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Alexander J, Hembach N, Schwartz T. Identification of critical control points for antibiotic resistance discharge in sewers. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 820:153186. [PMID: 35051461 DOI: 10.1016/j.scitotenv.2022.153186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 06/14/2023]
Abstract
Disrupting the spread of clinically relevant antibiotic resistance genes (ARGs) is one of the key components for the success of the One Health strategy. While waste water treatment plants (WWTPs) represent a final control point for daily discharges of antibiotic resistance genes (ARGs) to the aquatic environment, a decentralized upstream monitoring of wastewater feeds of selected urban drainage areas for blaCTX-M32, blaCTX-M15, blaOXA48, blaCMY-2, mecA, blaNDM-1, blaKPC3, vanA, and mcr-1 representing clinically relevant ARGs has been performed. Besides hospitals, also retirement homes were found to be responsible for high levels of ARG discharges compared to housing area sewer systems. The monitoring combines qPCR-based quantifications, flow volume-based analyses, and multiple antibiotic resistance analyses of isolates. As result of the study, local actions at identified critical control points could help to prevent contaminations of larger volumes of wastewaters. This strategy will support a more cost-effective treatment compared to central actions at WWTPs, only. A polluter-pays principle should be applied by this monitoring strategy.
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Affiliation(s)
- Johannes Alexander
- Karlsruhe Institute of Technology (KIT), Institute of Functional Interfaces, Hermann-von-Helmholtz Platz 1, D-76344 Eggenstein-Leopoldshafen, Germany
| | - Norman Hembach
- Karlsruhe Institute of Technology (KIT), Institute of Functional Interfaces, Hermann-von-Helmholtz Platz 1, D-76344 Eggenstein-Leopoldshafen, Germany
| | - Thomas Schwartz
- Karlsruhe Institute of Technology (KIT), Institute of Functional Interfaces, Hermann-von-Helmholtz Platz 1, D-76344 Eggenstein-Leopoldshafen, Germany.
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52
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Teixeira P, Tacão M, Henriques I. Occurrence and distribution of Carbapenem-resistant Enterobacterales and carbapenemase genes along a highly polluted hydrographic basin. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 300:118958. [PMID: 35131334 DOI: 10.1016/j.envpol.2022.118958] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
We determined the distribution and temporal variation of Carbapenem Resistant Enterobacterales (CRE), carbapenemase-encoding genes and other antibiotic resistance genes (ARGs) in a highly polluted river (Lis River; Portugal), also assessing the potential influence of water quality to this distribution. Water samples were collected in two sampling campaigns performed one year apart (2018/2019) from fifteen sites and water quality was analyzed. CRE were isolated and characterized. The abundance of four ARGs (blaNDM, blaKPC, tetA, blaCTX-M), two Microbial Source Tracking (MST) indicators (HF183 and Pig-2-Bac) and the class 1 integrase gene (IntI1) was measured by qPCR. RESULTS: confirmed the poor quality of the Lis River water, particularly in sites near pig farms. A collection of 23 CRE was obtained: Klebsiella (n = 19), Enterobacter (n = 2) and Raoultella (n = 2). PFGE analysis revealed a clonal relationship between isolates obtained in different sampling years and sites. All CRE isolates exhibited multidrug resistance profiles. Klebsiella and Raoultella isolates carried blaKPC while Enterobacter harbored blaNDM. Conjugation experiments were successful for only four Klebsiella isolates. All ARGs were detected by qPCR on both sampling campaigns. An increase in ARGs and IntI1 abundances was detected in sites located downstream of wastewater treatment plants. Strong correlations were observed between blaCTX-M, IntI1 and the human-pollution marker HF183, and also between tetA and the pig-pollution marker Pig-2-bac, suggesting that both human- and animal-derived pollution in the Lis River are a potential source of ARGs. Plus, water quality parameters related to eutrophication and land use were significantly correlated with ARGs abundances. Our findings demonstrated that the Lis River encloses high levels of antibiotic resistant bacteria and ARGs, including CRE and carbapenemase-encoding genes. Overall, this study provides a better understanding on the impacts of water pollution resulting from human and animal activities on the resistome of natural aquatic systems.
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Affiliation(s)
- Pedro Teixeira
- Biology Department and CESAM (Centre for Marine and Environmental Studies), University of Aveiro, Aveiro, Portugal, University of Aveiro, Aveiro, Portugal
| | - Marta Tacão
- Biology Department and CESAM (Centre for Marine and Environmental Studies), University of Aveiro, Aveiro, Portugal, University of Aveiro, Aveiro, Portugal.
| | - Isabel Henriques
- University of Coimbra, Centre for Functional Ecology and Department of Life Sciences, Faculty of Science and Technology, Coimbra, Portugal
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Teban-Man A, Szekeres E, Fang P, Klümper U, Hegedus A, Baricz A, Berendonk TU, Pârvu M, Coman C. Municipal Wastewaters Carry Important Carbapenemase Genes Independent of Hospital Input and Can Mirror Clinical Resistance Patterns. Microbiol Spectr 2022; 10:e0271121. [PMID: 35234513 PMCID: PMC8941857 DOI: 10.1128/spectrum.02711-21] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/01/2022] [Indexed: 12/31/2022] Open
Abstract
The spatiotemporal variation of several carbapenemase-encoding genes (CRGs) was investigated in the influent and effluent of municipal WWTPs, with or without hospital sewage input. Correlations among gene abundances, bacterial community composition, and wastewater quality parameters were tested to identify possible predictors of CRGs presence. Also, the possible role of wastewaters in mirroring clinical resistance is discussed. The taxonomic groups and gene abundances showed an even distribution among wastewater types, meaning that hospital sewage does not influence the microbial diversity and the CRG pool. The bacterial community was composed mainly of Proteobacteria, Firmicutes, Actinobacteria, Patescibacteria, and Bacteroidetes. Acinetobacter spp. was the most abundant group and had the majority of operational taxonomic units (OTUs) positively correlated with CRGs. This agrees with recent reports on clinical data. The influent samples were dominated by blaKPC, as opposed to effluent, where blaIMP was dominant. Also, blaIMP was the most frequent CRG family observed to correlate with bacterial taxa, especially with the Mycobacterium genus in effluent samples. Bacterial load, blaNDM, blaKPC, and blaOXA-48 abundances were positively correlated with BOD5, TSS, HEM, Cr, Cu, and Fe concentrations in wastewaters. When influent gene abundance values were converted into population equivalent (PE) data, the highest copies/1 PE were identified for blaKPC and blaOXA-48, agreeing with previous studies regarding clinical isolates. Both hospital and non-hospital-type samples followed a similar temporal trend of CRG incidence, but with differences among gene groups. Colder seasons favored the presence of blaNDM, blaKPC and blaOXA-48, whereas warmer temperatures show increased PE values for blaVIM and blaIMP. IMPORTANCE Wastewater-based epidemiology has recently been recognized as a valuable, cost-effective tool for antimicrobial resistance surveillance. It can help gain insights into the characteristics and distribution of antibiotic resistance elements at a local, national, and even global scale. In this study, we investigated the possible use of municipal wastewaters in the surveillance of clinically relevant carbapenemase-encoding genes (CRGs), seen as critical antibiotic resistance determinants. In this matter, our results highlight positive correlations among CRGs, microbial diversity, and wastewater physical and chemical parameters. Identified predictors can provide valuable data regarding the level of raw and treated wastewater contamination with these important antibiotic resistance genes. Also, wastewater-based gene abundances were used for the first time to observe possible spatiotemporal trends of CRGs incidence in the general population. Therefore, possible hot spots of carbapenem resistance could be easily identified at the community level, surpassing the limitations of health care-associated settings.
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Affiliation(s)
- Adela Teban-Man
- Department of Taxonomy and Ecology, Faculty of Biology and Geology, Babeș-Bolyai University, Cluj-Napoca, Romania
- Department of Taxonomy and Ecology, Institute of Biological Research, Branch of NIRDBS, Cluj-Napoca, Romania
| | - Edina Szekeres
- Department of Taxonomy and Ecology, Institute of Biological Research, Branch of NIRDBS, Cluj-Napoca, Romania
| | - Peiju Fang
- Technische Universität Dresden, Institute of Hydrobiology, Dresden, Germany
| | - Uli Klümper
- Technische Universität Dresden, Institute of Hydrobiology, Dresden, Germany
| | - Adriana Hegedus
- Department of Taxonomy and Ecology, Institute of Biological Research, Branch of NIRDBS, Cluj-Napoca, Romania
| | - Andreea Baricz
- Department of Taxonomy and Ecology, Institute of Biological Research, Branch of NIRDBS, Cluj-Napoca, Romania
| | | | - Marcel Pârvu
- Department of Taxonomy and Ecology, Faculty of Biology and Geology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Cristian Coman
- Department of Taxonomy and Ecology, Institute of Biological Research, Branch of NIRDBS, Cluj-Napoca, Romania
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54
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Paruch L. Molecular Diagnostic Tools Applied for Assessing Microbial Water Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5128. [PMID: 35564522 PMCID: PMC9105083 DOI: 10.3390/ijerph19095128] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/16/2022]
Abstract
Microbial water quality is of vital importance for human, animal, and environmental health. Notably, pathogenically contaminated water can result in serious health problems, such as waterborne outbreaks, which have caused huge economic and social losses. In this context, the prompt detection of microbial contamination becomes essential to enable early warning and timely reaction with proper interventions. Recently, molecular diagnostics have been increasingly employed for the rapid and robust assessment of microbial water quality implicated by various microbial pollutants, e.g., waterborne pathogens and antibiotic-resistance genes (ARGs), imposing the most critical health threats to humans and the environment. Continuous technological advances have led to constant improvements and expansions of molecular methods, such as conventional end-point PCR, DNA microarray, real-time quantitative PCR (qPCR), multiplex qPCR (mqPCR), loop-mediated isothermal amplification (LAMP), digital droplet PCR (ddPCR), and high-throughput next-generation DNA sequencing (HT-NGS). These state-of-the-art molecular approaches largely facilitate the surveillance of microbial water quality in diverse aquatic systems and wastewater. This review provides an up-to-date overview of the advancement of the key molecular tools frequently employed for microbial water quality assessment, with future perspectives on their applications.
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Affiliation(s)
- Lisa Paruch
- Division of Environment and Natural Resources, Norwegian Institute of Bioeconomy Research-NIBIO Oluf Thesens vei 43, 1433 Aas, Norway
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55
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Zhang C, Zhao X, Wang C, Hakizimana I, Crittenden JC, Laghari AA. Electrochemical flow-through disinfection reduces antibiotic resistance genes and horizontal transfer risk across bacterial species. WATER RESEARCH 2022; 212:118090. [PMID: 35085844 DOI: 10.1016/j.watres.2022.118090] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 01/08/2022] [Accepted: 01/15/2022] [Indexed: 06/14/2023]
Abstract
Antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs), as emerging pollutants, are released into environment, increasing the risk of horizontal gene transfer (HGT). However, a limited number of studies quantified the effects of ARB disinfection on the HGT risk. This study investigated the inactivation of E. coli 10667 (sul) and the release and removal of ARGs using an electrochemical flow-through reactor (EFTR). Furthermore, the transfer frequencies and potential mechanisms of HGT after disinfection were explored using non-resistant E. coli GMCC 13373 as the recipient and E. coli DH5α carrying plasmid RP4 as the donor. A threshold of current density (0.25 mA/cm2) was observed to destroy cells and release intracellular ARGs (iARGs) to increase extracellular ARGs (eARGs) concentration. The further increase in the current density to 1 mA/cm2 resulted in the decline of eARGs concentration due to the higher degradation rate of eARGs than the release rate of iARGs. The performance of ARGs degradation and HGT frequency by EFTR were compared with those of conventional disinfection processes, including chlorination and ultraviolet radiation (UV). A higher ARGs degradation (83.46%) was observed by EFTR compared with that under chlorination (10.23%) and UV (27.07%). Accordingly, EFTR reduced the HGT frequency (0.69) of released ARGs into the recipient (Forward transfer), and the value was lower than that by chlorination (2.69) and UV (1.73). Meanwhile, the surviving injured E. coli 10667 (sul) with increased cell permeability was transferred by plasmid RP4 from the donor (Reverse transfer) with a higher frequency of 0.33 by EFTR compared with that under chlorination (0.26) and UV (0.16). In addition, the sul3 gene was the least resistant to EFTR than sul1 and sul2 gene. These findings provide important insights into the mechanism of HGT between the injured E. coli 10667 (sul) and environmental bacteria. EFTR is a promising disinfection technology for preventing the spread of antibiotic resistance.
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Affiliation(s)
- Cong Zhang
- School of Environmental Science and Engineering, Tianjin University, Tianjin, 300350, China
| | - Xin Zhao
- School of Environmental Science and Engineering, Tianjin University, Tianjin, 300350, China.
| | - Can Wang
- School of Environmental Science and Engineering, Tianjin University, Tianjin, 300350, China.
| | - Israel Hakizimana
- School of Environmental Science and Engineering, Tianjin University, Tianjin, 300350, China
| | - John C Crittenden
- Brook Byers Institute of Sustainable Systems, School of Civil and Environmental Engineering, Georgia Institute of Technology, Atlanta, GA 30332, United States
| | - Azhar Ali Laghari
- School of Environmental Science and Engineering, Tianjin University, Tianjin, 300350, China
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56
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Azuma T, Nakano T, Koizumi R, Matsunaga N, Ohmagari N, Hayashi T. Evaluation of the Correspondence between the Concentration of Antimicrobials Entering Sewage Treatment Plant Influent and the Predicted Concentration of Antimicrobials Using Annual Sales, Shipping, and Prescriptions Data. Antibiotics (Basel) 2022; 11:472. [PMID: 35453223 PMCID: PMC9027251 DOI: 10.3390/antibiotics11040472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 02/05/2023] Open
Abstract
The accuracy and correspondence between the measured concentrations from the survey and predicted concentrations on the basis of the three types of statistical antimicrobial use in Japan was evaluated. A monitoring survey of ten representative antimicrobials: ampicillin (APL), cefdinir (CDN), cefpodoxime proxetil (CPXP), ciprofloxacin (CFX), clarithromycin (CTM), doxycycline (DCL), levofloxacin (LFX), minocycline (MCL), tetracycline (TCL), and vancomycin (VMC), in the influent of sewage treatment plant (STP) located in urban areas of Japan, was conducted. Then, the measured values were verified in comparison with the predicted values estimated from the shipping volumes, sales volumes, and prescription volumes based on the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB). The results indicate that the correspondence ratios between the predicted concentrations calculated on the basis of shipping and NDB volumes and the measured concentrations (predicted concentration/measured concentration) generally agreed for the detected concentration of antimicrobials in the STP influent. The correspondence ratio on the basis of shipping volume was, for CFX, 0.1; CTM, 2.9; LFX, 0.5; MCL, 1.9; and VMC, 1.7, and on the basis of NDB volume the measured concentration was CFX, 0.1; CTM, 3.7; DCL, 0.4; LFX, 0.7; MCL, 1.9; TCL, 0.6; and VMC, 1.6. To our knowledge, this is the first report to evaluate the accuracy of predicted concentrations based on sales, shipping, NDB statistics and measured concentrations for antimicrobials in the STP influent.
