Occurrence, diversity, and persistence of antibiotic resistant enterococci in full-scale constructed wetlands treating urban wastewater in Sicily

Enterococci, Van Gene-Carrying Enterococci, and Vancomycin Concentrations in the Influent of a Wastewater Treatment Plant in Southeast Germany

Vancomycin-resistant (VR) Enterococcus spp. can be detected in high concentrations in wastewaters and pose a risk to public health. During a one-year study (September 2022-August 2023), 24 h composite raw wastewater samples (n = 192) of a municipal wastewater treatment plant were investigated for cultivable enterococci. After growth on Slanetz-Bartley agar (SBA), a mean concentration of 29,736 ± 9919 cfu/mL was calculated. Using MALDI-TOF MS to characterize randomly picked colonies (n = 576), the most common species were found to be Enterococcus faecium (72.6%), E. hirae (13.7%), and E. faecalis (8.0%). Parallel incubation of wastewater samples on SBA and VRESelect agar resulted in a mean rate of VR enterococci of 2.0 ± 1.5%. All the tested strains grown on the VRESelect agar (n = 172) were E. faecium and carried the vanA (54.6%) or vanB gene (45.4%) with limited sequence differences. In susceptibility experiments, these isolates showed a high-level resistance to vancomycin (>256 µg/mL). Concentration of vancomycin was determined in 93.7% of 112 wastewater samples (mean: 123.1 ± 64.0 ng/L) and varied between below 100 ng/L (the detection limit) and 246.6 ng/L. A correlation between the concentration of vancomycin and the rate of VR strains among the total enterococci could not be found. The combination of incubation of samples on SBA and a commercial vancomycin-containing agar applied in clinical microbiology with a multiplex PCR for detection of van genes is an easy-to-use tool to quantify and characterize VR Enterococcus spp. in water samples.

Removal of micropollutants by UASB reactor and post-treatment by Fenton and photo-Fenton: Matrix effect and toxicity responses

Literature is scarce on the performance of Fenton-based processes as post-treatment of municipal wastewater treated by upflow anaerobic sludge blanket (UASB) reactor. This study aims to perform Fenton and photo-Fenton from UASB influent and effluent matrices to remove micropollutants (MPs) models: atrazine (ATZ), rifampicin (RIF), and 17α-ethynylestradiol (EE2). A UASB reactor at bench-scale (14 L) was operated with these MPs, and the AOPs experiments at bench-scale were performed on a conventional photochemical reactor (1 L). A high-pressure vapor mercury lamp was used for photo-Fenton process (UVA-Vis) as a radiation source. Microcrustacean Daphnia magna (acute toxicity) and seeds of Lactuca sativa (phytotoxicity) were indicator organisms for toxicity monitoring. The UASB reactor showed stability removing 90% of the mean chemical oxygen demand, and removal efficiencies for ATZ, RIF, and EE2 were 16.5%, 45.9%, and 15.7%, respectively. A matrix effect was noted regarding the application of both Fenton and photo-Fenton in UASB influent and effluent to remove MPs and toxicity responses. The pesticide ATZ was the most recalcitrant compound, yet the processes carried out from UASB effluent achieved removal >99.99%. The post-treatment of the UASB reactor by photo-Fenton removed acute toxicity in D. magna for all treatment times. However, only the photo-Fenton conducted for 90 min did not result in a phytotoxic effect in L. sativa.

Persistence, environmental hazards, and mitigation of pharmaceutically active residual contaminants from water matrices

Pharmaceutical compounds are designed to elicit a biological reaction in specific organisms. However, they may also elicit a biological response in non-specific organisms when exposed to ambient quantities. Therefore, the potential human health hazards and environmental effects associated with pharmaceutically active compounds presented in aquatic environments are being studied by researchers all over the world. Owing to their broad-spectrum occurrence in various environmental matrices, direct or indirect environmental hazardous impacts, and human-health related consequences, several pharmaceutically active compounds have been categorized as emerging contaminants (ECs) of top concern. ECs are often recalcitrant and resistant to abate from water matrices. In this review, we have examined the classification, occurrence, and environmental hazards of pharmaceutically active compounds. Moreover, because of their toxicity and the inefficiency of wastewater treatment plants to remove pharmaceutical pollutants, novel wastewater remediation technologies are urgently required. Thus, we have also analyzed the recent advances in microbes-assisted bioremediation as a suitable, cost-effective, and eco-friendly alternative for the decontamination of pharmaceutical pollutants. Finally, the most important factors to reach optimal bioremediation are discussed.

