摘要
      抗生素耐药性是对人类健康的全球性威胁，在中低收入国家影响最为严重。我们用霰弹枪宏基因组测序法研究了西非两个低收入国家贝宁和布基纳法索九家医院的医院废水中抗生素耐药性基因（ARGs）的存在。为了进行比较，我们还研究了芬兰的六家医院。在68个HWW样本中，ARGs的相对丰度总和最高的是贝宁，最低的是芬兰。贝宁和布基纳法索的HWW抵抗者和动员者比芬兰的更相似。在不同丰度下检测到许多碳青霉烯酶基因，特别是在布基纳法索和芬兰的HWW中。blaGES基因是贝宁HWW中最广泛的碳青霉烯酶基因，在贝宁一家医院院子的洗手水和水坑中也被发现。在这三个国家的HWW中都检测到了mcr基因，其中mcr-5是最常见的mcr基因。这些和其他mcr基因的相对丰度非常高，即使在布基纳法索的处理过的废水和贝宁的街道排水沟中也是如此。研究结果突出了废水处理的重要性，特别是HWW。
ABSTRACT
Antibiotic resistance is a global threat to human health, with the most severe effect in low- and middle-income countries. We explored the presence of antibiotic resistance genes (ARGs) in the hospital wastewater (HWW) of nine hospitals in Benin and Burkina Faso, two low-income countries in West Africa, with shotgun metagenomic sequencing. For comparison, we also studied six hospitals in Finland. The highest sum of the relative abundance of ARGs in the 68 HWW samples was detected in Benin and the lowest in Finland. HWW resistomes and mobilomes in Benin and Burkina Faso resembled each other more than those in Finland. Many carbapenemase genes were detected at various abundances, especially in HWW from Burkina Faso and Finland. The blaGES genes, the most widespread carbapenemase gene in the Beninese HWW, were also found in water intended for hand washing and in a puddle at a hospital yard in Benin. mcr genes were detected in the HWW of all three countries, with mcr-5 being the most common mcr gene. These and other mcr genes were observed in very high relative abundances, even in treated wastewater in Burkina Faso and a street gutter in Benin. The results highlight the importance of wastewater treatment, with particular attention to HWW.

https://journals.asm.org/doi/full/10.1128/msphere.00538-22