The drinking water treatment process as a potential source of affecting the bacterial antibiotic resistance

Antibiotics removal and antimicrobial resistance control by ozone/peroxymonosulfate-biological activated carbon: A novel treatment process

Biological activated carbon (BAC) is one of the important treatment processes in wastewater and advanced water treatment. However, the BAC process has been reported to have antimicrobial resistance (AMR) risks. In this study, a new BAC-related treatment process was developed to reduce AMR caused by BAC treatment: ozone/peroxymonosulfate-BAC (O3/PMS-BAC). The O3/PMS-BAC showed better treatment performance on the targeted five antibiotics and dissolved organic matter removal than O3-BAC and BAC treatments. The O3/PMS-BAC process had better control over the AMR than the O3-BAC and BAC processes. Specifically, the amount of targeted antibiotic-resistant bacteria in the effluent and biofilm of O3/PMS-BAC was only 0.01-0.03 and 0.11-0.26 times that of the BAC process, respectively. Additionally, the O3/PMS-BAC process removed 1.76 %-62.83 % and 38.14 %-99.27 % more of the targeted ARGs in the effluent and biofilm than the BAC process. The total relative abundance of the targeted 12 ARGs in the O3/PMS-BAC effluent was decreased by 86 % compared to the effluent after BAC treatment. In addition, Proteobacteria and Bacteroidetes were probably the main hosts for transmitting ARGs in this study, and their relative abundance decreased by 9.6 % and 6.0 % in the effluent of the O3/PMS-BAC treatment compared to that in BAC treatment. The relationship analysis revealed that controlling antibiotic discharge was crucial for managing AMR, as antibiotics were closely related to both ARGs and bacteria associated with their emergence. The results showed that the newly developed treatment process could reduce AMR caused by BAC treatment while ensuring effluent quality. Therefore, O3/PMS-BAC is a promising alternative to BAC treatment for future applications.

Unveiling the characteristics of free-living and particle-associated antibiotic resistance genes associated with bacterial communities along different processes in a full-scale drinking water treatment plant

Antibiotic resistance genes (ARGs) as emerging contaminants, often co-occur with mobile genetic elements (MGEs) and are prevalent in drinking water treatment plants (DWTPs). In this study, the characteristics of free-living (FL) and particle-associated (PA) ARGs associated with bacterial communities were investigated along two processes within a full-scale DWTP. A total of 13 ARGs and two MGEs were detected. FL-ARGs with diverse subtypes and PA-ARGs with high abundances displayed significantly different structures. PA-MGEs showed a strong positive correlation with PA-ARGs. Chlorine dioxide disinfection achieved 1.47-log reduction of FL-MGEs in process A and 0.24-log reduction of PA-MGEs in process B. Notably, PA-fraction virtually disappeared after treatment, while blaTEM, sul2, mexE, mexF and IntI1 of FL-fraction remained in the finished water. Moreover, Acinetobacter lwoffii (0.04 % ∼ 45.58 %) and Acinetobacter schindleri (0.00 % ∼ 18.54 %) dominated the 16 pathogens, which were more abundant in FL than PA bacterial communities. PA bacteria exhibited a more complex structure with more keystone species than FL bacteria. MGEs contributed 20.23 % and 19.31 % to the changes of FL-ARGs and PA-ARGs respectively, and water quality was a key driver (21.73 %) for PA-ARGs variation. This study provides novel insights into microbial risk control associated with size-fractionated ARGs in drinking water.

Deciphering the dynamics and driving mechanisms of high-risk antibiotic resistome in size-fractionated bacterial community during drinking water chlorination via metagenomic analysis

To reveal the impact of chlorination on the high-risk resistome in size-fractionated bacterial community, we employed metagenomic approaches to decipher dynamics of high-risk antibiotic resistance genes (ARGs) and driving mechanisms in the free-living and particle-associated fractions within a full-scale drinking water treatment system. Our results revealed that chlorination significantly increased the relative abundance of high-risk ARGs in the free-living fraction to 0.33 ± 0.005 copies/cell (cpc), bacitracin and chloramphenicol resistance types were major contributors. Furthermore, chlorination significantly increased the relative abundance of mobile genetic elements (MGEs) in the free-living fraction, while decreasing it in the particle-associated fraction. During chlorination, size-fractionated bacterial communities varied considerably. Multiple statistical analyses highlighted the pivotal role of the bacterial community in altering high-risk ARGs in both the free-living and particle-associated fractions, while MGEs had a more pronounced impact on high-risk ARGs in the free-living fraction. Specifically, the enrichment of pathogenic hosts, such as Comamonas and Pseudomonas, led to an increase in the abundance of high-risk ARGs. Concurrently, MGEs exhibited significant correlations with high-risk ARGs, indicating the potential of horizontal transfer of high-risk ARGs. These findings provide novel insights for mitigating antibiotic resistance risk by considering different bacterial fractions and respective risk ranks in drinking water.

Performance of public drinking water purifiers in control of trihalomethanes, antibiotics and antibiotic resistance genes

Point-of-use water purifiers are widely applied as a terminal treatment device to produce drinking water with high quality. However, concerns are raised regarding low efficiency in eliminating emerging organic pollutants. To enhance our understanding of the reliability and potential risks of water purifiers, the removal of trihalomethanes, antibiotics, and antibiotic resistance genes (ARGs) in four public water purifiers was investigated. In the four public water purifiers in October and November, the removal efficiencies of trichloromethane (TCM) and bromodichloromethane (BDCM) were 15%-69% (averagely 37%) and 6%-44% (averagely 23%). The levels of TCM and BDCM were lowered by all water purifiers in October and November, but accelerated in effluent compared to the influent in one public water purifier in December. The removal efficiencies of twelve antibiotics greatly varied with species and time. Out of twelve sampling cases, the removal efficiencies of total antibiotics were 25%-75% in ten cases. In the other two cases, very low removal efficiency (6%) or higher levels of antibiotics present in effluent compared to the influent were observed. Two public water purifiers effectively remove ARGs from water, with log removal rates of 0.45 log-3.89 log. However, in the other two public water purifiers, the ARG abundance accidently increased in the effluents. Overall, public water purifiers were more effective in removing antibiotics and ARGs compared to household water purifiers, but less or equally effective in removing trihalomethanes. Both public and household water purifiers could be contaminated and release the accumulated micro-pollutants or biofilm-related pollutants into effluent. The production frequency and standing time of water within water purifiers can impact the internal contamination and purification efficacy.

