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Understanding the movement of antimicrobial resistance genes (ARGs) in the environment is critical to managing their spread. To assess potential ARG transport through the air via urban bioaerosols in cities with poor sanitation, we quantified ARGs and a mobile integron (MI) in ambient air over periods spanning rainy and dry seasons in Kanpur, India ( n = 53), where open wastewater canals (OCWs) are prevalent. Gene targets represented major antibiotic groups—tetracyclines ( tetA ), fluoroquinolines ( qnrB ), and beta-lactams ( bla TEM )—and a class 1 mobile integron ( intI1 ). Over half of air samples located near, and up to 1 km from OCWs with fecal contamination ( n = 45) in Kanpur had detectable targets above the experimentally determined limits of detection (LOD): most commonly intI1 and tetA (56% and 51% of samples, respectively), followed by bla TEM (8.9%) and qnrB (0%). ARG and MI densities in these positive air samples ranged from 6.9 × 10 1 to 5.2 × 10 3 gene copies/m 3 air. Most (7/8) control samples collected 1 km away from OCWs were negative for any targets. In comparing experimental samples with control samples, we found that intI1 and tetA densities in air are significantly higher ( P = 0.04 and P = 0.01, respectively, alpha = 0.05) near laboratory-confirmed fecal contaminated waters than at the control site. These data suggest increased densities of ARGs and MIs in bioaerosols in urban environments with inadequate sanitation. In such settings, aerosols may play a role in the spread of AR. 

Abstract In India, high rates of antibiotic consumption and poor sanitation infrastructure combine to pose a significant risk to the public through the environmental transmission of antimicrobial resistance (AMR). The WHO has declared extended-spectrum beta-lactamase (ESBL)-positive Escherichia coli a key indicator for the surveillance of AMR worldwide. In the current study, we measured the prevalence of AMR bacteria in an urban aquatic environment in India by detecting metabolically active ESBL-positive E. coli. Water samples were collected in duplicate from 16 representative environmental water sources including open canals, drains, and rivers around Kanpur, Uttar Pradesh. We detected culturable E. coli in environmental water at 11 (69%) of the sites. Out of the 11 sites that were positive for culturable E. coli, ESBL-producing E. coli was observed at 7 (64%). The prevalence of ESBL-producing E. coli detected in the urban aquatic environment suggests a threat of AMR bacteria to this region.