Wastewater fertigation in agriculture: Issues and opportunities for improved water management and circular economy

Water shortages are an issue of growing worldwide concern. Irrigated agriculture accounts for about 70% of total freshwater withdrawals globally, therefore alternatives to use of conventional sources need to be investigated. This paper critically reviews the application of treated wastewater for agricultural fertigation (i.e., water and nutrient recovery) considering different perspectives: legislation, agronomic characteristics, social acceptability, sustainability of treatment technologies. Critical issues that still need further investigation for a wider application of fertigation practices include accumulation of emerging contaminants in soils, microbiological and public health implications, and stakeholders' acceptance. A techno-economic methodological approach for assessing the sustainability of treated wastewater reuse in agriculture is subsequently proposed herein, which considers different possible local conditions (cultivated crops and effluent characteristics). The results showed that tailoring effluent characteristics to the desired nutrient composition could enhance the process economic sustainability; however, water savings have a major economic impact than fertilizers' savings, partly due to limited P reuse efficiency. The developed methodology is based on a practical approach and may be generalized to most agricultural conditions, to evaluate and encourage safe and efficient agricultural wastewater reuse practices.

Performance Efficiency of Conventional Treatment Plants and Constructed Wetlands towards Reduction of Antibiotic Resistance

Domestic and industrial wastewater discharges harbor rich bacterial communities, including both pathogenic and commensal organisms that are antibiotic-resistant (AR). AR pathogens pose a potential threat to human and animal health. In wastewater treatment plants (WWTP), bacteria encounter environments suitable for horizontal gene transfer, providing an opportunity for bacterial cells to acquire new antibiotic-resistant genes. With many entry points to environmental components, especially water and soil, WWTPs are considered a critical control point for antibiotic resistance. The primary and secondary units of conventional WWTPs are not designed for the reduction of resistant microbes. Constructed wetlands (CWs) are viable wastewater treatment options with the potential for mitigating AR bacteria, their genes, pathogens, and general pollutants. Encouraging performance for the removal of AR (2-4 logs) has highlighted the applicability of CW on fields. Their low cost of construction, operation and maintenance makes them well suited for applications across the globe, especially in developing and low-income countries. The present review highlights a better understanding of the performance efficiency of conventional treatment plants and CWs for the elimination/reduction of AR from wastewater. They are viable alternatives that can be used for secondary/tertiary treatment or effluent polishing in combination with WWTP or in a decentralized manner.

Antimicrobial resistance in Enterococcus faecium and Enterococcus faecalis isolates of swine origin from eighteen provinces in China

Enterococcus faecium and E. faecalis are important human pathogens and also served as sentinel organisms for monitoring systems of antimicrobial resistance in both animals and humans. In this study, 106 E. faecium and 56 E. faecalis isolates were collected from 61 pig farms in 18 proveinces of China. Antimicrobial susceptibility was determined for 9 clinically important antibiotics and 3 antimicrobial growth promoters. The Enterococcus isolates showed high prevalence of resistance to medically important antibiotics, such as ampicillin (50.9% for E. faecium and 19.6% for E. faecalis), chloramphenicol (24.5% for E. faecium and 41.1% for E. faecalis), erythromycin (83.0% for E. faecium and 91.1% for E. faecalis), tetracycline (79.2% for E. faecium and 100% for E. faecalis), quinupristin/dalfopristin (26.4% for E. faecium) and ciprofloxacin (73.6% for E. faecium and 66.1% for E. faecalis). Resistance to tigecycline, linezolid and vancomycin was very rare. The resistance status of three representative in-feed antibiotics bacitracin, nosiheptide and enramycin was firstly investigated with Enterococcus as indicator bacteria. The Enterococcus isolates showed extremely high frequency of bacitracin resistance (96.7% for E. faecium and 87.8% for E. faecalis), while no nosiheptide and enramycin resistance was observed. Pulsed-field gel electrophoresis (PFGE) analysis showed that a majority of E. faecium and E. faecalis strains showed unrelated profiles, indicating high heterogeneity among the Enterococcus isolates. Our study provided basic data on the antimicrobial resistance of E. faecium and E. faecalis isolates.