Occurrences and implications of pathogenic and antibiotic-resistant bacteria in different stages of drinking water treatment plants and distribution systems

Different stages of drinking water treatment plants (DWTPs) play specific roles in diverse contaminants' removal present in natural water sources. Although the stages are recorded to promote adequate treatment of water, the occurrence of pathogenic bacteria (PB) and antibiotic-resistant bacteria (ARB) in the treated water and the changes in their diversity and abundance as it passed down to the end users through the drinking water distribution systems (DWDSs), is a great concern, especially to human health. This could imply that the different stages and the distribution system provide a good microenvironment for their growth. Hence, it becomes pertinent to constantly monitor and document the diversity of PB and ARB present at each stage of the treatment and distribution system. This review aimed at documenting the occurrence of PB and ARB at different stages of treatment and distribution systems as well as the implication of their occurrence globally. An exhaustive literature search from Web of Science, Science-Direct database, Google Scholar, Academic Research Databases like the National Center for Biotechnology Information, Scopus, and SpringerLink was done. The obtained information showed that the different treatment stages and distribution systems influence the PB and ARB that proliferate. To minimize the human health risks associated with the occurrence of these PB, the present review, suggests the development of advanced technologies that can promote quick monitoring of PB/ARB at each treatment stage and distribution system as well as reduction of the cost of environomics analysis to promote better microbial analysis.

Effects of treatments and distribution on microbiome and antibiotic resistome from source to tap water in three Chinese geographical regions based on metagenome assembly

Antibiotic resistance genes (ARGs) represent emerging environmental pollutants that present health risks. Drinking water supply systems (DWSSs), including sources to tap water, play crucial roles in the dissemination and propagation of ARGs. However, there was a paucity of knowledge on the relative abundance, diversity, mobility, and pathogenic hosts of ARGs in DWSSs from source to tap. Therefore, the effects of treatments and distributions on the microbial community and ARGs from three geographical regions (downstream areas of the Yellow, Yangtze, and Pearl Rivers) were elucidated in the present study. Treatment processes lowered the complexity of the microbial community network, whereas transportation increased it. The assembly mechanisms of the microbial community and antibiotic resistome were primarily driven by stochastic processes. Distribution greatly increased the contribution of stochastic processes. Multidrug ARGs (for example, multidrug transporter and adeJ) and bacitracin ARG (bacA) were the primary mobile ARGs in drinking water, as identified by the metagenomic assembly. Achromobacter xylosoxidans, Acinetobacter calcoaceticus, and Acinetobacter junii harbored diverse multidrug ARGs and mobile genetic elements (MGEs) (recombinases, integrases, and transposases) as potential pathogens and were abundant in the disinfected water. Environmental factors, including pH, chlorine, latitude, longitude, and temperature, influenced the ARG abundance by directly regulating the MGEs and microbial community diversity. This study provides critical information on the fate, mobility, host pathogenicity, and driving factors of ARGs in drinking water, which is conducive to ARG risk assessment and management to provide high-quality drinking water to consumers.

Carbapenem resistance in Enterobacterales from agricultural, environmental and clinical origins: South Africa in a global context

Carbapenem agents are regarded as last-resort antibiotics, however, bacterial resistance towards carbapenems has been reported in both clinical and agricultural settings worldwide. Carbapenem resistance, defined as the resistance of a bacteria towards one or more carbapenem drugs, can be mediated in either of, or a combination of, three mechanisms-although, the mechanism mediated through the production of carbapenemases (β-lactamases that are able to enzymatically degrade carbapenems) is of most significance. Of particular concern is the occurrence of carbapenemase producing Enterobacterales (CPE), with literature describing a dramatic increase in resistance globally. In South Africa, increases of carbapenemase activity occurring in Enterobacter species, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa have recently been reported. CPE can also be found in agricultural environments, as global studies have documented numerous instances of CPE presence in various animals such as pigs, cattle, seafood, horses and dogs. However, most reports of CPE occurrence in agricultural settings come from Northern America, Europe and some parts of Asia, where more extensive research has been conducted to understand the CPE phenomenon. In comparison to clinical data, there are limited studies investigating the spread of CPE in agricultural settings in Africa, highlighting the importance of monitoring CPE in livestock environments and the food chain. Further research is necessary to uncover the true extent of CPE dissemination in South Africa. This review will discuss the phenomenon of bacterial antibiotic resistance (ABR), the applications of the carbapenem drug and the occurrence of carbapenem resistance globally.

Dissemination of antibiotic resistance genes from the Pearl River Estuary to adjacent coastal areas

The spread of antibiotic resistance genes (ARGs) is a growing concern over the world's various environments. Coastal environments may receive pollutants from land runoffs via estuaries. However, the impact of ARG contamination from estuarine regions to coastal areas is rarely reported. This study used high-throughput quantitative PCR to examine the diversity and abundance of ARGs in Pearl River Estuary (PRE) and adjacent coastal areas. We found that the distribution of ARGs in seawater exhibited the distance-decay phenomenon from the estuary to coastal areas, while the sediment samples did not exhibit an obvious distribution pattern. The estuarine water was found to be the hotspot of ARGs, with 74 ARG species detected and absolute abundance being 5.93 × 10⁵ copies per mL, on average, while less species and lower abundance of ARGs were detected in coastal waters. Ordination analysis showed that estuarine ARG communities were significantly different from coastal ARG communities for water samples. SourceTracker analysis revealed that ARGs from the estuarine environment contributed only a minor fraction of ARG contamination to downstream coastal areas (1.5%-7.4% for water samples, and 0.7-1.8% for sediment samples), indicating the strong dilution effect of seawater. Mantel tests, redundancy analysis and random forest model analysis identified salinity, nutrients, microbial community structure and mobile genetic elements (MGEs) as important factors influencing ARG distribution. Partial least squares-path model revealed that, among all environmental factors, MGEs directly affected the distribution of ARGs, while other factors indirectly contributed by affecting the MGEs assemblage. Our study provides insight into the dissemination of ARGs from the PRE to adjacent coastal areas.

Insight into the dynamics of drinking water resistome in China

Antibiotic resistance (AR) is a serious environmental hazard of the current age. Antibiotic resistance genes (ARGs) are the fundamental entities that spread AR in the environment. ARGs are likely to be transferred from the non-pathogenic to pathogenic microbes that might ultimately be responsible for the AR in humans and other organisms. Drinking water (DW) is the primary interaction route between ARGs and humans. Being the highest producer and consumer of antibiotics China poses a potential threat to developing superbugs and ARGs dissemination. Herein, we comprehensively seek to review the ARGs from dominant DW sources in China. Furthermore, the origin and influencing factors of the ARGs to the DW in China have been evaluated. Commonly used methods, both classical and modern, are being compiled. In addition, the risk posed and mitigation strategies of DW ARGs in China have been outlined. Overall, we believe this review would contribute to the assessment of ARGs in DW of China and their dissemination to humans and other animals and ultimately help the policymakers and scientists in the field to counteract this problem on an emergency basis.