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Affiliation(s)
- Takashi Azuma
- Department of Environment and Health Sciences, Faculty of Pharmacy, Osaka Medical and Pharmaceutical University, Takatsuki 569-1094, Japan;
| | - Takashi Nakano
- Department of Microbiology and Infection Control, Faculty of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan;
| | - Ryuji Koizumi
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (R.K.); (N.M.); (N.O.)
| | - Nobuaki Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (R.K.); (N.M.); (N.O.)
| | - Norio Ohmagari
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (R.K.); (N.M.); (N.O.)
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Tetsuya Hayashi
- Department of Environment and Health Sciences, Faculty of Pharmacy, Osaka Medical and Pharmaceutical University, Takatsuki 569-1094, Japan;
- Department of Food and Nutrition Management Studies, Faculty of Human Development, Soai University, Osaka 559-0033, Japan
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57
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Cai M, Wang Z, Gu H, Dong H, Zhang X, Cui N, Zhou L, Chen G, Zou G. Occurrence and temporal variation of antibiotics and antibiotic resistance genes in hospital inpatient department wastewater: Impacts of daily schedule of inpatients and wastewater treatment process. CHEMOSPHERE 2022; 292:133405. [PMID: 34958787 DOI: 10.1016/j.chemosphere.2021.133405] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/15/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
The temporal variation of antibiotics and ARGs as well as the impact of daily schedule of inpatients on their regular occurrence in hospital wastewater (HWW) were previously obscure. In this study, the wastewater of the inpatient department pre- and posttreatment (hydraulic retention time = 8 h) was collected intraday and intraweek. The absolute concentrations of antibiotics/metabolites and ARGs in HWW were analyzed to investigate the temporal variations of their occurrence levels. Fluoroquinolones were the predominant drugs used in the inpatient department (681.30-881.66 ng/mL in the effluent) and the main contaminant in the outlet of the disinfection pond (538.29-671.47 ng/mL). Diurnal variations peaked at 19:00 for most antibiotics and ARGs, while the maximum of them occurred on weekends. Aminoglycoside resistance genes (AMRGs, 21.6-23000 copies/mL) and β-lactam resistance genes (BLGRs, 1.24-8500 copies/mL) were the dominant ARGs before and after treatment processing, respectively (p < 0.05). The significant removal rates (>50%) of most antibiotics and ARGs, as well as the integrase gene intI1 and 16S rRNA gene, were found to be subjected solely to the chloride disinfection process, suggesting the necessity of the self-contained wastewater treatment process. Meanwhile, the statistically significant correlation among antibiotics, ARGs, intI1, and 16S rRNA (p < 0.05) demonstrated that the risk of selective pressure, horizontal transfer and vertical propagation of ARGs in the effluent of the hospital was warranted. Principal component analysis (PCA) showed that the daily schedule of inpatients and wastewater treatment processes could markedly induce fluctuations in antibiotic and ARG levels in HWW, indicating that they should be considered an impact factor for environmental monitoring. This study demonstrated for the first time the temporal variations in the abundance and dissemination of antibiotics and ARGs in a semiclosed zone and provided new insight into the development of assessments of the associated ecological risk and human health.
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Affiliation(s)
- Min Cai
- Eco-environmental Protection Research Institute, Shanghai Academy of Agricultural Science, Shanghai, 201403, PR China; Shanghai Engineering Research Center of Low-carbon Agriculture (SERCLA), Shanghai, 201415, PR China
| | - Zhenglu Wang
- College of Oceanography, Hohai University, Nanjing, Jiangsu, 210024, PR China.
| | - Haotian Gu
- Eco-environmental Protection Research Institute, Shanghai Academy of Agricultural Science, Shanghai, 201403, PR China
| | - Hui Dong
- Agro-food Standards and Testing Technology Institute, Shanghai Academy of Agricultural Science, Shanghai, 201403, PR China
| | - Xu Zhang
- Eco-environmental Protection Research Institute, Shanghai Academy of Agricultural Science, Shanghai, 201403, PR China; Shanghai Engineering Research Center of Low-carbon Agriculture (SERCLA), Shanghai, 201415, PR China
| | - Naxin Cui
- Eco-environmental Protection Research Institute, Shanghai Academy of Agricultural Science, Shanghai, 201403, PR China; Shanghai Engineering Research Center of Low-carbon Agriculture (SERCLA), Shanghai, 201415, PR China
| | - Li Zhou
- Eco-environmental Protection Research Institute, Shanghai Academy of Agricultural Science, Shanghai, 201403, PR China; Shanghai Engineering Research Center of Low-carbon Agriculture (SERCLA), Shanghai, 201415, PR China
| | - Guifa Chen
- Eco-environmental Protection Research Institute, Shanghai Academy of Agricultural Science, Shanghai, 201403, PR China; Shanghai Engineering Research Center of Low-carbon Agriculture (SERCLA), Shanghai, 201415, PR China
| | - Guoyan Zou
- Eco-environmental Protection Research Institute, Shanghai Academy of Agricultural Science, Shanghai, 201403, PR China; Shanghai Engineering Research Center of Low-carbon Agriculture (SERCLA), Shanghai, 201415, PR China.
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Foroughi M, Khiadani M, Kakhki S, Kholghi V, Naderi K, Yektay S. Effect of ozonation-based disinfection methods on the removal of antibiotic resistant bacteria and resistance genes (ARB/ARGs) in water and wastewater treatment: a systematic review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 811:151404. [PMID: 34767893 DOI: 10.1016/j.scitotenv.2021.151404] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/03/2021] [Accepted: 10/30/2021] [Indexed: 06/13/2023]
Abstract
Antibiotic resistance is considered a universal health threat of the 21st century which its distribution and even development are mainly mediated by water-based media. Disinfection processes with the conventional methods are still the most promising options to combat such crises in aqueous matrices especially wastewater. Knowing that the extent of effectiveness and quality of disinfection is of great importance, this paper aimed to systematically review and discuss ozonation (as one of the main disinfectants with large scale application) effect on removing antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) from aqueous solutions, for which no study has been reported. For this, a comprehensive literature survey was performed within the international databases using appropriate keywords which yielded several studies involving different aspects and the effectiveness extent of ozonation on ARB & ARGs. The results showed that no definite conclusion could be drawn about the superiority of ozone alone or in a hybrid form. Mechanism of action was carefully evaluated and discussed although it is still poorly understood. Evaluation of the studies from denaturation and repairment perspectives showed that regrowth cannot be avoided after ozonation, especially for some ARB & ARGs variants. In addition, the comparison of the effectiveness on ARB & ARGs showed that ozonation is more effective for resistant bacteria than their respective genes. The degradation efficiency was found to be mainly influenced by operational parameters of CT (i.e. ozone dose & contact time), solids, alkalinity, pH, and type of pathogens and genes. Moreover, the correlation between ARB & ARGs removal and stressors (such as antibiotic residuals, heavy metals, aromatic matters, microcystins, opportunistic pathogens, etc.) has been reviewed to give the optimal references for further in-depth studies. The future perspectives have also been reported.
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Affiliation(s)
- Maryam Foroughi
- Department of Environmental Health Engineering, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran; Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mehdi Khiadani
- Associate Dean (Research), School of Engineering, Edith Cowan University, Joondalup, Perth WA, Australia
| | - Samaneh Kakhki
- Department of Clinical Biochemistry, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
| | - Vahid Kholghi
- Department of Medical Biotechnology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran; Research Center of Advanced Technologies in Medicine, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | | | - Sama Yektay
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
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59
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Kehl K, Schallenberg A, Szekat C, Albert C, Sib E, Exner M, Zacharias N, Schreiber C, Parčina M, Bierbaum G. Dissemination of carbapenem resistant bacteria from hospital wastewater into the environment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:151339. [PMID: 34740643 DOI: 10.1016/j.scitotenv.2021.151339] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
Infections with antibiotic resistant pathogens threaten lives and cause substantial costs. For effective interventions, knowledge of the transmission paths of resistant bacteria to humans is essential. In this study, carbapenem resistant bacteria were isolated from the wastewater of a maximum care hospital during a period of two years, starting in the patient rooms and following the sewer system to the effluent of the wastewater treatment plant (WWTP). The bacteria belonged to six different species and 44 different sequence types (STs). The most frequent STs, ST147 K. pneumoniae (blaNDM/blaOXA-48) and ST235 P. aeruginosa (blaVIM) strains, were present at nearly all sampling sites from the hospital to the WWTP effluent. After core genome multi-locus sequence typing (cgMLST), all ST147 K. pneumoniae strains presented a single epidemiological cluster. In contrast, ST235 P. aeruginosa formed five cgMLST clusters and the largest cluster contained the strain from the WWTP effluent, indicating without doubt, a direct dissemination of both high-risk clones into the environment. Thus, there are - at least two - possible transmission pathways to humans, (i) within the hospital by contact with the drains of the sanitary installations and (ii) by recreational or irrigation use of surface waters that have received WWTP effluent. In conclusion, remediation measures must be installed at both ends of the wastewater system, targeting the drains of the hospital as well as at the effluent of the WWTP.
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Affiliation(s)
- Katja Kehl
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Anja Schallenberg
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Christiane Szekat
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Cathrin Albert
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Esther Sib
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Martin Exner
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
| | - Nicole Zacharias
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
| | - Christiane Schreiber
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
| | - Marjio Parčina
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - Gabriele Bierbaum
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany.
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60
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Silva V, Ribeiro J, Rocha J, Manaia CM, Silva A, Pereira JE, Maltez L, Capelo JL, Igrejas G, Poeta P. High Frequency of the EMRSA-15 Clone (ST22-MRSA-IV) in Hospital Wastewater. Microorganisms 2022; 10:147. [PMID: 35056595 PMCID: PMC8780076 DOI: 10.3390/microorganisms10010147] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 12/29/2021] [Accepted: 01/05/2022] [Indexed: 12/07/2022] Open
Abstract
Hospital wastewaters often carry multidrug-resistant bacteria and priority pathogens, such as methicillin-resistant Staphylococcus aureus (MRSA). Pathogens and antibiotic resistance genes present in wastewaters may reach the natural environment facilitating their spread. Thus, we aimed to isolate MRSA from wastewater of 3 hospitals located in the north of Portugal and to characterize the isolates regarding the antimicrobial resistance and genetic lineages. A total of 96 wastewater samples were collected over six months. The water was filtered, and the filtration membrane was immersed in BHI broth supplemented with 6.5% of NaCl and incubated. The inoculum was streaked in ORSAB agar plates for MRSA isolation. The isolates susceptibility testing was performed against 14 antimicrobial agents. The presence of resistance and virulence genes was accessed by PCR. Molecular typing was performed in all isolates. From the 96 samples, 28 (29.2%) were MRSA-positive. Most isolates had a multidrug-resistant profile and carried the mecA, blaZ, aac(6')-Ie-aph(2″)-Ia, aph(3')-IIIa, ermA, ermB, ermC, tetL, tetM, dfrA dfrG and catpC221 genes. Most of the isolates were ascribed to the immune evasion cluster (IEC) type B. The isolates belonged to ST22-IV, ST8-IV and ST105-II and spa-types t747, t1302, t19963, t6966, t020, t008 and tOur study shows that MRSA can be found over time in hospital wastewater. The wastewater treatment processes can reduce the MRSA load. The great majority of the isolates belonged to ST22 and spa-type t747 which suggests the fitness of these genetic lineages in hospital effluents.
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Affiliation(s)
- Vanessa Silva
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (V.S.); (J.R.); (A.S.); (J.E.P.); (L.M.)
- Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal;
- Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal
- Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, 1099-085 Lisboa, Caparica, Portugal
| | - Jessica Ribeiro
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (V.S.); (J.R.); (A.S.); (J.E.P.); (L.M.)
- Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal;
- Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal
| | - Jaqueline Rocha
- CBQF—Centro de Biotecnologia e Química Fina—Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal; (J.R.); (C.M.M.)
| | - Célia M. Manaia
- CBQF—Centro de Biotecnologia e Química Fina—Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal; (J.R.); (C.M.M.)
| | - Adriana Silva
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (V.S.); (J.R.); (A.S.); (J.E.P.); (L.M.)
- Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal;
- Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal
- Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, 1099-085 Lisboa, Caparica, Portugal
| | - José Eduardo Pereira
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (V.S.); (J.R.); (A.S.); (J.E.P.); (L.M.)
- Veterinary and Animal Research Centre, Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal
| | - Luís Maltez
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (V.S.); (J.R.); (A.S.); (J.E.P.); (L.M.)
- Veterinary and Animal Research Centre, Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal
| | - José Luis Capelo
- BIOSCOPE Group, LAQV@REQUIMTE, Chemistry Department, Faculty of Science and Technology, NOVA University of Lisbon, 2825-466 Almada, Portugal;
- Proteomass Scientific Society, Costa de Caparica, 2825-466 Setubal, Portugal
| | - Gilberto Igrejas
- Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal;
- Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal
- Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, 1099-085 Lisboa, Caparica, Portugal
| | - Patrícia Poeta
- Microbiology and Antibiotic Resistance Team (MicroART), Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (V.S.); (J.R.); (A.S.); (J.E.P.); (L.M.)
- Associated Laboratory for Green Chemistry (LAQV-REQUIMTE), University NOVA of Lisboa, 1099-085 Lisboa, Caparica, Portugal
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Katagiri M, Kuroda M, Sekizuka T, Nakada N, Ito Y, Otsuka M, Watanabe M, Kusachi S. Comprehensive Genomic Survey of Antimicrobial-Resistance Bacteria in the Sewage Tank Replacement with Hospital Relocation. Infect Drug Resist 2022; 14:5563-5574. [PMID: 34984011 PMCID: PMC8709547 DOI: 10.2147/idr.s336418] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/18/2021] [Indexed: 12/31/2022] Open
Abstract
Background Excrement containing antimicrobial-resistant bacteria (ARB) is discharged from the hospital sewage through wastewater treatment plants (WWTP) into rivers, increasing the antimicrobial resistance (AMR) burden on the environment. Purpose We illustrate the contamination of hospital sewage tanks with ARB harboring antimicrobial resistance genes (ARGs) using comprehensive metagenomic sequencing. During the study period, we moved to a new hospital building constructed for renovation. Therefore, we investigated the difference in bacterial flora in the sewage tanks for each building with different departments, and the change in bacterial flora over time in new sewage tanks. Furthermore, we performed a comparative genome analysis of extended spectrum β-lactamase (ESBL)-producing organisms (EPOs) from hospital sewage and clinical samples. Residual antibiotics in the sewage tank were also measured. Methods Metagenomic analysis was performed on the hospital sewage samples, followed by whole genome sequencing of EPOs. Results The bacterial composition of new sewage tanks was comparable with that of old tanks within 1 month after relocation and was instantly affected by excrement. The bacterial composition of sewage tanks in the old and new buildings, containing rooms where seriously ill patients were treated, was similar. Selection on CHROMagar ESBL allowed detection of EPOs harboring blaCTX-M and carbapenemase genes in all sewage tanks. One of the sewage Escherichia coli strain comprising ST393 harboring blaCTX-M-27 corresponded to the clinical isolates based on core genome analysis. Moreover, the levels of levofloxacin and clarithromycin in the hospital sewage were 0.0325 and 0.0135 µg/mL, respectively. Conclusion Hospital sewage was contaminated with many ARB species, ARGs and residual antibiotics, which can cause a burden on WWTP sewage treatment. The bacterial flora in the sewage tank was rapidly affected, especially by the ward with seriously ill patients. AMR monitoring of hospital sewage may help detect carriers prior to nosocomial ARB-associated outbreaks and control the outbreaks.