Artificial sweeteners stimulate horizontal transfer of extracellular antibiotic resistance genes through natural transformation

Antimicrobial resistance has emerged as a global threat to human health. Natural transformation is an important pathway for horizontal gene transfer, which facilitates the dissemination of antibiotic resistance genes (ARGs) among bacteria. Although it is suspected that artificial sweeteners could exert antimicrobial effects, little is known whether artificial sweeteners would also affect horizontal transfer of ARGs via transformation. Here we demonstrate that four commonly used artificial sweeteners (saccharin, sucralose, aspartame, and acesulfame potassium) promote transfer of ARGs via natural transformation in Acinetobacter baylyi ADP1, a model organism for studying competence and transformation. Such phenomenon was also found in a Gram-positive human pathogen Bacillus subtilis and mice faecal microbiome. We reveal that exposure to these sweeteners increases cell envelope permeability and results in an upregulation of genes encoding DNA uptake and translocation (Com) machinery. In addition, we find that artificial sweeteners induce an increase in plasmid persistence in transformants. We propose a mathematical model established to predict the long-term effects on transformation dynamics under exposure to these sweeteners. Collectively, our findings offer insights into natural transformation promoted by artificial sweeteners and highlight the need to evaluate these environmental contaminants for their antibiotic-like side effects.

The Wide Range of Antibiotic Resistance and Variability of Genotypic Profiles in Escherichia coli from Domestic Animals in Eastern Sicily

The emergence of multidrug resistance among Enterobacteriaceae in livestock poses a serious public health threat. Escherichia coli, a usual host of intestinal microbiota, is recognized also as etiological agent of numerous infections widespread in both humans and animals. The colibacillosis is one of the most reported zoonoses worldwide, typically treated with antibiotics in the primary stages. This strategy has promoted the onset of antibiotic-resistant serotypes of E. coli, reducing the effectiveness of therapeutic treatments and contributing to antibiotic resistance spread. The current study focused on biodiversity, pathogenicity, and antibiotic resistance profile of 104 E. coli strains isolated from domestic animals in Eastern Sicily. The strains were isolated from sick animals and carcasses of six different animal species and screened for resistance against 16 antibiotic molecules, as recommended by WHO and OIE. The antibiotic resistance patterns highlighted that all strains were multi-resistant, showing resistance to at least three antibiotic classes. The highest incidence of resistance was observed against amoxicillin (100%), tylosin (97%), sulfamethoxazole (98%), and erythromycin (92%), while the lowest for colistin (8%). The pathotype characterization identified two EPEC strains and the study of genetic linkage (PFGE) showed a wide variety of profiles. The current study emphasized the wide range of multidrug resistance and genotyping profiles in E. coli isolated in Easter Sicily.

Potential of constructed wetland treatment systems for agricultural wastewater reuse under the EU framework

One of the solutions for the problems regarding increasing water scarcity and pollution of water resources can be wastewater reuse. Constructed wetlands (CWs) are a sustainable and cost-effective technology for wastewater treatment. If they are able to produce effluent of a needed quality, they can be a valuable addition for wastewater reuse schemes. This review studied 39 treatment systems based on CWs, and it assessed their characteristics and performance on pollutant removal. Moreover, their potential to reach the new European Union standards for agricultural wastewater reuse was evaluated. The results showed that the combination of CWs with additional technologies (e.g. UV treatment, anaerobic reactors) can further increase their performance and provide better removal efficiencies in comparison with conventional horizontal and vertical subsurface flow CWs. Particularly, hybrid systems showed a better removal of organic matter and bacterial indicators than single-stage CWs. For most of the systems considered, the concentrations of biochemical oxygen demand and total suspended solids in treated effluent were below the limits for agricultural reuse. However, that was often not the case with Escherichia coli and therefore it is recommended to add a disinfection unit to the systems in order to achieve the levels required in the case of agricultural reuse.

