Diversity and dissemination of resistant genes to last resort drugs from healthcare settings of Bangladesh: A role for cockroaches as vectors of multidrug-resistant ESKAPE pathogens

Since multidrug-resistant bacteria frequently emerge and endanger our lives, antimicrobial resistance (AMR) has become a pressing issue. Antibiotic resistance genes are still widely distributed in various species, and this diversity leads to multidrug-resistant (MDR), extensively drug-resistant (XDR), and/or pandrug-resistant (PDR) organisms. In a hospital context, a number of things may help with selection pressure on the spread of resistance genes in the neighborhood. AMR genes may be present in hospital-dwelling cockroaches and flies, which may also contaminate food and other items by droppings. The infections known as ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.) can live in the body parts or intestines of those cockroaches and can be fatal to humans with impaired immune systems. These infections might stay in cockroaches for a longer time and spread throughout the hospital's community. In order to identify the variety of diseases, continuous surveillance is required and their capacity to form biofilms should also be measured. But the metagenomics approach, with its lower cost and superior results, changed culture-dependent methods. Thus, the culture-independent technique clarifies intricate microbial diversity and antibiotic resistance genes in the environment. The current study's objectives are to explore ESKAPE infections that are multi-drug resistant and to conduct a metagenomic analysis of the microbial population in hospital settings. Cockroaches and the accompanying swab will be gathered for these from various locations across the hospital setting. We will screen for multidrug-resistant ESKAPE pathogens carrying AMR genes and find out whether one is resistant to last-resort antibiotics (Oxacillin, Meropenem, Colistin Sulfate, and Cefepime). Whole genome sequencing for the multidrug-resistant pathogens will be performed to determine the presence of plasmid, virulence factors, and antibiotic-resistant by next generation sequencing technology and cutting-edge bioinformatics method. To ascertain the diversity of the microbial community, 16S and ITS metagenomics will be carried out to identify the diversity of bacterial, archaeal, and fungal community. Antimicrobial resistance genes (ARGs) profiling, virulence factor genes (VFGs) profiling, and viral diversity profiling will be determined using a whole genome metagenomics approach with deep sequencing from the same data.