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

The Role of Wastewater Treatment Plants in Dissemination of Antibiotic Resistance: Source, Measurement, Removal and Risk Assessment

Antibiotic Resistance Genes (ARGs) are contaminants of emerging concern with marked potential to impact public and environmental health. This review focusses on factors that influence the presence, abundance, and dissemination of ARGs within Wastewater Treatment Plants (WWTPs) and associated effluents. Antibiotic-Resistant Bacteria (ARB) and ARGs have been detected in the influent and the effluent of WWTPs worldwide. Different levels of wastewater treatment (primary, secondary, and tertiary) show different degrees of removal efficiency of ARGs, with further differences being observed when ARGs are captured as intracellular or extracellular forms. Furthermore, routinely used molecular methodologies such as quantitative polymerase chain reaction or whole genome sequencing may also vary in resistome identification and in quantifying ARG removal efficiencies from WWTP effluents. Additionally, we provide an overview of the One Health risk assessment framework, as well as future strategies on how WWTPs can be assessed for environmental and public health impact.

Metagenome sequencing reveals shifts in phage-associated antibiotic resistance genes from influent to effluent in wastewater treatment plants

Antibiotic resistance poses a significant threat to global health, and the microbe-rich activated sludge environment may contribute to the dissemination of antibiotic resistance genes (ARGs). ARGs spread across various bacterial populations via multiple dissemination routes, including horizontal gene transfer mediated by bacteriophages (phages). However, the potential role of phages in spreading ARGs in wastewater treatment systems remains unclear. This study characterized the core resistome, mobile genetic elements (MGEs), and virus-associated ARGs (vir_ARGs) in influents (Inf) and effluents (Eff) samples from nine WWTPs in eastern China. The abundance of ARGs in the Inf samples was higher than that in the Eff samples. A total of 21 core ARGs were identified, accounting for 38.70 %-83.70 % of the different samples. There was an increase in MGEs associated with phage-related processes from influents to effluents (from 12.68 % to 21.10 %). These MGEs showed strong correlations in relative abundance and composition with the core ARGs in the Eff samples. Across the Inf and Eff samples, 58 unique vir_ARGs were detected, with the Eff samples exhibiting higher diversity of vir_ARGs than the Inf samples. Statistical analyses indicated a robust relationship between core ARG profile, MGEs associated with phage-related processes, and vir_ARG composition in the Eff samples. Additionally, the co-occurrence of MGEs and ARGs in viral genomes was observed, ranging from 22.73 % to 68.75 %. This co-occurrence may exacerbate the persistence and spread of ARGs within WWTPs. The findings present new information on the changes in core ARGs, MGEs, and phage-associated ARGs from influents to effluents in WWTPs and provide new insights into the role of phage-associated ARGs in these systems.

The integrative and conjugative element ICECiPOL15 mediates horizontal transfer of β-lactam resistance gene in Chryseobacterium indoltheticum POL15

OBJECTIVES

The dissemination of antibiotic resistance genes (ARGs) from the environment, including agricultural sources, is of increasing concern. In this study, we examined the antibiotic resistance profile and genomic sequence of a strain of Chryseobacterium indoltheticum obtained from an agricultural location.

METHODS

The multidrug-resistant bacterial strain POL15 was isolated from the wastewater of a livestock farm in China. Whole-genome sequencing was performed followed by bioinformatics analyses to identify integrative and conjugative elements (ICEs) and ARGs. Mating assays were performed to analyse ICE transferability.

RESULTS

Whole-genome sequencing and annotation showed that the genome of POL15 encodes ARGs. Additionally, an ICE named ICECiPOL15, which carries a class C β-lactamase-encoding gene blaAQU, was identified in the POL15 genome. Genes encoding an integrase, an excisionase, a relaxase, a type IV coupling protein and conjugative transposon proteins involved in a type IV secretion system were also identified in ICECiPOL15. Sequence alignment revealed that ICECiPOL15 might have evolved from other Chryseobacterium species. The horizontal transferability of ICECiPOL15 was demonstrated by mating experiments between C. indoltheticum POL15 and Escherichia coli DL21.

CONCLUSIONS

This study represents the first characterization of a mobilizable antibiotic resistance ICE in a species of C. indoltheticum and provides evidence that C. indoltheticum strains could be important reservoirs and vehicles for ARGs on livestock farms.

Antibiotic occurrence, environmental risks, and their removal from aquatic environments using microalgae: Advances and future perspectives

Antibiotic pollution has caused a continuous increase in the development of antibiotic-resistant bacteria and antibiotic-resistant genes (ARGs) in aquatic environments worldwide. Algae-based bioremediation technology is a promising eco-friendly means to remove antibiotics and highly resistant ARGs, and the generated biomass can be utilized to produce value-added products of industrial significance. This review discussed the prevalence of antibiotics and ARGs in aquatic environments and their environmental risks to non-target organisms. The potential of various microalgal species for antibiotic and ARG removal, their mechanisms, strategies for enhanced removal, and future directions were reviewed. Antibiotics can be degraded into non-toxic compounds in microalgal cells through the action of extracellular polymeric substances, glutathione-S-transferase, and cytochrome P450; however, antibiotic stress can alter microalgal gene expression and growth. This review also deciphered the effect of antibiotic stress on microalgal physiology, biomass production, and biochemical composition that can impact their commercial applications.

Determining the spatiotemporal variation, sources, and ecological processes of antibiotic resistance genes in a typical lake of the middle reaches of the Yangtze River

Antibiotic resistance genes (ARGs) are emerging environmental pollutants, influenced by complex regulatory factors. River-lake systems act as natural reservoirs for ARGs and provide an ideal model for studying their regulatory mechanisms. This study employed high-throughput quantitative PCR, high-throughput sequencing, correlation analyses, and model predictions to investigate the dynamics of ARGs and their influencing factors in Liangzi Lake, located in the mid-reaches of the Yangtze River. The research specifically centered on three environmental components: lake water, sediment, and river water. Results indicated that the ARGs from eight major antibiotic classes, displaying distinct seasonal distribution patterns. In comparison to the sediment, the water phase demonstrated a higher diversity of ARGs, with the highest level of ARGs sharing observed between lake and river waters (approximately 83.7 %). Furthermore, seasonal variations significantly influenced the distributions of both ARGs and bacterial communities. The diversity of ARGs was highest during the summer and autumn, and specific bacterial species exhibited robust correlations with ARGs (including matA/mel, aac (6')-Ib-03, and blaROB). It is worth noting that environmental attributes and bacterial diversity had the most substantial impact on the dynamic changes in ARGs. Lastly, source tracking analysis pinpointed that sediment as the primary source of ARGs in lake water, constituting 45 % to 48 % of the total ARGs. Our study provides a comprehensive analysis of ARGs and their influencing factors in the river-lake system of the middle reaches of the Yangtze River, with Liangzi Lake as a representative case.

Dengue havoc: overview and eco-friendly strategies to forestall the current epidemic

Dengue fever is a mosquito-borne viral illness that affects over 100 nations around the world, including Africa, America, the Eastern Mediterranean, Southeast Asia, and the Western Pacific. Those who get infected by virus for the second time are at greater risk of having persistent dengue symptoms. Dengue fever has yet to be treated with a long-lasting vaccination or medication. Because of their ease of use, mosquito repellents have become popular as a dengue prevention technique. However, this has resulted in environmental degradation and harm, as well as bioaccumulation and biomagnification of hazardous residues in the ecosystem. Synthetic pesticides have caused a plethora of serious problems that were not foreseen when they were originally introduced. The harm caused by the allopathic medications/synthetic pesticides/chemical mosquito repellents has paved the door to employment of eco-friendly/green approaches in order to reduce dengue cases while protecting the integrity of the nearby environment too. Since the cases of dengue have become rampant these days, hence, starting the medication obtained from green approaches as soon as the disease is detected is advisable. In the present paper, we recommend environmentally friendly dengue management strategies, which, when combined with a reasonable number of vector control approaches, may help to avoid the dengue havoc as well as help in maintaining the integrity of the ecosystem.