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Affiliation(s)
- Miwa Katagiri
- Department of Surgery, Toho University Ohashi Medical Center, Meguro-ku, Tokyo, Japan.,Laboratory of Bacterial Genomics, Pathogen Genomics Center, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Makoto Kuroda
- Laboratory of Bacterial Genomics, Pathogen Genomics Center, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Tsuyoshi Sekizuka
- Laboratory of Bacterial Genomics, Pathogen Genomics Center, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Norihide Nakada
- Research Center for Environmental Quality Management, Graduate School of Engineering, Kyoto University, Otsu-shi, Shiga, Japan
| | - Yukitaka Ito
- Division of Clinical Microbiology Laboratory, Toho University Ohashi Medical Center, Meguro-ku, Tokyo, Japan
| | - Masanobu Otsuka
- Division of Clinical Microbiology Laboratory, Toho University Ohashi Medical Center, Meguro-ku, Tokyo, Japan
| | - Manabu Watanabe
- Department of Surgery, Toho University Ohashi Medical Center, Meguro-ku, Tokyo, Japan
| | - Shinya Kusachi
- Department of Surgery, Toho University Ohashi Medical Center, Meguro-ku, Tokyo, Japan
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Castanheira B, Otubo L, Oliveira CLP, Montes R, Quintana JB, Rodil R, Brochsztain S, Vilar VJP, Teixeira ACSC. Functionalized mesoporous silicas SBA-15 for heterogeneous photocatalysis towards CECs removal from secondary urban wastewater. CHEMOSPHERE 2022; 287:132023. [PMID: 34461335 DOI: 10.1016/j.chemosphere.2021.132023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/15/2021] [Accepted: 08/24/2021] [Indexed: 06/13/2023]
Abstract
The photocatalytic activity of TiO2 nanoparticles (NPs) supported on mesoporous silica SBA-15 (TiO2/SBA-15) was evaluated for the photodegradation of sulfadiazine (SDZ), as target contaminant of emerging concern (CEC), using either pure water solutions (PW) or a real secondary urban wastewater (UWW) spiked with SDZ. For this purpose, TiO2/SBA-15 samples with 10, 20 and 30% TiO2 (w/w) were prepared by the sol-gel post synthetic method on pre-formed SBA-15, using titanium (IV) isopropoxide as a precursor. The TiO2/SBA-15 materials were characterized by HRTEM, SAXS and XRD, nitrogen adsorption isotherms and UV-vis diffuse reflectance spectroscopy. TiO2 NPs were shown to be attached onto the external surface, decorating the SBA-15 particles. The TiO2/SBA-15 catalysts were active in SDZ photodegradation using the annular FluHelik photoreactor, when irradiated with UVA light. The 30% TiO2/SBA-15 sample presented the best performance in optimization tests performed using PW, and it was further used for the tests with UWW. The photocatalytic activity of 30% TiO2/SBA-15 was higher (56% SDZ degradation) than that of standard TiO2-P25 (32% SDZ degradation) in the removal of SDZ spiked in the UWW ([SDZ] = 2 mg L-1). The photodegradation of SDZ with 30% TiO2/SBA-15 eached 90% for UWW spiked with a lower SDZ concentration ([SDZ] = 40 μg L-1). Aside of SDZ, a suit of 65 other CECs were also identified in the UWW sample using LC-MS spectrometry. A fast-screening test showed the heterogeneous photocatalytic system was able to remove most of the detected CECs from UWW, by either adsorption and/or photocatalysis.
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Affiliation(s)
- Bruna Castanheira
- Research Group in Advanced Oxidation Processes (AdOx), Chemical Systems Engineering Center, Department of Chemical Engineering, Escola Politécnica, University of São Paulo, Av. Prof. Luciano Gualberto, tr. 3, 380, São Paulo, SP, Brazil
| | - Larissa Otubo
- Nuclear and Energy Research Institute (IPEN), Av. Prof. Lineu Prestes, 2242, 05508-000, São Paulo, SP, Brazil
| | - Cristiano L P Oliveira
- Institute of Physics, University of São Paulo, Rua do Matão 1371, 05508-090, São Paulo, SP, Brazil
| | - Rosa Montes
- Department of Analytical Chemistry, Nutrition and Food Sciences, Institute of Research on Chemical and Biological Analysis (IAQBUS), Universidade de Santiago de Compostela, Constantino Candeira S/N, 15782, Santiago de Compostela, Spain
| | - José Benito Quintana
- Department of Analytical Chemistry, Nutrition and Food Sciences, Institute of Research on Chemical and Biological Analysis (IAQBUS), Universidade de Santiago de Compostela, Constantino Candeira S/N, 15782, Santiago de Compostela, Spain
| | - Rosario Rodil
- Department of Analytical Chemistry, Nutrition and Food Sciences, Institute of Research on Chemical and Biological Analysis (IAQBUS), Universidade de Santiago de Compostela, Constantino Candeira S/N, 15782, Santiago de Compostela, Spain
| | - Sergio Brochsztain
- Federal University of ABC, Av. dos Estados, 5001, 09210-580, Santo André, SP, Brazil
| | - Vítor J P Vilar
- Laboratory of Separation and Reaction Engineering-Laboratory of Catalysis and Materials (LSRE-LCM), Department of Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465, Porto, Portugal.
| | - Antonio Carlos S C Teixeira
- Research Group in Advanced Oxidation Processes (AdOx), Chemical Systems Engineering Center, Department of Chemical Engineering, Escola Politécnica, University of São Paulo, Av. Prof. Luciano Gualberto, tr. 3, 380, São Paulo, SP, Brazil.
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Li D, Li H, Long M, Bai X, Zhao Q, Wen Q, Song F. Synergetic effect of photocatalysis and peroxymonosulfate activated by MIL-53Fe@TiO2 for efficient degradation of tetracycline hydrochloride under visible light irradiation. CrystEngComm 2022. [DOI: 10.1039/d2ce00372d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The MIL-53Fe was prepared by simple solvothermal method, and the MIL-53Fe photocatalysts showed lower photocatalytic activity for the degradation of tetracycline hydrochloride under visible light irradiation. After combined with TiO2,...
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Aslam B, Khurshid M, Arshad MI, Muzammil S, Rasool M, Yasmeen N, Shah T, Chaudhry TH, Rasool MH, Shahid A, Xueshan X, Baloch Z. Antibiotic Resistance: One Health One World Outlook. Front Cell Infect Microbiol 2021; 11:771510. [PMID: 34900756 PMCID: PMC8656695 DOI: 10.3389/fcimb.2021.771510] [Citation(s) in RCA: 175] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/29/2021] [Indexed: 01/07/2023] Open
Abstract
Antibiotic resistance (ABR) is a growing public health concern worldwide, and it is now regarded as a critical One Health issue. One Health’s interconnected domains contribute to the emergence, evolution, and spread of antibiotic-resistant microorganisms on a local and global scale, which is a significant risk factor for global health. The persistence and spread of resistant microbial species, and the association of determinants at the human-animal-environment interface can alter microbial genomes, resulting in resistant superbugs in various niches. ABR is motivated by a well-established link between three domains: human, animal, and environmental health. As a result, addressing ABR through the One Health approach makes sense. Several countries have implemented national action plans based on the One Health approach to combat antibiotic-resistant microbes, following the Tripartite’s Commitment Food and Agriculture Organization (FAO)-World Organization for Animal Health (OIE)-World Health Organization (WHO) guidelines. The ABR has been identified as a global health concern, and efforts are being made to mitigate this global health threat. To summarize, global interdisciplinary and unified approaches based on One Health principles are required to limit the ABR dissemination cycle, raise awareness and education about antibiotic use, and promote policy, advocacy, and antimicrobial stewardship.
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Affiliation(s)
- Bilal Aslam
- Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Mohsin Khurshid
- Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan
| | | | - Saima Muzammil
- Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Maria Rasool
- Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Nafeesa Yasmeen
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Taif Shah
- Faculty of Life Science and Technology, Kunming University of Life Science and Technology, Kunming, China
| | - Tamoor Hamid Chaudhry
- Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan.,Public Health Laboratories Division, National Institute of Health, Islamabad, Pakistan
| | | | - Aqsa Shahid
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Faisalabad, Pakistan
| | - Xia Xueshan
- Faculty of Life Science and Technology, Kunming University of Life Science and Technology, Kunming, China
| | - Zulqarnain Baloch
- Faculty of Life Science and Technology, Kunming University of Life Science and Technology, Kunming, China
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Lovšin Ž, Klančnik A, Kotnik T. Electroporation as an Efficacy Potentiator for Antibiotics With Different Target Sites. Front Microbiol 2021; 12:722232. [PMID: 34733244 PMCID: PMC8558673 DOI: 10.3389/fmicb.2021.722232] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/29/2021] [Indexed: 01/21/2023] Open
Abstract
Antibiotic resistance is a global health threat, and there is ample motivation for development of novel antibacterial approaches combining multiple strategies. Electroporation is among the promising complementary techniques – highly optimizable, effective against a broad range of bacteria, and largely impervious to development of resistance. To date, most studies investigating electroporation as an efficacy potentiator for antibacterials used substances permissible in food industry, and only few used clinical antibiotics, as acceptable applications are largely limited to treatment of wastewaters inherently contaminated with such antibiotics. Moreover, most studies have focused mainly on maximal achievable effect, and less on underlying mechanisms. Here, we compare Escherichia coli inactivation potentiation rates for three antibiotics with different modes of action: ampicillin (inhibits cell wall synthesis), ciprofloxacin (inhibits DNA replication), and tetracycline (inhibits protein synthesis). We used concentrations for each antibiotic from 0 to 30× its minimum inhibitory concentration, a single 1-ms electric pulse with amplitude from 0 to 20 kV/cm, and post-pulse pre-dilution incubation either absent (≲1 min) or lasting 60 min, 160 min, or 24 h. Our data show that with incubation, potentiation is significant for all three antibiotics, increases consistently with pulse amplitude, and generally also with antibiotic concentration and incubation time. With incubation, potentiation for ampicillin was rather consistently (although with weak statistical significance) superior to both ciprofloxacin and tetracycline: ampicillin was superior to both in 42 of 48 data points, including 7 with significance with respect to both, while at 60- and 160-min incubation, it was superior in 31 of 32 data points, including 6 with significance with respect to both. This suggests that electroporation potentiates wall-targeting antibiotics more than those with intracellular targets, providing motivation for in-depth studies of the relationship between the mode of action of an antibiotic and its potentiation by electroporation. Identification of substances permissible in foods and targeting the cell wall of both Gram-negative and Gram-positive bacteria might provide candidate antibacterials for broad and strong potentiation by electroporation applicable also for food preservation.
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Affiliation(s)
- Žana Lovšin
- Faculty of Electrical Engineering, University of Ljubljana, Ljubljana, Slovenia
| | - Anja Klančnik
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Tadej Kotnik
- Faculty of Electrical Engineering, University of Ljubljana, Ljubljana, Slovenia
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McCubbin KD, Anholt RM, de Jong E, Ida JA, Nóbrega DB, Kastelic JP, Conly JM, Götte M, McAllister TA, Orsel K, Lewis I, Jackson L, Plastow G, Wieden HJ, McCoy K, Leslie M, Robinson JL, Hardcastle L, Hollis A, Ashbolt NJ, Checkley S, Tyrrell GJ, Buret AG, Rennert-May E, Goddard E, Otto SJG, Barkema HW. Knowledge Gaps in the Understanding of Antimicrobial Resistance in Canada. Front Public Health 2021; 9:726484. [PMID: 34778169 PMCID: PMC8582488 DOI: 10.3389/fpubh.2021.726484] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/16/2021] [Indexed: 01/21/2023] Open
Abstract
Current limitations in the understanding and control of antimicrobial resistance (AMR) in Canada are described through a comprehensive review focusing on: (1) treatment optimization; (2) surveillance of antimicrobial use and AMR; and (3) prevention of transmission of AMR. Without addressing gaps in identified areas, sustained progress in AMR mitigation is unlikely. Expert opinions and perspectives contributed to prioritizing identified gaps. Using Canada as an example, this review emphasizes the importance and necessity of a One Health approach for understanding and mitigating AMR. Specifically, antimicrobial use in human, animal, crop, and environmental sectors cannot be regarded as independent; therefore, a One Health approach is needed in AMR research and understanding, current surveillance efforts, and policy. Discussions regarding addressing described knowledge gaps are separated into four categories: (1) further research; (2) increased capacity/resources; (3) increased prescriber/end-user knowledge; and (4) policy development/enforcement. This review highlights the research and increased capacity and resources to generate new knowledge and implement recommendations needed to address all identified gaps, including economic, social, and environmental considerations. More prescriber/end-user knowledge and policy development/enforcement are needed, but must be informed by realistic recommendations, with input from all relevant stakeholders. For most knowledge gaps, important next steps are uncertain. In conclusion, identified knowledge gaps underlined the need for AMR policy decisions to be considered in a One Health framework, while highlighting critical needs to achieve realistic and meaningful progress.
