Can chlorination co-select antibiotic-resistance genes?

Nature-based bioreactors: Tackling antibiotic resistance in urban wastewater treatment

The overuse and misuse of antibiotics have accelerated the selection of antibiotic-resistant bacteria, significantly impacting human, animal, and environmental health. As aquatic environments are vulnerable to antibiotic resistance, suitable management practices should be adopted to tackle this phenomenon. Here we show an effective, nature-based solution for reducing antibiotic resistance from actual wastewater. We utilize a bioreactor that relies on benthic (biofilms) and planktonic microbial communities to treat secondary effluent from a small urban wastewater treatment plant (<10,000 population equivalent). This treated effluent is eventually released into the local aquatic ecosystem. We observe high removal efficiency for genes that provide resistance to commonly used antibiotic families, as well as for mobile genetic elements that could potentially aid in their spread. Importantly, we notice a buildup of sulfonamide (sul1 and sul2) and tetracycline (tet(C), tet(G), and tetR) resistance genes specifically in biofilms. This advancement marks the initial step in considering this bioreactor as a nature-based, cost-effective tertiary treatment option for small UWWTPs facing antibiotic resistance challenges.

Impact of chlorine disinfection on intracellular and extracellular antimicrobial resistance genes in wastewater treatment and water reclamation

Wastewater treatment plants and water reclamation facilities are reservoirs of antimicrobial resistance genes (ARGs). These ARGs are not limited solely to intracellular DNA (inARGs) but include extracellular DNA (exARGs) present in wastewater. The release of exARGs from cells can be exacerbated by treatment processes, including chlorine disinfection, which disrupts bacterial cells. Given the potential for exARGs to drive horizontal gene transfer and contribute to the proliferation of antimicrobial resistance, it is imperative to recognize these fractions as emerging environmental pollutants. In this study, we conducted a comprehensive year-long assessment of both inARGs and exARGs, further differentiating between dissolved exARGs (Dis_exARGs) and exARGs adsorbed onto particulate matter (Ads_exARGs), within a full-scale wastewater treatment and water reclamation facility. The results revealed that Ads_exARGs comprised up to 30 % of the total ARGs in raw sewage with high biomass content. Generally, treatments at low and high doses of chlorine increased the abundance of Dis_exARGs and Ads_exARGs. The fate of ARG levels that varied depending on the type of ARGs suggested variations in the susceptibility of the host bacteria to chlorination. Moreover, co-occurrence of several potential opportunistic pathogenic bacteria and ARGs were observed. Therefore, we propose higher doses of chlorination as a prerequisite for the effective removal of inARGs and exARGs.

Discovery of sulfonamide resistance genes in deep groundwater below Patna, India

Global usage of pharmaceuticals has led to the proliferation of bacteria that are resistant to antimicrobial treatments, creating a substantial public health challenge. Here, we investigate the emergence of sulfonamide resistance genes in groundwater and surface water in Patna, a rapidly developing city in Bihar, India. We report the first quantification of three sulfonamide resistance genes (sulI, sulII and sulIII) in groundwater (12-107 m in depth) in India. The mean relative abundance of gene copies was found to be sulI (2.4 × 10-2 copies/16S rRNA gene) > sulII (5.4 × 10-3 copies/16S rRNA gene) > sulIII (2.4 × 10-3 copies/16S rRNA gene) in groundwater (n = 15) and surface water (n = 3). A comparison between antimicrobial resistance (AMR) genes and wastewater indicators, particularly tryptophan:fulvic-like fluorescence, suggests that wastewater was associated with AMR gene prevalence. Urban drainage channels, containing hospital and domestic wastes, are likely a substantial source of antimicrobial resistance in groundwater and surface water, including the Ganges (Ganga) River. This study is a reference point for decision-makers in the fight against antimicrobial resistance because it quantifies and determines potential sources of AMR genes in Indian groundwater.

Sensitivity and consistency of long- and short-read metagenomics and epicPCR for the detection of antibiotic resistance genes and their bacterial hosts in wastewater

Wastewater surveillance is a powerful tool to assess the risks associated with antibiotic resistance in communities. One challenge is selecting which analytical tool to deploy to measure risk indicators, such as antibiotic resistance genes (ARGs) and their respective bacterial hosts. Although metagenomics is frequently used for analyzing ARGs, few studies have compared the performance of long-read and short-read metagenomics in identifying which bacteria harbor ARGs in wastewater. Furthermore, for ARG host detection, untargeted metagenomics has not been compared to targeted methods such as epicPCR. Here, we 1) evaluated long-read and short-read metagenomics as well as epicPCR for detecting ARG hosts in wastewater, and 2) investigated the host range of ARGs across the wastewater treatment plant (WWTP) to evaluate host proliferation. Results highlighted long-read revealed a wider range of ARG hosts compared to short-read metagenomics. Nonetheless, the ARG host range detected by long-read metagenomics only represented a subset of the hosts detected by epicPCR. The ARG-host linkages across the influent and effluent of the WWTP were characterized. Results showed the ARG-host phylum linkages were relatively consistent across the WWTP, whereas new ARG-host species linkages appeared in the WWTP effluent. The ARG-host linkages of several clinically relevant species found in the effluent were identified.

The fate of antibiotic resistance genes in wastewater containing microalgae treated by chlorination, ultra-violet, and Fenton reaction

Antibiotic resistance genes (ARGs) and bacteria (ARBs) in the effluent of wastewater treatment plants (WWTPs) are of utmost importance for the dissemination of ARGs in natural aquatic environments. Therefore, there is an urgent need for effective technologies to eliminate WWTP ARGs/ARBs and mitigate the associated risks posed by the discharged ARG in aquatic environments. To test the effective technology for eliminating ARGs/ARBs, we compared the removal of ARGs and ARBs by three different tertiary treatments, namely ultra-violet (UV) disinfection, chlorination disinfection, and Fenton oxidation. Then, the treated wastewater was co-cultured with Chlorella vulgaris (representative of aquatic biota) to investigate the fate of discharged ARGs into the aquatic environment. The results demonstrated that chlorination (at a chlorine concentration of 15 mg/L) and Fenton (at pH 2.73, with 0.005 mol/L Fe2+ and 0.0025 mol/L H2O2) treatment showed higher efficacy in ARG removal (1.8 - 4.17 logs) than UV treatment (15 min) (1.29 - 3.87 logs). Moreover, chlorine at 15 mg/L and Fenton treatment effectively suppressed ARB regeneration while UV treatment for 15 min could not. Regardless of treatments tested in this study, the input of treated wastewater to the Chlorella system increased the number of ARGs and mobile genetic elements (MGEs), indicating the potential risk of ARG dissemination associated with WWTP discharge. Among the wastewater-Chlorella co-culture systems, chlorination resulted in less of an increase in the number of ARGs and MGEs compared to Fenton and UV treatment. When comparing the wastewater systems to the co-culture systems, it was observed that Chlorella vulgaris reduced the number of ARGs and MGEs in chlorination and UV-treated wastewater; however, Chlorella vulgaris promoted ARG survival in Fenton-treated water, suggesting that aquatic microalgae might act as a barrier to ARG dissemination. Overall, chlorination treatment not only effectively removes ARGs and inhibits ARB regeneration but also shows a lower risk of ARG dissemination. Therefore, chlorination is recommended for practical application in controlling the spread of discharged ARGs from WWTP effluent in natural aquatic environments.

Insights into microbial contamination and antibiotic resistome traits in pork wholesale market: An evaluation of the disinfection effect of sodium hypochlorite

Chlorine and its derivatives, such as sodium hypochlorite (NaClO) and chlorine dioxide, are frequently employed as disinfectants throughout the pork supply chain in China. Nevertheless, the extensive use of NaClO has the potential to cause the creation of 'chlorine-tolerant bacteria' and accelerate the evolution of antibiotic resistance. This study evaluated the efficacy of NaClO disinfection by examining alterations in the microbiome and resistome of a pork wholesale market (PWM), and bacteria isolation and analysis were performed to validate the findings. As expected, the taxonomic compositions of bacteria was significantly different before and after disinfection. Notably, Salmonella enterica (S. enterica), Salmonella bongori (S. bongori), Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), and Pseudomonas aeruginosa (P. aeruginosa) were observed on all surfaces, indicating that the application of NaClO disinfection treatment in PWM environments for pathogenic bacteria is limited. Correlations were identified between antibiotic resistance genes (ARGs) associated with aminoglycosides (aph(3'')-I, aph(6')-I), quinolone (qnrB, abaQ), polymyxin (arnA, mcr-4) and disinfectant resistance genes (emrA/BD, mdtA/B/C/E/F). Furthermore, correlations were found between risk Rank I ARGs associated with aminoglycoside (aph(3')-I), tetracycline (tetH), beta_lactam (TEM-171), and disinfectant resistance genes (mdtB/C/E/F, emrA, acrB, qacG). Importantly, we found that Acinetobacter and Salmonella were the main hosts of disinfectant resistance genes. The resistance mechanisms of the ARGs identified in PWM were dominated by antibiotic deactivation (38.7%), antibiotic efflux (27.2%), and antibiotic target protection (14.4%). The proportion of genes encoding efflux pumps in the PWM resistome increased after disinfection. Microbial cultures demonstrated that the traits of microbial contamination and antibiotic resistane were consistent with those observed by metagenomic sequencing. This study highlights the possibility of cross-resistance between NaClO disinfectants and antibiotics, which should not be ignored.