Metagenomic insight into the prevalence and driving forces of antibiotic resistance genes in the whole process of three full-scale wastewater treatment plants

The spread of antibiotic resistance genes (ARGs) is an emerging global health concern, and wastewater treatment plants (WWTPs), as an essential carrier for the occurrence and transmission of ARGs, deserves more attention. Based on the Illumina NovaSeq high-throughput sequencing platform, this study conducted a metagenomic analysis of 18 samples from three full-scale WWTPs to explore the fate of ARGs in the whole process (influent, biochemical treatment, advanced treatment, and effluent) of wastewater treatment. Total 70 ARG subtypes were detected, among which multidrug, aminoglycoside, tetracycline, and macrolide ARGs were most abundant. The different treatment processes used for three WWTPs were capable of reducing ARG diversity, but did not significantly reduce ARG abundance. Compared to that by denitrification filters, the membrane bioreactor (MBR) process was advantageous in controlling the prevalence of multidrug ARGs in WWTPs. Linear discriminant analysis Effect Size (LEfSe) suggested g_Nitrospira, g_Curvibacter, and g_Mycobacterium as the key bacteria responsible for differential ARG prevalence among different WWTPs. Meanwhile, adeF, sul1, and mtrA were the persistent antibiotic resistance genes (PARGs) and played dominant roles in the prevalence of ARGs. Proteobacteria and Actinobacteria were the host bacteria of majority ARGs in WWTPs, while Pseudomonas and Nitrospira were the most crucial host bacteria influencing the dissemination of critical ARGs (e.g., adeF). In addition, microbial richness was determined to be the decisive factor affecting the diversity and abundance of ARGs in wastewater treatment processes. Overall, regulating the abundance of microorganisms and key host bacteria by selecting processes with microbial interception, such as MBR process, may be beneficial to control the prevalence of ARGs in WWTPs.

Elevated levels of anthropogenic antibiotic resistance gene marker, sul1, linked with extreme fecal contamination and poor water quality in wastewater-receiving ponds

In several low- and middle-income countries, such as India, the rapid construction of toilets to combat open defecation has not been matched with adequate wastewater treatment, resulting in extreme fecal contamination of the receiving environments. The sewage-receiving surface water bodies, typically close to the residences, are a potential hotspot for disease transmission and antibiotic resistance. Water, soil, and sediment samples from seven wastewater-receiving ponds (WRPs) were analyzed for water quality, chlorophyll-a, fecal contamination (yccT for Escherichia coli), 16S rRNA gene copies, and anthropogenic antibiotic resistance gene markers-sul1 and intI1. These WRPs were contrasted with two ponds that did not directly receive sewage. The water quality in the WRPs was comparable to raw sewage (BOD: 210-380 mg/L; COD: 350-630 mg/L; total-N: 100-190 mg/L; and total-P: 6-21 mg/L), and the relative levels of the DNA marker of E. coli were very high (yccT: 0.1% to ∼100% of total bacterial count) indicating extreme fecal contamination. The relative levels of sul1 and intI1 were 1-3 orders of magnitude higher in WRPs (sul1: 0.32%-10% of total bacterial count; and intI1: 0.2%-5% of total bacterial count) compared to the ponds that did not receive sewage directly. The relative levels of sul1 correlated with the DNA marker for the fecal indicator, E. coli (p-value < 0.05; r = 0.50; Spearman's rank correlation), and poor water quality.

Characteristics of antibiotic resistance gene distribution in rainfall runoff and combined sewer overflow

Rainfall runoff and combined sewer overflow (CSO) converge with organic waste, nutrients, and microbes from the ground and wastewater. These pollutants promote the spread and transformation of antibiotic resistance genes (ARGs). In this study, four rainfall runoff and one CSO outfall were chosen, and samples were collected to explore the occurrence and distribution of ARGs. The ARGs were extracted from suspended solids and analyzed using metagenomic sequencing. A total of 888 ARG subtypes, belonging to 17 ARG types, were detected in all samples. Eleven ARG types were shared by all the samples. Multidrug resistance genes had the highest relative abundance. Their total relative abundance reached 1.07 ratio (ARG copy number/16S rRNA gene copy number) and comprised 46.6% of all the ARGs. In all samples, the CSO outfall had the highest total relative abundance (8.25 × 10^-1 ratio) of ARGs, with a ratio ranging ND (not detected)-3.78 × 10^-1 ratio. Furthermore, the relationship between ARG types and environmental factors was determined using redundancy analysis. The results showed that chemical organic demand (COD) and bacterial abundance were positively correlated with most ARG types, including multidrug, bacitracin, aminoglycoside, β-lactam, tetracycline, and sulfonamide. NH₃-N, TN, and TP were positively correlated with rifamycin, fosmidomycin, and vancomycin resistance genes. The relationship among the ARG subtypes was investigated using network analyses. The multidrug resistance gene subtypes had the highest frequency of co-occurrence. This study provides insights into the occurrence and distribution of ARGs under non-point source pollution and may contribute to the control of ARGs.

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.

Antibiotic resistant genes in the environment-exploring surveillance methods and sustainable remediation strategies of antibiotics and ARGs

Antibiotic Resistant Genes (ARGs) are an emerging environmental health threat due to the potential change in the human microbiome and selection for the emergence of antibiotic resistant bacteria. The rise of antibiotic resistant bacteria has caused a global health burden. The WHO (world health organization) predicts a rise in deaths due to antibiotic resistant infections. Since bacteria can acquire ARGs through horizontal transmission, it is important to assess the dissemination of antibioticresistant genes from anthropogenic sources. There are several sources of antibiotics, antibiotic resistant bacteria and genes in the environment. These include wastewater treatment plants, landfill leachate, agricultural, animal industrial sources and estuaries. The use of antibiotics is a worldwide practice that has resulted in the evolution of resistance to antibiotics. Our review provides a more comprehensive look into multiple sources of ARG's and antibiotics rather than one. Moreover, we focus on effective surveillance methods of ARGs and antibiotics and sustainable abiotic and biotic remediation strategies for removal and reduction of antibiotics and ARGs from both terrestrial and aquatic environments. Further, we consider the impact on public health as this problem cannot be addressed without a global transdisciplinary effort.

Distribution and driving factors of antibiotic resistance genes in treated wastewater from different types of livestock farms

Treated wastewater from livestock farms is an important reservoir for antibiotic resistance genes (ARGs), and is a main source of ARGs in the environment. However, the distribution and driving factors of ARGs in treated wastewater from different types of livestock farms are rarely reported. In this study, treated wastewater from 69 large-scale livestock farms of different types, including broiler, layer, and pig farms, was collected, and 11 subtypes of ARGs, 2 mobile genetic elements (MGEs) and bacterial community structure were analyzed. The results revealed detection rates of NDM-1 and mcr-1 of 90 % and 43 %, respectively, and the detection rates of other ARGs were 100 %. The relative abundance of ARGs, such as tetA, tetX and strB, in broiler farms was significantly higher than that in layer farms, but the bacterial α diversity was significantly lower than that in other farm types. Furthermore, although the treatment process had a greater impact on the physicochemical properties of the treated wastewater than the livestock type, livestock type was the main factor affecting the bacterial community in the treated wastewater. The analysis of potential host bacteria of ARGs revealed significant differences in the host bacteria of ARGs in treated wastewater from different types of livestock farms. The host bacteria of ARGs in broiler farms mainly belonged to Actinobacteria, layer farms mainly belonged to Proteobacteria, and pig farms mainly belonged to Firmicutes. Additionally, redundancy analysis showed that the distribution of ARGs may have resulted from the combination of multiple driving factors in different types of livestock farms, among which tnpA and NH₄⁺-N were the main influencing factors. This study revealed multiple driving factors for the distribution of typical ARGs in treated wastewater from different types of livestock farms, providing basic data for the prevention and control of ARG pollution in agricultural environments.