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Affiliation(s)
- Kayley D. McCubbin
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
| | | | - Ellen de Jong
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
| | - Jennifer A. Ida
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Diego B. Nóbrega
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - John P. Kastelic
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - John M. Conly
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
- Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Calgary, AB, Canada
| | - Matthias Götte
- Department of Medical Microbiology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Tim A. McAllister
- Agriculture and Agri-Food Canada, Lethbridge Research Centre, Lethbridge, AB, Canada
| | - Karin Orsel
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
| | - Ian Lewis
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, AB, Canada
| | - Leland Jackson
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, AB, Canada
| | - Graham Plastow
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, AB, Canada
| | - Hans-Joachim Wieden
- Department of Chemistry and Biochemistry, University of Lethbridge, Lethbridge, AB, Canada
| | - Kathy McCoy
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Myles Leslie
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- School of Public Policy, University of Calgary, Calgary, AB, Canada
| | - Joan L. Robinson
- Department of Pediatrics, Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Lorian Hardcastle
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Faculty of Law, University of Calgary, Calgary, AB, Canada
| | - Aidan Hollis
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Department of Economics, Faculty of Arts, University of Calgary, Calgary, AB, Canada
| | - Nicholas J. Ashbolt
- Faculty of Science and Engineering, Southern Cross University, Lismore, NSW, Australia
| | - Sylvia Checkley
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Gregory J. Tyrrell
- Alberta Precision Laboratories, Alberta Health Services, Calgary, AB, Canada
- Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Calgary, AB, Canada
| | - André G. Buret
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
- Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, AB, Canada
| | - Elissa Rennert-May
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ellen Goddard
- Department of Resource Economics and Environmental Sociology, Faculty of Agriculture, Life and Environmental Science, University of Alberta, Edmonton, AB, Canada
| | - Simon J. G. Otto
- HEAT-AMR Research Group, School of Public Health, University of Alberta, Edmonton, AB, Canada
- Thematic Area Lead, Healthy Environments, Centre for Healthy Communities, School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Herman W. Barkema
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Gutiérrez M, Grillini V, Mutavdžić Pavlović D, Verlicchi P. Activated carbon coupled with advanced biological wastewater treatment: A review of the enhancement in micropollutant removal. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 790:148050. [PMID: 34091341 DOI: 10.1016/j.scitotenv.2021.148050] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 05/27/2023]
Abstract
This study consists of a review on the removal efficiencies of a wide spectrum of micropollutants (MPs) in biological treatment (mainly membrane bioreactor) coupled with activated carbon (AC) (AC added in the bioreactor or followed by an AC unit, acting as a post treatment). It focuses on how the presence of AC may promote the removal of MPs and the effects of dissolved organic matter (DOM) in wastewater. Removal data collected of MPs are analysed versus AC dose if powdered AC is added in the bioreactor, and as a function of the empty bed contact time in the case of a granular activated carbon (GAC) column acting as a post treatment. Moreover, the enhancement in macropollutant (organic matter, nitrogen and phosphorus compounds) removal is analysed as well as the AC mitigation effect towards membrane fouling and, finally, how sludge properties may change in the presence of AC. To sum up, it was found that AC improves the removal of most MPs, favouring their sorption on the AC surface, promoted by the presence of different functional groups and then enhancing their degradation processes. DOM is a strong competitor in sorption on the AC surface, but it may promote the transformation of GAC in a biologically activated carbon thus enhancing all the degradation processes. Finally, AC in the bioreactor increases sludge floc strength and improves its settling characteristics and sorption potential.
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Affiliation(s)
- Marina Gutiérrez
- Department of Engineering, University of Ferrara, Via Saragat 1, 44122 Ferrara, Italy.
| | - Vittoria Grillini
- Department of Engineering, University of Ferrara, Via Saragat 1, 44122 Ferrara, Italy.
| | - Dragana Mutavdžić Pavlović
- Department of Analytical Chemistry, Faculty of Chemical Engineering, University of Zagreb, Trg Marka Marulića 19, 10000 Zagreb, Croatia.
| | - Paola Verlicchi
- Department of Engineering, University of Ferrara, Via Saragat 1, 44122 Ferrara, Italy.
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68
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Magureanu M, Bilea F, Bradu C, Hong D. A review on non-thermal plasma treatment of water contaminated with antibiotics. JOURNAL OF HAZARDOUS MATERIALS 2021; 417:125481. [PMID: 33992019 DOI: 10.1016/j.jhazmat.2021.125481] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/05/2021] [Accepted: 02/19/2021] [Indexed: 06/12/2023]
Abstract
Large amounts of antibiotics are produced and consumed worldwide, while wastewater treatment is still rather inefficient, leading to considerable water contamination. Concentrations of antibiotics in the environment are often sufficiently high to exert a selective pressure on bacteria of clinical importance that increases the prevalence of resistance. Since the drastic reduction in the use of antibiotics is not envisaged, efforts to reduce their input into the environment by improving treatment of contaminated wastewater is essential to limit uncontrollable spread of antibiotic resistance. This paper reviews recent progress on the use of non-thermal plasma for the degradation of antibiotics in water. The target compounds removal, the energy efficiency and the mineralization are analyzed as a function of discharge configuration and the most important experimental parameters. Various ways to improve the plasma process efficiency are addressed. Based on the identified reaction intermediates, degradation pathways are proposed for various classes of antibiotics and the degradation mechanisms of these chemicals under plasma conditions are discussed.
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Affiliation(s)
- M Magureanu
- National Institute for Lasers, Plasma and Radiation Physics, Department of Plasma Physics and, Nuclear Fusion, Atomistilor Str. 409, P.O. Box MG-36, Magurele, 077125 Bucharest, Romania.
| | - F Bilea
- National Institute for Lasers, Plasma and Radiation Physics, Department of Plasma Physics and, Nuclear Fusion, Atomistilor Str. 409, P.O. Box MG-36, Magurele, 077125 Bucharest, Romania; University of Bucharest, Faculty of Chemistry, Department of Analytical Chemistry, Panduri Avenue 90, 050663 Bucharest, Romania
| | - C Bradu
- University of Bucharest, Faculty of Biology, Department of Systems Ecology and Sustainability, Splaiul Independentei 91-95, 050095 Bucharest, Romania
| | - D Hong
- GREMI, UMR 7344, Université d'Orléans, CNRS, Orléans, France
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Mackuľak T, Cverenkárová K, Vojs Staňová A, Fehér M, Tamáš M, Škulcová AB, Gál M, Naumowicz M, Špalková V, Bírošová L. Hospital Wastewater-Source of Specific Micropollutants, Antibiotic-Resistant Microorganisms, Viruses, and Their Elimination. Antibiotics (Basel) 2021; 10:1070. [PMID: 34572652 PMCID: PMC8471966 DOI: 10.3390/antibiotics10091070] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/25/2021] [Accepted: 08/31/2021] [Indexed: 12/23/2022] Open
Abstract
Municipal wastewaters can generally provide real-time information on drug consumption, the incidence of specific diseases, or establish exposure to certain agents and determine some lifestyle consequences. From this point of view, wastewater-based epidemiology represents a modern diagnostic tool for describing the health status of a certain part of the population in a specific region. Hospital wastewater is a complex mixture of pharmaceuticals, illegal drugs, and their metabolites as well as different susceptible and antibiotic-resistant microorganisms, including viruses. Many studies pointed out that wastewater from healthcare facilities (including hospital wastewater), significantly contributes to higher loads of micropollutants, including bacteria and viruses, in municipal wastewater. In addition, such a mixture can increase the selective pressure on bacteria, thus contributing to the development and dissemination of antimicrobial resistance. Because many pharmaceuticals, drugs, and microorganisms can pass through wastewater treatment plants without any significant change in their structure and toxicity and enter surface waters, treatment technologies need to be improved. This short review summarizes the recent knowledge from studies on micropollutants, pathogens, antibiotic-resistant bacteria, and viruses (including SARS-CoV-2) in wastewater from healthcare facilities. It also proposes several possibilities for improving the wastewater treatment process in terms of efficiency as well as economy.
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Affiliation(s)
- Tomáš Mackuľak
- Department of Environmental Engineering, Faculty of Chemical and Food Technology STU, Slovak University of Technology in Bratislava, Radlinského 9, 812 37 Bratislava, Slovakia; (T.M.); (M.F.); (M.T.); (A.B.Š.)
| | - Klára Cverenkárová
- Department of Nutrition and Food Quality Assessment, Faculty of Chemical and Food Technology STU, Slovak University of Technology in Bratislava, Radlinského 9, 812 37 Bratislava, Slovakia;
| | - Andrea Vojs Staňová
- Department of Analytical Chemistry, Faculty of Natural Sciences, Comenius University in Bratislava, Ilkovičova 6, 842 15 Bratislava, Slovakia;
- South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, Faculty of Fisheries and Protection of Waters, University of South Bohemia in Ceske Budejovice, Zatisi 728/II, CZ-389 25 Vodnany, Czech Republic
| | - Miroslav Fehér
- Department of Environmental Engineering, Faculty of Chemical and Food Technology STU, Slovak University of Technology in Bratislava, Radlinského 9, 812 37 Bratislava, Slovakia; (T.M.); (M.F.); (M.T.); (A.B.Š.)
| | - Michal Tamáš
- Department of Environmental Engineering, Faculty of Chemical and Food Technology STU, Slovak University of Technology in Bratislava, Radlinského 9, 812 37 Bratislava, Slovakia; (T.M.); (M.F.); (M.T.); (A.B.Š.)
| | - Andrea Bútor Škulcová
- Department of Environmental Engineering, Faculty of Chemical and Food Technology STU, Slovak University of Technology in Bratislava, Radlinského 9, 812 37 Bratislava, Slovakia; (T.M.); (M.F.); (M.T.); (A.B.Š.)
| | - Miroslav Gál
- Department of Inorganic Technology, Faculty of Chemical and Food Technology STU, Slovak University of Technology in Bratislava, Radlinského 9, 812 37 Bratislava, Slovakia; (M.G.); (V.Š.)
| | - Monika Naumowicz
- Department of Physical Chemistry, Faculty of Chemistry, University of Bialystok, K. Ciolkowskiego 1K, 15-245 Bialystok, Poland;
| | - Viera Špalková
- Department of Inorganic Technology, Faculty of Chemical and Food Technology STU, Slovak University of Technology in Bratislava, Radlinského 9, 812 37 Bratislava, Slovakia; (M.G.); (V.Š.)
- Department of Zoology and Fisheries, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, Kamýcka 129, 165 00 Praha, Czech Republic
| | - Lucia Bírošová
- Department of Nutrition and Food Quality Assessment, Faculty of Chemical and Food Technology STU, Slovak University of Technology in Bratislava, Radlinského 9, 812 37 Bratislava, Slovakia;
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Scott LC, Wilson MJ, Esser SM, Lee NL, Wheeler ME, Aubee A, Aw TG. Assessing visitor use impact on antibiotic resistant bacteria and antibiotic resistance genes in soil and water environments of Rocky Mountain National Park. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 785:147122. [PMID: 33932658 DOI: 10.1016/j.scitotenv.2021.147122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 06/12/2023]
Abstract
Antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) have been detected in soil and water in close proximity to anthropogenic sources, but the extent to which human impact plays into ARB and ARGs entering the environment is not well described. This study aimed to determine the impact of visitor use on ARB and ARGs in a national park environment. Soil (n = 240) and water (n = 210) samples were collected across a gradient of human activity in Rocky Mountain National Park and analyzed for bacteria resistant to doxycycline, levofloxacin, and vancomycin. Amount of physical effort required to access a sampling site was used as a metric for the likelihood of human presence. A subset of samples was analyzed for the presence and abundance of six ARGs using quantitative polymerase chain reaction. Linear regression analysis demonstrated that anthropogenic factors including hiking effort and proximity to a toilet significantly contributed to the variance of the abundance of ARB for multiple antibiotics in soil and water. Additionally, ecological factors such as water movement, soil texture, and season may play a role in the detection of ARB and ARGs. Predictive analysis suggests that both human presence and human activities, such as waste elimination, significantly contributed to the abundance of ARB in soil and water. The results of this work evidence that the ecology of antibiotic resistance in remote environments is more complex than anthropogenic impact alone, necessitating further environmental characterization of ARB and ARGs.
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Affiliation(s)
- Laura C Scott
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Mark J Wilson
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Scott M Esser
- Continental Divide Research Learning Center, Rocky Mountain National Park. Estes Park, CO, USA
| | - Nicholas L Lee
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Michael E Wheeler
- School of Renewable Natural Resources, Louisiana State University, Baton Rouge, LA, USA
| | - Alexandra Aubee
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Tiong Gim Aw
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
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Antibiotic resistance and biofilm formation of Acinetobacter baumannii isolated from high-risk effluent water in tertiary hospitals in South Africa. J Glob Antimicrob Resist 2021; 27:82-90. [PMID: 34481121 DOI: 10.1016/j.jgar.2021.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Discharge of drug-resistant, biofilm-forming pathogens from hospital effluent water into municipal wastewater treatment plants poses a public health concern. This study examined the relationship between antibiotic resistance levels and biofilm formation of Acinetobacter baumannii strains isolated from hospital effluents. METHODS Antibiotic susceptibility of 71 A. baumannii isolates was evaluated by the Kirby-Bauer disk diffusion method. Minimum inhibitory concentrations (MICs) were determined by the agar dilution method, while the minimum biofilm eradication concentration (MBEC) was determined by the broth dilution method. Genotyping was performed for plasmid DNA. Biofilm formation was evaluated by the microtitre plate method and was quantified using crystal violet. A P-value of <0.05 was regarded as statistically significant in all tests. RESULTS Extensively drug-resistant (XDR) strains made up 58% of the isolates, while multidrug-resistant (MDR) and pandrug-resistant (PDR) strains made up 50% of the isolates from final effluent. The MBEC of ciprofloxacin increased by 255-fold, while that of ceftazidime was as high as 63-1310-fold compared with their respective MICs. Isolates were classified into four plasmid pattern groups with no association between biofilm formation and plasmid type (P = 0.0921). The degree of biofilm formation was independent of the level of antibiotic resistance, although MDR, XDR and PDR isolates produced significant biofilm biomass (P = 0.2580). CONCLUSION These results suggest that hospital effluent is a potential source of MDR biofilm-forming A. baumannii strains. Appropriate treatment and disposal of effluents are essential to prevent the presence of drug-resistant pathogens in wastewater.
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72
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Baghal Asghari F, Dehghani MH, Dehghanzadeh R, Farajzadeh D, Yaghmaeian K, Mahvi AH, Rajabi A. Antibiotic resistance and antibiotic-resistance genes of Pseudomonas spp. and Escherichia coli isolated from untreated hospital wastewater. WATER SCIENCE AND TECHNOLOGY 2021; 84:172-181. [PMID: 34280162 DOI: 10.2166/wst.2021.207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Hospitals are considered an important factor in the spread of antibiotic-resistant bacteria (ARBs) and antibiotic-resistance genes (ARGs). The purpose of this research was to characterize the microbial populations in hospital wastewater and investigated the prevalence of β-lactamase, SulІ and QnrS resistance genes. In the first step, culture method was used to isolate Pseudomonas aeruginosa and Escherichia coli. In the next step, accurate identification of isolated bacteria was carried out using the polymerase chain reaction (PCR) method, then the resistance of the bacteria at different concentrations of antibiotics (8-128 μg/mL) was examined. Finally the ARGs were detected using the PCR method. The averages of heterotrophic plate count (HPC) and ARB concentration in wastewater samples were 1.8 × 108 and 4.3 × 106 CFU/100 mL, respectively. The highest resistance rates were found for sulfamethoxazole and the highest resistance rates in the β-lactamase group were for ceftazidime, while highest sensitivity was for gentamicin and there was no isolate that was sensitive to the studied antibiotics. SulІ and QnrS were the highest and lowest abundance of all ARGs in samples respectively and blaSHV was the highest β-lactam resistance gene. Our results indicated an increase in the resistance of identified bacteria to several antibiotics. So it can be concluded that numerous antibiotic-resistant pathogens and vast numbers of ARGs exist in the human body so that their release from hospitals without effective treatment can cause many dangers to the environment and human health.