Occurrence of antibiotic-resistant bacteria and resistance genes in the urban water cycle

This study investigates the antibiotic resistance fate in the urban water cycle, evaluating the dynamics of antibiotic-resistant bacteria (ARB) and antibiotic-resistant genes (ARGs) in three different full-scale wastewater treatment plants (WWTPs) and two drinking water treatment plants (DWTPs) located in the same geographical area (North-West of Italy). ARB (tetracycline-, ampicillin-, and sulfonamide-resistant bacteria) were quantified by plate counting and the abundances of selected ARGs (i.e., tetA, bla_TEM, and sulII) and intI1 gene were measured using quantitative real-time PCR (qPCR). Higher concentrations of ARB and ARGs were observed in the WWTPs with respect to the DWTPs identifying the WWTP as hotspot for the spread of antibiotic resistances. Although a significant reduction of ARB and ARGs was observed in WWTPs and DWTPs after the treatment, none of the detected ARB or ARGs was completely removed in drinking water. The stability of the antibiotic-resistant rates between inlet and outlet associated with the reduction of relative ARG abundances underlined that both the treatments (WWTs and DWTs) did not apply any selective pressure. The overall results highlighted the importance to investigate the antibiotic resistance dynamics in aquatic ecosystems involved in urban water cycle integrating the information obtained by culture-dependent method with the culture-independent one and the need to monitor the presence of ARB and ARGs mainly in drinking water that represents a potential route of transmission to human.

Antibiotic resistome alteration along a full-scale drinking water supply system deciphered by metagenome assembly: Regulated by seasonality, mobile gene elements and antibiotic resistant gene hosts

Both drinking water treatment processes and distribution can lead to antibiotic resistome variation, yet the variation of antibiotic resistome in the whole drinking water supply system (DWSS) combined with seasonality remains unknown. In this study, microbial community, antibiotic resistome, mobile genetic elements (MGEs) co-existing with antibiotic resistance genes (ARGs) and ARG hosts would be explored along a DWSS for four seasons with metagenome assembly. Multidrug and bacitracin ARGs were dominant ARGs in DWSS. Integrase, plasmids, recombinase and transposase were major MGEs co-existing with ARGs. Filtration and disinfection treatments could alter the ARG relative abundance, mainly via changing the abundance of ARG hosts (Limnohabitans and Polynucleobacter), which was influenced by water total organic carbon (TOC) content. When TOC was relatively high, filtration could proliferate ARGs via promoting antibiotic resistance bacteria (ARB) but chlorine dioxide could decrease ARGs via killing ARB. Filtration played an important role in controlling ARGs by reducing ARB when TOC was relatively low. The stimulation effect of disinfection on ARGs existed in more oligotrophic environment. Distribution could enrich ARGs in higher temperature by increasing MGEs co-occurring with ARGs and diversifying ARG hosts. MGEs co-occurring with ARGs became more abundant and diverse in disinfected water in warmer seasons. Microbial community was the most important factor determining the antibiotic resistome along a DWSS. These findings extend the knowledge about how and why water treatment processes and pipe distribution shape drinking water antibiotic resistome in different seasons.

The Phenomenon of Antibiotic Resistance in the Polar Regions: An Overview of the Global Problem

The increasing prevalence of antibiotic resistance is a global problem in human and animal health. This leads to a reduction in the therapeutic effectiveness of the measures used so far and to the limitation of treatment options, which may pose a threat to human health and life. The problem of phenomenon of antibiotic resistance affects more and more the polar regions. This is due to the increase in tourist traffic and the number of people staying at research stations, unmodernised sewage systems in inhabited areas, as well as the migration of animals or the movement of microplastics, which may contain resistant bacteria. Research shows that the presence of antibiotic resistance genes is more dominant in zones of human and wildlife influence than in remote areas. In a polluted environment, there is evidence of a direct correlation between human activity and the spread and survival of antibiotic-resistant bacteria. Attention should be paid to the presence of resistance to synthetic and semi-synthetic antibiotics in the polar regions, which is likely to be correlated with human presence and activity, and possible steps to be taken. We need to understand many more aspects of this, such as bacterial epigenetics and environmental stress, in order to develop effective strategies for minimizing the spread of antibiotic resistance genes. Studying the diversity and abundance of antibiotic resistance genes in regions with less anthropogenic activity could provide insight into the diversity of primary genes and explain the historical evolution of antibiotic resistance.

Intrinsic chlorine resistance of bacteria modulated by glutaminyl-tRNA biosynthesis in drinking water supply systems

The existence of chlorine-resistant bacteria (CRB) in drinking water supply systems (DWSSs) results in significant challenges to the biological security of drinking water. However, little is known about the intrinsic chlorine-resistant molecular metabolic mechanism of bacteria in DWSSs. This research explored the microbial interactions and the key metabolic pathways that modulate the chlorine resistance of bacteria in full-scale chloraminated DWSSs. The dominant CRB, including Bdellovibrio, Bradyrhizobium, Peredibacter, Sphingomonas, and Hydrogenophaga, strongly interacted with each other to maintain basic metabolism. A total of 4.21% of the bacterial metabolic pathways were key and specific to chlorine-resistant bacteria. Glutaminyl-tRNA biosynthesis was the dominant metabolic pathway of CRB in the target DWSSs. After chloramine disinfection, the relative abundance of glutamate-tRNA ligase (GlnRS) and the related orthologous genes increased by 10.11% and 14.58%, respectively. The inactivation rate of the GlnRS overexpression strain (81.40%) was lower than that of the wild-type strain (90.11%) after exposure to chloramine. Meanwhile, the growth rate of the GlnRS overexpression strain was higher than that of the wild-type strain. Glutaminyl-tRNA biosynthesis can enhance chlorine resistance in DWSSs.

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.

Hospital wastewater treatment and the role of membrane filtration - removal of micropollutants and pathogens: A review

Dissemination of multiresistant bacteria and high concentrations of micropollutants by hospitals and other medical facilities can be significantly reduced by a wide variety of on-site treatment approaches. Membrane filtration technologies, ranging from microfiltration to reverse osmosis, have been adapted in many studies and offer multiple purposes in advanced wastewater treatment configurations. While the direct rejection of pharmaceutical compounds and pathogens can only be achieved with nanofiltration and reverse osmosis processes, porous membranes are known for their pathogen removal capabilities and can be used in combination with other advanced treatment approaches, such as oxidation and adsorption processes. This review was conducted to systematically assess studies with membrane filtration technologies that are used as either stand-alone or hybrid systems for the treatment of hospital wastewater. In this review, four different databases were screened with a pre-set of search strings to thoroughly investigate the application of membrane filtration technology in hospital wastewater treatment. Hybrid systems that combine multiple treatment technologies seem to be the most promising way of consistently removing micropollutants and pathogens from hospital wastewater, but additional economic assessments are needed for an extensive evaluation.