Bacterial Resistance to β-Lactam Antibiotics in Municipal Wastewater: Insights from a Full-Scale Treatment Plant in Poland

This study investigated enzymatic and genetic determinants of bacterial resistance to β-lactam antibiotics in the biocenosis involved in the process of biological treatment of wastewater by activated sludge. The frequency of bacteria resistant to selected antibiotics and the activity of enzymes responsible for resistance to β-lactam antibiotics were estimated. The phenomenon of selection and spread of a number of genes determining antibiotic resistance was traced using PCR and gene sequencing. An increase in the percentage of bacteria showing resistance to β-lactam antibiotics in the microflora of wastewater during the treatment process was found. The highest number of resistant microorganisms, including multi-resistant strains, was recorded in the aeration chamber. Significant amounts of these bacteria were also present in treated wastewater, where the percentage of penicillin-resistant bacteria exceeded 50%, while those resistant to the new generation β-lactam antibiotics meropenem and imipenem were found at 8.8% and 6.4%, respectively. Antibiotic resistance was repeatedly accompanied by the activity of enzymes such as carbapenemases, metallo-β-lactamases, cephalosporinases and β-lactamases with an extended substrate spectrum. The activity of carbapenemases was shown in up to 97% of the multi-resistant bacteria. Studies using molecular biology techniques showed a high frequency of genes determining resistance to β-lactam antibiotics, especially the blaTEM1 gene. The analysis of the nucleotide sequences of blaTEM1 gene variants present in bacteria at different stages of wastewater treatment showed 50-100% mutual similarity of.

Emerging technologies for enhanced removal of residual antibiotics from source-separated urine and wastewaters: A review

Antibiotic residues are of significant concern in the ecosystem because of their capacity to mediate antibiotic resistance development among environmental microbes. This paper reviews recent technologies for the abatement of antibiotics from human urine and wastewaters. Antibiotics are widely distributed in the aquatic environment as a result of the discharge of municipal sewage. Their existence is a cause for worry due to the potential ecological impact (for instance, antibiotic resistance) on bacteria in the background. Numerous contaminants that enter wastewater treatment facilities and the aquatic environment, as a result, go undetected. Sludge can act as a medium for some chemicals to concentrate while being treated as wastewater. The most sewage sludge that has undergone treatment is spread on agricultural land without being properly checked for pollutants. The fate of antibiotic residues in soils is hence poorly understood. The idea of the Separation of urine at the source has recently been propagated as a measure to control the flow of pharmaceutical residues into centralized wastewater treatment plants (WWTPs). With the ever increasing acceptance of urine source separation practices, visibility and awareness on dedicated treatement technologies is needed. Human urine, as well as conventional WWTPs, are point sources of pharmaceutical micropollutants contributing to the ubiquitous detection of pharmaceutical residues in the receiving water bodies. Focused post-treatment of source-separated urine includes distillation and nitrification, ammonia stripping, and adsorption processes. Other reviewed methods include physical and biological treatment methods, advanced oxidation processes, and a host of combination treatment methods. All these are aimed at ensuring minimized risk products are returned to the environment.

Aquatic Environments as Hotspots of Transferable Low-Level Quinolone Resistance and Their Potential Contribution to High-Level Quinolone Resistance

The disposal of antibiotics in the aquatic environment favors the selection of bacteria exhibiting antibiotic resistance mechanisms. Quinolones are bactericidal antimicrobials extensively used in both human and animal medicine. Some of the quinolone-resistance mechanisms are encoded by different bacterial genes, whereas others are the result of mutations in the enzymes on which those antibiotics act. The worldwide occurrence of quinolone resistance genes in aquatic environments has been widely reported, particularly in areas impacted by urban discharges. The most commonly reported quinolone resistance gene, qnr, encodes for the Qnr proteins that protect DNA gyrase and topoisomerase IV from quinolone activity. It is important to note that low-level resistance usually constitutes the first step in the development of high-level resistance, because bacteria carrying these genes have an adaptive advantage compared to the highly susceptible bacterial population in environments with low concentrations of this antimicrobial group. In addition, these genes can act additively with chromosomal mutations in the sequences of the target proteins of quinolones leading to high-level quinolone resistance. The occurrence of qnr genes in aquatic environments is most probably caused by the release of bacteria carrying these genes through anthropogenic pollution and maintained by the selective activity of antimicrobial residues discharged into these environments. This increase in the levels of quinolone resistance has consequences both in clinical settings and the wider aquatic environment, where there is an increased exposure risk to the general population, representing a significant threat to the efficacy of quinolone-based human and animal therapies. In this review the potential role of aquatic environments as reservoirs of the qnr genes, their activity in reducing the susceptibility to various quinolones, and the possible ways these genes contribute to the acquisition and spread of high-level resistance to quinolones will be discussed.

Clinically Relevant β-Lactam Resistance Genes in Wastewater Treatment Plants

Antimicrobial resistance (AMR) is one of the largest global concerns due to its influence in multiple areas, which is consistent with One Health's concept of close interconnections between people, animals, plants, and their shared environments. Antibiotic-resistant bacteria (ARB) and antibiotic-resistance genes (ARGs) circulate constantly in various niches, sediments, water sources, soil, and wastes of the animal and plant sectors, and is linked to human activities. Sewage of different origins gets to the wastewater treatment plants (WWTPs), where ARB and ARG removal efficiency is still insufficient, leading to their transmission to discharge points and further dissemination. Thus, WWTPs are believed to be reservoirs of ARGs and the source of spreading AMR. According to a World Health Organization report, the most critical pathogens for public health include Gram-negative bacteria resistant to third-generation cephalosporins and carbapenems (last-choice drugs), which represent β-lactams, the most widely used antibiotics. Therefore, this paper aimed to present the available research data for ARGs in WWTPs that confer resistance to β-lactam antibiotics, with a particular emphasis on clinically important life-threatening mechanisms of resistance, including extended-spectrum β-lactamases (ESBLs) and carbapenemases (KPC, NDM).

Distribution, sources, and potential risks of antibiotic resistance genes in wastewater treatment plant: A review

Irrational use of antibiotics produces a large number of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs). Wastewater treatment plants (WWTPs) act as important sources and sinks of ARGs, and play an important role in their generation, treatment, and dissemination. This study summarizes the types, concentrations, and factors of ARGs in WWTPs, investigates the sources of ARGs in wastewater, compares the removal efficiencies of different treatment processes on ARGs, and analyzes the potential risks of ARGs accumulation in effluent, sludge and their emission into the air. The results show that the main ARGs detected in the influent of WWTPs are the genes resistant to macrolides (ermB, ermF), tetracyclines (tetW, tetA, tetC), sulfonamides (sul1, sul2), and β-lactams (bla_OXA, bla_TEM). The concentrations of ARGs in the influent of the WWTPs are 2.23 × 10²-3.90 × 10⁹ copies/mL. Wastewater quality and microbial community are the dominant factors that affect the distribution characteristics of ARGs. The accumulation of ARGs in effluent, sludge, and aerosols pose potential risks to the regional ecological environment and human health. Based on these results, research trends with respect to ARGs in WWTPs are also prospected.

Antibiotics and antibiotic resistant bacteria/genes in urban wastewater: A comparison of their fate in conventional treatment systems and constructed wetlands

There is a growing concern that the use and misuse of antibiotics can increase the detection of antibiotic resistant genes (ARGs) in wastewater. Conventional wastewater treatment plants provide a pathway for ARGs and antibiotic resistant bacteria (ARB) to be released into natural water bodies. Research has indicated that conventional primary and secondary treatment systems can reduce ARGs/ARB to varying degrees. However, in developing/low-income countries, only 8-28% of wastewater is treated via conventional treatment processes, resulting in the environment being exposed to high levels of ARGs, ARB and pharmaceuticals in raw sewage. The use of constructed wetlands (CWs) has the potential to provide a low-cost solution for wastewater treatment, with respect to removal of nutrients, pathogens, ARB/ARGs either as a standalone treatment process or when integrated with conventional treatment systems. Recently, CWs have also been employed for the reduction of antibiotic residues, pharmaceuticals, and emerging contaminants. Given the benefits of ARG removal, low cost of construction, maintenance, energy requirement, and performance efficiencies, CWs offer a promising solution for developing/low-income countries. This review promotes a better understanding of the performance efficiency of treatment technologies (both conventional systems and CWs) for the reduction of antibiotics and ARGs/ARB from wastewater and explores workable alternatives.