Microbial communities responded to tetracyclines and Cu(II) in constructed wetlands microcosms with Myriophyllum aquaticum

Combined antibiotic and heavy metal pollution has generated considerable concern. Constructed wetlands (CWs) have been shown to efficiently remove pollutants; however, the microbial community responses to combined pollutants remain enigmatic. In this study, seven microcosm CWs were planted with Myriophyllum aquaticum, spiked with tetracyclines (TCs) (300-30,000 μg/L), alone or with Cu(II), to investigate the response of plant-associated microbial communities. TCs and the Cu/TC ratio greatly affected the performance of CWs. Tetracyclines led to higher microbial diversity, evenness and richness, while UniFrac distances and principal coordinate (PC_O) and redundancy analyses revealed that the co-presence of TCs and Cu(II) led to variations in bacterial communities. Proteobacteria, Cyanobacteria and Bacteroidetes were the dominant microbial phyla and Cloacibacterium, Hydrogenophaga, Rheinheimera and Denitratisoma accounted for 6.2-21.0% of all genera. Therefore, the co-occurrence of heavy metals should be considered when judging the removal potential of TCs in phytoremediation.

The Role of Urban Wastewater in the Environmental Transmission of Antimicrobial Resistance: The Current Situation in Italy (2010-2019)

Scientific studies show that urban wastewater treatment plants (UWWTP) are among the main sources of release of antibiotics, antibiotic resistance genes (ARG) and antibiotic-resistant bacteria (ARB) into the environment, representing a risk to human health. This review summarizes selected publications from 1 January 2010 to 31 December 2019, with particular attention to the presence and treatment of ARG and ARB in UWWTPs in Italy. Following a brief introduction, the review is divided into three sections: (i) phenotypic assessment (ARB) and (ii) genotypic assessment (ARG) of resistant microorganisms, and (iii) wastewater treatment processes. Each article was read entirely to extract the year of publication, the geographical area of the UWWTP, the ARB and ARG found, and the type of disinfection treatment used. Among the ARB, we focused on the antibiotic resistance of Escherichia coli, Klebsiella pneumoniae, and Enterococci in UWWTP. The results show that the information presented in the literature to date is not exhaustive; therefore, future scientific studies at the national level are needed to better understand the spread of ARB and ARG, and also to develop new treatment methods to reduce this spread.

Wetlands for environmental protection

This article presents an update on the research and practical demonstration of wetland-based treatment technologies for protecting water resources and environment covering papers published in 2019. Wetland applications in wastewater treatment, stormwater management, and removal of nutrients, metals, and emerging pollutants including pathogens are highlighted. A summary of studies focusing on the effects of vegetation, wetland design and operation strategies, and process configurations and modeling, for efficient treatment of various municipal and industrial wastewaters, is included. In addition, hybrid and innovative processes with wetlands as a platform treatment technology are presented.

Potential of Myriophyllum aquaticum for phytoremediation of water contaminated with tetracycline antibiotics and copper

Water pollution caused by antibiotics and heavy metals has attracted considerable concern, and efficient approaches are urgently needed for their removal. The objective of this study was to investigate the potential of Myriophyllum aquaticum for long-term phytoremediation of wastewater containing tetracycline (TC) antibiotics and copper. Seven hydroponic microcosms were constructed, spiked with tetracycline, oxytetracycline (OTC) and chlortetracycline (CTC) (300-30,000 μg/L), alone or simultaneously with Cu (II), and operated for 12 weeks. The TC removal efficiencies using the hydroponic microcosms here were commensurate or higher than those in previous studies. However, the Cu/TC ratio greatly affected the removal, accumulation of TCs by M. aquaticum, and plant growth. Low levels of Cu (II) (<1000 μg/L) promoted TC removal, but excessive Cu (II) (>10,000 μg/L) impeded it. Mass balance analysis showed that most TCs (45%-64% on average) accumulated in the roots of M. aquaticum. Plant biomass was correlated with the removal of COD, TN, TP, and NH₄⁺-N (p ≤ 0.05) but not with removal of the TCs. Proteobacteria, Bacteroidetes, and Fusobacteria were dominant in the microbial communities, but they showed little correlation with the TC removal. M. aquaticum can be employed as an effective means of TC removal from water. The co-existence of heavy metals should be considered when evaluating the removal potential of TCs in phytoremediation.

