Antimicrobial Resistance Across the Urban Wastewater Continuum: A One Health Assessment Using High-Throughput qPCR

Area of Science:

• Environmental microbiology
• One Health surveillance
• Antimicrobial resistance (AMR)

Background:

• Limited global data on antimicrobial resistance (AMR) in wastewater from rapidly urbanizing regions.
• Wastewater systems offer a One Health approach to track AMR.
• Arabian Gulf region lacks comprehensive AMR surveillance data.

Purpose of the Study:

• To investigate AMR profiles in wastewater from Dubai, UAE.
• To assess the diversity and abundance of antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs).
• To evaluate wastewater as a tool for AMR surveillance in an urban setting.

Main Methods:

• Eight-month prospective study in Dubai, UAE.
• Monthly sampling of community, hospital, and wastewater treatment plant (WWTP) nodes.
• Analysis using high-throughput quantitative PCR (HT-qPCR) with a 72-target One Health gene panel.

Main Results:

• Detected 26-68 gene targets across 120 samples, with highest diversity in hospital wastewater.
• Pathogen-associated markers and widespread ARGs (macrolide, tetracycline, aminoglycoside) were prevalent.
• Hospital wastewater showed higher ARG burden, including specific genes like blaKPC-2.
• Mobile genetic elements (MGEs) were ubiquitous, with integron markers prominent in WWTP effluent.
• ARG-MGE networks indicated extensive co-occurrence and MGEs acting as central hubs.

Conclusions:

• Wastewater effectively captures distinct resistome profiles, supporting its role in AMR surveillance.
• Persistence of ARGs and MGEs in WWTP effluent suggests potential for environmental dissemination.
• Treated wastewater reuse may contribute to the spread of antimicrobial resistance.