Antimicrobial Resistance Monitoring of Water Environments: A Framework for Standardized Methods and Quality Control

Antimicrobial resistance (AMR) is a grand societal challenge with important dimensions in the water environment that contribute to its evolution and spread. Environmental monitoring could provide vital information for mitigating the spread of AMR; this includes assessing antibiotic resistance genes (ARGs) circulating among human populations, identifying key hotspots for evolution and dissemination of resistance, informing epidemiological and human health risk assessment models, and quantifying removal efficiencies by domestic wastewater infrastructure. However, standardized methods for monitoring AMR in the water environment will be vital to producing the comparable data sets needed to address such questions. Here we sought to establish scientific consensus on a framework for such standardization, evaluating the state of the science and practice of AMR monitoring of wastewater, recycled water, and surface water, through a literature review, survey, and workshop leveraging the expertise of academic, governmental, consulting, and water utility professionals.

Occurrence of antibiotics and bacterial resistance genes in wastewater: resistance mechanisms and antimicrobial resistance control approaches

Antimicrobial pharmaceuticals are classified as emergent micropollutants of concern, implying that even at low concentrations, long-term exposure to the environment can have significant eco-toxicological effects. There is a lack of a standardized regulatory framework governing the permissible antibiotic content for monitoring environmental water quality standards. Therefore, indiscriminate discharge of antimicrobials at potentially active concentrations into urban wastewater treatment facilities is rampant. Antimicrobials may exert selective pressure on bacteria, leading to resistance development and eventual health consequences. The emergence of clinically important multiple antibiotic-resistant bacteria in untreated hospital effluents and wastewater treatment plants (WWTPs) has been linked to the continuous exposure of bacteria to antimicrobials. The levels of environmental exposure to antibiotics and their correlation to the evolution and spread of resistant bacteria need to be elucidated to help in the formulation of mitigation measures. This review explores frequently detected antimicrobials in wastewater and gives a comprehensive coverage of bacterial resistance mechanisms to different antibiotic classes through the expression of a wide variety of antibiotic resistance genes either inherent and/or exchanged among bacteria or acquired from the reservoir of antibiotic resistance genes (ARGs) in wastewater systems. To complement the removal of antibiotics and ARGs from WWTPs, upscaling the implementation of prospective interventions such as vaccines, phage therapy, and natural compounds as alternatives to widespread antibiotic use provides a multifaceted approach to minimize the spread of antimicrobial resistance.

Degradation of Bacterial Antibiotic Resistance Genes during Exposure to Non-Thermal Atmospheric Pressure Plasma

Bacterial resistance to antibiotics has become a major public health problem in recent years. The occurrence of antibiotics in the environment, especially in wastewater treatment plants, has contributed to the development of antibiotic-resistant bacteria (ARB) and the spread of antibiotic resistance genes (ARGs). Despite the potential of some conventional processes used in wastewater treatment plants, the removal of ARB and ARGs remains a challenge that requires further research and development of new technologies to avoid the release of emerging contaminants into aquatic environments. Non-thermal atmospheric pressure plasmas (NTAPPs) have gained a significant amount of interest for wastewater treatment due to their oxidizing potential. They have shown their effectiveness in the inactivation of a wide range of bacteria in several fields. In this review, we discuss the application of NTAPPs for the degradation of antibiotic resistance genes in wastewater treatment.

A Review on Occurrence and Spread of Antibiotic Resistance in Wastewaters and in Wastewater Treatment Plants: Mechanisms and Perspectives

This paper reviews current knowledge on sources, spread and removal mechanisms of antibiotic resistance genes (ARGs) in microbial communities of wastewaters, treatment plants and downstream recipients. Antibiotic is the most important tool to cure bacterial infections in humans and animals. The over- and misuse of antibiotics have played a major role in the development, spread, and prevalence of antibiotic resistance (AR) in the microbiomes of humans and animals, and microbial ecosystems worldwide. AR can be transferred and spread amongst bacteria via intra- and interspecies horizontal gene transfer (HGT). Wastewater treatment plants (WWTPs) receive wastewater containing an enormous variety of pollutants, including antibiotics, and chemicals from different sources. They contain large and diverse communities of microorganisms and provide a favorable environment for the spread and reproduction of AR. Existing WWTPs are not designed to remove micropollutants, antibiotic resistant bacteria (ARB) and ARGs, which therefore remain present in the effluent. Studies have shown that raw and treated wastewaters carry a higher amount of ARB in comparison to surface water, and such reports have led to further studies on more advanced treatment processes. This review summarizes what is known about AR removal efficiencies of different wastewater treatment methods, and it shows the variations among different methods. Results vary, but the trend is that conventional activated sludge treatment, with aerobic and/or anaerobic reactors alone or in series, followed by advanced post treatment methods like UV, ozonation, and oxidation removes considerably more ARGs and ARB than activated sludge treatment alone. In addition to AR levels in treated wastewater, it examines AR levels in biosolids, settled by-product from wastewater treatment, and discusses AR removal efficiency of different biosolids treatment procedures. Finally, it puts forward key-points and suggestions for dealing with and preventing further increase of AR in WWTPs and other aquatic environments, together with a discussion on the use of mathematical models to quantify and simulate the spread of ARGs in WWTPs. Mathematical models already play a role in the analysis and development of WWTPs, but they do not consider AR and challenges remain before models can be used to reliably study the dynamics and reduction of AR in such systems.

Metagenomic Analysis Reveals the Fate of Antibiotic Resistance Genes in a Full-Scale Wastewater Treatment Plant in Egypt

Wastewater treatment plants (WWTPs) are recognized as hotspots for the dissemination of antibiotic resistance genes (ARGs) and antibiotic-resistant bacteria (ARBs) in the environment. Our study utilized a high-throughput sequencing-based metagenomic analysis approach to compare the ARG abundance profiles of the raw sewage, treated effluent and activated sludge samples from a full-scale WWTP in Egypt. In addition, the difference in microbial community composition due to the treatment process was assessed. As a result, 578 ARG subtypes (resistance genes) belonging to 18 ARG types (antibiotic resistance classes) were identified. ARGs encoding for resistance against multidrug, aminoglycoside, bacitracin, beta-lactam, sulfonamide, and tetracycline antibiotics were the most abundant types. The total removal efficiency percentage of ARGs in the WWTP was found to be 98% however, the ARG persistence results indicated that around 68% of the ARGs in the influent could be found in the treated effluent. This finding suggests that the treated wastewater poses a potential risk for the ARG dissemination in bacterial communities of the receiving water bodies via horizontal gene transfer (HGT). The community composition at phylum level showed that Proteobacteria, Bacteroidetes, Firmicutes, and Actinobacteria were the most abundant phyla in all datasets. Although the relative abundance of several pathogenic bacteria in the influent declined to less than 1% in the effluent, the taxonomic assignments at species level for the effluent and sludge metagenomes demonstrated that clinically important pathogens such as Escherichia coli, Klebsiella pneumonia, and Aeromonas caviae were present. Overall, the results of this study would hopefully enhance our knowledge about the abundance profiles of ARGs and their fate in different wastewater treatment compartments that have never been examined before.

International high-risk clone of fluoroquinolone-resistant Escherichia coli O15:H1-D-ST393 in remote communities of Brazilian Amazon

The global dissemination of multidrug-resistant Escherichia coli lineages belonging to high- risk clones poses a significant public health threat. Herein we report the identification and genomic profiling of two multidrug-resistant E. coli strains [BL-II-03(2) and BL-II-11(3)] belonging to the O15:H1-D-ST393 (clonal complex 31) worldwide spread clone, isolated from fecal samples of indigenous peoples belonging to two different ethnic groups of remote communities of Brazilian Amazon. Genomic analysis revealed genes and mutations conferring resistance to β-lactams [bla_TEM-1], aminoglycosides [aadA5, aph(3″)-Ib, aph(6)-Id], tetracyclines [tetB], sulfamethoxazole/trimethoprim [sul1, sul2, dfrA17], and fluoroquinolones [gyrA (D87N, S83L), parC (S80I, S57T), parE (L416F)]; and presence of IncQ1, IncFIA, and IncFIB(pB171) plasmids. On the other hand, phylogenomics of globally reported E. coli ST393 assigned E. coli strains BL-II-03(2) and BL-II-11(3) to a cluster comprising human isolates from Australia, Canada, China, Sweden, and United States of America. These results might provide valuable information for understanding dissemination of intercontinental multidrug-resistant clones in remote communities with low levels of antibiotic exposure.