Removal of antibiotics from wastewaters by membrane technology: Limitations, successes, and future improvements

Antibiotics and related pharmaceuticals are applied to enhance public health and life quality. A major environmental concern is wastewaters from pharmaceutical industries, which contain significant amounts of antibiotics. Pharmaceutical industries apply conventional processes (biological, filtration, coagulation, flocculation, and sedimentation) for wastewater treatment, but these approaches cannot remove antibiotics completely. Moreover, unmetabolized antibiotics released by humans and animals are dangerous for municipal and effluent wastewater. Besides, antibiotic resistance is another challenge in treatment of wastewater for superbugs. This comprehensive study summarizes different techniques for antibiotic removal with an emphasis on membrane technology in individual and hybrid systems such as chemical, physical, biological, and conditional-based strategies. A combination of membrane processes with advanced oxidation processes (AOPs), adsorption, and biological treatments can be the right solution for perfect removal. Furthermore, this review briefly compares different procedures for antibiotic removal, which can be helpful for further studies with their advantages and drawbacks.

Conurbation size drives antibiotic resistance along the river

With growing concerns about antibiotic resistance, the tracking of antibiotic resistance genes (ARGs) in urban waterways will facilitate our increased understanding of the impact of urbanization on ARGs dissemination. In the current study, we assessed the ARGs profiles and antibiotic resistome in water samples along the Jiulong River basin, a distance of 250 km, to better understand the impact of anthropogenic activities. A total of 244 ARGs and 12 MGEs were detected from 21 sampling sites. Both relative and absolute abundance of the observed resistome decreased with increasing distance from urban areas. Ordinary least-squares (OLS) regression revealed that both the relative and absolute resistome abundance were positively correlated with city size. The resistome had several inputs and outputs and Fast Expectation Maximization Microbial Source Tracking (FEAST), suggested that the majority of the antibiotic resistome originated from anthropogenic activities. A total of 8 ARGs and 20 microbial OTUs were considered as biomarkers that differentiated the location of sampling sites. Bacterial communities were significantly correlated with ARGs according to Procrustes analysis and Mantel test, which was also supported by a co-occurrence network. Variation partitioning analysis revealed that ARG profiles were driven by multiple factors. Although antibiotic resistome abundance significantly increased near urban conurbations, overall resistome abundance decreased as the river flowed downstream. Our study highlights the effect of conurbation size on antibiotic resistance profiles within the river basin and the potential resilience of rivers to recover from ARGs contamination.

Antibiotic Resistance in the Drinking Water: Old and New Strategies to Remove Antibiotics, Resistant Bacteria, and Resistance Genes

Bacterial resistance is a naturally occurring process. However, bacterial antibiotic resistance has emerged as a major public health problem in recent years. The accumulation of antibiotics in the environment, including in wastewaters and drinking water, has contributed to the development of antibiotic resistant bacteria and the dissemination of antibiotic resistance genes (ARGs). Such can be justified by the growing consumption of antibiotics and their inadequate elimination. The conventional water treatments are ineffective in promoting the complete elimination of antibiotics and bacteria, mainly in removing ARGs. Therefore, ARGs can be horizontally transferred to other microorganisms within the aquatic environment, thus promoting the dissemination of antibiotic resistance. In this review, we discuss the efficiency of conventional water treatment processes in removing agents that can spread/stimulate the development of antibiotic resistance and the promising strategies for water remediation, mainly those based on nanotechnology and microalgae. Despite the potential of some of these approaches, the elimination of ARGs remains a challenge that requires further research. Moreover, the development of new processes must avoid the release of new contaminants for the environment, such as the chemicals resulting from nanomaterials synthesis, and consider the utilization of green and eco-friendly alternatives such as biogenic nanomaterials and microalgae-based technologies.

What is the effect on antibiotic resistant genes of chlorine disinfection in drinking water supply systems? A systematic review protocol

Background

Antibiotic-resistant bacteria (ARB) usually enter water sources in different ways, such as via municipal and hospital wastewaters. Because conventional technologies used to treat water inefficient in removing these contaminants (especially antibiotic-resistant genes; ARGs), these contaminants easily enter drinking water distribution networks and pose serious threats to consumers’ health. This study’s main purpose is to systematically investigate the effect of chlorine disinfection on ARGs in drinking water supply systems. This study could play an important role in elucidating the effect of chlorine disinfection on ARGs.

Methods

The systematic review outlining this protocol will be performed according to the Collaboration for Environmental Evidence (CEE) guidelines. The main question is, “what is the effect of chlorine disinfection on ARGs in drinking water supply systems?” For this purpose, the articles will be considered, in which chlorine’s effect on ARGs is investigated. The search includes electronic resources, grey literature, and related websites. Electronic resources include Scopus, PubMed, Embase, Web of Science Core Collection, and Science Direct. After the final search, the obtained articles will be collected in the reference management software (Endnote X8). Upon removing the duplicate articles, the first stage of article screening will be performed based on the title and abstract the articles. In the second stage, the articles obtained from the first screening stage will be screened based on the full text of the articles based on the eligibility criteria. Then, two members of the expert team extract the data. To assess the validity of the articles, bias sources will be determined by an expert team. Biases will be defined according to the criteria designed by Bilotta et al. Finally, a narrative synthesis will be performed for the extracted data; if appropriate data are available, quantitative analysis will also be performed.

Fate, mobility, and pathogenicity of drinking water treatment plant resistomes deciphered by metagenomic assembly and network analyses

Antibiotic resistance genes (ARGs) have been regarded as emerging environmental contaminants. The profile of resistome (collection of all ARGs) in drinking water and its fate during drinking water treatment remain unclear. This study applied metagenomic assembly combined with network analysis to decipher the profile, mobility, host, and pathogenicity of resistomes in two full-scale drinking water treatment plants (DWTPs), each applying conventional treatment and advanced treatment of ozonation followed by biological activated carbon filtration. In source waters and effluents of each treatment process collected from both DWTPs, 215 ARGs belonging to 20 types were detected with total concentration ranging from 6.30 ± 1.83 to 5.20 ± 0.26 × 10⁴ copies/mL. Both the conventional and advanced DWTPs were revealed to effectively reduce the concentration of total ARGs, with the average removal efficiency of 3.61-log₁₀ and 2.21-log₁₀, respectively. Multiple statistical analyses (including network analysis) indicated drinking water resistome correlated tightly with mobile gene elements (MGEs) and bacterial community, with the latter acting as the premier driver of resistome alteration in DWTPs. Further analysis of ARG-carrying contigs (ACCs) assembled from drinking water metagenomes (i) tracked down potential bacterial hosts of ARGs (e.g., Proteobacteria phylum as the major pool of resistome), (ii) provided co-localization information of ARGs and MGEs (e.g., MacB-E7196 plasmid1), and (iii) identified ARG-carrying human pathogens (e.g., Enterococcus faecium and Ralstonia pickettii). This work firstly determined the concentration, mobility incidence, and pathogenicity incidence of DWTP resistomes, based on which the actual health risk regarding antibiotic resistance could be quantitatively assessed in further study, providing a useful direction for decision-making concerning the risk control of ARGs in DWTPs.

