Journal
ANTIBIOTICS-BASEL
Volume 10, Issue 11, Pages -Publisher
MDPI
DOI: 10.3390/antibiotics10111362
Keywords
multidrug-resistant tuberculosis; antibiotic resistant genes; wastewater; droplet digital PCR; wastewater-based epidemiology
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Funding
- Bill and Melinda Gates Foundation [96086]
- South African Research Chair Initiative (SARChI) of the National Research Foundation
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This study used molecular techniques to determine the occurrence and concentration of antibiotic-resistance genes associated with tuberculosis resistance in untreated and treated wastewater samples from South Africa. It highlights the potential of wastewater surveillance for monitoring antibiotic resistance in TB treatment within communities.
Essential components of public health include strengthening the surveillance of infectious diseases and developing early detection and prevention policies. This is particularly important for drug-resistant tuberculosis (DR-TB), which can be explored by using wastewater-based surveillance. This study aimed to use molecular techniques to determine the occurrence and concentration of antibiotic-resistance genes (ARGs) associated with tuberculosis (TB) resistance in untreated and treated wastewater. Raw/untreated and treated (post-chlorination) wastewater samples were taken from three wastewater treatment plants (WWTPs) in South Africa. The ARGs were selected to target drugs used for first- and second-line TB treatment. Both conventional polymerase chain reaction (PCR) and the more advanced droplet digital PCR (ddPCR) were evaluated as surveillance strategies to determine the distribution and concentration of the selected ARGs. The most abundant ARG in the untreated wastewater was the rrs gene, associated with resistance to the aminoglycosides, specifically streptomycin, with median concentration ranges of 4.69-5.19 log copies/mL. In contrast, pncA gene, associated with resistance to the TB drug pyrazinamide, was the least detected (1.59 to 2.27 log copies/mL). Resistance genes associated with bedaquiline was detected, which is a significant finding because this is a new drug introduced in South Africa for the treatment of multi-drug resistant TB. This study, therefore, establishes the potential of molecular surveillance of wastewater for monitoring antibiotic resistance to TB treatment in communities.
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