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

Sludge biolysis pretreatment to reduce antibiotic resistance genes (ARGs): Insight into the relationship between potential ARGs hosts and BALOs' preferred prey

As an important reservoir of antibiotic resistance genes (ARGs), the sludge discharged from wastewater treatment plants is the key intermediate for ARG transport into the environment. Bdellovibrio-and-like organisms (BALOs) are predatory bacteria that are expected to attack antibiotic-resistant bacteria (ARB). In this study, the screened BALOs (C3 & D15) were mixed with the sludge for biolysis to achieve the satisfying removal efficiencies of six tet genes, two sul genes, and one mobile genetic element (intl 1). Among them, tet(Q) demonstrated the highest reduction rate in relative abundance at 87.3 ± 1.0 %, while tet(X) displayed the lowest of 11.7 ± 0.2 %. The microorganisms, including Longilinea, Methanobacterium, Acetobacterium, Sulfurimonas, allobaculum, Gaiella, AAP99, Ellin6067, Rhodoferax, Ferruginibacter and Thermomonas, were expected to play a dual role in the reduction of ARGs by serving as ARB and BALOs' preferred prey. Meanwhile, BALOs consortium improved ARGs reduction efficiency via the expansion of the prey profile. Additionally, BALOs decreased the relative abundance of not only pathogens (Shinella, Rickettsia, Burkholderia, Acinetobacter, Aeromonas, Clostridium, Klebsiella and Pseudomonas), but also the ARGs' host pathogens (Mycobacterium, Plesiocystis, Burkholderia, and Bacteroides). Therefore, the application of BALOs for sludge biolysis are promising to decrease the sludge's public health risks via limiting the spread of ARGs and pathogens into the environment.

Effect of meddling ARBs on ARGs dynamics in fungal infested soil and their selective dispersal along spatially distant mycelial networks

During the recent times, environmental antibiotic resistance genes (ARGs) and their potential transfer to other bacterial hosts of pathogenic importance are of serious concern. However, the dissemination strategies of such ARGs are largely unknown. We tested that saprotrophic soil fungi differentially enriched antibiotic resistant bacteria (ARBs) and subsequently contributed in spatial distribution of selective ARGs. Wafergen qPCR analysis of 295 different ARGs was conducted for manure treated pre-sterilized soil incubated or not with selected bacterial-fungal consortia. The qPCR assay detected unique ARGs specifically found in the mycosphere of ascomycetous and basidiomycetous fungi. Both fungi exerted potentially different selection pressures on ARBs, resulting in different patterns of ARGs dissemination (to distant places) along their respective growing fungal highways. The relative abundance of mobile genetic elements (MGEs) was significantly decreased along fungal highways compared to the respective inoculation points. Moreover, the decrease in MGEs and ARGs (along fungal highways) was more prominent over time which depicts the continuous selection pressure of growing fungi on ARBs for enrichment of particular ARGs in mycosphere. Such data also indicate the potential role of saprotrophic soil fungi to facilitate horizontal gene transfer within mycospheric environmental settings. Our study, therefore, advocates to emphasize the future investigations for such (bacteria-fungal) interactive microbial consortia for potential (spatial) dissemination of resistance determinants which may ultimately increase the exposure risks of ARGs.

Change characteristics, bacteria host, and spread risks of bioaerosol ARGs/MGEs from different stages in sewage and sludge treatment process

The spread of antibiotic resistance genes (ARGs) in the atmospheric environment has seriously threatened human health. Wastewater treatment plants (WWTPs) are an important source of aerosol ARGs. A large WWTP, including sewage treatment process (SWP) and sludge treatment process (SDP), was selected in North China for sampling in this study. The content of ARGs, mobile genetic elements (MGEs), and bacterial genera in sewage/sludge and aerosols from different process stages was detected. The possible correlation between ARGs/ MGEs and bacteria was analyzed. The risk of antibiotic-resistant bacteria was evaluated and the diffusion of ARGs/MGEs was simulated. The results showed that the concentration of ARGs/MGEs varied as the process progressed, and which in the aeration tank was relatively high. The ARGs/MGEs content in SWP aerosol (8.35-163.27 copies/m3) was higher than that in SDP (5.52-16.36 copies/m3). The main ARGs/MGEs detected in SWP aerosol were tnpA-05, tnpA-04, and ermF, while the main ARGs/MGEs detected in SDP aerosol were sul1, ermF, and blaPAO. ARGs were positively correlated with most bacteria and Escherichia coli with ARGs carries higher cytotoxicity. ARGs/MGEs mainly diffused towards the southeast, which may cause harm to urban residents with the diffusion of aerosols. This study provides clues and theoretical basis for preventing the hazards of ARGs from WWTP sources.