Gamma-ray irradiation as an effective method for mitigating antibiotic resistant bacteria and antibiotic resistance genes in aquatic environments

The prevalence of antibiotic resistance genes (ARGs) in municipal wastewater treatment plants (MWTPs) has emerged as a significant environmental concern. Despite advanced treatment processes, high levels of ARGs persist in the secondary effluent from MWTPs, posing ongoing environmental risks. This study explores the potential of gamma-ray irradiation as a novel approach for sterilizing antibiotic-resistant bacteria (ARB) and reducing ARGs in MWTP secondary effluent. Our findings reveal that gamma-ray irradiation at an absorbed dose of 1.6 kGy effectively deactivates all culturable bacteria, with no subsequent revival observed after exposure to 6.4 kGy and a 96-h incubation in darkness at room temperature. The removal efficiencies for a range of ARGs, including tetO, tetA, blaTEM-1, sulI, sulII, and tetW, were up to 90.5% with a 25.6 kGy absorbed dose. No resurgence of ARGs was detected after irradiation. Additionally, this study demonstrates a considerable reduction in the abundances of extracellular ARGs, with the transformation efficiencies of extracellular tetracycline and sulfadiazine resistance genes decreasing by 56.3-81.8% after 25.6 kGy irradiation. These results highlight the effectiveness of gamma-ray irradiation as an advanced and promising method for ARB sterilization and ARG reduction in the secondary effluent of MWTPs, offering a potential pathway to mitigate environmental risks associated with antibiotic resistance.

An evaluation of conventional and nature-based technologies for controlling antibiotic-resistant bacteria and antibiotic-resistant genes in wastewater treatment plants

Antibiotic resistance is a globally recognized health concern which leads to longer hospital stays, increased morbidity, increased mortality, and higher medical costs. Understanding how antibiotic resistance persists and exchanges in environmental systems like soil, water, and wastewater are critically important for understanding the emergence of pathogens with new resistance profiles and the subsequent exposure of people who indirectly/directly come in contact with these pathogens. There are concerns about the widespread application of prophylactic antibiotics in the clinical and agriculture sectors, as well as chemicals/detergents used in food and manufacturing industries, especially the quaternary ammonium compounds which have been found responsible for the generation of resistant genes in water and soil. The rates of horizontal gene transfer increase where there is a lack of proper water/wastewater infrastructure, high antibiotic manufacturing industries, or endpoint users - such as hospitals and intensive agriculture. Conventional wastewater treatment technologies are often inefficient in the reduction of ARB/ARGs and provide the perfect combination of conditions for the development of antibiotic resistance. The wastewater discharged from municipal facilities may therefore be enriched with bacterial communities/pathogens and provide a suitable environment (due to the presence of nutrients and other pollutants) to enhance the transfer of antibiotic resistance. However, facilities with tertiary treatment (either traditional/emerging technologies) provide higher rates of reduction. This review provides a synthesis of the current understanding of wastewater treatment and antibiotic resistance, examining the drivers that may accelerate their possible transmission to a different environment, and highlighting the need for tertiary technologies used in treatment plants for the reduction of resistant bacteria/genes.

The factors controlling antibiotic resistance genes in different treatment processes of mainstream full-scale wastewater treatment plants

The alteration of antibiotic resistance genes (ARGs) in wastewater has been less studied in wastewater treatment plants (WWTPs), making it difficult to assess ARGs' spreading risk comprehensively. Therefore, this study investigated the distribution and reduction of ARGs in the main process (Anaerobic-Anoxic-Oxic with Membrane Bio-Reactor (A2/O + MBR), Oxidation Ditch with sedimentation (OD), and Cyclic Activated Sludge System (CASS) with sedimentation) and disinfection process (Ultra-violet and Chlorination) of full-scale WWTPs. The wastewater was sampled before and after the different main process and disinfection process; then, the diversity and abundance of ARGs and mobile genetic genes (MGEs, helping the horizontal transfer of ARGs) in wastewater of different treatment stages were determined by a real-time high-throughput quantitative PCR (HT-qPCR) system. It was found that similar influents would result in similar ARGs in wastewater samples, independent of the treatment processes used. The main process could effectively reduce the abundance of ARGs and MGEs by 1.80-2.12 and 1.46-2.18 logarithm units, respectively. The main factors affecting ARGs were mainly wastewater quality index, especially COD, and MGEs like transposase and insertion sequences which were significantly associated with 66 and 48 subtypes of ARGs, respectively. Moreover, disinfection was more effective than the main process in inactivating antibiotic resistance bacteria (ARB), and the removal rate of ARB by disinfection reached 43.53 %-100 %. However, there are still risks of ARB regeneration (up to 4.22 log units) in the effluent of WWTPs. In the future, nutrient removal and disinfection process improvement is necessary to benefit ARG and ARB removal.

Enhance antibiotic resistance and human health risks in aerosols during the COVID-19 pandemic

Aerosols are an important route for the transmission of antibiotic resistance genes (ARGs). Since the 2019 (COVID-19) pandemic, the large-scale use of disinfectants has effectively prevented the spread of environmental microorganisms, but studies regarding the antibiotic resistance of airborne bacteria remain limited. This study focused on four functional urban areas (commercial areas, educational areas, residential areas and wastewater treatment plant) to study the variations in ARG abundances, bacterial community structures and risks to human health during the COVID-19 pandemic in aerosol. The results indicated the abundance of ARGs during the COVID-19 period were up to approximately 13-fold greater than before the COVID-19 period. Large-scale disinfection resulted in a decrease in total bacterial abundance. However, chlorine-resistant bacteria tended to be survived. Among the four functional areas, the diversity and abundance of aerosol bacteria were highest in commercial aera. Antibiotic susceptibility assays suggested elevated resistance of isolated bacteria to several tested antibiotics due to disinfection exposure. The potential exposure risks of ARGs to human health were 2 times higher than before the COVID-19 pandemic, and respiratory intake was the main exposure route. The results highlighted the elevated antibiotic resistance of bacteria in aerosols that were exposed to disinfectants after the COVID-19 pandemic. This study provides theoretical guidance for the rational use of disinfectants and control of antimicrobial resistance.

Airborne antibiotic resistome and human health risk in railway stations during COVID-19 pandemic

Antimicrobial resistance is recognized as one of the greatest public health concerns. It is becoming an increasingly threat during the COVID-19 pandemic due to increasing usage of antimicrobials, such as antibiotics and disinfectants, in healthcare facilities or public spaces. To explore the characteristics of airborne antibiotic resistome in public transport systems, we assessed distribution and health risks of airborne antibiotic resistome and microbiome in railway stations before and after the pandemic outbreak by culture-independent and culture-dependent metagenomic analysis. Results showed that the diversity of airborne antibiotic resistance genes (ARGs) decreased following the pandemic, while the relative abundance of core ARGs increased. A total of 159 horizontally acquired ARGs, predominantly confering resistance to macrolides and aminoglycosides, were identified in the airborne bacteria and dust samples. Meanwhile, the abundance of horizontally acquired ARGs hosted by pathogens increased during the pandemic. A bloom of clinically important antibiotic (tigecycline and meropenem) resistant bacteria was found following the pandemic outbreak. 251 high-quality metagenome-assembled genomes (MAGs) were recovered from 27 metagenomes, and 86 genera and 125 species were classified. Relative abundance of ARG-carrying MAGs, taxonomically assigned to genus of Bacillus, Pseudomonas, Acinetobacter, and Staphylococcus, was found increased during the pandemic. Bayesian source tracking estimated that human skin and anthropogenic activities were presumptive resistome sources for the public transit air. Moreover, risk assessment based on resistome and microbiome data revealed elevated airborne health risks during the pandemic.

Transmission of antibiotic resistance genes through mobile genetic elements in Acinetobacter baumannii and gene-transfer prevention

Antibiotic resistance is a major global public health concern. Acinetobacter baumannii is a nosocomial pathogen that has emerged as a global threat because of its high levels of resistance to many antibiotics, particularly those considered as last-resort antibiotics, such as carbapenems. Mobile genetic elements (MGEs) play an important role in the dissemination and expression of antibiotic resistance genes (ARGs), including the mobilization of ARGs within and between species. We conducted an in-depth, systematic investigation of the occurrence and dissemination of ARGs associated with MGEs in A. baumannii. We focused on a cross-sectoral approach that integrates humans, animals, and environments. Four strategies for the prevention of ARG dissemination through MGEs have been discussed: prevention of airborne transmission of ARGs using semi-permeable membrane-covered thermophilic composting; application of nanomaterials for the removal of emerging pollutants (antibiotics) and pathogens; tertiary treatment technologies for controlling ARGs and MGEs in wastewater treatment plants; and the removal of ARGs by advanced oxidation techniques. This review contemplates and evaluates the major drivers involved in the transmission of ARGs from the cross-sectoral perspective and ARG-transfer prevention processes.