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.

Dynamics of antibiotic resistance and its association with bacterial community in a drinking water treatment plant and the residential area

Drinking water treatment techniques are used globally in the context of water security and public health, yet they are not applicable to antibiotic resistance gene (ARG) contamination. Using high-throughput quantitative PCR, we analyzed the prevalence and diversity of ARGs and mobile genetic elements (MGEs) in water supplies. A total of 224 ARGs and MGEs were detected in all sampling sites. Absolute abundance and detected number of ARGs decreased significantly (P < 0.05) in sand filter water after drinking water treatment and increased thereafter at point-of-use (household tap water). Changes in the composition and diversity of the bacterial community were observed in water samples at different steps. A significant correlation (P < 0.001) between microbial communities and ARG profiles was observed, and variance in ARG profiles could be primarily attributed to community composition (11.9%), and interaction between community composition, environmental factors and MGEs (30.7%). A network analysis was performed, and the results showed eight bacterial phyla were significantly correlated with nine different classes of ARGs, suggesting the potential bacterial host for ARGs. This study suggested that although the absolute abundance of ARGs decreased after treatment of drinking water treatment plants (DWTPs), the rebounded of ARGs in the water distribution system should not be neglected.

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.

Measurement of free chlorine levels in water using potentiometric responses of biofilms and applications for monitoring and managing the quality of potable water

Residual free chlorine is not monitored continuously at scale in drinking water distribution systems because existing real-time sensor technologies require frequent maintenance, cleaning, and calibration, which makes these products too costly to be used throughout a distribution system. As a result, current measurement approaches require manual sampling, which is not feasible for the consistent monitoring of free chlorine because chlorine concentrations vary significantly throughout pipeline distribution and over time and space. This research presents an alternative and cost-effective method of predicting free chlorine levels in drinking water using graphite electrodes coated with naturally grown microbial biofilms. This Microbial Potentiometric Sensor (MPS) array was installed in a Continuously Mixed Batch Reactor (CMBR), and drinking water containing variable free chlorine concentrations. The chlorine concentrations were introduced in a controlled manner, and the MPS signals were monitored over time. MPS signals were measured from the change in Open Circuit Potential (OCP) across the MPS array in real-time. An empirically derived relationship between the normalized change in OCP and free chlorine was established by fitting individual and average MPS data to a decaying exponential growth function in order to predict free chlorine levels. The results show that free chlorine can be predicted with reasonable accuracy, with model validation showing an average absolute error of ±0.09 ppm below 1.1 ppm and ±0.30 ppm between 1.1 and 2.7 ppm. However, the accuracy of predictions was reduced at higher free chlorine levels. The researchers conclude that MPS systems may benefit drinking water distribution systems by measuring free chlorine. These advantages of the MPS are especially pronounced in the developing world because this system is inexpensive and does not require routine maintenance or cleaning. The system relies on a naturally forming and regenerating biofilm and an inexpensive potentiometric meter to produce stable measurements.

Disinfectant resistance in bacteria: Mechanisms, spread, and resolution strategies

Disinfectants are widely acknowledged for removing microorganisms from the surface of the objects and transmission media. However, the emergence of disinfectant resistance has become a severe threat to the safety of life and health and the rational allocation of resources due to the reduced disinfectant effectiveness. The horizontal gene transfer (HGT) of disinfectant resistance genes has also expanded the resistant flora, making the situation worse. This review focused on the resistance mechanisms of disinfectant resistant bacteria on biofilms, cell membrane permeability, efflux pumps, degradable enzymes, and disinfectant targets. Efflux can be the fastest and most effective resistance mechanism for bacteria to respond to stress. The qac genes, located on some plasmids which can transmit resistance through conjugative transfer, are the most commonly reported in the study of disinfectant resistance genes. Whether the qac genes can be transferred through transformation or transduction is still unclear. Studying the factors affecting the resistance of bacteria to disinfectants can find breakthrough methods to more adequately deal with the problem of reduced disinfectant effectiveness. It has been confirmed that the interaction of probiotics and bacteria or the addition of 4-oxazolidinone can inhibit the formation of biofilms. Chemicals such as eugenol and indole derivatives can increase bacterial sensitivity by reducing the expression of efflux pumps. The role of these findings in anti-disinfectant resistance has proved invaluable.

Prevalence of Antibiotic Resistance Genes, Heavy Metal Resistance Genes and the Class 1 Integron Gene in Well Water and Tap Water Samples from Four Cities in Henan Province, China

The presence of multi-resistance to both antibiotics and heavy metals in drinking water poses a significant risk to human health. Herein, we utilized qPCR to assess patterns of antibiotic resistance genes (ARGs), heavy metal resistance genes (HMRGs), and class 1 integron (intI1) gene expression levels in well and tap water samples from four cities in Henan Province, China. The relative abundance of most index values was higher in well water relative to tap water, or was highest in Shangqiu City and lowest in Puyang City on average. The expression of ARG was closely correlated with that of intI1 and HMRG in both well and tap water. Overall, our data highlighted the health threat posed by ARGs in the drinking water supply and underscore the potential for the transfer of these genes between bacteria with the aid of intI1 under selective pressure associated with human activity and heavy metal stress.

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.

Metagenomic analysis of microbiota and antibiotic resistome in household activated carbon drinking water purifiers

Existing drinking water treatment systems have limited ability to control emerging contaminants such as antibiotic resistance genes (ARGs). Household activated carbon water purifiers (HWPs) are convenient measures to assure drinking water quality. However, ARGs distribution in HWPs has not been reported. Here, ARGs, mobile genetic elements (MGEs) and bacteria communities were profiled in tap water (TW), filter water (FW) and activated carbon (AC) biofilm from six kinds of HWPs after 80 days operation, using metagenomics. Results showed that the bacteria community diversities in FW and AC were higher than those in TW. A total of 88, 116 and 80 ARG subtypes were detected in TW, AC and FW, respectively. The AC structure was an important factor influencing the bacterial communities and ARG profiles in FW. The network analysis revealed the co-occurrence patterns between ARGs and bacteria. SourceTracker analyses showed AC biofilms were important contributors of microbes (29-79%) and ARGs (17-53%) in FW. Moreover, MGEs e.g. pBBta01, pMKMS02 and pMFLV01 plasmids, and ISMysp3 had significant co-occurrence patterns with ARGs in the AC biofilms. This study helps to understand the actual purification effect of HWPs and provides a theoretical reference for the management and control of ARGs pollution in domestic drinking water.

