Antibiotic resistance genes in municipal wastewater treatment systems and receiving waters in Arctic Canada

Removal of antibiotic resistance genes in two tertiary level municipal wastewater treatment plants

Raw wastewater can contain high levels of antibiotic resistance genes (ARGs), making municipal wastewater treatment plants (WWTPs) critical for the control of the release of ARGs into the environment. The objective of this study was to investigate how individual treatment steps in two tertiary WWTPs affected the removal (copies/mL) and relative abundance of ARGs (copies/copies 16S rRNA genes). Nine ARG markers, representing resistance to commonly used antibiotics, as well as one integron gene (intl1) to assess ARG mobility potential, were quantified using quantitative real-time PCR (qPCR). Both WWTPs met provincial effluent regulations for removal of carbonaceous oxygen demand (CBOD₅) and total suspended solids. Eight of the ten ARG markers (intl1, sul1, sul2, tet(O), ermB, bla_CTX-M, bla_TEM, qnrS) were detected in all samples. In contrast, mecA was detected intermittently and vanA remained below the detection limit in all samples. The total ARG marker abundances decreased by log 1.77 (p < 0.05) in the plant using an aerated lagoon (AL), and by 2.69 logs (p < 0.05) through treatment in the plant employing a biological nutrient removal (BNR) system. The BNR and secondary clarifier steps in both plants afforded the most removal of ARGs. The relative abundance of ARGs remained unchanged at the AL plant and showed a decreasing trend at the BNR plant. Levels of CBOD_5, nitrate and the human Bacteroides fecal marker correlated with ARG concentrations, suggesting these variables may be useful in predicting ARG removal. In conclusion, the effluent coming from the WWTPs contained eight of the studied ARG markers in concentrations ranging from 0.01 to 3.6 log copies/mL, indicating their release into the environment, however, the relative abundance of ARGs was not enriched during treatment in the two WWTPs.

Fate of antibiotic resistance genes in two Arctic tundra wetlands impacted by municipal wastewater

In the Canadian Arctic, it is common practice to discharge municipal wastewater into tundra wetlands. Antibiotic resistant bacteria and the antibiotic resistance genes (ARGs) they contain can be present in municipal wastewater and there is a scarcity of knowledge on ARGs in wastewater in Arctic environments. This study was initiated on the fate of ARGs in tundra wetland ecosystems impacted by anthropogenic wastewater sources in Arctic communities. In the summer season of 2016, two wetlands were studied in the Inuit communities of Sanikiluaq and Naujaat in Nunavut, Canada. Genomic DNA was extracted from both soil and water during the spring freshet and late summer in the wetlands, and a suite of nine clinically relevant ARGs (sul1, sul2, mecA, vanA, qnrS, ermB, tetO, bla_TEM, bla_CTX-M), and an integron gene (int1) were analyzed using quantitative polymerase chain reaction (qPCR). Hydrological and water quality measurements were conducted in conjunction with the microbiological sampling. Gene targets were consistently present in the wastewater, and throughout both wetlands, except for vanA and mecA. Concentrations of ARGs were greater during the spring freshet, due to short hydraulic retention times (<2 days), which coincided with decreased treatment performance. The environmental resistome in un-impacted wetlands had above detection limit concentrations of int1, sul1, sul2, bla_CTX-M in water in Naujaat, and sul1, qnrS and tetO in soil in Sanikiluaq. First-order rate constants were widely variable and specific to the gene target. ARGs were present in concentrations elevated above baseline reference sites in tundra wetlands influenced by municipal wastewater, and hydrological conditions had a large impact on their spatial distribution and levels.

