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Title: Comparison of methods proposed for monitoring cefotaxime-resistant Escherichia coli in the water environment
ABSTRACT <p><italic>Escherichia coli</italic>is a promising subject for globally coordinated surveillance of antimicrobial resistance (AMR) in water environments due to its clinical relevance and widespread use as an indicator of fecal contamination. Cefotaxime-resistant<italic>E. coli</italic>was recently evaluated favorably for this purpose by the World Health Organization TriCycle Protocol, which specifies tryptone bile x-glucuronide (TBX) medium and incubation at 35°C. We assessed comparability with the U.S. Environmental Protection Agency-approved method for<italic>E. coli</italic>quantification, which uses membrane-thermotolerant<italic>E. coli</italic>(mTEC) agar and incubation at 44.5°C, in terms of recovery of<italic>E. coli</italic>and cefotaxime-resistant<italic>E. coli</italic>from wastewater influent and surface waters. Total<italic>E. coli</italic>concentrations in wastewater influent were 10<sup>6</sup>–10<sup>8</sup>CFU/100 mL, while cefotaxime-resistant<italic>E. coli</italic>were ~100-fold lower. Total<italic>E. coli</italic>in surface waters were ~10<sup>2</sup>CFU/100 mL, and cefotaxime-resistant isolates were near the limit of detection (0.4 CFU/100 mL). Total and putative cefotaxime-resistant<italic>E. coli</italic>concentrations did not differ significantly between media or by incubation method; however, colonies isolated on mTEC were more frequently confirmed to species (97.1%) compared to those from TBX (92.5%). Incubation in a water bath at 44.5°C significantly decreased non-specific background growth and improved confirmation frequency on both media (97.4%) compared to incubation at 35°C (92.3%). This study helps to advance globally coordinated AMR in water environments and suggests that the TriCycle Protocol is adaptable to other standard methods that may be required in different locales, while also offering a means to improve specificity by decreasing the frequency of false-positive identification of cefotaxime-resistant<italic>E. coli</italic>by modifying incubation conditions.</p><sec><title>IMPORTANCE

As antibiotic-resistant bacteria in water environments are increasingly recognized as contributors to the global antibiotic resistance crisis, the need for a monitoring subject that captures antibiotic resistance trends on a global scale increases. The World Health Organization TriCycle Protocol proposes the use of cefotaxime-resistantEscherichia coliisolated on tryptone bile x-glucuronide agar. The U.S. Environmental Protection Agency (USEPA) criteria for safe recreational waters also useE. colias an indicator but specify the use of mTEC agar at a higher incubation temperature (44.5°C vs 35°C). We assessed the comparability of these methods for isolating total and cefotaxime-resistantE. coli, finding overall good agreement and performance, but significantly higher specificity towardE. coliselection with the use of the USEPA incubation protocol and mTEC agar. This study is the first to directly compare these methods and provides evidence that the methods may be used interchangeably for global surveillance of antibiotic resistance in the environment.

 
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Award ID(s):
2125798
PAR ID:
10538524
Author(s) / Creator(s):
; ;
Editor(s):
Semrau, Jeremy D
Publisher / Repository:
American Society for Microbiology
Date Published:
Journal Name:
Applied and Environmental Microbiology
Volume:
90
Issue:
5
ISSN:
0099-2240
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
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