Monitoring Microbial Populations and Antibiotic Resistance Gene Enrichment Associated with Arctic Waste Stabilization Ponds

Given that the microbial communities of Arctic waste stabilization ponds (WSPs) are poorly studied to date, our characterization of multiple WSP systems and time points provides important baseline data that will assist with ongoing monitoring of effluent impacts on downstream aquatic ecosystems in the Arctic. This research also identifies indicator amplicon sequence variants (ASVs) of WSPs that will be helpful for future monitoring for WSP effluent attenuation and demonstrates that WSP microbial communities are enriched in antibiotic resistance genes.

Wastewater management in the Canadian Arctic is challenging due to climate extremes, small population sizes, and lack of conventional infrastructure for wastewater treatment. Although many northern communities use waste stabilization ponds (WSPs) as their primary form of wastewater treatment, few studies have explored WSP microbial communities and assessed effluent impacts on receiving waters from a microbiological perspective. Here, we used 16S rRNA gene and metagenome sequencing to characterize WSP and receiving water microbial communities for two time points bracketing the spring WSP thaw in Baker Lake (Nunavut) and compared these results to other Nunavut WSPs in Cambridge Bay and Kugluktuk. Most amplicon sequence variants (ASVs) recovered from these WSP samples belonged to the phylum Proteobacteria, with considerable variation between the three locations and only six ASVs shared among the WSPs at >0.2% relative abundance. Wastewater indicator ASVs for the Baker Lake WSP were identified, and few indicator ASVs were detected in samples originating from other upstream or downstream sites. The metagenomic data revealed a strong enrichment of antibiotic resistance genes for WSP samples relative to downstream and reference samples, especially for genes associated with macrolide resistance. Together, our results provide a baseline characterization for WSP microbial communities, demonstrate how indicator ASVs can be used to monitor attenuation and dilution of effluent microorganisms, and reveal that WSPs can serve as hot spots for antibiotic resistance genes.

IMPORTANCE Given that the microbial communities of Arctic waste stabilization ponds (WSPs) are poorly studied to date, our characterization of multiple WSP systems and time points provides important baseline data that will assist with ongoing monitoring of effluent impacts on downstream aquatic ecosystems in the Arctic. This research also identifies indicator amplicon sequence variants (ASVs) of WSPs that will be helpful for future monitoring for WSP effluent attenuation and demonstrates that WSP microbial communities are enriched in antibiotic resistance genes. Given operational and infrastructure changes anticipated for wastewater treatment systems in the Arctic, baseline data such as these are essential for further development of safe and effective wastewater treatment systems.

Prevalence of antibiotic resistance genes in wastewater collected from ornamental fish market in northern China

Large amounts of antibiotics/disinfectants are used in the farming of ornamental fish so as to prevent and treat bacterial infection. This may exert considerable selection pressures on the prevalence and propagation of antibiotic resistance genes (ARGs). However, the levels of ARGs and their potential prevalence mechanism in the wastewater of the ornamental fish industry remains unclear. In this work, wastewater is collected from a representative ornamental fish market (OFM) that is located at the northern China to study the occurrence and abundance of 21 ARGs and 2 integrase genes. Results indicated that 15 different ARGs and 2 integrase genes are existent and prevalent in the wastewater of OFM, whereby concentrations range from 2.01 to 10.34 copies/L. Proteobacteria, Bacteroidetes, Verrucomicrobia, and Firmicutes are the predominant phyla in the wastewater samples. 17 species of human opportunistic pathogens are present with relative abundance of up to 0.01%, which suggests a considerable risk of pathogens acquiring and disseminating ARGs. Moreover, oxytetracycline, ciprofloxacin, norfloxacin, sulfadiazine, and chloramphenicol are most frequently detected in wastewater, with concentrations of up to 1150, 877, 514, 1970, and 1700 ng/L, respectively. Notably, good correlations have been determined among ARGs and antibiotics, non-antibiotic environmental factors in wastewater of OFM. This current study reveals, for the first time, that OFM is a previously unperceived reservoir for ARG prevalence in aquatic environment and water environmental factors (particularly antibiotics), and their induced shifts in the microbial communities are the key factors for distribution of ARGs in OFM.

Urban ponds as hotspots of antibiotic resistome in the urban environment

The occurrence, dissemination and assembly processes of antibiotic resistance genes (ARGs) in urban water ecosystems are far from being understood. Here, we examined the diversity and abundance of ARGs in urban water ecosystems including landscape ponds, drinking water reservoirs, influents (IFs) and effluents (EFs) of wastewater treatment plants of a coastal city, China through high-throughput quantitative PCR. A total of 237 ARGs were identified, where multidrug, aminoglycoside and beta-lactamase resistance genes were the most abundant. Urban ponds had a comparatively high diversity and large numbers of shared ARGs with IFs and EFs. The average absolute abundance of ARGs (1.38 × 10⁷ copies/mL) and mobile genetic elements (MGEs) (4.19 × 10⁶ copies/mL) in ponds were only one order of magnitude lower than those of IFs, but higher than those of EFs and reservoirs. Stochastic processes dominated the ARG community assembly in IFs and ponds due to the random horizontal gene transfer caused by MGEs. These results imply that urban ponds are hotspots of ARGs. We further identified 25, 3, and 11 indicator ARGs for tracing the ARG contamination from IFs, EFs and ponds, respectively. Our study represents the first to highlight the role of urban ponds in the dissemination of ARGs.

Occurrence of antibiotics and antibiotic resistance genes in the Fuxian Lake and antibiotic source analysis based on principal component analysis-multiple linear regression model

In recent years, the dramatic increase in antibiotic use has led to the evolution of antibiotic resistant genes (ARGs), posing a potential risk to human and aquatic ecological safety. In this study, source contribution and correlations between twelve antibiotics and their corresponding ARGs were firstly investigated in surface water in the Fuxian Lake. The results showed that sulfamethoxazole (SMX) (0.98-14.32 ng L^-1) and ofloxacin (OFL) (0.77-7.3 ng L^-1) were the dominant antibiotics in surface water, whereas erythromycin-H₂O (EM-H₂O), SMX and OFL posed the medium risk to aquatic organisms. Meanwhile, the mean concentrations of MLs in inflowing rivers were 5.6 times more than those in the lake, which was related to dilution and degradation. Moreover, the facter1 (co-sources L (Living quarters), M (Mining area), A (Agricultural district) and T (tourist area)) contributed 78% of antibiotic concentrations, and the source L was predominant. The results also revealed the prevalence of intL1, sul1 and sul2 in all the sampling sites, and that the abundance of ARGs in the lake was significantly lower (P < 0.01) than that in inflowing rives. Additionally, significant correlations (p < 0.0001) between intL1 and sulfanilamide resistance genes (sul1, sul2) were detected, indicating that intL1 promoted the propagation and they originated from the same anthropogenic sources. Overall, our findings revealed the presence of antibiotics and ARGs and their inconsistent correlations in the Fuxian Lake, which provides a foundation to support further exploration of the occurrence and transmission mechanisms of antibiotics and ARGs.

