Kuwait Medical Electronic Library

Antibiotic Resistance Genes in Aerosols: Baseline from Kuwait

Nazima Habibi 1, Saif Uddin 1, Montaha Behbehani 1, Mohamed Kishk 1, Nasreem Abdul Razzack 1, Farhana Zakir 1, Anisha Shajan 1

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04 April 2023

doi: 10.3390/ijms24076756

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.

Keywords: HT-qPCR; antibiotic-resistant bacteria; antibiotics; human pathogens; molecular methods.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1 Bacterial cell counts and number of ARGs detected in indoor and outdoor bioaerosols. (a) Box plot showing the number of bacterial cells per m−3 of air. (b) Box plot comparing the mean number of ARGs. (c) Number of ARGs in indoor aerosols at the different months of sampling. (d) Number of ARGs in outdoor aerosols at the different months of sampling.

Figure 2 Drug classes identified in bioaerosols. (a) Number of ARG of each drug type in indoor and outdoor locations. (b) Category of ARGs in the respective month of sampling. (c) Types of ARGs. (d) Core resistome of bioaerosols.

Figure 3 Spatio-temporal variation in relative abundances of: (a) drug classes and (b) ARGs present in aerosols. (c) Hierarchical clustering on Bray Curtis distances.

KMEL References

https://pubmed.ncbi.nlm.nih.gov/

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