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

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

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.

Deciphering the Role of WWTPs in Cold Environments as Hotspots for the Dissemination of Antibiotic Resistance Genes

Cold environments are the most widespread extreme habitats in the world. However, the role of wastewater treatment plants (WWTPs) in the cryosphere as hotspots in antibiotic resistance dissemination has not been well established. Hence, a snapshot of the resistomes of WWTPs in cold environments, below 5 °C, was provided to elucidate their role in disseminating antibiotic resistance genes (ARGs) to the receiving waterbodies. The resistomes of two natural environments from the cold biosphere were also determined. Quantitative PCR analysis of the aadA, aadB, ampC, blaSHV, blaTEM, dfrA1, ermB, fosA, mecA, qnrS, and tetA(A) genes indicated strong prevalences of these genetic determinants in the selected environments, except for the mecA gene, which was not found in any of the samples. Notably, high abundances of the aadA, ermB, and tetA(A) genes were found in the influents and activated sludge, highlighting that WWTPs of the cryosphere are critical hotspots for disseminating ARGs, potentially worsening the resistance of bacteria to some of the most commonly prescribed antibiotics. Besides, the samples from non-disturbed cold environments had large quantities of ARGs, although their ARG profiles were highly dissimilar. Hence, the high prevalences of ARGs lend support to the fact that antibiotic resistance is a common issue worldwide, including environmentally fragile cold ecosystems.

Tracking spatio-temporal distribution and transmission of antibiotic resistance in aquatic environments by using ESBL-producing Escherichia coli as an indicator

Wastewater treatment plants (WWTPs) play an important role in the production, and transmission of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) as a convergence for human, animal, and environmental wastewater. The aim of this study was to investigate the spatio-temporal variation and influencing factors of ARB in different functional areas of the urban WWTP and the connecting rivers for 1-year monitoring using extended-spectrum β-lactamase-producing Escherichia coli (ESBL-Ec) as an indicator bacteria, and to study the transmission patterns of ARB in the aquatic environment. The results showed that ESBL-Ec isolates were identified from the WWTP (n = 219), including influent (n = 53), anaerobiotic tank (n = 40), aerobiotic tank (n = 36), activated sludge tank (n = 31), sludge thickner tank (n = 30), effluent (n = 16), and mudcake storage area (n = 13). The dehydration process can significantly remove the ESBL-Ec isolates; however, ESBL-Ec was still detected in samples collected from the effluent of the WWTP (37.0%). The detection rate of ESBL-Ec was significantly different across seasons (P < 0.05), and ambient temperature was negatively correlated with the detection rate of ESBL-Ec (P < 0.05). Furthermore, a high prevalence of ESBL-Ec isolates (29/187, 15.5%) was detected in samples collected from the river system. These findings emphasize that the high majority of ESBL-Ec in aquatic environments is alarming because it poses a significant threat to public health. Clonal transmission of ESBL-Ec isolates between the WWTP and rivers based on the spatio-temporal scale was observed by pulsed-field gel electrophoresis analysis, ST38 and ST69 ESBL-Ec clone were selected as prioritized isolates for antibiotic resistance monitoring in the aquatic environment. Further phylogenetic analysis showed human-associated (feces, blood) E. coli was the main source contributing to the presence of antibiotic resistance in aquatic environments. Longitudinal and targeted monitoring of ESBL-Ec in WWTPs and the development of effective wastewater disinfection strategies before effluent discharge from WWTPs are urgently required, to prevent and control the spread of antibiotic resistance in the environment.