Relationship between modification of activated sludge wastewater treatment and changes in antibiotic resistance of bacteria

Biological treatment processes at wastewater treatment plants (WWTPs), which are the most common methods of sewage treatment, could cause selective elimination and/or changes in the proportions of phenotypes/genotypes within bacterial populations in effluent. Therefore, WWTPs based on activated sludge used in sewage treatment constitute an important reservoir of enteric bacteria which harbour potentially transferable resistance genes. Together with treated wastewater, these microorganisms can penetrate the soil, surface water, rural groundwater supplies and drinking water. Because of this, the aim of this study was to determine the impact of various modification of sewage treatment (the conventional anaerobic/anoxic/oxic (A2/O) process, mechanical-biological (MB) system, sequencing batch reactors (SBR), mechanical-biological system with elevated removal of nutrients (MB-ERN)) on the amount of antibiotic resistant bacteria (ARB) (including E. coli) and antibiotic resistance genes (ARGs) in sewage flowing out of the 13 treatment plants using activated sludge technology. There were no significant differences in ARB and ARGs regardless of time of sampling and type of treated wastewater (p > 0.05). The highest percentage of reduction (up to 99.9%) in the amount of ARB and ARGs was observed in WWTPs with MB and MB-ERN systems. The lowest reduction was detected in WWTPs with SBR. A significant increase (p < 0.05) in the percentage of bacteria resistant to the new generation antibiotics (CTX and DOX) in total counts of microorganisms was observed in effluents (EFF) from WWTPs with A2/O system and with SBR. Among all ARGs analyzed, the highest prevalence of ARGs copies in EFF samples was observed for sul1, tet(A) and qepA, the lowest for bla_TEM and bla_SHV. Although, the results of presented study demonstrate high efficiency of ARB and ARGs removal during the wastewater treatment processes, especially by WWTPs with MB and MB-ERN systems, EFF is still an important reservoir of ARGs which can be transferred to other microorganisms.

Antimicrobial resistance gene surveillance in the receiving waters of an upgraded wastewater treatment plant

Wastewater treatment plants (WWTPs) have been identified as hotspots for antimicrobial resistance genes (ARGs) and thus represent a critical point where patterns in ARG abundances can be monitored prior to their release into the environment. The aim of the current study was to measure the impact of the release of the final treated effluent (FE) on the abundance of ARGs in the receiving water of a recently upgraded WWTP in the Canadian prairies. Sample nutrient content (phosphorous and nitrogen species) was measured as a proxy for WWTP functional performance, and quantitative PCR (qPCR) was used to measure the abundance of eight ARGs, the intI1 gene associated with class I integrons, and the 16S rRNA gene. The genes ermB, sul1, intI1, blaCTX-M, qnrS, and tetO all had higher abundances downstream of the WWTP, consistent with the genes with highest abundance in the FE. These findings are consistent with the increasing evidence suggesting that human activity affects the abundances of ARGs in the environment. Although the degree of risk associated with releasing ARGs into the environment is still unclear, understanding the environmental dimension of this threat will help develop informed management policies to reduce the spread of antibiotic resistance and protect public health.

Occurrence and persistence of carbapenemases genes in hospital and wastewater treatment plants and propagation in the receiving river

This study aims to investigate the prevalence of clinically relevant carbapenemases genes (bla_KPC, bla_NDM and bla_OXA-48) in water samples collected over one-year period from hospital (H), raw and treated wastewater of two wastewater treatment plants (WWTPs) as well as along the Zenne River (Belgium). The genes were quantified in both particle-attached (PAB) and free-living (FLB) bacteria. Our results showed that absolute abundances were the highest in H waters. Although absolute abundances were significantly reduced in WWTP effluents, the relative abundance (normalized per 16S rRNA) was never lowered through wastewater treatment. Particularly, for the PAB the relative abundances were significantly higher in the effluents respect to the influents of both WWTPs for all the genes. The absolute abundances along the Zenne River increased from upstream to downstream, peaking after the release of WWTPs effluents, in both fractions. Our results demonstrated that bla_KPC, bla_NDM and bla_OXA-48 are widely distributed in the Zenne as a consequence of chronic discharge from WWTPs. To conclude, the levels of carbapenemases genes are significantly lower than other genes conferring resistance to more widely used antibiotics (analyzed in previous studies carried out at the same sites), but could raise up to the levels of high prevalent resistance genes.