Occurrence and fate of antibiotics, antibiotic resistant genes (ARGs) and antibiotic resistant bacteria (ARB) in municipal wastewater treatment plant: An overview

The occurrence and fate of antibiotics and antibiotic resistant genes (ARGs) and antibiotic resistant bacteria (ARB) in Municipal Wastewater Treatment Plants (WWTPs) worldwide were reviewed. The prevalence of antibiotics in WWTPs among different periods (1999-2009 and 2010-2019) and geographical areas (Europe, America, Asia and Africa) was summarized, analyzed and evaluated. The classes of macrolides (clarithromycin, erythromycin/erythromycin-H₂O, azithromycin, roxithromycin), sulfonamides (sulfamethoxazole), trimethoprim, quinolones (ofloxacin, ciprofloxacin, norfloxacin) and tetracyclines (tetracycline) were the antibiotics most frequently detected, while bla (bla_CTXM, bla_TEM), sul (sul1, sul2), tet (tetO, tetQ, tetW) and ermB genes were the ARGs commonly reported in WWTPs. There was a positive correlation between antibiotics and ARGs commonly detected in WWTPs, except for β-lactam antibiotics and bla genes. The genes bla were found frequently, despite β-lactam antibiotics were seldom detected owing to the hydrolysis. Most of antibiotics had lower levels in the period 2010-2019 in Asian countries than that in period 1999-2009 in North American and European countries. In the effluent of secondary treatment, the concentration of trimethoprim was the highest (138 ng/L in median) and the concentration of other antibiotics remained at lower than 80 ng/L, while the relative abundance of ARGs ranged 2.9-4.6 logs (copies/mL, in median). Future researches on the development of effective antibiotic removal technologies, such as advanced oxidation processes, are suggested to focus on antibiotics frequently detected and their corresponding ARGs in WWTPs.

Quantitative microbial risk assessment for waterborne pathogens in a wastewater treatment plant and its receiving surface water body

BACKGROUND

Access to safe water for drinking and domestic activities remains a challenge in emerging economies like South Africa, forcing resource-limited communities to use microbiologically polluted river water for personal and household purposes, posing a public health risk. This study quantified bacterial contamination and the potential health hazards that wastewater treatment plant (WWTP) workers and communities may face after exposure to waterborne pathogenic bacteria in a WWTP and its associated surface water, respectively.

RESULTS

Escherichia coli (Colilert®-18/ Quanti-Tray® 2000) and enterococci (Enterolert®/ Quanti-Tray® 2000) were quantified and definitively identified by real-time polymerase chain reaction targeting the uidA and tuf genes, respectively. An approximate beta-Poisson dose-response model was used to estimate the probability of infection (Pi) with pathogenic E. coli. Mean E. coli concentration ranged from 2.60E+ 02/100 mL to 4.84E+ 06/100 mL; enterococci ranged from 2.60E+ 02/100 mL to 3.19E+ 06/100 mL across all sampled sites. Of the 580 E. coli isolates obtained from this study, 89.1% were intestinal, and 7.6% were extraintestinal pathogenic E. coli. The 579 enterococci obtained were 50.4% E. faecalis (50.4%), 31.4% E. faecium, 3.5%, E. casseliflavus and 0.7% E. gallinarum. The community health risk stemming from the use of the water for recreational and domestic purposes revealed a greater health risk (Pi) from the ingestion of 1 mL of river water from upstream (range, 55.1-92.9%) than downstream (range, 26.8-65.3%) sites. The occupational risk of infection with pathogenic E. coli for workers resulting from a once-off unintentional consumption of 1 mL of water was 0% (effluent) and 23.8% (raw influent). Multiple weekly exposures of 1 mL over a year could result in a Pi of 1.2 and 100% for the effluent and influent, respectively.

CONCLUSION

Our findings reveal that there is a potentially high risk of infection for WWTP workers and communities that use river water upstream and downstream of the investigated WWTP.

The prevalence of drug-resistant and virulent Staphylococcus spp. in a municipal wastewater treatment plant and their spread in the environment

Drug-resistant and pathogenic Staphylococcus spp. strains can reach surface waters and air with wastewater evacuated to the environment. These strains increase the environmental pool of genetic determinants conferring antibiotic resistance and virulence, and constitute a health risk for the employees of wastewater treatment plants (WWTP) who come into daily contact with bioaerosols. The aim of this study was to identify the genetic determinants of drug resistance and virulence in Staphylococcus spp. strains isolated from untreated (UWW) and treated wastewater (TWW), an activated sludge (AS) bioreactor, river water collected upstream and downstream from the wastewater discharge point (URW and DRW), and WWTP employees. All isolates were analysed for the presence of the rpoB gene, and were subjected to clonal analysis by ERIC fingerprinting. As a result, 249 of the 455 analysed isolates were selected for PCR. The presence of the gene encoding nuclease activity in S. aureus (nuc), the methicillin resistance gene (mecA), vancomycin resistance gene (vanA), antiseptic resistance gene (qacA/B) and virulence genes (sasX, pvl, tst1, hla, sec) was determined. The prevalence of nuc, mecA, vanA and qacA/B genes in wastewater and river water was determined by quantitative PCR (qPCR). In the group of strains isolated from wastewater and water samples, 63% were identified as S. aureus, and 20% of the strains carried the vanA gene. The hla virulence gene was present in 80% of the isolates, and the pvl gene was detected in 27% of the isolates. In the group of strains isolated from the employees, 82% were identified as S. aureus, and the presence of vanA and mecA genes was confirmed in 14% and 16% of the isolates, respectively. The most prevalent virulence gene was hla (74%), whereas pvl was observed in 43% of the isolates. The quantitative analysis revealed the highest concentrations of the studied genes in UWW samples, at 2.56x10⁴ gene copies/ml for nuc, 1.18x10³ gene copies /ml for mecA, 8.28x10⁵ gene copies /ml for vanA and 3.83x10⁵ gene copies /ml for qacA/B. Some of analysed genes were identified in the isolates from both URW and DRW samples, as well as in genomic DNA of these samples. These results indicate that wastewater is not effectively treated in the analysed WWTP, which could contribute to the dissemination of antibiotic resistance genes (ARGs) and antibiotic-resistant bacteria (ARB) to the environment. An analysis of the genetic relatedness of selected isolates revealed clusters of strains originating from UWW samples, AS samples and the employees. These observations suggest that ARGs and ARB are transmitted by wastewater bioaerosols to the upper respiratory tract mucosa of the plant's employees, thus increasing their exposure to infectious factors.

The environmental contribution to the dissemination of carbapenem and (fluoro)quinolone resistance genes by discharged and reused wastewater effluents: The role of cellular and extracellular DNA

Wastewater treatment plants (WWTPs) are major reservoirs and sources for the dissemination of antibiotic resistance into the environment. In this study, the population dynamics of two full-scale WWTPs was characterized along different sampling points, including the reused effluents, in both cellular and extracellular DNA samples. The analysis was performed by high throughput sequencing targeting the 16S rRNA V4 gene region and by three in-house TaqMan multiplex qPCR assays that detect and quantify the most clinically relevant and globally distributed carbapenem (bla) and (fluoro)quinolone (qnr) resistance genes. The obtained results identify the biological treatment as the crucial step on tailoring the wastewater bacterial community, which is thereafter maintained in both discharged and reused effluents. The influent bacterial community does not alter the WWTP core community, although it clearly contributes for the introduction and spread of antibiotic resistance to the in-house bacteria. The presence of high concentrations of bla and qnr genes was not only detected in the wastewater influents and discharged effluents, but also in the reused effluents, which therefore represent another gateway for antibiotic resistant bacteria and genes into the environment and directly to the human populations. Moreover, and together with the study of the cellular DNA, it was described for the first time the role of the extracellular DNA in the dissemination of carbapenem and (fluoro)quinolone resistance, as well as the impact of the wastewater treatment process on this DNA fraction. Altogether, the results prove that the current wastewater treatments are inefficient in the removal of antibiotic resistant bacteria and genes and reinforce that targeted treatments must be developed and implemented at full-scale in the WWTPs for wastewater reuse to become a safe and sustainable practice, able to be implemented in areas such as agricultural irrigation.