Contribution of wastewater to antimicrobial resistance: A review article

OBJECTIVES

Antimicrobial resistance (AMR) is a global challenge that has raised concern globally, owing to its detrimental effects on the health and economy of countries. The ever-growing threat of AMR and sources of AMR are still being investigated. Wastewater plays an important role as a habitat for bacteria and an environment conducive to gene transfer. The primary aim of this review was to highlight the contribution of wastewater to AMR.

METHODS

Evidence of AMR in wastewater was drawn from literature published in the last 10 years, from 2012 to 2022.

RESULTS

Wastewater from agricultural practices, pharmaceutical manufacturing plants, and hospital effluents was established to promote AMR. Furthermore, stress factors such as the presence of antibiotics, heavy metals, pH, and temperature initiate and propagate AMR in bacteria living in wastewater. AMR in bacteria from wastewater was established to be either natural or acquired. Wastewater treatment techniques such as membrane filtration, coagulation, adsorption, and advanced oxidation processes have been used to remove resistant bacteria with varying success levels.

CONCLUSION

Wastewater is a major contributor to AMR, and an understanding of its role in AMR is necessary to find a lasting solution. In this regard, the spread of AMR in wastewater should be considered a threat that requires a strategy to stop further damage.

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.

A sludge bulking wastewater treatment plant with an oxidation ditch-denitrification filter in a cold region: bacterial community composition and antibiotic resistance genes

Bacterial community structure of activated sludge directly affects the stable operation of WWTPS, and these bacterial communities may carry a variety of antibiotic resistance genes (ARGs), which is a threat to the public health. This study employed 16S rRNA gene sequencing and metagenomic sequencing to investigate the bacterial community composition and the ARGs in a sludge bulking oxidation ditch-denitrification filter WWTP in a cold region. The results showed that Trichococcus (20.34%), Blautia (7.72%), and Faecalibacterium (3.64%) were the main bacterial genera in the influent. The relative abundances of norank_f_Saprospiraceae and Candidatus_Microthrix reached 10.24% and 8.40%, respectively, in bulking sludge, and those of norank_f_Saprospiraceae and Candidatus_Microthrix decreased to 6.56 and 7.10% after the anaerobic tank, indicating that the anaerobic tank had an inhibitory effect on filamentous bacteria. After 20 mJ/cm² UV disinfection, about 540 bacterial genera, such as Romboutsia (7.99%), Rhodoferax (7.98%), and Thermomonas (4.13%), could still be detected in the effluent. The ARGs were 345.11 ppm in the influent and 11.20 ppm in the effluent; 17 subtypes, such as sul1, msrE, aadA5, ErmF, and tet(A), could be detected throughout the entire process. These ARG subtypes were persistent ARGs with a high health risk. Network analysis indicated that the changes in filamentous bacteria norank_f_Saprospiraceae abundance mainly contributed to the abundance shift of MexB, and Acinetobacter mainly increased the abundance of drfA1. These results above will provide theoretical support for the sludge bulking and ARGs controls of WWTPs in cold regions.

Surveillance on ESBL-Escherichia coli and Indicator ARG in Wastewater and Reclaimed Water of Four Regions of Spain: Impact of Different Disinfection Treatments

In the present study, the occurrence of indicator antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) both in the influent and the effluent of four Spanish wastewater treatment plants (WWTPs) was monitored for 12 months, and the susceptibility profiles of 89 recovered extended spectrum β-lactamase (ESBL)-producing Escherichia coli isolates were obtained against a wide range of antimicrobials. The aim of the study was to better understand whether the current wastewater treatment practices allow us to obtain safe reclaimed water mitigating the spread of ARB and ARGs to the environment. Results showed high concentrations of ESBL-producing E. coli as well as a high prevalence of a range of ARGs in the influent samples. The reclamation treatments implemented in the WWTPs were effective in reducing both the occurrence of ESBL E. coli and ARGs, although significant differences were observed among WWTPs. Despite these reductions in occurrence observed upon wastewater treatment, our findings suggest that WWTP effluents may represent an important source of ARGs, which could be transferred among environmental bacteria and disseminate antimicrobial resistance through the food chain. Remarkably, no major differences were observed in the susceptibility profiles of the ESBL E. coli isolated from influent and effluent waters, indicating that water treatments do not give rise to the emergence of new resistance phenotypes.