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Affiliation(s)
- Farzaneh Baghal Asghari
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hadi Dehghani
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Institute for Environmental Research, Center for Solid Waste Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Dehghanzadeh
- Health and Environment Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Davoud Farajzadeh
- Department of Cellular and Molecular Biology, Faculty of Biological Sciences, Azarbaijan Shahid Madani University, Tabriz, Iran
| | - Kamyar Yaghmaeian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Mahvi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Rajabi
- Health and Environment Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Pharmaceuticals in Wastewater Treatment Plants: A Systematic Review on the Substances of Greatest Concern Responsible for the Development of Antimicrobial Resistance. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11156670] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
In recent years, there is a growing concern about the alarming spread of antimicrobial resistance (AMR) in different environments. Increasingly, many species of bacteria, fungi and viruses are becoming immune to the most commonly used pharmaceuticals. One of the causes of the development of the resistance is the persistence of these drugs, excreted by humans, in municipal and hospital wastewater (WW). Consequently, wastewater treatment plants (WWTPs) are a primary source of antimicrobial resistance genes as novel pollutants. This systematic review sought to examine the relevant literature on pharmaceutical residues (PRs) responsible for AMR in municipal and hospital WW in order to propose a classification of the PRs of greatest concern and provide an updated source for AMR management in WWTPs. Among 546 studies collected from four databases, 18 were included in the present review. The internal and external validity of each study was assessed, and the risk of bias was evaluated on a 20-parameter basis. Results were combined in a narrative synthesis discussing influent and effluent PR concentrations at 88 WWTPs, seasonal variations, differences between hospital and municipal WW, environmental risk assessment values of antimicrobial substances and treatment facilities removal efficiencies. Among the 45 PRs responsible for AMR evaluated in this study, the antibiotics ciprofloxacin, clarithromycin, erythromycin, metronidazole, ofloxacin, sulfamethoxazole and trimethoprim constitute a considerable risk in terms of ubiquitous distribution, worrying concentrations, risk quotient values and resistance to removal treatments. Gaps in knowledge, data and information reported in this review will provide a valuable source for managing AMR in WWTPs.
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74
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Meijer J, Lamoree M, Hamers T, Antignac JP, Hutinet S, Debrauwer L, Covaci A, Huber C, Krauss M, Walker DI, Schymanski EL, Vermeulen R, Vlaanderen J. An annotation database for chemicals of emerging concern in exposome research. ENVIRONMENT INTERNATIONAL 2021; 152:106511. [PMID: 33773387 DOI: 10.1016/j.envint.2021.106511] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/03/2021] [Accepted: 03/06/2021] [Indexed: 05/18/2023]
Abstract
BACKGROUND Chemicals of Emerging Concern (CECs) include a very wide group of chemicals that are suspected to be responsible for adverse effects on health, but for which very limited information is available. Chromatographic techniques coupled with high-resolution mass spectrometry (HRMS) can be used for non-targeted screening and detection of CECs, by using comprehensive annotation databases. Establishing a database focused on the annotation of CECs in human samples will provide new insight into the distribution and extent of exposures to a wide range of CECs in humans. OBJECTIVES This study describes an approach for the aggregation and curation of an annotation database (CECscreen) for the identification of CECs in human biological samples. METHODS The approach consists of three main parts. First, CECs compound lists from various sources were aggregated and duplications and inorganic compounds were removed. Subsequently, the list was curated by standardization of structures to create "MS-ready" and "QSAR-ready" SMILES, as well as calculation of exact masses (monoisotopic and adducts) and molecular formulas. The second step included the simulation of Phase I metabolites. The third and final step included the calculation of QSAR predictions related to physicochemical properties, environmental fate, toxicity and Absorption, Distribution, Metabolism, Excretion (ADME) processes and the retrieval of information from the US EPA CompTox Chemicals Dashboard. RESULTS All CECscreen database and property files are publicly available (DOI: https://doi.org/10.5281/zenodo.3956586). In total, 145,284 entries were aggregated from various CECs data sources. After elimination of duplicates and curation, the pipeline produced 70,397 unique "MS-ready" structures and 66,071 unique QSAR-ready structures, corresponding with 69,526 CAS numbers. Simulation of Phase I metabolites resulted in 306,279 unique metabolites. QSAR predictions could be performed for 64,684 of the QSAR-ready structures, whereas information was retrieved from the CompTox Chemicals Dashboard for 59,739 CAS numbers out of 69,526 inquiries. CECscreen is incorporated in the in silico fragmentation approach MetFrag. DISCUSSION The CECscreen database can be used to prioritize annotation of CECs measured in non-targeted HRMS, facilitating the large-scale detection of CECs in human samples for exposome research. Large-scale detection of CECs can be further improved by integrating the present database with resources that contain CECs (metabolites) and meta-data measurements, further expansion towards in silico and experimental (e.g., MassBank) generation of MS/MS spectra, and development of bioinformatics approaches capable of using correlation patterns in the measured chemical features.
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Affiliation(s)
- Jeroen Meijer
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands; Department Environment & Health, Vrije Universiteit, Amsterdam, the Netherlands
| | - Marja Lamoree
- Department Environment & Health, Vrije Universiteit, Amsterdam, the Netherlands
| | - Timo Hamers
- Department Environment & Health, Vrije Universiteit, Amsterdam, the Netherlands
| | | | | | - Laurent Debrauwer
- Toxalim (Research Centre in Food Toxicology), Toulouse University, INRAE, ENVT, INP-Purpan, Toulouse, France; Metatoul-AXIOM Platform, National Infrastructure for Metabolomics and Fluxomics: MetaboHUB, Toxalim, INRAE, Toulouse, France
| | - Adrian Covaci
- Toxicological Center, University of Antwerp, Belgium
| | - Carolin Huber
- Department Effect-Directed Analysis, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Martin Krauss
- Department Effect-Directed Analysis, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Douglas I Walker
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Emma L Schymanski
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Jelle Vlaanderen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands.
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Azuma T, Hayashi T. On-site chlorination responsible for effective disinfection of wastewater from hospital. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 776:145951. [PMID: 33647640 DOI: 10.1016/j.scitotenv.2021.145951] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/30/2021] [Accepted: 02/14/2021] [Indexed: 05/10/2023]
Abstract
Both hospital effluent and a model sewage treatment plant (STP) wastewater prepared by mixing STP influent and STP secondary effluent at a volume ratio of 1:9 were directly treated with chlorine for investigation of their effects on disinfection of antimicrobial-resistant bacteria (AMRB) and antimicrobial-susceptible bacteria (AMSB). The overall results indicate that the chlorine disinfection effectively inactivated the majority of AMRB and AMSB, expect for MRSA and Staphylococcus aureus in both wastewaters. No significant differences could further be observed in the taxonomic diversity of micro-organisms after the treatment. The degrees of disinfection given by the direct chlorination were comparable to those attained by combination of conventional activated sludge process and additional chlorine treatment at the STP. The results of this study evoked a recommendation to operate local chlorination treatment directly for the wastewater from medicinal facilities prior to its flow into the STP as sewage. Although additional disinfection treatment at the STP seems necessary to remove the recalcitrant MRSA and Staphylococcus aureus, the present study desirably contributes to a great reduction of the loads of STP and urgent prevention of spreading of infectious diseases in the present state.
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Affiliation(s)
- Takashi Azuma
- Osaka University of Pharmaceutical Sciences, 4-20-1 Nasahara, Takatsuki, Osaka 569-1094, Japan.
| | - Tetsuya Hayashi
- Osaka University of Pharmaceutical Sciences, 4-20-1 Nasahara, Takatsuki, Osaka 569-1094, Japan
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76
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Tang Y, Zhao S, Peng Z, Li Z, Chen L, Gan P. Cu 2O nanoparticles anchored on carbon for the efficient removal of propofol from operating room wastewater via peroxymonosulfate activation: efficiency, mechanism, and pathway. RSC Adv 2021; 11:20983-20991. [PMID: 35479351 PMCID: PMC9034049 DOI: 10.1039/d1ra03049c] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/29/2021] [Indexed: 11/29/2022] Open
Abstract
Anesthetic drug wastage has increasingly become the main resource of operating room sewage, which poses a great risk to the safety of humans and other organisms. Propofol is the most widely used anesthetic drug in the world, and also occupies the largest proportion of the total anesthetic wastage in the operating room. In this work, a 2D Cu2O anchored carbon catalyst (Cu2O@NC) was prepared by the assembly-pyrolysis process and successfully applied to peroxymonosulfate (PMS) activation. We took propofol as a typical example and investigated the removal activity through heterostructure-enhanced advanced oxidation processes (AOPs). Through the degradation process, propofol can be removed from 20 ppm to ultralow levels within 5 min using the PMS/Cu2O@NC system. The degradation pathway of propofol was deduced through quantum chemical calculation and LC/GC-MS results. The final products were verified as CO2 and H2O. Moreover, sulfate radicals (SO4˙-) proved to be the dominant reactive oxidation species by radical scavenger experiments and ESR results. In addition, it has great universality for various pharmaceuticals such as tetracycline (TC), amoxicillin (AMX), cephalexin (CPX), and norfloxacin (NFX). Our work provided the possibility to treat operation room sewage in a rapid, high-efficiency, and feasible way.
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Affiliation(s)
- Yujie Tang
- Hunan Provincial Maternal and Child Health Care Hospital Changsha 410008 P. R. China
| | - Shiyin Zhao
- Faculty of Health Sciences, University of Macau Macau SAR 999078 P. R. China
| | - Zemin Peng
- Hunan Provincial Maternal and Child Health Care Hospital Changsha 410008 P. R. China
| | - Zhen Li
- Hunan Provincial Maternal and Child Health Care Hospital Changsha 410008 P. R. China
| | - Liang Chen
- Hunan Provincial Maternal and Child Health Care Hospital Changsha 410008 P. R. China
| | - Pei Gan
- Hunan Provincial Maternal and Child Health Care Hospital Changsha 410008 P. R. China
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Monahan C, Nag R, Morris D, Cummins E. Antibiotic residues in the aquatic environment - current perspective and risk considerations. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2021; 56:733-751. [PMID: 33979269 DOI: 10.1080/10934529.2021.1923311] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
Antimicrobial resistance is a major concern for human and animal health, projected to deteriorate with time and given current trends of antimicrobial usage. Antimicrobial use, particularly in healthcare and agriculture, can result in the release of antimicrobials into surface waters, promoting the development of antibiotic resistance in the environment, and potentially leading to human health risks. This study reviews relevant literature, and investigates current European and Irish antimicrobial usage trends in humans and animals, as well as potential pathways that antibiotics can take into surface waters following use. Reported levels in the aquatic environment are summarized, with particular focus on Ireland. There are relatively few studies examining Irish water bodies or sewage effluent for antibiotic residues, however, five antibiotics, namely azithromycin, ciprofloxacin, clarithromycin, metronidazole, and trimethoprim, have been measured in Irish waters, in concentrations predicted to select for resistance. Numerous isolates of multi-drug resistant bacteria have also been found in water bodies throughout Ireland and Europe. The value of risk assessment methodologies in understanding risks posed by antibiotic residues is reviewed including the advantages and disadvantages of specific approaches. Hazard quotient and bespoke Monte Carlo approaches are predominant risk assessment tools used to examine antimicrobial release and their complex pathways. This study highlights the need for monitoring of antimicrobial releases and the potential for resistance development, persistence and transmission while highlighting the role of risk assessment methodologies in assessing potential human and environmental health impacts.
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Affiliation(s)
- Ciaran Monahan
- School of Biosystems and Food Engineering, University College Dublin, Dublin, Ireland
| | - Rajat Nag
- School of Biosystems and Food Engineering, University College Dublin, Dublin, Ireland
| | - Dearbháile Morris
- Galway School of Medicine, National University of Ireland, Galway, Ireland
| | - Enda Cummins
- School of Biosystems and Food Engineering, University College Dublin, Dublin, Ireland
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da Silva Santos DH, Paulino JCPL, Dos Santos Alves GF, de Magalhães Oliveira LMT, de Carvalho Nagliate P, da Silva Duarte JL, Meili L, Tonholo J, Zanta CLDPES. Effluent treatment using activated carbon adsorbents: a bibliometric analysis of recent literature. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:10.1007/s11356-021-14267-w. [PMID: 33950424 DOI: 10.1007/s11356-021-14267-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 04/29/2021] [Indexed: 06/12/2023]
Abstract
Agricultural practices and industrial and human discharges play an important role in the generation of highly contaminated effluents, which becomes a threat to the environment. The persistence of many of these compounds to conventional treatments in recent years has meant that numerous efforts have been devoted to the proposal of new selective materials that allow the removal of these contaminants by adsorption. In addition, bibliometric studies have grown as powerful tools to indicate trends in innovation. In this way, the present study consisted of evaluating the potential interest to use activated carbon as adsorbent through a prospection study in scientific and technological databases. The number of records obtained for the use of activated carbon in effluent remediation processes is equivalent to 4898, which corresponds to approximately 2.5% of the total documents (articles/patents) found for the use of carbon with no defined purpose. A total of 2275 works that used the adsorptive property of activated carbon were recovered. According to the data recovered, Brazil is the leader in scientific publications among Latin American countries and the 12th worldwide, according to the SciELO and Scopus databases, respectively. In general, a significant number of patents have been recovered for this theme, in the Derwent database, 1167 documents were recovered. The results obtained in this work evidenced the growing interest in developing technologies in this area.
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Affiliation(s)
- Danilo Henrique da Silva Santos
- Laboratório de Eletroquímica Aplicada, Instituto de Química e Biotecnologia, Universidade Federal de Alagoas, UFAL, Maceió, Brazil
| | | | | | | | | | - José Leandro da Silva Duarte
- Laboratório de Eletroquímica Aplicada, Instituto de Química e Biotecnologia, Universidade Federal de Alagoas, UFAL, Maceió, Brazil
- Laboratório de Processos, Centro de Tecnologia, Universidade Federal de Alagoas, UFAL, Maceió, Brazil
| | - Lucas Meili
- Laboratório de Processos, Centro de Tecnologia, Universidade Federal de Alagoas, UFAL, Maceió, Brazil.