DNA phosphorothioate modification facilitates the dissemination of mcr-1 and blaNDM-1 in drinking water supply systems

The mechanism driving the dissemination of antibiotic resistance genes (ARGs) in drinking water supply systems (DWSSs) with multiple barriers remains poorly understood despite several recent efforts. Phosphorothioate (PT) modifications, governed by dndABCDE genes, occur naturally in various bacteria and involve the incorporation of sulfur into the DNA backbone. PT is regarded as a mild antioxidant in vivo and is known to provide protection against bacterial genomes. We combined quantitative polymerase chain reaction, metagenomic, and network analyses for the water treatment process and laboratory-scale experiments for chlorine treatment using model strains to determine if DNA PT modification occurred in DWSS and facilitated the dissemination of mobilized colistin resistance-1 (mcr-1) and New Delhi metallo-β-lactamase-1 (bla_NDM-1) in DWSS. Our results indicated that the relative abundance of dndB increased in the effluent, compared with the influent, in the water treatment plants. Presence of dndB copies had a positive correlation with the concentration of chloramine disinfectant. Network analysis revealed Bdellovibrio as a potential host for MCR genes, NDM genes, and dndB in the DWSS. E. coli DH10B (Wild-type with the dndABCDE gene cluster and ΔdndB) model strains were used to investigate resistance to chlorine treatment at the concentration range of 0.5-3 mg/L. The resistance of the wild-type strain increased with increasing concentration of chlorine. DNA PT modification protected MCR- and NDM-carrying bacteria from chloramine disinfection during the water treatment process. The higher relative abundance of ARGs in the effluent of the water treatment plants may be due to the resistance of DNA PT modification to chloramine disinfection, thereby causing the enrichment of genera carrying MCR, NDM, and dndB. This study provides a new understanding on the mechanism of ARG dissemination in DWSS, which will help to improve the performance of drinking water treatment to control the risk associated with antibiotic-resistant bacteria.

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.

Prevalence of antibiotic resistance genes in drinking water and biofilms: The correlation with the microbial community and opportunistic pathogens

The emergence of antibiotic resistance genes (ARGs) and opportunistic pathogens (OPs) in drinking water system posed potential risks to human health. However, the occurrence of ARGs and OPs in drinking water biofilms is still at its infancy. In this study, we investigated the occurrence of ARGs and OPs in both water and biofilm samples from a drinking water system, and the correlation between ARGs and microbial communities was analyzed. The quantitative PCR results showed that the drinking water treatment process effectively decreased the absolute abundances of ARGs. However, the relative concentration of ARGs did not show a significant difference between raw water and treated water samples. Compared with bulk water and tap water samples, biofilms had higher relative abundances of ARGs. 16 S Illumina Miseq sequencing results showed that microbial communities of biofilms were distinguished with water samples. Meanwhile, qPCR results of OPs also showed that biofilms had higher relative abundances of OPs compared with water samples. Furthermore, the Spearman correlation analysis indicated that Dechloromonas, Desulfovibrio, Methylobacterium and Propionivibrio correlated well with the relative abundance of ARGs. The absolute concentrations of OPs and ARGs also showed a significant correlation. Results of this study suggest that biofilms could serve as the reservoirs for the spread of ARGs and the interaction between biofilms and bulk water requires further research.

Preparation of a Three-Dimensional Porous Graphene Oxide-Kaolinite-Poly(vinyl alcohol) Composite for Efficient Adsorption and Removal of Ciprofloxacin

Because of the widespread presence of antibiotics in water, soil, and other environments, they pose great potential risks to the environment, threatening human and animal health. In this study, graphene oxide-kaolinite homogeneous dispersion was prepared by simple liquid phase exfoliation. The three-dimensional (3D) porous graphene oxide-kaolinite-poly(vinyl alcohol) composites were prepared by the cross-linking of poly(vinyl alcohol) and the formation of ice crystals during the freezing-drying process. Three influencing factors [adsorbent dosage, ciprofloxacin (CIP) initial concentration, and time] of CIP adsorption and removal were systematically analyzed by the response surface method. The order of significance for response values (CIP removal rate) was adsorbent dosage > CIP initial concentration > time. The 3D porous material showed good adsorption capacity of CIP, the theoretical maximum adsorption capacity was 408.16 mg/g, and it had good recyclability. By Fourier transform infrared (FTIR) and X-ray photoelectron spectroscopy analysis, it was found the composite adsorbs CIP by hydrogen bonding and π-π interaction. In conclusion, the graphene oxide-kaolinite-poly(vinyl alcohol) porous composite is a good candidate for efficient antibiotic wastewater treatment.

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.

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.

Behavior of last resort antibiotic resistance genes (mcr-1 and blaNDM-1) in a drinking water supply system and their possible acquisition by the mouse gut flora

Mcr-1 and bla_NDM-1 antibiotic resistance genes (ARGs) confer resistance to colistins and carbapenems, which are often antibiotics used as a last resort in tertiary care hospitals. Dissemination of these two ARGs in drinking water supply systems and their effect on healthy gut bacteria are poorly studied. In this study, the dissemination of mcr-1 and bla_NDM-1 in a drinking water supply system, and their effect on the antibiotic resistance of mouse gut bacteria are explored. Metagenome analysis revealed that source water (Taipu river and Jinze reservoir) was polluted with ARGs. Mcr-1 and bla_NDM-1 can be disseminated through the water distribution system. Even advanced water treatments (ozone and biological activated carbon (BAC)) could not effectively remove mcr-1 and bla_NDM-1. Low concentrations of chloramine disinfectants in the water distribution system were not effective at limiting ARG abundance. Mobile genetic elements were also found to play a major role in the dissemination of ARGs via horizontal gene transfer (HGT) throughout the water supply system. Statistical analysis revealed that there was no effect of temperature on the abundance of mcr-1 and bla_NDM-1 throughout the water supply system. A last resort ARG, mcr-1 can disseminate from drinking water to the healthy mouse gut. The presence of mcr-1 in a strain belonging to Enterococcus hirae, which is different from the strain belonging to the Bacillus cereus group isolated from drinking water, strongly supports the phenomena of HGT inside the gut. This research provides novel insights into the role of drinking water in disseminating ARGs to the gut and strongly suggests that drinking water may also play a major role apart from other factors known to be involved in the prevalence of last resort ARGs in the gut.

The effects of ultraviolet disinfection on vancomycin-resistant Enterococcus faecalis

The emergence of vancomycin-resistant Enterococcus faecalis (E. faecalis) in water is threatening the health of human beings. The effect of ultraviolet disinfection on vancomycin-resistant E. faecalis, including the effectiveness, photoreactivation and dark repair of E. faecalis, and the deactivation mechanism were investigated in this work. Ultraviolet disinfection could quickly inactivate the target antibiotic resistant bacterium (ARB), E. faecalis, and it caused damage to the cell membrane and induced the decrease of the total adenosine triphosphate (ATP) content and the superoxide dismutase (SOD) activity significantly (p < 0.05). E. faecalis could reactivate after ultraviolet disinfection especially under light conditions. Furthermore, the removal of the selected antibiotic resistance gene (ARG), vanB, by ultraviolet radiation and the effect on the vancomycin resistance of E. faecalis were investigated, which showed that ultraviolet disinfection had no significant effect on the vancomycin resistance of E. faecalis (p > 0.05).