Removal of antibiotic resistance genes in various water resources recovery facilities

Water resources recovery facilities (WWTPs) are hotspots for antibiotic resistance genes (ARGs) and pose a significant threat to environments. Therefore, ARG removal efficiencies of WWTPs are of great importance. In this study, conventional activated sludge (CAS), biological nutrient removal (BNR), sequencing batch reactor (SBR), membrane bioreactor (MBR), package MBR, and WWTP with coagulation-flocculation and UV disinfection units were investigated in terms of their removal efficiencies on overall bacterial genes with 16S rDNA and seven ARGs including the genes aadA, bla_CTX-M , cmlA, ermB, sul1, tetA, and qnrS corresponding to commonly used antibiotics aminoglycosides, β-lactams, amphenicols, macrolides-lincosamides-streptogramins, sulfonamides-trimethoprim, tetracyclines, and quinolones, respectively. Seasonal abundance of overall genes and ARGs in influents and effluents of each WWTPs was determined by quantitative polymerase chain reaction. Membrane bioreactor and package MBR systems showed the highest removal efficiency up to 5-log reductions. Seasonal changes affected ARG removal efficiencies of BNR and CAS significantly (p < 0.05). The lowest log reductions were determined in summer for BNR and in both autumn and winter for CAS. The abundance of the genes increased in sludge treatment of CAS. In all WWTPs tested, ARG removal rates were correlated with the 16S rDNA gene removal (p > 0.05). The results elucidated that the removal mechanism was not ARG-specific. PRACTITIONER POINTS: Removal of genes in WWTPs was found to be not ARG-specific. MBR and package MBR systems had the highest gene removal efficiencies. Effluents of the MBR systems still retained up to 10⁴  gene copy number/ml. Removal of genes in CAS and BNR systems showed seasonal variations. The copy numbers of the genes increased in the sludge of CAS.

Continental-scale spatio-temporal distribution of antibiotic resistance genes in coastal waters along coastline of China

Antibiotic resistance genes (ARGs) have been frequently detected in various matrices all over the world to attract wide attention due to the potential risks. Rare information is available on the pollution of ARGs in the waters of critical ecologically fragile regions such as the coastal zone at a continental scale. Therefore, this study performed field sampling during winter and summer along 18000 km coastline of China to investigate the distribution of target ARGs in coastal waters at a continental scale. The absolute abundances of ARGs in coastal waters showed drastic spatio-temporal variation with a mean value of 8.79 × 10⁴/1.39 × 10⁵ copies/mL in summer/winter, much lower than those in tail water from the maricultural zone or wastewater. The average absolute abundance of class 1 integron-integrase gene (intI1) in coastal waters was 9.68 × 10³/4.15 × 10⁴ copies/mL in summer/winter, still lower than that in tail water or wastewater. Quinolone resistance genes were the dominant ARGs in coastal waters to account for over 50% of total ARGs in most of sampling sites. Bacterial communities in coastal waters showed significant difference both at phylum and genus levels. Abundances of ARGs in coastal waters of this study were comparable with those in other regions previously reported. Tail water and wastewater might be the essential sources of ARGs in coastal waters. The findings of this study provided comprehensive information on the pollution status of ARGs in coastal waters at a continental scale, indicating that ARGs pollution has become a crucial stress affecting the sustainable development of coastal regions.

Wastewater sources of per- and polyfluorinated alkyl substances (PFAS) and pharmaceuticals in four Canadian Arctic communities

Effective removal of organic contaminants in wastewater effluent poses a challenge to small communities worldwide, particularly in the Arctic due to infrastructure challenges and harsh climates. To understand better the efficacy of current treatment options and risks posed by pharmaceuticals and pesticides on receiving waters in the Arctic, four representative human communities in Nunavut, Canada were evaluated. Per- and polyfluorinated alkyl substances (PFASs) were also investigated in one community. These communities have treatment ranging from primary lagoons, engineered wetlands, and natural lakes. Pharmaceuticals and pesticides were measured using the organic diffusive gradients in thin film (o-DGT) passive sampler in summer 2018. Of the 34 compounds studied, seven pharmaceuticals were found at least once: atenolol, carbamazepine, metoprolol, naproxen, sulfapyridine, sulfamethoxazole, and trimethoprim. With the exception of 5210 ng naproxen/L in Iqaluit, most receiving waters showed negligible amounts of contamination. Iqaluit had the poorest overall system performance while Baker Lake had the best. Measured pharmaceutical concentrations do not appear to pose a significant acute hazard to receiving waters at this time, based on known toxicological endpoints. PFAS concentrations were found to be over 100-fold greater in Cambridge Bay wastewater than previously reported Arctic seawater. Results suggest that wastewater may be an important point source of PFASs in Arctic communities. The o-DGT passive samplers performed well in marine Arctic settings. We recommend further testing of wastewater efficiencies in Arctic communities along with evaluations of seasonal variations.

Investigation of pharmaceuticals and their metabolites in Brazilian hospital wastewater by LC-QTOF MS screening combined with a preliminary exposure and in silico risk assessment

This work evaluates the occurrence of pharmaceuticals, with special emphasis on their metabolites, in raw hospital wastewater (HWW) using wide-scope screening based on liquid chromatography coupled to high resolution mass spectrometry. The applied strategy uses an extended purpose-built database, containing >1000 pharmaceuticals and 250 metabolites. Raw HWW samples from a hospital located in south Brazil were collected over six months, with a monthly sampling frequency. Accurate-mass full-spectrum data provided by quadrupole-time of flight MS allowed the identification of 43 pharmaceuticals and up to 31 metabolites in the samples under study. Additionally, other four metabolites not included in the initial database could be identified using a complementary strategy based on the common fragmentation pathway between the parent compound and its metabolites. Nine metabolites derived from four pharmaceuticals were identified in the raw HWW samples, whereas their parent compounds were not found in these samples. The results of this work illustrate the importance of including not only parent pharmaceuticals but also their main metabolites in screening analysis. Besides, the inclusion of in silico QSAR predictions allowed assessing the environmental fate and effect of pharmaceuticals and metabolites in terms of biodegradability, as possible Persistent, Bioaccumulative and Toxic (PBT) compounds, and their potential hazard to the aquatic environment.

Antibiotic resistance genes identified in wastewater treatment plant systems - A review

The intensive use of antibiotics for human, veterinary and agricultural purposes, results in their continuous release into the environment. Together with antibiotics, antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) are introduced into wastewater. Wastewater treatment plants (WWTPs) are believed to be probable hotspots for antibiotic resistance dissemination in the environment as they offer convenient conditions for ARB proliferation as well as for horizontal transfer of ARGs among different microorganisms. In fact, genes conferring resistance to all classes of antibiotics together with mobile genetic elements (MGEs) like plasmids, transposons, bacteriophages, integrons are detected in WWTPs in different countries. It seems that WWTPs with conventional treatment processes are capable of significant reduction of ARB but are not efficient in ARG removal. Implementation of advanced wastewater cleaning processes in addition to a conventional wastewater treatment is an important step to protect the aquatic environment. Growing interest in presence and fate of ARB and ARGs in WWTP systems resulted in the fact that knowledge in this area has increased staggeringly in the past few years. The main aim of the article is to collect and organize available data on ARGs, that are commonly detected in raw sewage, treated wastewater or activated sludge. Resistance to the antibiotics usually used in antibacterial therapy belonging to main classes like beta-lactams, macrolides, quinolones, sulfonamides, trimethoprim and tetracyclines was taken into account. The presence of multidrug efflux genes is also included in this paper. The occurrence of antibiotics may promote the selection of ARB and ARGs. As it is important to discuss the problem considering all aspects that influence it, the levels of antibiotics detected in influent and effluent of WWTPs were also presented.

The occurrence of sulfonamide and quinolone resistance genes at the Fildes Peninsula in Antarctica

Antibiotic resistance pollution is globalizing. However, little quantitative data exists regarding the occurrence of antibiotic resistance genes (ARGs) in Antarctica, which is central to assessing the level of global contamination of ARGs. Soil, sediment, and animal feces were sampled from 12 sites in the Fildes Peninsula in January and February 2017. The occurrence and distribution of qnrS, sul1 and sul2 were investigated. The results showed that sul1 was the predominant ARG and that all the ARGs were detected in animal feces. The total absolute abundance of the ARGs in animal feces (5.86 × 10⁷ copies) was the highest. Strong and positive correlations between sul1 and int1 were found, indicating that int1 might play an important role in the creation and spread of ARGs. This data and the analysis are critical for filling the data gap regarding ARGs in Antarctica and for improving understanding of the globalization of antibiotic resistance pollution.

