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<p>The dissemination and rise in newer generations of cephalosporin resistance pose a significant threat to global healthcare, especially towards infections caused by Critical Priority Pathogens (CPP). Despite the urgency, the information on the distribution of environmental cephalosporin-resistant CPP remains inadequate. The current review employed an in silico approach to investigate the cephalosporin resistance profile, virulence, and global environmental risk management strategies for CPP. Metagenomic analysis of publicly available datasets for hospital (Ho) and domestic solid waste and wastewater (Solid: DS and Water: WW) revealed the prevalence of cephalosporin resistance in CPP, primarily affecting <i>P. aeruginosa, K. pneumoniae, E. coli</i>, and <i>A. baumannii.</i> Additionally, a high abundance of genes encoding β-lactamases, penicillin-binding proteins, along with multidrug efflux pumps was identified. These findings highlight a worrisome trend of increasing resistance to newer-generation cephalosporins in healthcare settings, potentially exacerbated by DS. Network analysis confirmed the co-occurrence of resistant CPP strains, further emphasizing the interconnectedness of resistant populations. Whole-genome mining revealed the critical roles played by mobile genetic elements (copR, XerD, XerC3, insN1, insO1, pil, oppD) and associated virulence factors in facilitating the dissemination of cephalosporin resistance within CPP. Furthermore, the recurrent identification of plasmids harboring cephalosporin resistance genes (pHOU-1, pRS, pGMI, pZI09) highlights the potential for rapid horizontal gene transfer. Given the ubiquity of horizontal gene transfer across diverse species, a "One-Health" approach is crucial for exploring the interrelationships among human, animal, and environmental microbiota. Identifying hotspots and breeding grounds for resistant CPP can serve as a novel surveillance strategy to minimize environmental impact and prevent potential epidemics.</p>

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Critical priority pathogen resistant to third-generation cephalosporin: comparative waste resistome pattern and risk management

  • 期刊论文

  • 发表日期：

    2026年5月8日

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  • Bhumika Maharana,
  • Sejal Mahalle,
  • Nishant A. Dafale

摘要

The dissemination and rise in newer generations of cephalosporin resistance pose a significant threat to global healthcare, especially towards infections caused by Critical Priority Pathogens (CPP). Despite the urgency, the information on the distribution of environmental cephalosporin-resistant CPP remains inadequate. The current review employed an in silico approach to investigate the cephalosporin resistance profile, virulence, and global environmental risk management strategies for CPP. Metagenomic analysis of publicly available datasets for hospital (Ho) and domestic solid waste and wastewater (Solid: DS and Water: WW) revealed the prevalence of cephalosporin resistance in CPP, primarily affecting P. aeruginosa, K. pneumoniae, E. coli, and A. baumannii. Additionally, a high abundance of genes encoding β-lactamases, penicillin-binding proteins, along with multidrug efflux pumps was identified. These findings highlight a worrisome trend of increasing resistance to newer-generation cephalosporins in healthcare settings, potentially exacerbated by DS. Network analysis confirmed the co-occurrence of resistant CPP strains, further emphasizing the interconnectedness of resistant populations. Whole-genome mining revealed the critical roles played by mobile genetic elements (copR, XerD, XerC3, insN1, insO1, pil, oppD) and associated virulence factors in facilitating the dissemination of cephalosporin resistance within CPP. Furthermore, the recurrent identification of plasmids harboring cephalosporin resistance genes (pHOU-1, pRS, pGMI, pZI09) highlights the potential for rapid horizontal gene transfer. Given the ubiquity of horizontal gene transfer across diverse species, a "One-Health" approach is crucial for exploring the interrelationships among human, animal, and environmental microbiota. Identifying hotspots and breeding grounds for resistant CPP can serve as a novel surveillance strategy to minimize environmental impact and prevent potential epidemics.