Metagenomic Sequences of Three Drinking Water and Two Shower Hose Biofilm Samples Treated with or without Copper-Silver Ionization

We announce five shotgun metagenomics data sets from two Norwegian premise plumbing systems. The samples were shotgun sequenced on two lanes of an Illumina HiSeq 3000 instrument (THRUplex chemistry, 151 bp, paired-end reads), providing an extensive resource for sequence analyses of tap water and biofilm microbial communities.

We announce five shotgun metagenomics data sets from two Norwegian premise plumbing systems. The samples were shotgun sequenced on two lanes of an Illumina HiSeq 3000 instrument (THRUplex chemistry, 151 bp, paired-end reads), providing an extensive resource for sequence analyses of tap water and biofilm microbial communities.

Linking Microbial Community Composition in Treated Wastewater with Water Quality in Distribution Systems and Subsequent Health Effects

The increases in per capita water consumption, coupled in part with global climate change have resulted in increased demands on available freshwater resources. Therefore, the availability of safe, pathogen-free drinking water is vital to public health. This need has resulted in global initiatives to develop sustainable urban water infrastructure for the treatment of wastewater for different purposes such as reuse water for irrigation, and advanced waste water purification systems for domestic water supply. In developed countries, most of the water goes through primary, secondary, and tertiary treatments combined with disinfectant, microfiltration (MF), reverse osmosis (RO), etc. to produce potable water. During this process the total bacterial load of the water at different stages of the treatment will decrease significantly from the source water. Microbial diversity and load may decrease by several orders of magnitude after microfiltration and reverse osmosis treatment and falling to almost non-detectable levels in some of the most managed wastewater treatment facilities. However, one thing in common with the different end users is that the water goes through massive distribution systems, and the pipes in the distribution lines may be contaminated with diverse microbes that inhabit these systems. In the main distribution lines, microbes survive within biofilms which may contain opportunistic pathogens. This review highlights the role of microbial community composition in the final effluent treated wastewater, biofilms formation in the distribution systems as the treated water goes through, and the subsequent health effects from potential pathogens associated with poorly treated water. We conclude by pointing out some basic steps that may be taken to reduce the accumulation of biofilms in the water distribution systems.

Contamination of antibiotic resistance genes (ARGs) in a typical marine aquaculture farm: source tracking of ARGs in reared aquatic organisms

Although the prevalence and concentrations of antibiotic resistance genes (ARGs) in aquaculture is receiving increasing scientific interest, there is little understanding of the direct sources and dissemination pathways of ARGs in marine aquaculture-reared organisms. This study investigated the dynamics of ARGs and the bacterial community throughout the rearing period in a typical marine aquaculture farm in South China. The results demonstrated that sul1 and qnrD were predominant in the sediment, and qnrD and qnrA were predominant in the intestinal tracts of shrimps. Network analysis showed that the chemical oxygen demand, total organic carbon, dissolved organic carbon, suspended solids, and total phosphorus were positively correlated with the predominant ARGs. The results of the network and source tracking analyses indicate that environmental factors and the bacterial community may drive the dissemination of ARGs dissemination in the environment and in shrimp reared by marine aquaculture, and sediment is the most direct and important medium in this dissemination. These results aid in improving our understanding of the sources, level, and dissemination of ARGs in marine aquaculture.

Distribution and co-occurrence of antibiotic and metal resistance genes in biofilms of an anthropogenically impacted stream

Urban stream biofilms are potential hotspots for resistomes and antibiotic resistance genes (ARGs). Biofilm communities that harbor resistance genes may be influenced by contaminant input (e.g., metals and antibiotics) from urban drainage (i.e., Wastewater Treatment Plant effluent and stormwater runoff); understanding the ecology of these communities and their resistome is needed. Given the potential importance of the co-occurrence of ARGs and metal resistance genes (MRGs), we investigated the spatial and temporal distribution of three ARGs (tetracycline [tetW] and sulfonamides [sulI and sulII]), four MRGs (lead [pbrT], copper [copA], and cadmium/cobalt/zinc [czcA and czcC]) via quantitative PCR and biofilm bacterial community composition via MiSeq 16S sequencing at four time points along an urbanization gradient (i.e., developed, agriculture, and forested sites) in a stream's watershed. Our results revealed that ARG and MRG abundances were significantly affected by land use-time interaction, with greater resistance abundances occurring in more urban locations during particular times of the year. It was also observed that changes in ARG and MRG profiles were influenced by differences in community composition among land use types, and that these differences were in response to changes in stream physicochemical parameters (pH, redox, temperature, nutrient availability, and metal concentration) that were driven by sub-watershed land use. Moreover, the dynamics between ARGs and MRGs within these communities correlated strongly and positively with one another. Taken altogether, our results demonstrate that changes in environmental properties due to human activity may drive the ARG-MRG profiles of biofilm communities by modulating community structure over time and space.

Occurrence and reduction of antibiotic resistance genes in conventional and advanced drinking water treatment processes

Antibiotic resistance is extensively detected in drinking water sources, threatening its safety and human health, which deserves further attention to the removal of antibiotic resistance genes (ARGs) in the drinking water system. In this study, the occurrence and reduction of integrase gene intI1 and forty-one ARG subtypes, which confers resistance to six antibiotic classes (β-lactam, aminoglycoside, macrolide, tetracycline, sulfonamide, and quinolone), were investigated in a drinking water treatment plant (DWTP). Seventeen ARG subtypes with absolute concentrations ranging from 1.4 × 10⁰ to 7.3 × 10⁵ and 3.9 × 10⁴ genes/mL (intI1) were detected in the raw water; and sul1 and sul2 were the two dominant ARG subtypes. Overall, the whole DWTPs achieved 0.03-2.4 log reduction of ARGs compared with those presented in raw water. The reduction efficiencies of sul1, strA, and intI1 were the highest (1.0-2.4 log) in both conventional and advanced processes. However, the levels of sul1, sul2, and ermC still remained high (1.3 × 10⁰-1.9 × 10⁴ genes/mL) in finished water. The treatment units, including pre-flocculation/sedimentation/sand filtration, and ozonation units, were beneficial for the reduction of ARGs, which was mostly ascribed to the decline in biomass and the strong oxidizing properties of ozone. However, the reduction effect was subsequently counteracted by the granular activated carbon and chlorination units. This study provides basic data for ARG pollution in the drinking water system, and suggests that ARGs persist in drinking water, even after conventional chlorination or advanced treatment processes, highlighting the need for new and efficient water purification technologies.