- Laboratory of Processes - LAPRO, Center of Technology, Federal University of Alagoas, Campus A. C. Simões, Av. Lourival Melo Mota, Tabuleiro dos Martins, Maceió, AL, CEP 57072-970, Brazil.
| | - Josealdo Tonholo
- Laboratório de Eletroquímica Aplicada, Instituto de Química e Biotecnologia, Universidade Federal de Alagoas, UFAL, Maceió, Brazil
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79
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Roy N, Alex SA, Chandrasekaran N, Mukherjee A, Kannabiran K. A comprehensive update on antibiotics as an emerging water pollutant and their removal using nano-structured photocatalysts. JOURNAL OF ENVIRONMENTAL CHEMICAL ENGINEERING 2021; 9:104796. [DOI: 10.1016/j.jece.2020.104796] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
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80
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Verburg I, van Veelen HPJ, Waar K, Rossen JWA, Friedrich AW, Hernández Leal L, García-Cobos S, Schmitt H. Effects of Clinical Wastewater on the Bacterial Community Structure from Sewage to the Environment. Microorganisms 2021; 9:718. [PMID: 33807193 PMCID: PMC8065902 DOI: 10.3390/microorganisms9040718] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/21/2021] [Accepted: 03/26/2021] [Indexed: 12/30/2022] Open
Abstract
This study pertains to measure differences in bacterial communities along the wastewater pathway, from sewage sources through the environment. Our main focus was on taxa which include pathogenic genera, and genera harboring antibiotic resistance (henceforth referred to as "target taxa"). Our objective was to measure the relative abundance of these taxa in clinical wastewaters compared to non-clinical wastewaters, and to investigate what changes can be detected along the wastewater pathway. The study entailed a monthly sampling campaign along a wastewater pathway, and taxa identification through 16S rRNA amplicon sequencing. Results indicated that clinical and non-clinical wastewaters differed in their overall bacterial composition, but that target taxa were not enriched in clinical wastewater. This suggests that treatment of clinical wastewater before release into the wastewater system would only remove a minor part of the potential total pathogen load in wastewater treatment plants. Additional findings were that the relative abundance of most target taxa was decreased after wastewater treatment, yet all investigated taxa were detected in 68% of the treated effluent samples-meaning that these bacteria are continuously released into the receiving surface water. Temporal variation was only observed for specific taxa in surface water, but not in wastewater samples.
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Affiliation(s)
- Ilse Verburg
- Wetsus, European Centre of Excellence for Sustainable Water Technology, 8900 CC Leeuwarden, The Netherlands; (I.V.); (H.P.J.v.V.); (L.H.L.)
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (J.W.A.R.); (A.W.F.); (S.G.-C.)
| | - H. Pieter J. van Veelen
- Wetsus, European Centre of Excellence for Sustainable Water Technology, 8900 CC Leeuwarden, The Netherlands; (I.V.); (H.P.J.v.V.); (L.H.L.)
| | - Karola Waar
- Izore, Centrum Infectieziekten Friesland, 8900 JA Leeuwarden, The Netherlands;
| | - John W. A. Rossen
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (J.W.A.R.); (A.W.F.); (S.G.-C.)
| | - Alex W. Friedrich
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (J.W.A.R.); (A.W.F.); (S.G.-C.)
| | - Lucia Hernández Leal
- Wetsus, European Centre of Excellence for Sustainable Water Technology, 8900 CC Leeuwarden, The Netherlands; (I.V.); (H.P.J.v.V.); (L.H.L.)
| | - Silvia García-Cobos
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (J.W.A.R.); (A.W.F.); (S.G.-C.)
| | - Heike Schmitt
- Wetsus, European Centre of Excellence for Sustainable Water Technology, 8900 CC Leeuwarden, The Netherlands; (I.V.); (H.P.J.v.V.); (L.H.L.)
- Institute for Risk Assessment Sciences, Utrecht University, 3508 TD Utrecht, The Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3721 MA Bilthoven, The Netherlands
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81
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Verlicchi P. Trends, new insights and perspectives in the treatment of hospital effluents. CURRENT OPINION IN ENVIRONMENTAL SCIENCE & HEALTH 2021; 19:100217. [PMID: 33103011 PMCID: PMC7571420 DOI: 10.1016/j.coesh.2020.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Recently, investigations of hospital effluent management and treatment have not only interested research groups with acquired experience in the field, but have also attracted the interest of new groups over the world. The most recent literature provides new insights into the occurrence of pharmaceuticals and other contaminants of emerging concern, pathogens, viruses, and antibiotic-resistant bacteria and genes in hospital effluent in various new developing and developed countries. It also provides information on the effective removal of key compounds (mainly antibiotics, analgesics, beta-blockers and chemotherapy drugs) by means of enhanced biological treatments and advanced oxidation processes. The current debate among the scientific community is mainly about the proper treatment to reduce the spread of antibiotic-resistant bacteria and genes and about the feasibility (from a technical and economic point of view) of treatment trains tested at lab and pilot scales.
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Affiliation(s)
- Paola Verlicchi
- Department of Engineering, University of Ferrara, Via Saragat 1, 44122 Ferrara, Italy
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82
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Ogwugwa VH, Oyetibo GO, Amund OO. Taxonomic profiling of bacteria and fungi in freshwater sewer receiving hospital wastewater. ENVIRONMENTAL RESEARCH 2021; 192:110319. [PMID: 33069702 DOI: 10.1016/j.envres.2020.110319] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 06/11/2023]
Abstract
Consistent discharges of hospital wastewaters (HWWs) pose ecological risk to the biome of the receiving environment with cumulative effect on its healthiness. Understanding the taxonomic profile of microorganisms in the impacted systems is required to establish taxa that are bio-indicators of toxicants, and provide possible taxa for mitigating ecotoxicity of the HWWs. Geochemistry, pollution status and ecotoxicity of heavy metals (HMs) in HWW-impacted sewer (LU) were assessed. The microbiome profiling was based on 16S rDNA and ITS of 18S rDNA metagenomes. The degree of HMs contamination exceeded 50 and HMs pollution load index of LU was severe (1,084), which consequently exerted severe risk (1,411,575 toxic response factors) with very high toxic responses of Co, Cu, Pb, and Cd. Eco-toxicological impact of the HMs on LU skewed microbiome towards Proteobacteria (43%), Actinobacteria (18%), and about 5% apiece for Chloroflexi, Acidobacteria, Plantomycetes, and Bacteroidetes. Likewise, the relative abundance of in LU inclined towards Ascomycota (59%), Basidiomycota (17%) and unclassified Eukarya_uc_p (16%). Exclusively found in LU sediments were 44,862 bacterial species and 42,881 fungi taxa, while 72,877 and 53,971 species of bacteria and fungi, respectively, were found missing. Extinction and emergence of bacteria and fungi taxa in LU were in response to HMs ecotoxicity and the need for natural attenuation processes respectively. The profiled taxa in LU may be plausible in bioremediation strategies of the impacted system, and in designing knowledge-based bioreactor system for the treatment of HWWs before discharge into the environment.
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Affiliation(s)
- Vincent Happy Ogwugwa
- Department of Microbiology, Faculty of Science, University of Lagos, Akoka, Yaba, Lagos State, 101017, Nigeria.
| | - Ganiyu Oladunjoye Oyetibo
- Department of Microbiology, Faculty of Science, University of Lagos, Akoka, Yaba, Lagos State, 101017, Nigeria.
| | - Olukayode Oladipupo Amund
- Department of Microbiology, Faculty of Science, University of Lagos, Akoka, Yaba, Lagos State, 101017, Nigeria.
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83
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Luo Y, Feng L, Jia R, Yang G, Yang Q, Mu J. Variation in microbial populations and antibiotic resistance genes in mariculture sediments in the present of the seaweed Ulva fasciata and under selective pressure of oxytetracycline. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2020; 204:111114. [PMID: 32798752 DOI: 10.1016/j.ecoenv.2020.111114] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 06/11/2023]
Abstract
The widely distributed seaweed Ulva fasciata has nutrient absorption abilities and can be used in the bioremediation of polluted maricultural environments. This study explored microbial community and antibiotic resistance gene (ARG) variation in mariculture sediments in response to different trace levels (10, 100, and 500 μg L-1) of oxytetracycline (OTC) and the presence of Ulva fasciata. The increase in OTC level promoted nutrient (NO3_-N and PO43--P) removal mainly due to Ulva fasciata adsorption. The abundances of the Euryarchaeota and Planctomycetes phyla in sediments were positively related to the increase in OTC stress, while a negative correlation occurred for the Proteobacteria phylum via metagenomic analysis. Compared with the control system, the increase rates of total ARGs were 3.90%, 7.36% and 13.42% at the OTC levels of 10, 100 and 500 μg L-1, respectively. OTC stress mainly favoured the collateral enrichment of non-corresponding polypeptide and MLS ARGs, mainly due to the enrichment of the phyla Planctomycetes and Euryarchaeota by the synergistic effect of OTC and nutrients. The results of quantitative PCR with tetracycline resistance genes (TRGs) (tetO, tetT, tetPB, tetW and otrA) and a horizontal transfer gene (intl1) demonstrated that all of genes had much higher gene numbers in sediments after 3 months of OTC stress than in those without OTC stress, which was strongly related to the variation in the phyla Bacteroidetes, Gemmatimonadetes and Acidobacteria. The significant correlation between intl1 and the target TRGs is indicative of the important role of the horizontal transfer of integron-resistant genes in the spread of TRGs.
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Affiliation(s)
- Yuqin Luo
- Department of Environment Science and Engineering, Zhejiang Ocean University, Zhoushan, 316022, PR China
| | - Lijuan Feng
- Department of Environment Science and Engineering, Zhejiang Ocean University, Zhoushan, 316022, PR China.
| | - Rong Jia
- Department of Environment Science and Engineering, Zhejiang Ocean University, Zhoushan, 316022, PR China
| | - Guangfeng Yang
- Department of Environment Science and Engineering, Zhejiang Ocean University, Zhoushan, 316022, PR China
| | - Qiao Yang
- Department of Environment Science and Engineering, Zhejiang Ocean University, Zhoushan, 316022, PR China
| | - Jun Mu
- Department of Environment Science and Engineering, Zhejiang Ocean University, Zhoushan, 316022, PR China; School of Ecology and Environment, Hainan Tropical Ocean University, Sanya City, 572022, PR China
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84
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Zhang S, Huang J, Zhao Z, Cao Y, Li B. Hospital Wastewater as a Reservoir for Antibiotic Resistance Genes: A Meta-Analysis. Front Public Health 2020; 8:574968. [PMID: 33194975 PMCID: PMC7655780 DOI: 10.3389/fpubh.2020.574968] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 10/01/2020] [Indexed: 11/13/2022] Open
Abstract
Background: The emergence and dissemination of antibiotic resistance genes (ARGs) in the environment poses a huge global health hazard. Hospital wastewater (HWW), in which a high density of antibiotic residues and antibiotic-resistant bacteria are present, may be a reservoir of ARGs dissemination into the environment. Our meta-analysis comprehensively analyzes the prevalence of ARGs in HWW, as well as the influencing factors in ARGs distribution. Methods: Online databases were used to search for literature using the subject terms: “Drug Resistance” AND “Genes” AND “Hospitals” AND “Wastewater.” Two reviewers independently applied predefined criteria to assess the literature and extract data including “relative abundance of ARGs,” “title,” “authors,” “country,” “location,” “sampling year,” and “sampling seasons.” The median values and 95% confidence intervals of ARGs abundance were calculated by Wilcox.test function in R. Temporal trends, spatial differences, seasonal variations and removal efficiency of ARGs were analyzed by Pearson correlation analysis and Kruskal-Wallis H test. Results: Resistance genes to carbapenems, sulfonamides, tetracyclines and mobile genetic elements were found at high relative abundance (>10−4 gene copies/16S rRNA gene copies) in HWW. The abundance of resistance genes to extended-spectrum β-lactams, carbapenems, sulfonamides and glycopeptide significantly decreased, while tetracycline resistance genes abundance increased from 2014 to 2018. The abundance of ARGs was significantly different by country but not by season. ARGs could not be completely removed by on-site HWW treatments and the removal efficiency varies for different ARGs. Conclusions: HWW presents more types of ARGs, and their abundance is higher than those in most wastewater systems. HWW may be a reservoir of ARGs and play an important role in the dissemination of ARGs.
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Affiliation(s)
- Shengcen Zhang
- Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jiangqing Huang
- Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhichang Zhao
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yingping Cao
- Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, China
| | - Bin Li
- Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, China
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85
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Efflux Pump-Driven Antibiotic and Biocide Cross-Resistance in Pseudomonas aeruginosa Isolated from Different Ecological Niches: A Case Study in the Development of Multidrug Resistance in Environmental Hotspots. Microorganisms 2020; 8:microorganisms8111647. [PMID: 33114277 PMCID: PMC7690850 DOI: 10.3390/microorganisms8111647] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 12/11/2022] Open
Abstract
Pseudomonas aeruginosa is an opportunistic pathogen displaying high intrinsic antimicrobial resistance and the ability to thrive in different ecological environments. In this study, the ability of P. aeruginosa to develop simultaneous resistance to multiple antibiotics and disinfectants in different natural niches were investigated using strains collected from clinical samples, veterinary samples, and wastewater. The correlation between biocide and antimicrobial resistance was determined by employing principal component analysis. Molecular mechanisms linking biocide and antimicrobial resistance were interrogated by determining gene expression using RT-qPCR and identifying a potential genetic determinant for co- and cross-resistance using whole-genome sequencing. A subpopulation of P. aeruginosa isolates belonging to three sequence types was resistant against the common preservative benzalkonium chloride and showed cross-resistance to fluoroquinolones, cephalosporins, aminoglycosides, and multidrug resistance. Of these, the epidemiological high-risk ST235 clone was the most abundant. The overexpression of the MexAB-OprM drug efflux pump resulting from amino acid mutations in regulators MexR, NalC, or NalD was the major contributing factor for cross-resistance that could be reversed by an efflux pump inhibitor. This is the first comparison of antibiotic-biocide cross-resistance in samples isolated from different ecological niches and serves as a confirmation of laboratory-based studies on biocide adapted isolates. The isolates from wastewater had a higher incidence of multidrug resistance and biocide-antibiotic cross-resistance than those from clinical and veterinary settings.
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86
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Zieliński W, Korzeniewska E, Harnisz M, Hubeny J, Buta M, Rolbiecki D. The prevalence of drug-resistant and virulent Staphylococcus spp. in a municipal wastewater treatment plant and their spread in the environment. ENVIRONMENT INTERNATIONAL 2020; 143:105914. [PMID: 32615351 DOI: 10.1016/j.envint.2020.105914] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 05/06/2023]
Abstract
Drug-resistant and pathogenic Staphylococcus spp. strains can reach surface waters and air with wastewater evacuated to the environment. These strains increase the environmental pool of genetic determinants conferring antibiotic resistance and virulence, and constitute a health risk for the employees of wastewater treatment plants (WWTP) who come into daily contact with bioaerosols. The aim of this study was to identify the genetic determinants of drug resistance and virulence in Staphylococcus spp. strains isolated from untreated (UWW) and treated wastewater (TWW), an activated sludge (AS) bioreactor, river water collected upstream and downstream from the wastewater discharge point (URW and DRW), and WWTP employees. All isolates were analysed for the presence of the rpoB gene, and were subjected to clonal analysis by ERIC fingerprinting. As a result, 249 of the 455 analysed isolates were selected for PCR. The presence of the gene encoding nuclease activity in S. aureus (nuc), the methicillin resistance gene (mecA), vancomycin resistance gene (vanA), antiseptic resistance gene (qacA/B) and virulence genes (sasX, pvl, tst1, hla, sec) was determined. The prevalence of nuc, mecA, vanA and qacA/B genes in wastewater and river water was determined by quantitative PCR (qPCR). In the group of strains isolated from wastewater and water samples, 63% were identified as S. aureus, and 20% of the strains carried the vanA gene. The hla virulence gene was present in 80% of the isolates, and the pvl gene was detected in 27% of the isolates. In the group of strains isolated from the employees, 82% were identified as S. aureus, and the presence of vanA and mecA genes was confirmed in 14% and 16% of the isolates, respectively. The most prevalent virulence gene was hla (74%), whereas pvl was observed in 43% of the isolates. The quantitative analysis revealed the highest concentrations of the studied genes in UWW samples, at 2.56x104 gene copies/ml for nuc, 1.18x103 gene copies /ml for mecA, 8.28x105 gene copies /ml for vanA and 3.83x105 gene copies /ml for qacA/B. Some of analysed genes were identified in the isolates from both URW and DRW samples, as well as in genomic DNA of these samples. These results indicate that wastewater is not effectively treated in the analysed WWTP, which could contribute to the dissemination of antibiotic resistance genes (ARGs) and antibiotic-resistant bacteria (ARB) to the environment. An analysis of the genetic relatedness of selected isolates revealed clusters of strains originating from UWW samples, AS samples and the employees. These observations suggest that ARGs and ARB are transmitted by wastewater bioaerosols to the upper respiratory tract mucosa of the plant's employees, thus increasing their exposure to infectious factors.