Antibiotic resistant bacteria: A bibliometric review of literature

Antibiotic-resistant bacteria (ARB) are a serious threat to the health of people and the ecological environment. With this problem becoming more and more serious, more countries made research on the ARB, and the research number has been sharply increased particularly over the past decade. Therefore, it is quite necessary to globally retrace relevant researches on the ARB published from 2010 to 2020. This will help researchers to understand the current research situation, research trends and research hotspots in this field. This paper uses bibliometrics to examine publications in the field of ARB from 2010 to 2020 that were retrieved from the Web of Science (WOS). Our study performed a statistical analysis of the countries, institutions, journals, authors, research areas, author keywords, Essential Science Indicators (ESI) highly cited papers, and ESI hotspots papers to provide an overview of the ARB field as well as research trends, research hotspots, and future research directions in the field. The results showed that the number of related studies is increasing year by year; the USA is most published in the field of ARB; China is the most active in this field in the recent years; the Chinese Acad Sci published the most articles; Sci. Total Environ. published the greatest number of articles; CM Manaia has the most contributions; Environmental Sciences and Ecology is the most popular research area; and "antibiotic resistance," "antibiotics," and "antibiotic resistance genes" were the most frequently occurring author keywords. A citation analysis showed that aquatic environment-related antibiotic resistance is a key research area in this field, while antimicrobial nanomaterial-related research is a recent popular topic.

Composition and distribution of bacterial communities and antibiotic resistance genes in fish of four mariculture systems

Fish-related antibiotic resistance genes (ARGs) have attracted attention for their potentially harmful effects on food safety and human health through the food chain transfer. However, the potential factors affecting these ARGs have not been fully explored. In this study, ARGs and bacterial communities in the fish gut, mucosal skin, and gill filaments in fish were comprehensively evaluated in four different mariculture systems formed by hybrid grouper (Epinephelus fuscoguttatus♀ × E. lanceolatus♂), Gracilaria bailinae, and Litopenaeus vannamei using different combinations. The results showed that 9 ARGs were detected in the gut and mucosal skin and 6 ARGs in the gill filaments. The detection rate of aphA1 was the highest, and the abundance was 1.91 × 10^-3 - 6.30 × 10^-2 copies per 16 S rRNA gene. Transposase gene (tnpA-04) was detected in all samples with the abundance of 3.57 × 10^-3 - 3.59 × 10^-2 copies per 16 S rRNA gene, and was strongly correlated with multiple ARGs (e.g., aphA1, tet(34), mphA-02). Proteobacteria, Deinococcus-Thermus, Firmicutes, and Bacteroidetes were the dominant phyla in the four mariculture systems, accounting for 65.1%-96.2% of the total bacterial community. Notably, the high relative abundance of Stenotrophomonas, a potential human pathogen, was elevated by 20.5% in the hybrid grouper gut in the monoculture system. In addition, variation partitioning analysis (VPA) showed that the difference in bacterial communities between mariculture systems was the main driving factor of ARGs distribution differences in hybrid groupers. This study provides a new comprehensive understanding of the characterization of fish-related ARGs contamination in different mariculture systems and facilitates the assessment of potential risks of ARGs and pathogen taxa to human health.

Restriction of biosolids returning to land: Fate of antibiotic resistance genes in soils after long-term biosolids application

Although the utilization of biosolids in agricultural lands is widely considered as an effective way to improve resource reuse, the presence of antibiotic resistance genes (ARGs) severely restricts biosolids returning to fields. A 12-year long-term experiment with different biosolids application rates (from 0 to 36 t ha^-1 yr^-1) was conducted to study the effect of biosolids application on shaping ARGs in soil. Biosolids application significantly increased ARGs abundance in the soil, except for MBS treatment (9 t ha^-1 yr^-1 biosolids application). The abundance of ARGs in soil did not increase linearly with the dose of biosolids applied, but they were significantly (P < 0.05) positively correlated. A total of 173 subtypes were detected, among them mobile genetic elements (MGEs), aminoglycoside, and multidrug resistance genes were the most dominant types. Except for MBS treatment, most of the ARGs detected were enriched in amended soils after long-term continuous biosolids application. Specifically, tetPA, sul1, mefA, and IS6100 were highly enriched in all amended soils. In addition, biosolids application increased soil nutrients and heavy metals, and changed the soil microbial community, all of which affected ARGs formation. But MGEs may be a greater factor for shaping ARGs profiles than soil properties. Overall, controlling the rate of biosolid application is the key to reducing the accumulation and horizontal transfer of ARGs in soils.

Distinguishing removal and regrowth potential of antibiotic resistance genes and antibiotic resistant bacteria on microplastics and in leachate after chlorination or Fenton oxidation

The prevalence of antibiotic resistance, as well as microplastics (MPs) as vectors for antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) has attracting growing attention. However, the fate of ARB/ARGs on MPs treated by chlorination and Fenton oxidation were poorly understood. Herein, the removal and regrowth of ARGs/ARB on MPs and in MPs-surrounding landfill leachate (an important reservoir of MPs and ARGs) after chlorination and Fenton oxidation were comparatively analyzed. Target ARGs on MPs were reduced obviously less than that in leachate, with the largest percentages reduction of 34.0-46.3% vs. 54.3-77.6% after chlorination and 92.1-97.3% vs. > 99.9% after Fenton oxidation, and similar removal patterns were observed for ARB. Moreover, a considerable regrowth of ARGs/ARB in leachate were found after 48 h of storage at the end of chlorination (5, 10, 20 and 50 mg/L), and a greater regrowth of ARGs and ARB occurred on MPs with up to 17 and 139 fold, respectively. In contrast, Fenton oxidation achieved a reduced regrowth of target ARGs/ARB. These findings indicated that the removal of ARGs/ARB on MPs were more difficult than that in leachate, and ARGs/ARB in leachate and especially on MPs exhibited a considerable potential for rapid regrowth after chlorination.

Occurrence of antibiotic resistance genes and multidrug-resistant bacteria during wastewater treatment processes

Wastewater treatment plants (WWTPs) constantly receive a wide variety of contaminants, including pharmaceuticals, and are potential reservoirs of antibiotic resistance genes (ARGs). This favors the development of multidrug-resistant bacteria (MRB) through horizontal gene transfer. Samples from five different WWTP processes were collected in September 2020 and January 2021 to monitor ARG resistomes and culturable MRB in the presence of eight different antibiotics. Nanopore-based ARG abundance and bacterial community analyses suggested that ARG accumulation favors the generation of MRB. Activated and mixed sludges tended to have lower bacterial diversity and ARG abundance because of selective forces that favored the growth of specific microorganisms during aeration processes. Escherichia strains enriched in WWTPs (up to 71%) were dominant in all the samples, whereas Cloacamonas species were highly abundant only in anaerobically digested sludge samples (60%-79%). Two ARG types [sulfonamide resistance genes (sul1) and aminoglycoside resistance genes (aadA1, aadA13, and aadA2)] were prevalent in all the processes. The total counts of culturable MRB, such as Niabella, Enterococcus, Bacillus, and Chryseobacterium species, gradually increased during aerobic WWTP processes. Genomic analyses of all MRB isolated from the samples revealed that the resistome of Enterococcus species harbored the highest number of ARGs (7-18 ARGs), commonly encoding ant(6)-la, lnu(B), erm(B), and tet(S/M). On the other hand, Niablella strains possibly had intrinsic resistant phenotypes without ARGs. All MRB possessed ARGs originating from the same mobile genetic elements, suggesting that WWTPs are hotspots for the migration of ARGs and emergence of MRB.

Grassland ecology system: A critical reservoir and dissemination medium of antibiotic resistance in Xilingol Pasture, Inner Mongolia

Antibiotic resistance is a major threat to human health. It is necessary to explore all the potential sources and comprehend the pathways that antibiotic resistance genes (ARGs) are transmitted. In this study, by applying high-throughput quantitative PCR and high-throughput sequencing, ARGs and microbial community structure were determined, to understand the reservoirs and spread of ARGs in the Xilingol grassland system. A total of 151,140 and 138 different ARGs were observed in manure, soil, and water samples, respectively. Only 12 ARGs were shared in all environmental and animal manure samples. Multidrug defense system, such as efflux pump, was the most dominant factor in manure and soil samples, followed by antibiotic deactivation processes. These genes coffering resistance to major classes of antibiotics including β_Lactamase (bla_SFO, fox5, bla_CTX-M-04, bla_OXY), vancomycin (vanC-03, vanXD), MLSB (vatE-01, mphA-01), aminoglycoside (aadA2-01), Multidrug (oprJ) and others (oprD, qacEdelta1-02), except sulfonamide and tetracycline. The 12 ARGs were significantly enriched in water samples compared to manure and soil samples (p < 0.01) and demonstrated that the water environment was an important transmission source of ARGs in the grassland. The highest enrichment was up to 324.5-fold. Moreover, the 12 shared ARGs were positively correlated with the mobile genetic elements (p < 0.01). The nonrandom co-occurrence network patterns between ARGs and microbial community suggested that a total of three bacterial phyla were viewed as the potential ARGs hosts. These findings indicate that ARGs were highly enriched in water samples, demonstrating that the water environment was a critical source and sink of ARGs in the grassland system. It may illuminate the mechanism stressing the effects of human activity on the occurrence and transmission of ARGs in the grassland system.

