Aguas residuales hospitalarias y su papel en la conexión entre las bacterias ESKAPE resistentes a antibióticos y bacterias acuáticas
el caso de Aeromonas
Abstract
Antimicrobial resistance (AMR) is a growing threat with a direct impact on human health. This phenomenon is associated with the excessive and irrational use of antibiotics, with hospitals standing out as major consumers and, consequently, key contributors to the generation of selective pressure driving the development of AMR. However, the problem does not end within this setting, as microorganisms carrying AMR can reach the environment and eventually communities through everyday exposure. In this context, hospital wastewater (HWW) serves as a vehicle for a variety of biological-infectious contaminants, including bacteria from the ESKAPE group, recognized for their ability to cause infections and harbor AMR genes. In parallel, in recent years, a bacterial genus known as Aeromonas, ubiquitous in the environment, particularly in aquatic systemshas gained relevance as an emerging opportunistic human pathogen capable of causing infections and exhibiting AMR similar to that observed in ESKAPE bacteria. The detection of Aeromonas strains carrying ESKAPE-type AMR suggests potential interactions between ESKAPE bacteria and Aeromonas, raising concern because these bacteria also have the capacity to disseminate AMR genes, acting as a “vehicle” between environmental settings and hospitals. In Mexico, the discharge of hospital wastewater into public sewer systems and subsequently into receiving water bodies may facilitate the spread of AMR bacteria to agricultural irrigation systems or recreational waters, where community exposure can occur through contaminated water and food. This work explains how the “hospital-environment-community” interaction occurs through hospital wastewater, highlighting its role as a key point for AMR surveillance and mitigation, and how interactions between ESKAPE bacteria and Aeromonas may contribute to the global increase of antimicrobial resistance.
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References
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