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Affiliation(s)
- Wiktor Zieliński
- Department of Engineering of Water Protection and Environmental Microbiology, The Faculty of Geoengineering, University of Warmia and Mazury in Olsztyn, Prawocheńskiego 1 Str., 10-719 Olsztyn, Poland
| | - Ewa Korzeniewska
- Department of Engineering of Water Protection and Environmental Microbiology, The Faculty of Geoengineering, University of Warmia and Mazury in Olsztyn, Prawocheńskiego 1 Str., 10-719 Olsztyn, Poland.
| | - Monika Harnisz
- Department of Engineering of Water Protection and Environmental Microbiology, The Faculty of Geoengineering, University of Warmia and Mazury in Olsztyn, Prawocheńskiego 1 Str., 10-719 Olsztyn, Poland
| | - Jakub Hubeny
- Department of Engineering of Water Protection and Environmental Microbiology, The Faculty of Geoengineering, University of Warmia and Mazury in Olsztyn, Prawocheńskiego 1 Str., 10-719 Olsztyn, Poland
| | - Martyna Buta
- Department of Engineering of Water Protection and Environmental Microbiology, The Faculty of Geoengineering, University of Warmia and Mazury in Olsztyn, Prawocheńskiego 1 Str., 10-719 Olsztyn, Poland
| | - Damian Rolbiecki
- Department of Engineering of Water Protection and Environmental Microbiology, The Faculty of Geoengineering, University of Warmia and Mazury in Olsztyn, Prawocheńskiego 1 Str., 10-719 Olsztyn, Poland
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87
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De Baat ML, Van der Oost R, Van der Lee GH, Wieringa N, Hamers T, Verdonschot PFM, De Voogt P, Kraak MHS. Advancements in effect-based surface water quality assessment. WATER RESEARCH 2020; 183:116017. [PMID: 32673894 DOI: 10.1016/j.watres.2020.116017] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/15/2020] [Accepted: 06/03/2020] [Indexed: 06/11/2023]
Abstract
Legally-prescribed chemical monitoring is unfit for determining the pollution status of surface waters, and there is a need for improved assessment methods that consider the aggregated risk of all bioavailable micropollutants present in the aquatic environment. Therefore, the present study aimed to advance effect-based water quality assessment by implementing methodological improvements and to gain insight into contamination source-specific bioanalytical responses. Passive sampling of non-polar and polar organic compounds and metals was applied at 14 surface water locations that were characterized by two major anthropogenic contamination sources, agriculture and wastewater treatment plant (WWTP) effluent, as well as reference locations with a low expected impact from micropollutants. Departing from the experience gained in previous studies, a battery of 20 in vivo and in vitro bioassays was composed and subsequently exposed to the passive sampler extracts. Next, the bioanalytical responses were divided by their respective effect-based trigger values to obtain effect-based risk quotients, which were summed per location. These cumulative ecotoxicological risks were lowest for reference locations (4.3-10.9), followed by agriculture locations (11.3-27.2) and the highest for WWTP locations (12.8-47.7), and were mainly driven by polar organic contaminants. The bioanalytical assessment of the joint risks of metals and (non-)polar organic compounds resulted in the successful identification of pollution source-specific ecotoxicological risk profiles: none of the bioassays were significantly associated with reference locations nor with multiple location types, while horticulture locations were significantly characterized by anti-AR and anti-PR activity and cytotoxicity, and WWTP sites by ERα activity and toxicity in the in vivo bioassays. It is concluded that the presently employed advanced effect-based methods can readily be applied in surface water quality assessment and that the integration of chemical- and effect-based monitoring approaches will foster future-proof water quality assessment strategies on the road to a non-toxic environment.
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Affiliation(s)
- M L De Baat
- Department of Freshwater and Marine Ecology, Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, the Netherlands.
| | - R Van der Oost
- Department of Technology, Research and Engineering, Waternet Institute for the Urban Water Cycle, Amsterdam, the Netherlands
| | - G H Van der Lee
- Department of Freshwater and Marine Ecology, Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, the Netherlands
| | - N Wieringa
- Department of Freshwater and Marine Ecology, Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, the Netherlands
| | - T Hamers
- Department of Environment & Health, Vrije Universiteit Amsterdam, the Netherlands
| | - P F M Verdonschot
- Department of Freshwater and Marine Ecology, Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, the Netherlands; Wageningen Environmental Research, Wageningen, UR, the Netherlands
| | - P De Voogt
- Department of Freshwater and Marine Ecology, Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, the Netherlands
| | - M H S Kraak
- Department of Freshwater and Marine Ecology, Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, the Netherlands
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88
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Hernando-Amado S, Coque TM, Baquero F, Martínez JL. Antibiotic Resistance: Moving From Individual Health Norms to Social Norms in One Health and Global Health. Front Microbiol 2020; 11:1914. [PMID: 32983000 PMCID: PMC7483582 DOI: 10.3389/fmicb.2020.01914] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/21/2020] [Indexed: 12/16/2022] Open
Abstract
Antibiotic resistance is a problem for human health, and consequently, its study had been traditionally focused toward its impact for the success of treating human infections in individual patients (individual health). Nevertheless, antibiotic-resistant bacteria and antibiotic resistance genes are not confined only to the infected patients. It is now generally accepted that the problem goes beyond humans, hospitals, or long-term facility settings and that it should be considered simultaneously in human-connected animals, farms, food, water, and natural ecosystems. In this regard, the health of humans, animals, and local antibiotic-resistance-polluted environments should influence the health of the whole interconnected local ecosystem (One Health). In addition, antibiotic resistance is also a global problem; any resistant microorganism (and its antibiotic resistance genes) could be distributed worldwide. Consequently, antibiotic resistance is a pandemic that requires Global Health solutions. Social norms, imposing individual and group behavior that favor global human health and in accordance with the increasingly collective awareness of the lack of human alienation from nature, will positively influence these solutions. In this regard, the problem of antibiotic resistance should be understood within the framework of socioeconomic and ecological efforts to ensure the sustainability of human development and the associated human-natural ecosystem interactions.
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Affiliation(s)
- Sara Hernando-Amado
- Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Teresa M. Coque
- Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) and Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Fernando Baquero
- Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) and Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - José L. Martínez
- Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
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89
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Anthony ET, Ojemaye MO, Okoh OO, Okoh AI. A critical review on the occurrence of resistomes in the environment and their removal from wastewater using apposite treatment technologies: Limitations, successes and future improvement. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 263:113791. [PMID: 32224385 DOI: 10.1016/j.envpol.2019.113791] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 12/08/2019] [Accepted: 12/09/2019] [Indexed: 06/10/2023]
Abstract
Recent reports are pointing towards the potential increasing risks of resistomes in human host. With no permissible limit in sight, resistomes are continually multiplying at an alarming rate in the ecosystem, with a disturbing level in drinking water source. The morphology and chemical constituent of resistomes afford them to resist degradation, elude membrane and counter ionic charge, thereby, rendering both conventional and advanced water and wastewater treatment inefficient. Water and wastewater matrix may govern the propagation of individual resistomes sub-type, co-selection and specific interaction towards precise condition may have enhanced the current challenge. This review covers recent reports (2011-2019) on the occurrence of ARB/ARGs and ease of spread of resistance genes in the aquatic ecosystem. The contributions of water matrix to the spread and mitigation, treatment options, via bulk removal or capture, and intracellular and extracellular DNA lysis were discussed. A complete summary of recent occurrences of ARB/ARGs, fate after disinfection and optimum conditions of individual treatment technology or in tandem, including process limitations, with a brief assessment of removal or degradation mechanism were highlighted.
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Affiliation(s)
- Eric Tobechukwu Anthony
- Department of Pure and Applied Chemistry, University of Fort Hare, Alice, 5700, South Africa; SAMRC, Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice, South Africa; AEMREG, Applied and Environmental Microbiology Research Group, University of Fort Hare, Alice, South Africa.
| | - Mike O Ojemaye
- Department of Pure and Applied Chemistry, University of Fort Hare, Alice, 5700, South Africa; SAMRC, Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice, South Africa; AEMREG, Applied and Environmental Microbiology Research Group, University of Fort Hare, Alice, South Africa
| | - Omobola O Okoh
- Department of Pure and Applied Chemistry, University of Fort Hare, Alice, 5700, South Africa; SAMRC, Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice, South Africa; AEMREG, Applied and Environmental Microbiology Research Group, University of Fort Hare, Alice, South Africa
| | - Anthony I Okoh
- SAMRC, Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice, South Africa; AEMREG, Applied and Environmental Microbiology Research Group, University of Fort Hare, Alice, South Africa
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90
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Haas CN. Quantitative Microbial Risk Assessment and Molecular Biology: Paths to Integration. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:8539-8546. [PMID: 32539352 DOI: 10.1021/acs.est.0c00664] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Quantitative microbial risk assessment (QMRA) has now been in use for over 35 years and has formed the basis for developing criteria for ensuring public health related to water, food, and remediation, to name a few areas. The initial data for QMRA (both in exposure assessment and in dose response assessment) came from measurements using assays for viability, such as plate counts, plaque assays, or animal infectivity. With the increasing use of molecular methods for the measurement of microorganisms in the environment, it has become important to assess how to use such data to estimate infectious disease risks. The limitations to the use of such data and needs to resolve the limitations will be addressed.
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Affiliation(s)
- Charles N Haas
- Department of Civil, Architectural & Environmental Engineering, Drexel University, Philadelphia, Pennsylvania 19104, United States
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91
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Evaluation of antibiotic resistance dissemination by wastewater treatment plant effluents with different catchment areas in Germany. Sci Rep 2020; 10:8952. [PMID: 32488142 PMCID: PMC7265433 DOI: 10.1038/s41598-020-65635-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/07/2020] [Indexed: 11/16/2022] Open
Abstract
The study quantified the abundances of antibiotic resistance genes (ARGs) and facultative pathogenic bacteria (FPB) as well as one mobile genetic element in genomic DNA via qPCR from 23 different wastewater treatment plant (WWTP) effluents in Germany. 12 clinically relevant ARGs were categorized into frequently, intermediately, and rarely occurring genetic parameters of communal wastewaters. Taxonomic PCR quantifications of five FPB targeting Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, and enterococci were performed. The WWTPs differed in their catchment areas being impacted by hospitals, food processing companies, or housing areas only. The total discharges of the analyzed ARGs and FPB were found to cluster independently of the sizes of the WWTPs with a maximum difference of two log units within one cluster. Initially, quantitative data evaluations revealed no significant difference between ARG categories and WWTP catchment areas. More distinct correlations became obvious with a Pearson correlation approach, where each single taxonomic marker is compared to each ARG target. Here, increased correlation of FPB (i.e. E. coli, K. pneumoniae, P. aeruginosa, and enterococci) with clinically relevant ARGs of the category of rarely occurring resistance genes (blaNDM-1, vanA) was found in WWTP effluents being influenced by hospital wastewaters.
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92
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Scott LC, Lee N, Aw TG. Antibiotic Resistance in Minimally Human-Impacted Environments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113939. [PMID: 32498349 PMCID: PMC7313453 DOI: 10.3390/ijerph17113939] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/26/2020] [Accepted: 05/28/2020] [Indexed: 12/28/2022]
Abstract
Antibiotic resistant bacteria (ARB) have become contaminants of concern in environmental systems. Studies investigating environmental ARB have primarily focused on environments that are greatly impacted by anthropogenic activity. Background concentrations of ARB in natural environments is not well understood. This review summarizes the current literature on the monitoring of ARB and antibiotic resistance genes (ARGs) in environments less impacted by human activity. Both ARB and ARGs have been detected on the Antarctic continent, on isolated glaciers, and in remote alpine environments. The methods for detecting and quantifying ARB and ARGs from the environment are not standardized and warrant optimization. Further research should be focused on the detection and quantification of ARB and ARGs along human gradients to better characterize the factors leading to their dissemination in remote environments.
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93
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Alygizakis NA, Urík J, Beretsou VG, Kampouris I, Galani A, Oswaldova M, Berendonk T, Oswald P, Thomaidis NS, Slobodnik J, Vrana B, Fatta-Kassinos D. Evaluation of chemical and biological contaminants of emerging concern in treated wastewater intended for agricultural reuse. ENVIRONMENT INTERNATIONAL 2020; 138:105597. [PMID: 32120059 DOI: 10.1016/j.envint.2020.105597] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/18/2020] [Accepted: 02/18/2020] [Indexed: 05/23/2023]
Abstract
The occurrence of chemical and biological contaminants of emerging concern (CECs) was investigated in treated wastewater intended for reuse in agriculture. An agarose hydrogel diffusion-based passive sampler was exposed to the outlet of a wastewater treatment plant (WWTP) located in Cyprus, which is equipped with membrane bioreactor (MBR). Passive samplers in triplicate were exposed according to a time-series exposure plan with maximum exposure duration of 28 days. Composite flow-proportional wastewater samples were collected in parallel with the passive sampling exposure plan and were processed by solid phase extraction using HORIZON SPE-DEX 4790 and the same sorbent material (Oasis HLB) as in the passive sampler. The analysis of passive samplers and wastewater samples enabled (i) the field-scale calibration of the passive sampler prototype by the calculation of in situ sampling rates of target substances, and (ii) the investigation of in silico predicted transformation products of the four most ecotoxicologically hazardous antibiotics (azithromycin, clarithromycin, erythromycin, ofloxacin). Additionally, the wastewater samples were subjected to the analysis of seven preselected antibiotic resistant genes (ARGs) and one mobile resistant element (int1). All extracts were analyzed for chemicals in a single batch using a highly sensitive method for pharmaceuticals, antibiotics and illicit drugs by liquid chromatography tandem MS/MS (LC-QQQ) and for various other target compounds (2316 compounds in total) by liquid chromatography high-resolution mass spectrometry (LC-HRMS). 279 CECs and all investigated ARGs (except for blaCTX-M-32) were detected, highlighting potential chemical and biological hazards related to wastewater reuse practices. 16 CECs were prioritized following ecotoxicological risk assessment, whereas sul1 and the mobile resistant element (int1) showed the highest abundance. Comprehensive monitoring efforts using novel sampling methods such as passive sampling, wide-scope target screening and molecular analysis are required to assure safe application of wastewater reuse and avoid spread and crop uptake of potentially hazardous chemicals.
