Published paper: Selective concentrations for ciprofloxacin

My colleagues in Gothenburg have published a new paper in Environment International, in which I was involved in the bioinformatics analyses. In the paper, for which Nadine Kraupner did the lion’s share of the work, we establish minimal selective concentrations (MSCs) for resistance to the antibiotic ciprofloxacin in Escherichia coli grown in complex microbial communities (1). We also determine the community responses at the taxonomic and resistance gene levels. Nadine has made use of Sara Lundström’s aquarium system (2) to grow biofilms in the exposure of sublethal levels of antibiotics. Using the system, we find that 1 μg/L ciprofloxacin selects for the resistance gene qnrD, while 10 μg/L ciprofloxacin is required to detect changes of phenotypic resistance. In short, the different endpoints studied (and their corresponding MSCs) were:

• CFU counts from test tubes, grown on R2A plates with 2 mg/L ciprofloxain – MSC = 5 μg/L
• CFU counts from aquaria, grown on R2A plates with 0.25 or 2 mg/L ciprofloxain – MSC = 10 μg/L
• Chromosomal resistance mutations – MSC ~ 10 μg/L
• Increased resistance gene abundances, metagenomics – MSC range: 1 μg/L
• Changes to taxonomic diversity – 1 µg/L
• Changes to taxonomic community composition – MSC ~ 1-10 μg/L

We have previously reported a predicted no-effect concentration for resistance of 0.064 µg/L for ciprofloxacin (3), which corresponds fairly well with the MSCs determined experimentally here, being around a factor of ten off. However, we cannot exclude that in other experimental systems, the selective effects of ciprofloxacin could be even lower and thus the predicted PNEC may still be relevant. The selective concentrations we report for ciprofloxacin are close to those that have been reported in sewage treatment plants (3-5), suggesting the possibility for weak selection of resistance. Several recent reports have underscored the need to populate the this far conceptual models for resistance development in the environment with actual numbers (6-10). Determining selective concentrations for different antibiotics in actual community settings is an important step on the road towards building accurate quantitative models for resistance emergence and propagation.

References

1. Kraupner N, Ebmeyer S, Bengtsson-Palme J, Fick J, Kristiansson E, Flach C-F, Larsson DGJ: Selective concentration for ciprofloxacin in Escherichia coli grown in complex aquatic bacterial biofilms. Environment International, 116, 255–268 (2018). doi: 10.1016/j.envint.2018.04.029 [Paper link]
2. Lundström SV, Östman M, Bengtsson-Palme J, Rutgersson C, Thoudal M, Sircar T, Blanck H, Eriksson KM, Tysklind M, Flach C-F, Larsson DGJ: Minimal selective concentrations of tetracycline in complex aquatic bacterial biofilms. Science of the Total Environment, 553, 587–595 (2016). doi: 10.1016/j.scitotenv.2016.02.103 [Paper link]
3. Bengtsson-Palme J, Larsson DGJ: Concentrations of antibiotics predicted to select for resistant bacteria: Proposed limits for environmental regulation. Environment International, 86, 140-149 (2016). doi: 10.1016/j.envint.2015.10.015
4. Michael I, Rizzo L, McArdell CS, Manaia CM, Merlin C, Schwartz T, Dagot C, Fatta-Kassinos D: Urban wastewater treatment plants as hotspots for the release of antibiotics in the environment: a review. Water Research, 47, 957–995 (2013). doi:10.1016/j.watres.2012.11.027
5. Bengtsson-Palme J, Hammarén R, Pal C, Östman M, Björlenius B, Flach C-F, Kristiansson E, Fick J, Tysklind M, Larsson DGJ: Elucidating selection processes for antibiotic resistance in sewage treatment plants using metagenomics. Science of the Total Environment, 572, 697–712 (2016). doi: 10.1016/j.scitotenv.2016.06.228
6. Ågerstrand M, Berg C, Björlenius B, Breitholtz M, Brunstrom B, Fick J, Gunnarsson L, Larsson DGJ, Sumpter JP, Tysklind M, Rudén C: Improving environmental risk assessment of human pharmaceuticals. Environmental Science and Technology (2015). doi:10.1021/acs.est.5b00302
7. Bengtsson-Palme J, Kristiansson E, Larsson DGJ: Environmental factors influencing the development and spread of antibiotic resistance. FEMS Microbiology Reviews, 42, 1, 68–80 (2018). doi: 10.1093/femsre/fux053
8. Joint Programming Initiative on Antimicrobial Resistance: JPIAMR Workshop on Environmental Dimensions of AMR: Summary and recommendations. JPIAMR (2017). [Link]
9. Angers A, Petrillo P, Patak, A, Querci M, Van den Eede G: The Role and Implementation of Next-Generation Sequencing Technologies in the Coordinated Action Plan against Antimicrobial Resistance. JRC Conference and Workshop Report, EUR 28619 (2017). doi: 10.2760/745099
10. Larsson DGJ, Andremont A, Bengtsson-Palme J, Brandt KK, de Roda Husman AM, Fagerstedt P, Fick J, Flach C-F, Gaze WH, Kuroda M, Kvint K, Laxminarayan R, Manaia CM, Nielsen KM, Ploy M-C, Segovia C, Simonet P, Smalla K, Snape J, Topp E, van Hengel A, Verner-Jeffreys DW, Virta MPJ, Wellington EM, Wernersson A-S: Critical knowledge gaps and research needs related to the environmental dimensions of antibiotic resistance. Environment International, in press (2018). doi: 10.1016/j.envint.2018.04.041