Ancient Oriental Wisdom still Works: Removing ARGs in Drinking Water by Boiling as compared to Chlorination

Antibiotic resistance genes (ARGs) in municipal drinking water may not be effectively removed during centralized treatment. To reduce potential health risks, water disinfection at the point-of-use scale is warranted. This study investigated the performance of boiling, a prevalent household water disinfection means, in response to ARGs contamination. We found that boiling was more efficient in inactivating both Escherichia coli and environmental bacteria compared to chlorination and pasteurization. Boiling of environmental bacteria suspension removed a much broader spectrum of ARGs and mobile genetic elements (up to 141 genes) than chlorination (up to 13 genes), such better performance was largely attributed to a stronger inactivation of chlorine-tolerant bacteria including Acinetobacter and Bacillus. Accumulation of extracellular ARGs was found during low-temperature heating (≤ 80°C) and in the initial stage of chlorination (first 3 min when initial chlorine was 5 mg/L and first 12 min when initial chlorine was 1 mg/L). These extracellular ARGs as well as the intracellular ARGs got removed as the heating temperature increased or the chlorination time prolonged. Under the same treatment time (30 min), high-temperature heating (≥ 90.1°C) damaged the DNA structure more thoroughly than chlorination (5 mg/L). Taking into account the low transferability of ARGs after DNA melting, boiling may provide an effective point-of-use approach to attenuating bacterial ARGs in drinking water and is still worth promoting in the future.

Risks of antibiotic resistance genes and antimicrobial resistance under chlorination disinfection with public health concerns

As a widely used disinfection technology, the effects of chlorination on antibiotic resistome and bacterial community received great scientific concerns, while the pathogens associated health risks kept largely unknown. With this concern, the present study used metagenomic analysis combined with culture method to reveal chlorination effects on antibiotic resistance genes (ARGs) and their bacterial hosts (total microbes and Escherichia coli) through simulating the chlorination dosage with human health concerns (drinking water and swimming pool). The resistome profiling showed that chlorination process could significantly decrease both abundance and diversity of total ARGs, while with limited removal rates of 6.0-8.7% for opportunistic pathogens E. coli isolates. Of all the observed 515 ARG subtypes, 105 core subtypes were identified and persistent during chlorination for both total microbes and E. coli. Antibiotic susceptibility test showed that chlorination treatment could efficiently remove multi-resistant E. coli isolates but select for tetracycline resistant isolates. Five ARG-carrying genomes (assigned to Bacteroidetes, Firmicutes, Actinobacteria) enriched by 18.1-102% after chlorination were retrieved by using metagenomic binning strategies. Bray-Curtis dissimilarity, network and procrustes analyses all indicated the remained antibiotic resistome and bacterial community were mainly chlorination-driven. Furthermore, a systematic pipeline for monitoring chlorination-associated antimicrobial resistance risks was proposed. These together enhance our knowledge of chlorination treatment associated public concerns, as important reference and guidance for surveillance and control of antibiotic resistance.

Antibiotic Resistance Genes and Potentially Pathogenic Bacteria in the Central Adriatic Sea: Are They Connected to Urban Wastewater Inputs?

Despite last decades’ interventions within local and communitarian programs, the Mediterranean Sea still receives poorly treated urban wastewater (sewage). Wastewater treatment plants (WWTPs) performing primary sewage treatments have poor efficiency in removing microbial pollutants, including fecal indicator bacteria, pathogens, and mobile genetic elements conferring resistance to antimicrobials. Using a combination of molecular tools, we investigated four urban WWTPs (i.e., two performing only mechanical treatments and two performing a subsequent conventional secondary treatment by activated sludge) as continuous sources of microbial pollution for marine coastal waters. Sewage that underwent only primary treatments was characterized by a higher content of traditional and alternative fecal indicator bacteria, as well as potentially pathogenic bacteria (especially Acinetobacter, Coxiella, Prevotella, Streptococcus, Pseudomonas, Vibrio, Empedobacter, Paracoccus, and Leptotrichia), than those subjected to secondary treatment. However, seawater samples collected next to the discharging points of all the WWTPs investigated here revealed a marked fecal signature, despite significantly lower values in the presence of secondary treatment of the sewage. WWTPs in this study represented continuous sources of antibiotic resistance genes (ARGs) ermB, qnrS, sul2, tetA, and blaTEM (the latter only for three WWTPs out of four). Still, no clear effects of the two depuration strategies investigated here were detected. Some marine samples were identified as positive to the colistin-resistance gene mcr-1, an ARG that threatens colistin antibiotics’ clinical utility in treating infections with multidrug-resistant bacteria. This study provides evidence that the use of sole primary treatments in urban wastewater management results in pronounced inputs of microbial pollution into marine coastal waters. At the same time, the use of conventional treatments does not fully eliminate ARGs in treated wastewater. The complementary use of molecular techniques could successfully improve the evaluation of the depuration efficiency and help develop novel solutions for the treatment of urban wastewater.

Occurrence of antibiotics and antibiotic resistance genes in WWTP effluent-receiving water bodies and reclaimed wastewater treatment plants

There is a growing concern on the fate and the consequent ecological or health risks of antibiotics and antibiotic resistance genes (ARGs) in natural or artificial water environment. The effluent of wastewater treatment plants (WWTPs) has been reported to be an important source of antibiotics and ARGs in the environment. WWTP effluent could be discharged into surface water bodies or recycled, either of which could lead to different exposure risks. The impact of WWTP effluents on the levels of antibiotics and ARGs in effluent-receiving water bodies and the removal efficiency of antibiotics and ARGs in reclaimed wastewater treatment plants (RWTPs) were seldom simultaneously investigated. Thus, in this study, we investigated the occurrence of antibiotics and ARGs in four WWTP effluents, and their downstream effluent-receiving water bodies and RWTPs in seasons of low-water-level. The total concentrations of ofloxacin, norfloxacin, ciprofloxacin, roxithromycin, azithromycin, erythromycin, tetracycline, oxytetracycline, chlortetracycline, and sulfamethoxazole in the secondary effluents were 1441.6-4917.6 ng L^-1. Ofloxacin had the highest concentration. The absolute and relative abundances of total ARGs (qnrD, qnrS, ermA, ermB, tetA, tetQ, sul1, and sul2) in the secondary effluents were 10³-10⁴ copies mL^-1 and 10^-4-10^-2 ARG/16S rRNA. Sul1 and sul2 were the major species with the highest detection frequencies and levels. In most cases, WWTP effluents were not the major contributors to the levels and species of antibiotics and ARGs in the surface water bodies. Four RWTPs removed 43.5-98.9% of antibiotics and - 0.19-2.91 log of ARGs. Antibiotics and ARGs increased in chlorination, ozonation and filtration units. Antibiotics had significantly positive correlations with ARGs, biological oxygen demands, total phosphorus, total nitrogen, and ammonia nitrogen in the four effluent-receiving water bodies. In RWTPs, the total concentrations of antibiotics showed a significant positive correlation with the total abundance of ARGs.

Differences in chlorine and peracetic acid disinfection kinetics of Enterococcus faecalis and Escherichia fergusonii and their susceptible strains based on gene expressions and genomics

This study was conducted to investigate mechanisms of cross-resistance to chlorine and peracetic acid (PAA) disinfectants by antibiotic-resistant bacteria. Our study evaluated chlorine and PAA based disinfection kinetics of erythromycin-resistant Enterococcus faecalis, meropenem-resistant Escherichia fergusonii, and susceptible strains of these species. Using the integrated second-order disinfectant decay model and first-order Chick-Watson's Law, it was found that the meropenem-resistant Escherichia fergusonii strain showed significantly less log inactivation compared to the susceptible E. fergusonii strain in response to both chlorine and PAA disinfection (p-value = 0.059, 3.5 × 10^-6). On the other hand, the susceptible Enterococcus faecalis strain showed similar log inactivation compared to the erythromycin-resistant strain in response to either treatment (p-value = 0.075, 0.28). Meropenem-resistant E. fergusonii showed an increase in gene expression of New Delhi metallo-β-lactamase (bla_NDM-1) gene to chlorine, but there was no increase in expression to PAA. Whole genome sequencing (WGS) was then conducted to elucidate the differences in genes among both resistant and susceptible table E. fergusonii strains. The average nucleotide identity (ANI) analysis of the draft genomes (>97% similarity) suggests that meropenem-resistant E. fergusonii (S1) and meropenem-susceptible E. fergusonii (S2) are the same species but different strains. Both strains have the same genes for oxidative stress pathways, oxidative scavenger genes, and nearly 40 different antibiotic efflux pump genes. The chromosomal and plasmid draft genomes of meropenem-resistant and susceptible E. fergusonii strains each have 65 and 52 antibiotic resistance genes, respectively. Of these, the resistant E. fergusonii strain harbored the extended-spectrum beta-lactamases bla_CTX-M-15 and bla_TEM-1 genes located on the chromosome, and a bla_TEM-1 gene on the plasmid. The overall findings of this study are significant, as they reveal that antibiotic-resistant and susceptible strains of E. fergusonii exhibit different responses towards chlorine and PAA disinfection.

