The spread of antibiotic-resistant bacteria is a growing problem and a public health issue. In recent decades, various genetic mechanisms involved in the spread of resistance genes among bacteria have been identified. Integrons -- genetic elements that acquire, exchange and express genes embedded within gene cassettes (GC) -- are one of these mechanisms. Integrons are widely distributed, especially in Gram-negative bacteria; they are carried by mobile genetic elements, plasmids and transposons, which promote their spread within bacterial communities. Initially studied mainly in the clinical setting for their involvement in antibiotic resistance, their role in the environment is now an increasing focus of attention. The aim of this review is to provide an in-depth analysis of recent studies of antibiotic-resistance integrons in the environment, highlighting their potential involvement in antibiotic resistance outside the clinical context. We will focus particularly on the impact of human activities (agriculture, industries, wastewater treatment, etc.).

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Integron Involvement in Environmental Spread of Antibiotic Resistance

Antibiotic resistance in major rivers in the world: A systematic review on occurrence, emergence, and management strategies

Antibiotics are being used intensively for humans and livestock worldwide and have led to the presence of antibiotic resistance bacteria (ARB) and antibiotic resistance genes (ARGs) in the environment. Wastewater treatment plants (WWTPs) have been identified as a point source for ARB&Gs, and water catchments consequently are potential receptors of ARB&Gs. The objective of this study was to investigate the occurrence of antibiotics (macrolides, sulfonamides, tetracyclines), ARGs (ermB, sul1, sul2, tetW), and class 1 integron (targeting the integrase gene), in a Dutch river that receives wastewater treatment plant effluent. Sediment and water samples were collected during one year along the river. The WWTP significantly increased the amounts of antibiotics and ARGs in the river as compared to the upstream samples, of which the antibiotics decreased once they entered the river. ARGs were persistent in the water and sediment from the WWTP effluent discharge point until 20 km downstream. This study provides insight in the prevalence of antibiotics and ARGs in a wastewater effluent-receiving river system in the Netherlands. Even though human antibiotic usage is low in the Netherlands, antibiotics, residues of antibiotics, and ARGs are detected in the river surface water-sediment system, which shows that a river has the potential to act as a reservoir of ARGs.

Prevalence of antibiotics and antibiotic resistance genes in a wastewater effluent-receiving river in the Netherlands

A systematic review of antibiotics and antibiotic resistance genes in estuarine and coastal environments

Continental-scale spatio-temporal distribution of antibiotic resistance genes in coastal waters along coastline of China

The occurrence, spatial and temporal distribution, and environmental routes of tetracycline resistance and integrase genes in Crassostrea virginica beds.

Dorset Hurley

Papers

The occurrence, spatial and temporal distribution, and environmental routes of tetracycline resistance and integrase genes in Crassostrea virginica beds.

Environmental factors responsible for the incidence of antibiotic resistance genes in pristine Crassostrea virginica reefs

Persistence of bacterial pathogens, antibiotic resistance genes, and enterococci in tidal creek tributaries.