610. Fecal contamination contributes to the “resistome” of urban surface waters in northeast Brazil
Session: Poster Abstract Session: Oh One World: Infections from Near and Far
Thursday, October 27, 2016
Room: Poster Hall
  • Poster Patricia IDWeek oct 21 PNG.png (1.3 MB)
  • Background: Surface waters are an underestimated reservoir of antibiotic resistant (AR) bacteria. Poor sanitation brings human and environmental bacteria into direct contact in rivers and lakes, potentially facilitating horizontal transfer of AR genes. We studied the point prevalence of fecal contamination and of AR genes and Enterobacteriaceae in an urban lake (ULB) and rural river system (RRB) in northeast Brazil, and compared them to those of a suburban lake (SLO) and an urban sewer system (USO) in northeast Ohio.Methods: Surface water was collected near the shore in clean 500 mL bottles for coliform culture, screening for Enterobacteriaceae with selective growth media and microbial source tracking (MST) for evidence of human fecal contamination. Enterobacteriaceae were further identified and tested for antimicrobial susceptibility with VITEK 2. Genetic typing was done using repetitive sequence-based PCR (rep-PCR). Isolates sharing >95% similarity were considered the same strain. Total water samples were screened with PCR for the presence of plasmid-mediated quinolone resistance (PMQR) (qnrA, qnrS, aac6'), extended spectrum beta lactamase (blaCTX-M), and carbapenemase (blaOXA-48, blaKPC, blaVIM-2) genes.Results: MST indicated the highest concentration of human fecal waste in ULB followed by USO, and RRB, but was absent from SLO. AR Enterobacteriaceae were rare (0-4), except in ULB where there was widespread AR Escherichia coli and Klebsiella pneumoniae at all 19 sites. Of these, 24/34 were resistant to extended spectrum cephalosporins, 28 to ciprofloxacin and 8 to gentamicin. Of these, the 25 E. coli formed 3 rep-PCR groups, one of which clustered with the ST 131 E. coli control. Water samples in USO amplified only VIM-2, while in ULB all PMQR and all carbapenamase genes were detected. Although not amplified from water samples, blaCTX-M was detected in plasmids from all isolates resistant to extended spectrum cephalosporins.Conclusion:Surface water from a typical urban lake in Brazil carrying significant human fecal contamination serves as a reservoir for AR. These data highlight the role of surface waters as an important compartment of the “resistome”. The role of poor sanitation in the spread of AR to humans needs further exploration. 
    Patricia Bartley, MD1, Cleiton Santos, PhD2, Vanessa Moretto, BS3, Viviane Ferreira, BS4, T. Nicholas Domitrovic, BA5, Rafael Ponce-Terashima, MD6, Mitermayer Reis, MD, PhD7, Maria Navas, MD8, Lucio Barbosa, PhD3, Federico Perez, MD9,10, Ronald Blanton, MD, MSc2 and Robert A. Bonomo, MD11, (1)Case Western Reserve University School of Medicine, Cleveland, OH, (2)Center for Global Health, Case Western Reserve University, Cleveland, OH, (3)Oswaldo Cruz Foundation - Bahia, Salvador, Brazil, (4)Bahiana University, Salvador, Brazil, (5)Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, (6)Infectious Disease, Mercer University School of Medicine, Macon, GA, (7)Oswaldo Cruz Fndn., Salvador, Bahia, Brazil, (8)Louis Stokes Cleveland VA Medical Center, Cleveland, OH, (9)Medicine Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH, (10)Case Western Reserve University, Cleveland, OH, (11)Pharmacology, Molecular Biology, and Microbiology, Case Western Reserve University, Cleveland, OH


    P. Bartley, None

    C. Santos, None

    V. Moretto, None

    V. Ferreira, None

    T. N. Domitrovic, None

    R. Ponce-Terashima, None

    M. Reis, None

    M. Navas, None

    L. Barbosa, None

    F. Perez, Pfizer: Grant Investigator , Grant recipient
    Actavis: Consultant , Consulting fee

    R. Blanton, None

    R. A. Bonomo, Merck: Grant Investigator and Scientific Advisor , Consulting fee and Research grant
    Allergan: Grant Investigator , Research grant
    Wockhardt: Grant Investigator , Research grant
    GlaxoSmithKline: Grant Investigator , Research grant
    AstraZeneca: Grant Investigator , Research grant
    Actavis: Invited Speaker , Speaker honorarium

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