QnrS (0.50) and OXA-55 (0.55) in the urban non-clinical settings. The indoor aerosols possessed a richer diversity (Observed, Chao1, Shannon’s and Pielou’s evenness) of ARGs compared to the outdoors. Seasonal variations (autumn vs. winter) in relative abundances and types of ARGs were also recorded (R2 of 0.132 at p < 0.08). The presence of ARGs was found in both the inhalable (2.1 µm, 1.1 µm, 0.7 µm and < 0.3 µm) and respirable (>9.0 µm, 5.8 µm, 4.7 µm and 3.3 µm) size fractions within hospital aerosols. All the ARGs are of pathogenic bacterial origin and are hosted by pathogenic forms. The findings present baseline data and underpin the need for detailed investigations looking at aerosol as a vehicle for ARG dissemination among human and non-human terrestrial biota.

https://www.mdpi.com/1422-0067/24/7/6756