Mcr-1 and blaNDM₋₁ antibiotic resistance genes (ARGs) confer resistance to colistins and carbapenems, which are often antibiotics used as a last resort in tertiary care hospitals. Dissemination of these two ARGs in drinking water supply systems and their effect on healthy gut bacteria are poorly studied. In this study, the dissemination of mcr-1 and blaNDM₋₁ in a drinking water supply system, and their effect on the antibiotic resistance of mouse gut bacteria are explored.Metagenome analysis revealed that source water (Taipu river and Jinze reservoir) was polluted with ARGs. Mcr-1 and blaNDM₋₁ can be disseminated through the water distribution system. Even advanced water treatments (ozone and biological activated carbon (BAC)) could not effectively remove mcr-1 and blaNDM₋₁. Low concentrations of chloramine disinfectants in the water distribution system were not effective at limiting ARG abundance. Mobile genetic elements were also found to play a major role in the dissemination of ARGs via horizontal gene transfer (HGT) throughout the water supply system. Statistical analysis revealed that there was no effect of temperature on the abundance of mcr-1 and blaNDM₋₁ throughout the water supply system.A last resort ARG, mcr-1 can disseminate from drinking water to the healthy mouse gut. The presence of mcr-1 in a strain belonging to Enterococcus hirae, which is different from the strain belonging to the Bacillus cereus group isolated from drinking water, strongly supports the phenomena of HGT inside the gut.This research provides novel insights into the role of drinking water in disseminating ARGs to the gut and strongly suggests that drinking water may also play a major role apart from other factors known to be involved in the prevalence of last resort ARGs in the gut.

Sediment samples from three coastal sites - two beach resorts (Beach 1 and Beach 2 sites) and an area lying between an oil refinery and a river estuary (Estuarine site) - were analyzed for antibiotic- and heavy metal (HM)-resistant enterococci.A total of 123 enterococci, 36 E. faecium, 34 E. casseliflavus, 33 E. hirae, 5 E. faecalis, 3 E. durans, 3 E. gallinarum, and 9 Enterococcus spp, were recovered. Strains resistant to erythromycin, tetracycline and quinupristin/dalfopristin (Q/D) were recovered from all sites, whereas multidrug-resistant isolates were recovered only from “Beach 2” (14%) and “Estuarine” (3.7%). As regards HM resistance, the strains showed a high frequency (68%) of cadmium and/or copper resistance and uniform susceptibility to mercury. The prevalence of cadmium-resistant strains was significantly higher among erythromycin-resistant than among erythromycin-susceptible strains. A significant association between cadmium or copper resistance and Q/D resistance was also observed at “Estuarine” site. The levels of the two HMs in sediment from all sites were fairly low, ranging from 0.070 to 0.126 μg/g, for cadmium and from 1.00 to 7.64 μg/g for copper. Mercury was always undetectable. These findings are consistent with reports that low HM concentrations may contribute to co-selection of antibiotic-resistant bacterial strains, including enterococci.

We investigated for the first time the occurrence, stability and antibiotic resistance of 593 enterococci in six samples collected from three urban sewage treatment plants (STPs) located in the north, south and west part of Tehran, Iran between October 2004 and September of 2005. Isolates were typed with a biochemical fingerprinting method (the PhPlate system) and tested for their resistance to six antibiotics. The most prevalent species in all three STPs were E. faecium followed by E. hirae and E. faecalis accounting for 93% of the total isolates examined. In all, 317 (55%) isolates were susceptible to all six antibiotics tested and the remaining isolates were resistant to between 1 and 6 antibiotics. Biochemical fingerprinting with PhPlate system showed a high diversity for E. faecalis (D i = 0.95), E. hirae (D i = 0.93) and E. faecium (D i = 0.95) populations with an overall diversity of D i = 0.97 for the whole enterococcal populations found in all three STPs. Our data indicate a high degree of polyclonality among the enterococci populations of human origin. This study suggest that the municipal wastewaters might be an important source of dissemination of antibiotic-resistant enterococci in Iran.