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Affiliation(s)
- Nikiforos A Alygizakis
- Environmental Institute, Okružná 784/42, 97241 Koš, Slovak Republic; Laboratory of Analytical Chemistry, Department of Chemistry, University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece.
| | - Jakub Urík
- Masaryk University, Faculty of Science, Research Centre for Toxic Compounds in the Environment (RECETOX), Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Vasiliki G Beretsou
- Department of Civil and Environmental Engineering and Nireas-International Water Research Center, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - Ioannis Kampouris
- Environmental Sciences Technische Universität Dresden, Institute for Hydrobiology, Dresden, Germany
| | - Aikaterini Galani
- Laboratory of Analytical Chemistry, Department of Chemistry, University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece
| | | | - Thomas Berendonk
- Environmental Sciences Technische Universität Dresden, Institute for Hydrobiology, Dresden, Germany
| | - Peter Oswald
- Environmental Institute, Okružná 784/42, 97241 Koš, Slovak Republic
| | - Nikolaos S Thomaidis
- Laboratory of Analytical Chemistry, Department of Chemistry, University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece.
| | | | - Branislav Vrana
- Masaryk University, Faculty of Science, Research Centre for Toxic Compounds in the Environment (RECETOX), Kamenice 753/5, 625 00 Brno, Czech Republic
| | - Despo Fatta-Kassinos
- Department of Civil and Environmental Engineering and Nireas-International Water Research Center, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
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94
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Paulus GK, Hornstra LM, Medema G. International tempo-spatial study of antibiotic resistance genes across the Rhine river using newly developed multiplex qPCR assays. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 706:135733. [PMID: 31818563 DOI: 10.1016/j.scitotenv.2019.135733] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/09/2019] [Accepted: 11/22/2019] [Indexed: 06/10/2023]
Abstract
The aim of this study was to capture and explain changes in antibiotic resistance gene (ARG) presence and concentration internationally across the Rhine river. Intl1 concentrations and national antibiotic usage were investigated as proxies to predict anthropogenic ARG pollution. Newly-developed multiplex qPCR assays were employed to investigate ARG profiles across 8 locations (L1-L8) in three countries (Switzerland, Germany, the Netherlands) and to detect potential regional causes for variation. Two of these locations were further monitored, over the duration of one month. A total of 13 ARGs, Intl1 and 16S rRNA were quantified. ARG presence and concentrations initially increased from L1(Diepoldsau) to L3(Darmstadt). A continuous increase could not be observed at subsequent locations, with the large river volume likely being a major contributing factor for stability. ARG presence and concentrations fluctuated widely across different locations. L2(Basel) and L3 were the two most polluted locations, coinciding with these locations being well-developed pharmaceutical production locations. We draw attention to the characteristic, clearly distinct ARG profiles, with gene presence being consistent and gene concentrations varying significantly less over time than across different locations. Five genes were Rhine-typical (ermB, ermF, Intl1, sul1 and tetM). Intl1 and sul1 were the genes with highest and second-highest concentration, respectively. Aph(III)a and blaOXA were permanently introduced downstream of L1, indicating no source of these genes prior to L1. We highlight that correlations between Intl1 and ARG concentrations (R2 = 0.72) were driven by correlations to sul1 and disappeared when excluding sul1 from the analysis (R2 = 0.05). Intl1 therefore seems to be a good proxy for sul1 concentrations but not necessarily for overall (anthropogenic) ARG pollution. Aminoglycoside usage per country correlated with concentrations of aph(III)a and several unrelated antibiotic resistance genes (blaOXA,ermB, ermF and tetM). This correlation can be explained by co-resistance caused by mobile genetic elements (MGEs), such as Tn1545.
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Affiliation(s)
- Gabriela K Paulus
- KWR Watercycle Research Institute, Groningenhaven 7, 3433PE Nieuwegein, the Netherlands; Delft University of Technology, Faculty of Civil Engineering & Geosciences, Department of Water Management, Stevinweg 1, 2628CN Delft, The Netherlands.
| | - Luc M Hornstra
- KWR Watercycle Research Institute, Groningenhaven 7, 3433PE Nieuwegein, the Netherlands
| | - Gertjan Medema
- KWR Watercycle Research Institute, Groningenhaven 7, 3433PE Nieuwegein, the Netherlands; Delft University of Technology, Faculty of Civil Engineering & Geosciences, Department of Water Management, Stevinweg 1, 2628CN Delft, The Netherlands
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95
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Schymanski EL, Baker NC, Williams AJ, Singh RR, Trezzi JP, Wilmes P, Kolber PL, Kruger R, Paczia N, Linster CL, Balling R. Connecting environmental exposure and neurodegeneration using cheminformatics and high resolution mass spectrometry: potential and challenges. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2019; 21:1426-1445. [PMID: 31305828 DOI: 10.1039/c9em00068b] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Connecting chemical exposures over a lifetime to complex chronic diseases with multifactorial causes such as neurodegenerative diseases is an immense challenge requiring a long-term, interdisciplinary approach. Rapid developments in analytical and data technologies, such as non-target high resolution mass spectrometry (NT-HR-MS), have opened up new possibilities to accomplish this, inconceivable 20 years ago. While NT-HR-MS is being applied to increasingly complex research questions, there are still many unidentified chemicals and uncertainties in linking exposures to human health outcomes and environmental impacts. In this perspective, we explore the possibilities and challenges involved in using cheminformatics and NT-HR-MS to answer complex questions that cross many scientific disciplines, taking the identification of potential (small molecule) neurotoxicants in environmental or biological matrices as a case study. We explore capturing literature knowledge and patient exposure information in a form amenable to high-throughput data mining, and the related cheminformatic challenges. We then briefly cover which sample matrices are available, which method(s) could potentially be used to detect these chemicals in various matrices and what remains beyond the reach of NT-HR-MS. We touch on the potential for biological validation systems to contribute to mechanistic understanding of observations and explore which sampling and data archiving strategies may be required to form an accurate, sustained picture of small molecule signatures on extensive cohorts of patients with chronic neurodegenerative disorders. Finally, we reflect on how NT-HR-MS can support unravelling the contribution of the environment to complex diseases.
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Affiliation(s)
- Emma L Schymanski
- Environmental Cheminformatics Group, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, 6 Avenue du Swing, L-4367 Belvaux, Luxembourg.
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96
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Singer AC, Xu Q, Keller VDJ. Translating antibiotic prescribing into antibiotic resistance in the environment: A hazard characterisation case study. PLoS One 2019; 14:e0221568. [PMID: 31483803 PMCID: PMC6726141 DOI: 10.1371/journal.pone.0221568] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 08/11/2019] [Indexed: 01/06/2023] Open
Abstract
The environment receives antibiotics through a combination of direct application (e.g., aquaculture and fruit production), as well as indirect release through pharmaceutical manufacturing, sewage and animal manure. Antibiotic concentrations in many sewage-impacted rivers are thought to be sufficient to select for antibiotic resistance genes. Yet, because antibiotics are nearly always found associated with antibiotic-resistant faecal bacteria in wastewater, it is difficult to distinguish the selective role of effluent antibiotics within a 'sea' of gut-derived resistance genes. Here we examine the potential for macrolide and fluoroquinolone prescribing in England to select for resistance in the River Thames catchment, England. We show that 64% and 74% of the length of the modelled catchment is chronically exposed to putative resistance-selecting concentrations (PNEC) of macrolides and fluoroquinolones, respectively. Under current macrolide usage, 115 km of the modelled River Thames catchment (8% of total length) exceeds the PNEC by 5-fold. Similarly, under current fluoroquinolone usage, 223 km of the modelled River Thames catchment (16% of total length) exceeds the PNEC by 5-fold. Our results reveal that if reduced prescribing was the sole mitigating measure, that macrolide and fluoroquinolone prescribing would need to decline by 77% and 85%, respectively, to limit resistance selection in the catchment. Significant reductions in antibiotic prescribing are feasible, but innovation in sewage-treatment will be necessary for achieving substantially-reduced antibiotic loads and inactivation of DNA-pollution from resistant bacteria. Greater confidence is needed in current risk-based targets for antibiotics, particularly in mixtures, to better inform environmental risk assessments and mitigation.
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Affiliation(s)
- Andrew C. Singer
- NERC Centre for Ecology & Hydrology, Benson Lane, Wallingford, United Kingdom
| | - Qiuying Xu
- NERC Centre for Ecology & Hydrology, Benson Lane, Wallingford, United Kingdom
- Environmental Diagnosis and Management, Royal Holloway University of London, Egham, United Kingdom
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97
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Abundance and Antimicrobial Resistance of Three Bacterial Species along a Complete Wastewater Pathway. Microorganisms 2019; 7:microorganisms7090312. [PMID: 31484380 PMCID: PMC6780886 DOI: 10.3390/microorganisms7090312] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 08/26/2019] [Accepted: 08/29/2019] [Indexed: 11/16/2022] Open
Abstract
After consumption, antibiotic residues and exposed bacteria end up via the feces in wastewater, and therefore wastewater is believed to play an important role in the spread of antimicrobial resistance (AMR). We investigated the abundance and AMR profiles of three different species over a complete wastewater pathway during a one-year sampling campaign, as well as including antimicrobial consumption and antimicrobial concentrations analysis. A total of 2886 isolates (997 Escherichia coli, 863 Klebsiella spp., and 1026 Aeromonas spp.) were cultured from the 211 samples collected. The bacterial AMR profiles mirrored the antimicrobial consumption in the respective locations, which were highest in the hospital. However, the contribution of hospital wastewater to AMR found in the wastewater treatment plant (WWTP) was below 10% for all antimicrobials tested. We found high concentrations (7-8 logs CFU/L) of the three bacterial species in all wastewaters, and they survived the wastewater treatment (effluent concentrations were around 5 log CFU/L), showing an increase of E. coli in the receiving river after the WWTP discharge. Although the WWTP had no effect on the proportion of AMR, bacterial species and antimicrobial residues were still measured in the effluent, showing the role of wastewater contamination in the environmental surface water.
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98
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Defining and combating antibiotic resistance from One Health and Global Health perspectives. Nat Microbiol 2019; 4:1432-1442. [PMID: 31439928 DOI: 10.1038/s41564-019-0503-9] [Citation(s) in RCA: 535] [Impact Index Per Article: 107.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 05/30/2019] [Indexed: 12/11/2022]
Abstract
Several interconnected human, animal and environmental habitats can contribute to the emergence, evolution and spread of antibiotic resistance, and the health of these contiguous habitats (the focus of the One Health approach) may represent a risk to human health. Additionally, the expansion of resistant clones and antibiotic resistance determinants among human-associated, animal-associated and environmental microbiomes have the potential to alter bacterial population genetics at local and global levels, thereby modifying the structure, and eventually the productivity, of microbiomes where antibiotic-resistant bacteria can expand. Conversely, any change in these habitats (including pollution by antibiotics or by antibiotic-resistant organisms) may influence the structures of their associated bacterial populations, which might affect the spread of antibiotic resistance to, and among, the above-mentioned microbiomes. Besides local transmission among connected habitats-the focus of studies under the One Health concept-the transmission of resistant microorganisms might occur on a broader (even worldwide) scale, requiring coordinated Global Health actions. This Review provides updated information on the elements involved in the evolution and spread of antibiotic resistance at local and global levels, and proposes studies to be performed and strategies to be followed that may help reduce the burden of antibiotic resistance as well as its impact on human and planetary health.
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99
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Alygizakis NA, Besselink H, Paulus GK, Oswald P, Hornstra LM, Oswaldova M, Medema G, Thomaidis NS, Behnisch PA, Slobodnik J. Characterization of wastewater effluents in the Danube River Basin with chemical screening, in vitro bioassays and antibiotic resistant genes analysis. ENVIRONMENT INTERNATIONAL 2019; 127:420-429. [PMID: 30959307 DOI: 10.1016/j.envint.2019.03.060] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/22/2019] [Accepted: 03/25/2019] [Indexed: 06/09/2023]
Abstract
Averaged 7-day composite effluent wastewater samples from twelve wastewater treatment plants (WWTPs) in nine countries (Romania, Serbia, Hungary, Slovenia, Croatia, Slovakia, Czechia, Austria, Germany) in the Danube River Basin were collected. WWTPs' selection was based on countries' dominant technology and a number of served population with the aim to get a representative holistic view of the pollution status. Samples were analyzed for 2248 chemicals of emerging concern (CECs) by wide-scope target screening employing LC-ESI-QTOF-MS. 280 compounds were detected at least in one sample and quantified. Spatial differences in the concentrations and distribution of the compounds classes were discussed. Additionally, samples were analyzed for the possible agonistic/antagonistic potencies using a panel of in vitro transactivation reporter gene CALUX® bioassays including ERα (estrogenics), anti-AR (anti-androgens), GR (glucocorticoids), anti-PR (anti-progestins), PPARα and PPARγ (peroxisome proliferators) and PAH assays. The potency of the wastewater samples to cause oxidative stress and induce xenobiotic metabolism was determined using the Nrf2 and PXR CALUX® bioassays, respectively. The signals from each of the bioassays were compared with the recently developed effect-based trigger values (EBTs) and thus allowed for allocating the wastewater effluents into four categories based on their measured toxicity, proposing a putative action plan for wastewater operators. Moreover, samples were analyzed for antibiotics and 13 antibiotic-resistant genes (ARGs) and one mobile genetic element (intl1) with the aim to assess the potential for antibiotic resistance. All data collected from these various types of analysis were stored in an on-line database and can be viewed via interactive map at https://norman-data.eu/EWW_DANUBE.
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Affiliation(s)
- Nikiforos A Alygizakis
- Environmental Institute, Okružná 784/42, 97241 Koš, Slovak Republic; Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece.
| | - Harrie Besselink
- BioDetection Systems b.v., Science Park 406, 1098 XH Amsterdam, the Netherlands
| | - Gabriela K Paulus
- KWR Watercycle Research Institute, 3433 PE Nieuwegein, the Netherlands; Department of Water Management, Faculty Civil Engineering & Geosciences, Delft University of Technology, Stevinweg 1, 2628 CN Delft, the Netherlands
| | - Peter Oswald
- Environmental Institute, Okružná 784/42, 97241 Koš, Slovak Republic
| | - Luc M Hornstra
- KWR Watercycle Research Institute, 3433 PE Nieuwegein, the Netherlands
| | | | - Gertjan Medema
- KWR Watercycle Research Institute, 3433 PE Nieuwegein, the Netherlands; Department of Water Management, Faculty Civil Engineering & Geosciences, Delft University of Technology, Stevinweg 1, 2628 CN Delft, the Netherlands
| | - Nikolaos S Thomaidis
- Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece.
| | - Peter A Behnisch
- BioDetection Systems b.v., Science Park 406, 1098 XH Amsterdam, the Netherlands
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