Interplay of Biologically Active Carbon Filtration and Chlorine-Based Disinfection in Mitigating the Dissemination of Antibiotic Resistance Genes in Water Reuse Distribution Systems

Appropriate management approaches are needed to minimize the proliferation of antibiotic resistance genes (ARGs) in reclaimed water distribution systems (RWDSs). Six laboratory-scale RWDSs were operated over 3 years receiving influent with or without biologically active carbon (BAC) filtration + chlorination, chloramination, or no disinfectant residual. Shotgun metagenomic sequencing was applied toward comprehensive characterization of resistomes, focusing on total ARGs, ARG mobility, and specific ARGs of clinical concern. ARGs such as aadA, bacA, bla_OXA, mphE, msrE, sul1, and sul2 were found to be particularly sensitive to varying RWDS conditions. BAC filtration with chlorination most effectively achieved and maintained the lowest levels of nearly all metagenomically derived antibiotic resistance indicators. However, BAC filtration or addition of residual disinfectants alone tended to increase these indicators. Biofilm and sediment compartments harbored ARGs in disinfected systems, presenting a concern for their release to bulk water. Relative and absolute abundances of most ARGs tended to decrease with water age (up to 5 days), with notable exceptions in BAC-filtered chloraminated and no residual systems. Superchlorination of unfiltered water especially raised concerns in terms of elevation of clinically relevant and mobile ARGs. This study revealed that BAC filtration and disinfection must be carefully coordinated in order to effectively mitigate ARG dissemination via RWDSs.

Removal of antibiotic-resistant genes during drinking water treatment: A review

Once contaminate the drinking water source, antibiotic resistance genes (ARGs) will propagate in drinking water systems and pose a serious risk to human health. Therefore, the drinking water treatment processes (DWTPs) are critical to manage the risks posed by ARGs. This study summarizes the prevalence of ARGs in raw water sources and treated drinking water worldwide. In addition, the removal efficiency of ARGs and related mechanisms by different DWTPs are reviewed. Abiotic and biotic factors that affect ARGs elimination are also discussed. The data on presence of ARGs in drinking water help come to the conclusion that ARGs pollution is prevalent and deserves a high priority. Generally, DWTPs indeed achieve ARGs removal, but some biological treatment processes such as biological activated carbon filtration may promote antibiotic resistance due to the enrichment of ARGs in the biofilm. The finding that disinfection and membrane filtration are superior to other DWTPs adds weight to the advice that DWTPs should adopt multiple disinfection barriers, as well as keep sufficient chlorine residuals to inhibit re-growth of ARGs during subsequent distribution. Mechanistically, DWTPs obtain direct and inderect ARGs reduction through DNA damage and interception of host bacterias of ARGs. Thus, escaping of intracellular ARGs to extracellular environment, induced by DWTPs, should be advoided. This review provides the theoretical support for developping efficient reduction technologies of ARGs. Future study should focus on ARGs controlling in terms of transmissibility or persistence through DWTPs due to their biological related nature and ubiquitous presence of biofilm in the treatment unit.

Regrowth of bacteria after light-based disinfection - What we know and where we go from here

Regrowth of bacteria after water/wastewater disinfection is a serious risk to public health, particularly when such pathogens carry antibiotic resistance genes. Despite increasing interest in light-based disinfection using ultraviolet or solar radiation, the mechanism of bacterial regrowth and their concentration upon light exposure (i.e., during storage, or after discharge into rivers or lakes) remain poorly understood. Therefore, we present a focused critical review to 1) elucidate regrowth mechanisms, 2) summarize the pros and cons of available experimental designs and detection techniques for regrowth evaluation, and 3) provide an outlook of key research directions for further investigations of post-disinfection bacterial regrowth. Bacterial regrowth can occur through reactivation from a viable but non-culturable state, repair of photo-induced DNA damage, and reproduction of bacteria surviving disinfection. Many studies have underestimated the degree of actual regrowth because of the use of simple experimental designs and plate count methods, which cannot quantify actual abundance of viable bacteria. Further research should investigate the effects of various factors on bacterial regrowth in realistic conditions in regrowth tests and adopt multiplex detection methods that combine culture-based and culture-independent approaches. An accurate understanding of the mechanisms involved in bacterial regrowth following disinfection is critical for safeguarding public health and aquatic environments.

Antibiotic and Disinfectant Resistance in Tap Water Strains - Insight into the Resistance of Environmental Bacteria

Although antibiotic-resistant bacteria (ARB) have been isolated from tap water worldwide, the knowledge of their resistance patterns is still scarce. Both horizontal and vertical gene transfer has been suggested to contribute to the resistance spread among tap water bacteria. In this study, ARB were isolated from finished water collected at two independent water treatment plants (WTPs) and tap water collected at several point-of-use taps during summer and winter sampling campaigns. A total of 24 strains were identified to genus or species level and subjected to antibiotic and disinfectant susceptibility testing. The investigated tap water ARB belonged to phyla Proteobacteria, Bacteroidetes, Actinobacteria, and Firmicutes. The majority of the isolates proved multidrug resistant and resistant to chemical disinfectant. Neither seasonal nor WTP-dependent variabilities in antibiotic or disinfectant resistance were found. Antibiotics most effective against the investigated isolates included imipenem, tetracyclines, erythromycin, and least effective - aztreonam, cefotaxime, amoxicillin, and ceftazidime. The most resistant strains originate from Afipia sp. and Methylobacterium sp. Comparing resistance patterns of isolated tap water ARB with literature reports concerning the same genera or species confirms intra-genus or even intra-specific variabilities of environmental bacteria. Neither species-specific nor acquired resistance can be excluded.

Degradation Kinetics of Antibiotic Resistance Gene mecA of Methicillin-Resistant Staphylococcus aureus (MRSA) during Water Disinfection with Chlorine, Ozone, and Ultraviolet Light

Degradation kinetics of antibiotic resistance genes (ARGs) by free available chlorine (FAC), ozone (O₃), and UV₂₅₄ light (UV) were investigated in phosphate buffered solutions at pH 7 using a chromosomal ARG (mecA) of methicillin-resistant Staphylococcus aureus (MRSA). For FAC, the degradation rates of extracellular mecA (extra-mecA) were accelerated with increasing FAC exposure, which could be explained by a two-step FAC reaction model. The degradation of extra-mecA by O₃ followed second-order reaction kinetics. The degradation of extra-mecA by UV exhibited tailing kinetics, which could be described by a newly proposed kinetic model considering cyclobutane pyrimidine dimer (CPD) formation, its photoreversal, and irreversible (6-4) photoproduct formation. Measured rate constants for extra-mecA increased linearly with amplicon length for FAC and O₃, or with number of intrastrand pyrimidine doublets for UV, which enabled prediction of degradation rate constants of extra-mecA amplicons based on sequence length and/or composition. In comparison to those of extra-mecA, the observed degradation rates of intracellular mecA (intra-mecA) were faster for FAC and O₃ at low oxidant exposures but significantly slower at high exposures for FAC and UV. Differences in observed extra- and intracellular kinetics could be due to decreased DNA recovery efficiency and/or the presence of MRSA aggregates protected from disinfectants.

Global bibliometric meta-analytic assessment of research trends on microbial chlorine resistance in drinking water/water treatment systems

Chlorine is the commonest and cheapest disinfectant used in drinking water and wastewater treatment at household, municipal and industrial levels. However, the uprising of microbial chlorine resistance (MCR) pose critical public health hazard concerns; because, its potentiate exposure to difficult-to-treat resistant pathogens. Therefore, this study aimed at evaluating the burden of MCR in drinking water/wastewater treatment and distribution systems (DWWTDS) via science mapping of research productivity (authors, countries, institutions), thematic conceptual framework, disciplines, research networks and associated intellectual landscape. MCR data were mined from Scopus and Web of Science based on optimized algorithms with the root key term "chlorine* resistant*'' and analysed for pre-set indicator variables. Results revealed 1127 documents from 442 journals and 1430% average growth rate (AGR) of research articles from 2017 to 2019 on MCR. Country-wise, the USA (n = 299), China (n = 119), and Japan (n = 43) ranked in the 1st, 2nd, and 3rd positions respectively, among the top participating countries in MCR research. MCR research had considerable performance in public health and sustainable concern subjects namely, Environmental Sciences & Ecology, Engineering, Microbiology, Water Resources, Biotechnology & Applied Microbiology, Food Science & Technology, Public, Environ & Occupational Health, Chemistry, Infectious Diseases, and Marine & Freshwater Biology; and with noticeable AGR in Environmental Sciences & Ecology (330%) and Infectious Diseases (130%). The study found biofilm-related thrusts (n = 90, 270% AGR) as main research hotspots on MCR. Overall, the study identified and discussed four important thematic areas of public health challenges in MCR that could promote increasing waterborne diseases due to (re)emerging pathogens, enteric viruses and dissemination in DWWTDS. In conclusion, this study provides comprehensive overview of the growing burden of MCR in DWWTDS and standout as a primer of information for researchers on MCR. It recommends direct, intentional and integrated research priorities on MCR to overcome accompanying public health and environmental threats. In addition, chlorine resistance in waterborne fungi have not received research attention. Research activities related to fungal chlorine resistance will be an invaluable future direction in DWWTDS and guide against exposure to waterborne pathogenic fungi and mycotoxins. It is unknown whether chlorine resistance can be acquired by horizontal gene transfer in microorganisms and future research should elucidate this important thrust.