Sources of Antibiotic Resistance Genes in a Rural River System

The increasing prevalence of antibiotic resistance genes (ARGs) in the environment is problematic due to the risk of horizontal gene transfer and development of antibiotic resistant pathogenic bacteria. Using a suite of monitoring tools, this study aimed to investigate the sources of ARGs in a rural river system in Nova Scotia, Canada. The monitoring program specifically focused on the relative contribution of ARGs from a single tertiary-level wastewater treatment plant (WWTP) in comparison to contributions from the upgradient rural, sparsely developed, watershed. The overall gene concentration significantly ( < 0.05) increased downstream from the WWTP, suggesting that tertiary-level treatment still contributes ARGs to the environment. As a general trend, ARG concentrations upstream were found to decrease as proximity to human-impacted areas decreased; however, many ARGs remained above detection limits in headwater river samples, which suggested their ubiquitous presence in this watershed in the absence of obvious pollution sources. Significant correlations with ARGs were found for human fecal marker, and some antibiotics, suggesting that these markers may be useful for prediction and understanding of ARG levels and sources in rural rivers.

Antibiotic resistance in urban and hospital wastewaters and their impact on a receiving freshwater ecosystem

The main objective of this study was to investigate the antibiotic resistance (AR) levels in wastewater (WW) and the impact on the receiving river. Samples were collected once per season over one year in the WW of a hospital, in the raw and treated WW of two wastewater treatment plants (WWTPs), as well as upstream and downstream from the release of WWTPs effluents into the Zenne River (Belgium). Culture-dependent methods were used to quantify Escherichia coli and heterotrophic bacteria resistant to amoxicillin, sulfamethoxazole, nalidixic acid and tetracycline. Six antibiotic resistance genes (ARGs) were quantified in both particle-attached (PAB) and free-living (FLB) bacteria. Our results showed that WWTPs efficiently removed antibiotic resistant bacteria (ARB) regardless of its AR profile. The ARGs levels were the highest in the hospital WW and were significantly reduced in both WWTPs. However, ARB and ARGs abundances significantly increased into the Zenne River downstream from the WWTPs outfalls. The variation in the relative abundance of ARGs through WW treatment differed depending on the WWTP, fraction, and gene considered. The sul1 and sul2 genes in PAB fraction showed significantly higher relative abundances in the effluent compared to the influent of both WWTPs. This study demonstrated that WWTPs could be hotspots for AR spread with significant impacts on receiving freshwater ecosystems. This was the first comprehensive study investigating at the same time antibiotics occurrence, fecal bacteria indicators, heterotrophic bacterial communities, and ARGs (distinguishing PAB and FLB) to assess AR levels in WW and impacts on the receiving river.

Vertical up-flow constructed wetlands exhibited efficient antibiotic removal but induced antibiotic resistance genes in effluent

The intensive use of antibiotics results in their continuous release into the environment and the subsequent widespread dissemination of antibiotic resistance genes (ARGs), thus posing potential risks for public health. Although vertical up-flow constructed wetlands (VUF-CWs) have been widely used to treat wastewater in remote or rural regions, few studies have assessed the potential risks of ARG dissemination when VUF-CWs are applied to treat wastewaters containing antibiotics. In this study, the removal performance of two typical antibiotics (sulfamethoxazole (SMX) and tetracycline (TC)) and the fate of ARGs were evaluated in three lab-scale VUF-CWs. The results indicated that high removal efficiencies (>98%) could be achieved for both SMX and TC. However, the exposure of antibiotics resulted in harboring abundant ARGs (mainly sul- and tet-related genes), even with increasing abundances with operation time. The abundances of ARGs had a positive correlation with the accumulation of SMX and TC in different layers of VUF-CWs, where the tet and sul genes have the highest abundance in the bottom layer due to the highest antibiotic exposure concentration. Positive correlations were observed between the abundance of tet gene and antibiotic concentration in effluent. Although the effluent had lower abundances of the ARGs than that in the wetland media, the occurrence of ARGs in effluent might still pose risk for public health. Further studies are required to explore effective control strategies to eliminate ARGs from VUF-CWs.