Wastewater-Based Surveillance of Antibiotic Resistance Genes Associated with Tuberculosis Treatment Regimen in KwaZulu Natal, South Africa

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...

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Autores principales:	Hlengiwe N. Mtetwa, Isaac D. Amoah, Sheena Kumari, Faizal Bux, Poovendhree Reddy
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	multidrug-resistant tuberculosis antibiotic resistant genes wastewater droplet digital PCR wastewater-based epidemiology Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/1677ba6c3485464c99661d5626fe3d58
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spelling	oai:doaj.org-article:1677ba6c3485464c99661d5626fe3d582021-11-25T16:23:40ZWastewater-Based Surveillance of Antibiotic Resistance Genes Associated with Tuberculosis Treatment Regimen in KwaZulu Natal, South Africa10.3390/antibiotics101113622079-6382https://doaj.org/article/1677ba6c3485464c99661d5626fe3d582021-11-01T00:00:00Zhttps://www.mdpi.com/2079-6382/10/11/1362https://doaj.org/toc/2079-6382Essential 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 <i>rrs</i> gene, associated with resistance to the aminoglycosides, specifically streptomycin, with median concentration ranges of 4.69–5.19 log copies/mL. In contrast, <i>pncA</i> 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.Hlengiwe N. MtetwaIsaac D. AmoahSheena KumariFaizal BuxPoovendhree ReddyMDPI AGarticlemultidrug-resistant tuberculosisantibiotic resistant geneswastewaterdroplet digital PCRwastewater-based epidemiologyTherapeutics. PharmacologyRM1-950ENAntibiotics, Vol 10, Iss 1362, p 1362 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	multidrug-resistant tuberculosis antibiotic resistant genes wastewater droplet digital PCR wastewater-based epidemiology Therapeutics. Pharmacology RM1-950
spellingShingle	multidrug-resistant tuberculosis antibiotic resistant genes wastewater droplet digital PCR wastewater-based epidemiology Therapeutics. Pharmacology RM1-950 Hlengiwe N. Mtetwa Isaac D. Amoah Sheena Kumari Faizal Bux Poovendhree Reddy Wastewater-Based Surveillance of Antibiotic Resistance Genes Associated with Tuberculosis Treatment Regimen in KwaZulu Natal, South Africa
description	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 <i>rrs</i> gene, associated with resistance to the aminoglycosides, specifically streptomycin, with median concentration ranges of 4.69–5.19 log copies/mL. In contrast, <i>pncA</i> 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.
format	article
author	Hlengiwe N. Mtetwa Isaac D. Amoah Sheena Kumari Faizal Bux Poovendhree Reddy
author_facet	Hlengiwe N. Mtetwa Isaac D. Amoah Sheena Kumari Faizal Bux Poovendhree Reddy
author_sort	Hlengiwe N. Mtetwa
title	Wastewater-Based Surveillance of Antibiotic Resistance Genes Associated with Tuberculosis Treatment Regimen in KwaZulu Natal, South Africa
title_short	Wastewater-Based Surveillance of Antibiotic Resistance Genes Associated with Tuberculosis Treatment Regimen in KwaZulu Natal, South Africa
title_full	Wastewater-Based Surveillance of Antibiotic Resistance Genes Associated with Tuberculosis Treatment Regimen in KwaZulu Natal, South Africa
title_fullStr	Wastewater-Based Surveillance of Antibiotic Resistance Genes Associated with Tuberculosis Treatment Regimen in KwaZulu Natal, South Africa
title_full_unstemmed	Wastewater-Based Surveillance of Antibiotic Resistance Genes Associated with Tuberculosis Treatment Regimen in KwaZulu Natal, South Africa
title_sort	wastewater-based surveillance of antibiotic resistance genes associated with tuberculosis treatment regimen in kwazulu natal, south africa
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/1677ba6c3485464c99661d5626fe3d58
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Wastewater-Based Surveillance of Antibiotic Resistance Genes Associated with Tuberculosis Treatment Regimen in KwaZulu Natal, South Africa

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