Multidrug Resistant Klebsiella pneumoniae ST101 Clone Survival Chain From Inpatients to Hospital Effluent After Chlorine Treatment

In this paper we describe the transmission of a multi-drug resistant Klebsiella pneumoniae ST101 clone from hospital to wastewater and its persistence after chlorine treatment. Water samples from influents and effluents of the sewage tank of an infectious diseases hospital and clinical strains collected from the intra-hospital infections, during a period of 10 days prior to wastewater sampling were analyzed. Antibiotic resistant K. pneumoniae strains from wastewaters were recovered on selective media. Based on antibiotic susceptibility profiles and PCR analyses of antibiotic resistance (AR) genetic background, as well as whole-genome sequencing (Illumina MiSeq) and subsequent bioinformatic analyses, 11 ST101 K. pneumoniae strains isolated from hospital wastewater influent, wastewater effluent and clinical sector were identified as clonally related. The SNP and core genome analyses pointed out that five strains were found to be closely related (with ≤18 SNPs and identical cgMLST profile). The strains belonging to this clone harbored multiple acquired AR genes [bla_CTX–M–15, bla_OXA–48, bla_OXA–1, bla_SHV–106, bla_TEM–150, aac(3)-IIa, aac(6′)-Ib-cr, oqxA10, oqxB17, fosA, catB3, dfrA14, tet(D)] and chromosomal mutations involved in AR (ΔmgrB, ΔompK35, amino acid substitutions in GyrA Ser83Tyr, Asp87Asn, ParC Ser80Tyr). Twenty-nine virulence genes involved in iron acquisition, biofilm and pili formation, adherence, and the type six secretion system – T6SS-III were identified. Our study proves the transmission of MDR K. pneumoniae from hospital to the hospital effluent and its persistence after the chlorine treatment, raising the risk of surface water contamination and further dissemination to different components of the trophic chain, including humans.

Intracellular versus extracellular antibiotic resistance genes in the environment: Prevalence, horizontal transfer, and mitigation strategies

Antibiotic resistance genes (ARGs) are present as both intracellular and extracellular fractions of DNA in the environment. Due to the poor yield of extracellular DNA in conventional extraction methods, previous studies have mainly focused on intracellular ARGs (iARGs). In this review, we evaluate the prevalence/persistence and horizontal transfer of iARGs and extracellular ARGs (eARGs) in different environments, and then explore advanced mitigation strategies in wastewater treatment plants (WWTPs) for preventing the spread of antibiotic resistance in the environment. Although iARGs are the main fraction of ARGs in nutrient-rich environments, eARGs are predominant in receiving aquatic environments. In such environments, natural transformation of eARGs occurs with a comparable frequency to conjugation of iARGs. Further, eARGs can be adsorbed by soil and sediments particles, protected from DNase degradation, and consequently persist longer than iARGs. Collectively, these characteristics emphasize the crucial role of eARGs in the spread of antibiotic resistance in the environment. Fate of iARGs and eARGs through advanced treatment technologies (disinfection and membrane filtration) indicates that different mitigation strategies may be required for each ARG fraction to be significantly removed. Finally, comprehensive risk assessment is needed to evaluate/compare the effect of iARGs versus eARGs in the environment.

Genome-Resolved Metagenomics and Antibiotic Resistance Genes Analysis in Reclaimed Water Distribution Systems

Water reuse is increasingly pursued to alleviate global water scarcity. However, the wastewater treatment process does not achieve full removal of biological contaminants from wastewater, hence microorganisms and their genetic elements can be disseminated into the reclaimed water distribution systems (RWDS). In this study, reclaimed water samples are investigated via metagenomics to assess their bacterial diversity, metagenome-assembled genomes (MAGs) and antibiotic resistance genes (ARGs) at both point of entry (POE) and point of use (POU) in 3 RWDS. The number of shared bacterial orders identified by metagenome was higher at the POE than POU among the three sites, indicating that specific conditions in RWDS can cause further differentiation in the microbial communities at the end of the distribution system. Two bacterial orders, namely Rhizobiales and Sphingomonadales, had high replication rates in two of the examined RWDS (i.e., site A and B), and were present in higher relative abundance in POU than at POE. In addition, MAG and ARG relative abundance exhibited a strong correlation (R2 = 0.58) in POU, indicating that bacteria present in POU may have a high incidence of ARG. Specifically, resistance genes associated with efflux pump mechanisms (e.g., adeF and qacH) increased in its relative abundance from POU to POE at two of the RWDS (i.e., site A and B). When correlated with the water quality data that suggests a significantly lower dissolved organic carbon (DOC) concentration at site D than the other two RWDS, the metagenomic data suggest that low DOC is needed to maintain the biological stability of reclaimed water along the distribution network.

Metagenomic and network analyses decipher profiles and co-occurrence patterns of antibiotic resistome and bacterial taxa in the reclaimed wastewater distribution system

Metagenomic and network analyses were applied to decipher the profiles and co-occurrence of resistome and microbial taxa in the reclaimed wastewater distribution system, including reclaimed wastewater and two types of biofilms, i.e., surface layer biofilms and inner layer biofilms. The effects of chlorination, UV irradiation and no disinfection treatment on ARG relative abundance and composition were systemically investigated. The reclaimed wastewater possesses more diverse and abundant ARGs than biofilms and total ARG relative abundance followed the order of reclaimed wastewater samples > surface layer biofilms > inner layer biofilms. Multidrug, bacitracin, sulfonamide, aminoglycoside, beta-lactam, and macrolide-lincosamide-streptogramin resistance genes were the six most dominant ARG types and their sum accounted for 90.1 %-96.0 % of the total ARG relative abundance in different samples. Beta-lactam resistance gene was the discriminative ARG type for reclaimed wastewater. Bacitracin resistance gene and bacA were the discriminative ARG type and subtype for biofilms. Chlorination significantly reduced ARG relative abundance in the reclaimed wastewater. Nevertheless, it could not reduce ARG relative abundance in biofilms. Regarding to the total ARG profiles, there were no obvious increasing or decreasing trends over time during one year period. Co-occurrence results revealed twenty-six genera were deduced as the potential hosts of twenty-two ARG subtypes.

Persistence of antibiotic resistance genes from river water to tap water in the Yangtze River Delta

Antibiotic resistance genes (ARGs) raise public concern as emerging contaminants. The abundance and variation of 11 ARGs, intI1 and 16S rRNA gene were deciphered using quantitative PCR (qPCR) in two drinking water treatment systems that include river, wetland, drinking water treatment plants (DWTPs) and tap water from the Yangtze River Delta. The influencing factors for ARG abundance in river water were also explored. All investigated genes were detected in river water and there was no significant difference between the two systems, with sulfonamide ARGs occupying the highest abundance. Temperature had a significant effect on the ARG distribution based on permutational multivariate analysis of variance (PERMANOVA). Further Spearman analysis demonstrated that temperature was strongly correlated with the abundance of sul1, sul2, tetA and tetC, and these genes were significantly correlated with environmental factors (including temperature, total organic carbon (TOC) and dissolved oxygen (DO)). Considering the frequency and abundance of ARGs, as well as their correlation with other genes, sul1, sul2, tetA and tetC could be used as indicators of ARGs in river water. No significant reduction was noted for the absolute abundance of ARGs from river water to wetland water. Principle coordinates analysis (PCoA) combined with PERMANOVA revealed that drinking water treatment was responsible for reducing 16S rRNA gene and ARG abundance resulting in 3-log reductions. However, it should be noted that after transportation of distribution pipeline, both 16S rRNA gene and ARGs still detected in tap water, which indicated persistence of ARGs and will require further research.