Antibiotic resistance in drinking water systems: Occurrence, removal, and human health risks

In recent years, there has been a growing interest on the occurrence of antibiotic-resistant bacteria (ARB) and antibiotic resistant genes (ARGs) in treated and untreated drinking water. ARB and ARGs pose a public health concern when they transfer antibiotic resistance (AR) to human pathogens. However, it is still unclear whether the presence of environmental ARB and ARGs in source water, drinking water treatment plants, and drinking water distribution systems has any significant impact on human exposure to pathogenic ARB. In this review, we critically examine the occurrence of AR in groundwater, surface water, and treated distributed water. This offered a new perspective on the human health threat posed by AR in drinking water and helped in crafting a strategy for monitoring AR effectively. Using existing data on removal of ARB and ARGs in drinking water treatment plants, presence and proliferation of AR in drinking water distribution systems, and mechanisms and pathways of AR transfer in drinking water treatment plants, we conclude that combining UV-irradiation with advanced oxidative processes (such as UV/chlorine, UV/H₂O₂, and H₂O₂/UV/TiO₂) may enhance the removal of ARB and ARGs, while disinfection may promote horizontal gene transfer from environmental ARB to pathogens. The potential human health risks of AR were determined by examining human exposure to antibiotic resistant human pathogens and re-evaluating waterborne disease outbreaks and their links to environmental AR. We concluded that integrating disease outbreak analysis, human exposure modelling, and clinical data could provide critical information that can be used to estimate the dose-response relationships of pathogenic ARB in drinking water, which is required for accurate risk assessments.

Chlorine injury enhances antibiotic resistance in Pseudomonas aeruginosa through over expression of drug efflux pumps

Adaption to adverse environments plays an important role in bacterial survival and is receiving increasing globe attention now. Here, cultivable chlorine-injured Pseudomonas aeruginosa, produced on the chlorination process, was investigated about their resistance to antibiotics. Then, global transcriptional analyses, quantitative PCR (qPCR) validation and antioxidant enzymes measurement were performed to explore the underlying mechanisms. The results showed that chlorine injury enhanced antibiotic resistance in P. aeruginosa and cultivable chlorine-injured P. aeruginosa exposed to 4 mg/L sodium hypochlorite (half of the lethal dose) improved antibiotic resistance against ceftazidime, chloramphenicol and ampicillin by 1.4-5.6 fold. This increase in antibiotic resistance was not hereditable and over expression of the MexEF-OprN efflux pump resulting from oxidative stress contributed to it. These results demonstrate temporal physiological persistence to antibiotics in cultivable chlorine-injured pathogens, suggesting their survival from adverse environments with antibiotic exposure and thereby posing lasting hazards to human health.

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.

Removal of p-cresol and tylosin from water using a novel composite of alginate, recycled MnO2 and activated carbon

For sustainable production, there is an urgent need to minimize the adverse environmental impacts of swine farming, which is a major contributor of the pollutants p-cresol and tylosin. Novel reactive composite alginate beads (CAB-MOACs) were fabricated by combining alginate with activated carbon (AC) and MnO₂ recovered from spent battery waste and used for efficient removal of p-cresol and tylosin from water. Batch experiments were carried out under varying pH (3-11), temperature (15-50 °C), and agitation speed (50-200 rpm) to understand their effects on removal efficiency. The CAB-MOACs had better removal efficiency for p-cresol and tylosin than alginate beads alone or beads containing only AC or MnO₂. Adsorption to CAB-MOACs followed pseudo-second-order kinetics (R²≥0.98) and Langmuir isotherm models (R²≥0.95). CAB-MOACs showed higher removal efficiency (∼99.9% after 10 h) compared to beads containing only immobilized MnO₂ (60-70%) or AC (94-96%). Regeneration and reuse performance of the CAB-MOACs was excellent through five cycles, although slightly better for p-cresol than tylosin. With low-cost manufacturing and beneficial utilization of hazardous waste such as spent batteries, the newly developed composite beads show potential as an effective adsorbent for treating wastewater effluent containing emerging contaminants like p-cresol and tylosin. Future studies may focus on product refinement and large-scale testing on actual wastewaters.

Human exposure to antibiotic resistant-Escherichia coli through irrigated lettuce

Antibiotic resistant bacteria (ARB) have been found on fresh fruit and vegetables globally. These types of ARB infections are spreading rapidly and are a major human health threat. A quantitative human exposure assessment model was created using scenario analysis to investigate the potential human exposure to antibiotic resistant Escherichia coli (AR-E. coli) through the consumption of lettuce irrigated with surface water. Scientific literature and site specific data were collected to model each process from farm to fork to calculate the concentration of AR-E. coli on the lettuce at the point of human consumption. The processes examined were the adhesion, colonisation and viability of bacteria on the lettuce; the effect of different post-harvest cleaning processes; the effect of consuming the lettuce before, on or after the expiry date; and the effect of the consumer washing the lettuce. The results show the mean human exposure levels ranged between 1.00 × 10-2 and 1.35 × 106 colony forming units (CFU) of AR-E. coli per 100 g of surface water irrigated lettuce for the different scenarios investigated. The mean probability of illness from consuming 100 g of lettuce contaminated with potential pathogenic antibiotic-sensitive E. coli was between 1.46 × 10-9 to 1.88 × 10-2. A back calculation revealed that in order for the EC No 1441/2007 regulation to be exceeded (≥1000 CFU/g of E. coli on lettuce at the manufacturing stage), the mean contamination levels required in the irrigation water would need to be 2.7, 3.1 or 4.8 log CFU/ml using the post-harvest treatments of washing with water, rapid cooling with water and washing with a chlorine solution respectively. The information generated from this model could help to set guidelines for producers on maximum permissible AR-E. coli contamination levels in irrigation water and provides recommendations on the best post-harvest treatment to use.

Prevalence and transmission of antibiotic resistance and microbiota between humans and water environments

The transmission routes for antibiotic resistance genes (ARGs) and microbiota between humans and water environments is poorly characterized. Here, we used high-throughput qPCR analyses and 16S rRNA gene sequencing to examine the occurrence and abundance of antibiotic resistance genes and microbiota in both healthy humans and associated water environments from a Chinese village. Humans carried the most diverse assemblage of ARGs, with 234 different ARGs being detected. The total abundance of ARGs in feces, on skin, and in the effluent from domestic sewage treatment systems were approximately 23, 2, and 7 times higher than their abundance in river samples. In total, 53 ARGs and 28 bacteria genera that were present in human feces could also be found in the influent and effluent of rural sewage treatment systems, and also downstream of the effluent release point. We identified the bacterial taxa that showed a significant association with ARGs (P < 0.01, r > 0.8) by network analysis, supporting the idea that these bacteria could carry some ARGs and transfer between humans and the environment. Analysis of ARGs and microbiota in humans and in water environments helps to define the transmission routes and dynamics of antibiotic resistance within these environments. This study highlights human contribution to the load of ARGs into the environment and suggests means to prevent such dissemination.