Lateral flow sand filters are effective for removal of antibiotic resistance genes from domestic wastewater

The ability of lateral flow sand filters, used as on-site wastewater treatment systems (OWTS), to remove antibiotic resistance genes (ARGs), antibiotic resistant bacteria (ARB), and other relevant genetic markers (HF183, 16S rRNA, and int1) was assessed. Municipal wastewater was settled in a septic tank prior to loading into six pilot-scale lateral flow sand filters comprised of three different sand media types, at 5 and 30% slopes. The sand filters were sampled bi-weekly for: 9 ARGs and 3 other complimentary gene markers (sul1, sul2, qnrS, tetO, ermB, bla_TEM, bla_CTX-M, mecA, vanA, int1, HF183, 16S rRNA), and conventional microbial and water quality indicators, from July to November in 2017, and four times in the summer of 2018. The sand filters were observed to attenuate 7 of the ARGs to mostly below 2 log gene copies per mL. Log reductions ranging from 2.9 to 5.4 log were observed for the removal of absolute abundances of ARGs from septic tank effluent in 5 of the 6 sand filters. The fine-grained filter on the 5% slope did not perform as well for ARG attenuation due to hydraulic failure. The apportionment of cell-associated versus cell-free DNA was determined for the gene markers and this indicated that the genes were primarily carried intracellularly. Average log reductions of ARB with resistance to either sulfamethoxazole, erythromycin, or tetracycline were approximately 2.3 log CFU per mL within the filters compared to the septic tank effluent. This field study provides in-depth insights into the attenuation of ARB, ARGs, and their genetic compartmentalization in variably saturated sand OWTS. Overall, this type of OWTS was found to pose little risk of antimicrobial resistance contamination spread into surrounding environments when proper hydraulic function was maintained.

Occurrence and spatial variation of antibiotic resistance genes (ARGs) in the Hetao Irrigation District, China

The prevalence and proliferation of antibiotic resistance genes (ARGs) has been identified as an emerging contaminant of concern and a crucial threat to public health worldwide. To determine the occurrence and distribution of ARGs in artificial agricultural irrigation systems, we designed eight sample sites of farmland drainage in the Hetao Irrigation District, Inner Mongolia, China. Results indicated that the distribution of ARGs in sub-drainage canals is influenced by the local urban area, agriculture, and animal husbandry structure. The bla_TEM gene was predominant in the water samples (up to 8.98 ARG copies/16S rRNA genes). The average ARG abundance in drainage channel sampling sites was significantly higher than the influent water from the Yellow River, which means that the artificial agricultural irrigation system enhances the abundance of resistance genes in the study area. Moreover, the effluent water of the whole irrigation system presented a lower abundance of ARGs than the influent water. This demonstrates that the Wuliangsuhai watershed ecosystem plays an important role in regulating the abundance of ARGs in the area. In our study, the mobile gene elements correlated with trB, emrD, mexF, and vanC (P < 0.001) in the irrigation system. Additionally, different correlations exist between other special subtypes of ARGs. These findings provided deeper insights into mitigating the propagation of ARGs and the associated risks to public health.

Inhibition of methanogens decreased sulfadiazine removal and increased antibiotic resistance gene development in microbial fuel cells

The aim of this work was to study sulfadiazine (SDZ) biodegradation efficiency, antibiotic resistance genes (ARGs) development and shift of microbial communities under conditions of limited methanogens activity in Microbial fuel cells (MFCs). The results indicated that the removal performance of SDZ was decreased with the suppression of methanogens in both MFCs and open-circuit controls. The relative abundances of ARGs were even enhanced by the inhibition of methanogens. The biodegradation mechanism of SDZ was obtained, in which SDZ was initially divided into aniline and pyrimidin-2ylsulfamic acid, then converted into small molecules. Geobacter was found as the dominant microorganism, indicating its potential to degrade SDZ in the MFCs. These findings suggest there is a trade-off between electricity production and SDZ removal and ARG development by the mean of methanogen inhibition in MFCs.

Annual changes in the occurrence of antibiotic-resistant coliform bacteria and enterococci in municipal wastewater

Wastewater contains subinhibitory concentrations of different micropollutants such as antibiotics that create selective pressure on bacteria. This phenomenon is also caused by insufficient wastewater treatment technology leading to the development and spread of antibiotic-resistant bacteria and resistance genes into the environment. Therefore, this work focused on monitoring of antibiotic-resistant coliform bacteria and enterococci in influent and effluent wastewaters taken from the second biggest wastewater treatment plant (Petržalka) in the capital of Slovakia during 1 year. Antibiotic-resistant strains were isolated, identified, and characterized in terms of susceptibility and biofilm production. All of 27 antibiotic-resistant isolates were identified mainly as Morganella morganii, Citrobacter spp., and E. coli. Multidrug-resistance was detected in 58% of isolated strains. All tested isolates could form biofilm; two strains were very strong producers, and 74% formed biofilm by strong intensity. The flow rate of the influent wastewater had a more significant impact on the number of studied bacteria than the temperature. Graphical abstract.

Screening-level microbial risk assessment of acute gastrointestinal illness attributable to wastewater treatment systems in Nunavut, Canada

Most arctic communities use primary wastewater treatment systems that are capable of only low levels of pathogen removal. Effluent potentially containing fecally derived microorganisms is released into wetlands and marine waters that may simultaneously serve as recreation or food harvesting locations for local populations. The purpose of this study is to provide the first estimates of acute gastrointestinal illness (AGI) attributable to wastewater treatment systems in Arctic Canada. A screening-level, point estimate quantitative microbial risk assessment model was developed to evaluate worst-case scenarios across an array of exposure pathways in five case study locations. A high annual AGI incidence rate of 5.0 cases per person is estimated in Pangnirtung, where a mechanical treatment plant discharges directly to marine waters, with all cases occurring during low tide conditions. The probability of AGI per person per single exposure during this period ranges between 1.0 × 10^-1 (shore recreation) and 6.0 × 10^-1 (shellfish consumption). A moderate incidence rate of 1.2 episodes of AGI per person is estimated in Naujaat, where a treatment system consisting of a pond and tundra wetland is used, with the majority of cases occurring during spring. The pathway with the highest individual probability of AGI per single exposure event is wetland travel at 6.0 × 10^-1. All other risk probabilities per single exposure are <1.0 × 10^-1. The AGI incidence rates estimated for the other three case study locations are <0.1. These findings suggest that wastewater treatment sites may be contributing to elevated rates of AGI in some arctic Canadian communities. Absolute risk values, however, should be weighed with caution based on the exploratory nature of this study design. These results can be used to inform future risk assessment and epidemiological research as well as support public health and sanitation decisions in the region.

Degradation of antibiotics and antibiotic resistance genes in fermentation residues by ionizing radiation: A new insight into a sustainable management of antibiotic fermentative residuals

Antibiotic fermentative residues are categorized into hazardous wastes in China due to the existence of antibiotic resistance genes (ARGs) and residual antibiotics How to treat and manage these wastes is a new challenge. This paper investigated the treatment of erythromycin thiocyanate fermentation (EryTcF) residues using ionizing radiation technology for removing ARGs and antibiotics from the fermentation residues. The results showed that as exposed the EryTcF residues to gamma radiation, the abundance of four macrolide resistance genes (ereA, ermB, mefA and mpfB) decreased 1.0-1.3 log with 90-95% removal, and around 56% of erythromycin was removed at absorbed dose of 30&#x202F;kGy and room temperature (19-22&#x202F;°C). Direct action of γ-ray radiation contributed to 42-53% of ARGs removal and indirect action (radicals' reaction) was mainly responsible for erythromycin removal (84%). The positive correlation between total ARGs and Shannon index was observed. The potential ARGs-linked hosts were assigned to genera Aeromonas and Enterobacteriaceae and their abundance decreased by 36-43% at 30&#x202F;kGy. Radiation has not obvious influence on the nutrient components of residues, such as protein content, suggesting that the radiation treated fermentative residues can be used as fertilizer, which is favorable for the development of recycling economy in antibiotic pharmaceutical factory. The results could provide a new insight into a sustainable management of antibiotic fermentative residuals.

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

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

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

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

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

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

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

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