Spatiotemporal Changes of Antibiotic Resistance and Bacterial Communities in Drinking Water Distribution System in Wrocław, Poland

Antibiotic resistance of bacteria is an emerging problem in drinking water treatment. This paper presents the comparison of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) prevalence during the summer and winter season in a full-scale drinking water distribution system (DWDS) supplied by two water treatment plants (WTPs). The effect of distance from WTP and physical–chemical water parameters on its microbial properties was also tested. Bacterial consortia dwelling in bulk tap water were additionally compared by means of denaturating gradient gel electrophoresis (DGGE). The results showed that among ARB, bacteria resistant to ceftazidime (CAZ) were the most abundant, followed by bacteria resistant to amoxicillin (AML), ciprofloxacin (CIP), and tetracycline (TE). Numerous ARGs were detected in tested tap water samples. Only CAZ resistant bacteria were more prevalent in the season of increased antibiotic consumption, and only AML resistant bacteria relative abundances increase was statistically significant with the distance from a WTP. The investigated tap water meets all legal requirements. It is therefore safe to drink according to the law. Nevertheless, because antibiotic resistance could pose a threat to consumer health, it should be further monitored in DWDSs.

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

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.

Inactivation of antibiotic resistant Escherichia coli and degradation of its resistance genes by glow discharge plasma in an aqueous solution

Emerging contaminants such as antibiotic resistance bacteria (ARB) and antibiotic resistance genes (ARGs) are becoming a global environmental problem. In this study, the glow discharge plasma (GDP) was applied for degrading antibiotic resistant Escherichia coli (E. coli) with resistance genes (tetA, tetR, aphA) and transposase gene (tnpA) in 0.9% sterile saline. The results showed that GDP was able to inactivate the antibiotic resistant E. coli and remove the ARGs and reduce the risk of gene transfer. The levels of E. coli determined by 16S rRNA decreased by approximately 4.7 logs with 15 min of discharge treatment. Propidium monoazide - quantitative polymerase chain reaction (PMA-qPCR) tests demonstrated that the cellular structure of 4.8 more logs E. coli was destroyed in 15 min. The reduction of tetA, tetR, aphA, tnpA genes was increased to 5.8, 5.4, 5.3 and 5.5 logs with 30 min discharge treatment, respectively. The removal of ARGs from high salinity wastewater was also investigated. The total abundance of ARGs was reduced by 3.9 logs in 30 min. Scavenging tests indicated that hydroxyl radicals (·OH) was the most probable agents for bacteria inactivation and ARGs degradation. In addition, the active chlorine (Cl· and Cl₂) which formed during the discharge may also contribute to the inactivation and degradation.

Reduction of erythromycin resistance gene erm(F) and class 1 integron-integrase genes in wastewater by Bardenpho treatment

Wastewaters routinely contain antibiotic-resistant bacteria (ARB) and genes (ARG) that are removed to a varying degree during wastewater treatment. This study investigated the removal of the erythromycin ribosome methylase class F (erm(F)) and class 1 integron-integrase (intI1) genes at each stage from two water resource recovery facilities in southern Arizona. Although genes were significantly reduced by Bardenpho treatment, erm(F) and intI1 were still observed in ≥ 9 and 7 out of 12 secondary effluent samples. Primary processes via sedimentation or dissolved air flotation, as well as chlorine disinfection, did not significantly impact erm(F) and intI1 concentrations. Therefore, Bardenpho treatment was critical to reduce erm(F) and intI1. Concentrations of erm(F) and intI1 were compared with each other and other markers for anthropogenic pollution. Results from this study support intI1 as one suitable marker to measure erythromycin resistance genes in wastewater, as intI1 was found at higher concentrations, persisted more throughout treatment, and correlated with erm(F) at nearly every treatment stage. PRACTITIONER POINTS: Bardenpho treatment was the key process responsible for the reduction of intI1 and erm(F) genes during wastewater treatment. Primary treatment and chlorine disinfection did not impact erm(F) and intI1 gene concentrations. The intI1 gene is a suitable marker for measuring erm(F) genes in wastewater.

Removal of Antibiotic Resistance Genes at Two Conventional Wastewater Treatment Plants of Louisiana, USA

Wastewater treatment plants (WWTPs) represent all known types of antibiotic resistance mechanisms and are considered as the critical points for the spread of antibiotic resistance genes (ARGs). The purpose of this study is to investigate the removal of a Class 1 integrase gene (intI1) and a selected set of ARGs (blaTEM, ermF, mecA, and tetA) at two conventional WWTPs by using chlorination in Louisiana, USA. We collected 69 wastewater samples (23 each from influent, secondary effluent, and final effluent) and determined the concentrations of ARGs by using quantitative polymerase chain reaction. All tested ARGs, except for mecA, were detected in 83–96% and 30–65% of influent and final effluent samples, respectively. Although the ARGs underwent approximately 3-log10 reduction, two WWTPs on an average still released 3.3 ± 1.7 log10 copies/mL of total ARGs studied in the effluents. Chlorination was found to be critical in the significant reduction of total ARGs (p < 0.05). Correlation analysis and the ability of intI1 to persist through the treatment processes recommend the use of intI1 as a marker of ARGs in effluents to monitor the spread of antibiotic resistance in effluents. Our study suggests that conventional WWTPs using chlorination do not favor the proliferation of antibiotic resistance bacteria and ARGs during wastewater treatment.

Metagenomic profiling of antibiotic resistance genes and their associations with bacterial community during multiple disinfection regimes in a full-scale drinking water treatment plant

For comprehensive insights into the effects of multiple disinfection regimes on antibiotic resistome in drinking water, this study utilized metagenomic approaches to reveal the changing patterns of antibiotic resistance genes (ARGs) and bacterial community as well as their associations. A total of 297 ARGs within 17 types were detected in the drinking water, and their total relative abundance ranged from 195.49 ± 24.85 to 626.31 ± 38.61 copies of ARGs per cell. The total ARG abundance was significantly increased after the antimicrobial resin and ultraviolet (AR/UV) disinfection while significantly decreased after the ozone and chlorine (O₃/Cl₂) disinfection and remained stable after AR/Cl₂ disinfection. Overall, 18 ARGs including bacA, mexT, and bla_OXA-12, mainly affiliated to bacitracin, multidrug, and beta-lactam, were persistent and discriminative during all the disinfection strategies in drinking water, and they were considered as key ARGs that represent the antibiotic resistome during drinking water disinfection. Additionally, possible hosts of 50% key ARGs were revealed based on co-occurrence network. During multiple disinfection processes, the change of Fusobacteriales and Aeromonadaceae in abundance mainly contributed to the abundance shift of bacA, and Pseudomonas mainly increased the abundance of mexT. These findings indicated that bacterial community shift may be the key factor driving the change of antibiotic resistome during disinfection. The strong association between antibiotic resistome alteration and bacterial community shift proposed in this study may enhance our understanding of the underlying mechanism of the disinfection effects on antibiotic resistance and benefit effective measures to improve safety of drinking water.

Exploring the resistome, virulome and microbiome of drinking water in environmental and clinical settings

Aquatic ecosystems harbor a vast pool of antibiotic resistance genes (ARGs), which can suffer mutation, recombination and selection events. Here, we explored the diversity of ARGs, virulence factors and the bacterial community composition in water samples before (surface raw water, RW) and after (disinfected water, DW) drinking water conventional treatment, as well as in tap water (TW) and ultrafiltration membranes (UM, recovered from hemodialysis equipment) through metagenomics. A total of 852 different ARGs were identified, 21.8% of them only in RW, which might reflect the impact of human activities on the river at the sampling point. Although a similar resistance profile has been observed between the samples, significant differences in the frequency of clinically relevant antibiotic classes (penam and peptide) were identified. Resistance determinants to last resort antibiotics, including sequences related to mcr, optrA and poxtA and clinically relevant beta-lactamase genes (i.e. bla_KPC, bla_GES, bla_IMP, bla_VIM, bla_SPM and bla_NDM) were detected. 830 coding sequences (CDSs - related to 217 different ARGs) were embedded in contigs associated with mobile genetic elements, specially plasmids, of which 68% in RW, DW and TW, suggesting the importance of water environments in resistance dissemination. Shifts in bacterial pathogens genera were observed, such as a significant increase in Mycobacterium after treatment and distribution. In UM, the potentially pathogenic genus Halomonas predominated. Its draft genome was closely related to H. stevensii, hosting mainly multidrug efflux pumps. These results broaden our understanding of the global ARGs diversity and stress the importance of tracking the ever-expanding environmental resistome.

Antibiotic Resistance Genes in Antibiotic-Free Chicken Farms

Rising concern about the use of antibiotics in food production has resulted in many studies on the occurrence of antibiotic resistance genes (ARGs) in animal-associated bacterial communities. There are few baseline data on the abundance of ARGs on farms where chickens are intensively raised with little or no use of antibiotics. This study used a high-throughput quantitative PCR array to survey two antibiotic-free chicken farms for the occurrence of ARGs and mobile genetic elements known to enhance the spread of ARGs. No antibiotics had been used on the study farms for five years prior to this study. The results provide a baseline for the occurrence of resistance genes in the chicken production system without direct selective pressure.

