Evaluation and Characterization of Quinolone-Resistant Escherichia coli in Wastewater Treatment Plant Effluents

Abstract

The increasing global incidence of quinolone antimicrobial resistance poses a considerable public health concern. The aquatic environment, particularly wastewater treatment plants (WWTPs), serves as a major reservoir for antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs), leading to the dissemination of antibiotic resistance. This study aimed to assess the prevalence and factors contributing to quinolone antibiotic resistance in Escherichia coli isolates obtained from effluents of 33 WWTPs. A total of 1082 E. coli isolates were analyzed, 32.6% and 17.1% of which showed resistance to nalidixic acid and ciprofloxacin, respectively. Phenotypic and genotypic analyses of antibiotic resistance demonstrated that quinolone resistance primarily originated from chromosomal mutations in the gyrA, parC, and parE genes, known as quinolone resistance-determining regions (QRDRs). The amino acid substitution at codon 83 in gyrA was closely associated with nalidixic acid resistance, whereas substitutions at codon 87 in gyrA and codon 80 in parC were significantly associated with ciprofloxacin resistance. The plasmid-mediated quinolone resistance (PMQR) genes qnrS and qnrB were identified in 41 isolates (11.5%) and 15 isolates (4.2%), respectively. Thus, we confirmed that the quinolone resistance in E. coli in WWTPs primarily occurs through QRDR mutations rather than through the acquisition of PMQR genes. Phylogenetic analysis revealed that most quinolone-resistant isolates belonged to the B1, A, B2, and D phylogenetic groups. Notably, the B2 group, which is responsible for extraintestinal infections, exhibited the highest rate of quinolone resistance. These findings provide novel insights into the presence and mechanisms of quinolone resistance in E. coli isolates from WWTPs, emphasizing the need for further research and understanding of quinolone resistance in the environment.