Effects of tourist flows on antibiotic resistance in wastewater of a Greek island

AIM

Antibiotic resistance in wastewaters reflects the clinical resistome. This study aimed at investigating whether changes in the population size and composition in the popular tourist destination of Zakynthos island are associated with differentiation in the antibiotic resistance of environmental micro-organisms isolated from wastewater.

METHODS AND RESULTS

The resistance profiles of four species (Escherichia coli, Staphylococcus sp., Pseudomonas sp. and Enterococcus sp.) were studied in 124 raw and treated municipal wastewaters from November 2015 to August 2016. Isolates were tested against their susceptibility to several antibiotics of different antimicrobial categories. Data concerning the alteration in the population size and composition, due to the tourist mobility, were collected and logistic regression models were used to examine the relationships between antimicrobial resistance and population changes. The decrease in resistance of E. coli to amoxicillin-clavulanate, of enterococci to norfloxacin and ampicillin, and of pseudomonads to almost all antibiotics tested was associated with population increase due to tourist flows. In contrast, the presence of tourists was linked to an increase in quinupristin-dalfopristin resistant enterococci. Resistance of staphylococci did not change during the tourist period.

CONCLUSION

Changes in population composition in touristic areas are reflected in antibiotic resistance of environmental bacteria in wastewater.

SIGNIFICANCE AND IMPACT OF THE STUDY

In touristic areas, where people carrying different resistomes are merged, medication should be adapted accordingly.

Hydrological and hydraulic behaviour of a surface flow constructed wetland treating agricultural drainage water in northern Italy

A surface flow constructed wetland (SFCW) treating agricultural drainage water was investigated with the aim to detect modifications in hydrological and hydraulic characteristics after more than a decade of operation. Ponded infiltration tests were conducted to estimate the saturated hydraulic conductivity, K_s, of the surface soil layer at the point scale. At the global scale, infiltration rate, i, was computed from the water balance to detect leakages from the pervious wetland surface. Tracer tests were conducted to analyse the existence of preferential flow inside the system and to estimate its hydraulic retention time (HRT). Clogging phenomena occurred given a mean K_s value of 30 mm h^-1 was measured near the SFCW inlet, that was 9.61 times lower than the value at the outlet zone. The estimated infiltration losses were two orders of magnitude lower than infiltration measured at the point scale. The results also confirmed the existence of a moderate amount of preferential flow paths and dead zones in the SFCW as the actual HRT (6.7 days) was shorter than the nominal one (8.1 days). Despite this, it can be concluded that the system performance is still good after 17 years of operation.

Eliminating partial-transformation products and mitigating residual toxicity of amoxicillin through intimately coupled photocatalysis and biodegradation

Intimately coupled photocatalysis and biodegradation (ICPB) is a promising technology for treating wastewater containing antibiotics. While past work has documented the benefits of ICPB for removing and mineralizing antibiotics, its impacts on mitigating biotoxicity from products has not been studied. We fabricated an ICPB carrier by coating Ag-doped TiO₂ on the outer skeleton of sponge carriers and allowing biofilm to grow in the internal macro-pores. We used amoxicillin (C₁₆H₁₉N₃O₅S) as the model antibiotic. The amoxicillin-removal rate contents with ICPB was greater by 40% vs. photocatalysis and 65% vs. biodegradation, based on the first-order kinetic simulation. While mineralization of amoxicillin was minimal for photocatalysis or biodegradation alone, it was ∼35% with ICPB. Photocatalysis alone led to accumulation of C₁₄H₂₁N₃O₂S; biodegradation alone resulted in accumulation of C₁₄H₂₁N₃O₃, C₁₆H₁₈N₂O₄S, and C₁₅H₂₁N₃O₃; but they were negligible after ICPB. As a result, ICPB reduced toxicity impacts measured by Staphylococcus aureas growth, Daphnia magna mobility, and teratogenicity to Zebrafish embryos. In contrast, photocatalysis alone increased each of the toxicity effects. In sum, ICPB gave greater removal and mineralization of amoxicillin, and it mitigated biotoxicity from treatment products.