Co-selection and stability of bacterial antibiotic resistance by arsenic pollution accidents in source water

Frequent heavy-metal pollution accidents severely deteriorated the source water quality of drinking water treatment plants (DWTP). Limited data have explicitly addressed the impact of these incidents on bacterial antibiotic resistance (BAR). In present study, we investigated the shift of antibiotic resistome caused by heavy metal pollution incidents via simulating an arsenic shock loading [As (III)], along with the associated risks imposed on drinking water systems. The results indicated that a quick co-selection of antibiotic resistant bacteria (ARB) was achieved after exposure to 0.2-1 mg/L As (III) for only 6 h, meanwhile, there was an increase of relative abundance of antibiotic resistance genes (ARGs) and mobile genetic elements. Most of the co-selected BAR could be maintained for at least 4 days in the absence of As (III) and antibiotics, implying that the pollution in source water possibly contributed to the preservation and proliferation of antibiotic resistance determinants in the subsequent DWTP. Bacterial community structure analysis showed a strong correlation between bacterial community shift and BAR promotion, and enrichment of opportunistic bacteria (e.g. Escherichia-Shigella, Empedobacter sp. and Elizabethkingia sp.). The results indicated a potential epidemiological threat to the public due to accident-level arsenic contamination in the source water. This study gave insight into understanding the source water pollution accidents from the perspective of bio-hazard and biological risks, and highlighted a neglected important source of BAR in drinking water systems.

State of the art of tertiary treatment technologies for controlling antibiotic resistance in wastewater treatment plants

Antibiotic resistance genes (ARGs) have been considered as emerging contaminants of concern nowadays. There are no special technologies designed to directly remove ARGs in wastewater treatment plants (WWTPs). In order to reduce the risk of ARGs, it is vital to understand the efficiency of advanced treatment technologies in removing antibiotic resistance genes in WWTPs. This review highlights the application and efficiency of tertiary treatment technologies on the elimination of ARGs, s, based on an understanding of their occurrence and fate in WWTPs. These technologies include chemical-based processes such as chlorination, ozonation, ultraviolet, and advanced oxidation technology, as well as physical separation processes, biological processes such as constructed wetland and membrane bioreactor, and soil aquifer treatment. The merits, limitations and ameliorative measures of these processes are discussed, with the view to optimizing future treatment strategies and identifying new research directions.

Global distribution and current research of AmpC beta-lactamase genes in aquatic environments: A systematic review

AmpC beta-lactamase genes are some of the most common antibiotic resistance genes and require special attention once they have become mobilised. The detection of these genes is well documented in clinical settings. However, there is insufficient knowledge of both plasmid and genomic AmpC genes in aquatic environments. This systematic review aimed to determine the extent of the knowledge gap in the literature regarding the prevalence of AmpC beta-lactamase genes in aquatic systems. Using selected criteria, a total of 27 databases were searched for applicable peer-reviewed journal articles. No date and language restrictions were applied. Journal articles that highlighted the detection of AmpC beta-lactamase genes in environmental aquatic systems, including wastewater treatment plants, were included. Of the 950 literature sources that were identified, 50 were selected for full text analysis based on predetermined criteria. Studies on AmpC genes detection were traced in 23 countries. These studies focused on surface water (24), wastewater (17), sea water (4) and both surface and wastewater (5). Most studies did not specifically aim to detect AmpC genes, but to detect antibiotic resistance genes in general. Presently no surveillance protocols, standardised detection methods or environmental limits exist for these genes and, due to a paucity of research in this field, it is unlikely that such systems will be implemented in the near future. The implications and dynamics of AmpC genes in aquatic systems remain unclear and require intense research to ensure the sustainability of environmental systems and human health.

Effects of UV disinfection on phenotypes and genotypes of antibiotic-resistant bacteria in secondary effluent from a municipal wastewater treatment plant

To elucidate the effects of UV disinfection on antibiotic resistance in biologically-treated wastewater, we investigated the antibiotic resistance profiles, species of cultivable heterotrophic bacteria, and antibiotic-resistance genes (ARGs) in antibiotic-resistant bacteria before and after treatment. UV disinfection greatly changed the bacterial community structure and the antibiotic resistance in wastewater. The antibiotic resistance in wastewater samples was strongly associated with the bacterial community. The proportions of Gram-positive bacteria gradually increased with increasing UV fluence. The proportions of bacteria resistant to cephalexin, penicillin, and vancomycin all greatly decreased after UV treatment in both sampling events (July 2018 and January 2019), and those for bacteria resistant to ofloxacin, ciprofloxacin, and sulfadiazine increased, resulting from the alternative antibiotic resistance profiles among different genera. UV disinfection induced the selection of multi-antibiotic resistant (MAR) bacteria. For example, the MAR indices of Aeromonas, the dominant genus during the treatments, were significantly increased after UV irradiation (P < 0.05). The MAR index was also markedly increased (P < 0.05) at a fluence of 5 mJ/cm² in both events. In UV10 treatment, the bacterial community structure was greatly changed. The genera with relatively low MAR indices replaced that with high MAR indices, and became the dominant genera. As a result, the MAR indices of treated samples showed a decreased trend after 10 mJ/cm² UV irradiation. The detection frequencies of ARGs located on the chromosome varied mainly due to the evolution of the microbial community. The occurrence of ARGs (tetA, tetC, tetM, tetW, tetX, and sul1) located on plasmid DNA decreased after UV disinfection, and the average detection frequencies of tet and sul genes decreased by 15% and 6%, respectively (P < 0.05). Generally speaking, the effect of UV disinfection on the enrichment of antibiotic resistance is limited in this study, and horizontal gene transfer via the plasmids in surviving bacteria might be impaired due to the decreased abundance of ARGs on the plasmids.

Impact of disinfectant on bacterial antibiotic resistance transfer between biofilm and tap water in a simulated distribution network

Bacterial antibiotic resistance (BAR) is profoundly important to human health, but the environmental reservoirs of resistance determinants are poorly understood. BAR of biofilm and tap water were analyzed by using a water distribution simulator where different doses of chlorine and chloramine were used in this study. The results revealed that the disinfectants (≥2 mg/L) suppressed antibiotic resistant bacteria (ARB) in tap water and biofilms, while disinfected water and biofilms had a high relative abundance of ARB. The difference of ARB concentration and ARB percentage between the samples obtained from a disinfected pipeline and a non-disinfected pipeline became smaller over time. Because the water supply system is a unidirectional process, it is unclear how planktonic bacteria in water transfer BAR over time, although biofilm is suspected to play a role in this process. Compared with the biofilm samples without disinfectant, the disinfected biofilm had lower ICC and HPC/ICC percentage, lower AOC and AOC/TOC percentage, indicating that the disinfectant inhibited the bacteria growth in biofilm, and the disinfected biofilm had high proportion of non-culturable bacteria and low biodegradability, which affected BAR in biofilms. High throughput sequencing showed that in biofilms, the relative abundance of genera (uncultured_f_Rhodocyclaceae, Brevundimonas, and Brevibacillus in chlorinated systems, and Brevundimonas, Brevibacillus in chloraminated systems) with multiple antibiotic resistance and high abundance (up to 78.5%), were positively associated with disinfectant concentration and ARB percentage. The major prevalent genera in biofilms were also detected in tap water, suggesting that biofilm growth or biofilm detachment caused by external environmental factors will allow the movement of biofilm clusters with higher ARB concentration and percentage into bulk water, thereby increasing the antibiotic resistance of bacteria in tap water.

Early development of apoplastic barriers and molecular mechanisms in juvenile maize roots in response to La2O3 nanoparticles

The increasing occurrence of engineered nanoparticles (NPs) in soils may decrease water uptake in crops, followed by lower crop yield and quality. As one of the most common rare earth oxide NPs, lanthanum oxide (La₂O₃) NPs may inhibit the relative expressions of aquaporin genes, thus reduce water uptake. In the present study, maize plants were exposed to different La₂O₃ NPs concentrations (0, 5, 50 mg L^-1) for 72 h and 144 h right after the first leaf extended completely. Our results revealed that water uptake was reduced by La₂O₃ NPs through accelerating the development of apoplastic barriers in maize roots. The level of abscisic acid, determined by using ultra high performance liquid chromatography-tandem mass spectrometry, was increased upon La₂O₃ NPs exposure. Furthermore, ZmPAL, ZmCCR2 and ZmCAD6, the core genes specific for biosynthesis of lignin, were up-regulated by 3-13 fold in roots exposed to 50 mg L^-1 La₂O₃ NPs. However, ZmF5H was suppressed, indicating that lignin with S units could be excluded for the formed lignin in apoplastic barriers upon La₂O₃ NPs exposure. The level of essential component of apoplastic barriers - lignin was increased by 1.5-fold. The early development of apoplastic barriers was observed, and stomatal conductance and transpiration rate of La₂O₃ NPs-treated plants were significantly decreased by 63%-83% and 42%-86%, respectively, as compared to the control. The lignin enriched apoplastic barriers in juvenile maize thus led to the reduction of water uptake, subsequently causing significant growth inhibition. This is the first study to show early development of root apoplastic barriers upon La₂O₃ NPs exposure. This study will help us better understand the function of apoplastic barriers in roots in response to NPs, further providing fundamental knowledge to develop safer and more efficient agricultural nanotechnology.