Deciphering the antibiotic resistome and microbial community in municipal wastewater treatment plants at different elevations in eastern and western China

Antibiotic resistance genes (ARGs) as emerging environmental contaminants pose severe global risks to public health and ecosystems. Municipal wastewater treatment plants (WWTPs) are crucial transmitters for the dissemination and propagation of ARGs into receiving water bodies via mobile genetic elements (MGEs). However, the comprehensive and deep deciphering of the diversity, abundance, and potential hosts of ARGs in two distinct altitudinal WWTPs is scarce. In this work, we revealed the elevational distribution characteristics of the resistance genes and microbial community of six WWTPs from two distinct geographical zones: a low-elevation (LE) region (Shandong, 10-22 m above sea level) and a high-elevation (HE) region (Gansu, 1,520-1,708 m above sea level). Significant elevational variations in the diversity and relative abundance of resistance genes were observed. Wastewater treatment could significantly reduce the concentrations of ARGs and MGEs by about 1-2 and 2-3 orders of magnitude, respectively. However, above 69.95% of resistance genes were enriched in effluent. In particular, 24 ARG subtype, 3 MGE subtypes, and 59 bacterial genera were persistent in all samples. More potential hosts for ARGs in LE region and more abundant human gut microbiota in HE region were identified. This work provides helpful information for controlling the spread of ARGs for their management and assessment, thereby mitigating the risks of ARGs in WWTPs.

Removal of antibiotic resistance genes during livestock wastewater treatment processes: Review and prospects

Antibiotic resistance genes (ARGs) are emerging pollutants that have received extensive attention. Many different types of ARGs exist in livestock wastewater. If not effectively treated, they can threaten animal production, public health and the ecological safety of the surrounding environment. To address the high risk of livestock wastewater contamination by ARGs, the effects of different wastewater treatment processes on ARGs and their influencing factors and mechanisms are reviewed herein. Additionally, the current problems associated with removal of ARGs are discussed, and future research is proposed.

Efficient and Reusable Sorbents Based on Nanostructured BN Coatings for Water Treatment from Antibiotics

Increasing contamination of wastewater with antibiotics used in agriculture, animal husbandry, and medicine is a serious problem for all living things. To address this important issue, we have developed an efficient platform based on a high specific surface area hexagonal boron nitride (BN) coating formed by numerous nanopetals and nanoneedles. The maximum sorption capacity of 1 × 1 cm² BN coatings is 502.78 µg/g (tetracycline, TET), 315.75 µg/g (ciprofloxacin, CIP), 400.17 µg/g (amoxicillin, AMOX), and 269.7 µg/g (amphotericin B, AMP), which exceeds the sorption capacity of many known materials. Unlike nanoparticles, BN-coated Si wafers are easy to place in and remove from antibiotic-contaminated aqueous solutions, and are easy to clean. When reusing the adsorbents, 100% efficiency was observed at the same time intervals as in the first cleaning cycle: 7 days (TET) and 14 days (CIP, AMOX, AMP) at 10 µg/mL, 14 days (TET, CIP, and AMOX) and 28 days (AMP) at 50 µg/mL, and 14 days (TET) and 28 days (CIP, AMOX and AMP) at 100 µg/mL. The results obtained showed that TET and CIP are best adsorbed on the surface of BN, so TET was chosen as an example for further theoretical modeling of the sorption process. It was found that adsorption is the main mechanism, and this process is spontaneous and endothermic. This highlights the importance of a high specific surface area for the efficient removal of antibiotics from aqueous solutions.

Modern knowledge-scape possess petite influence on the factual persistence of resistance determinants (ARGs/MGEs): A map and assessment of discharged wastewater and water bodies

Antibiotic resistance genes (ARGs) and Mobile genetic elements (MGEs) are major global emerging pollutants of the environment and water nexus which various investigators of related studies have reported. Observing ARGs and MGEs in water bodies, wastewater treatment systems, and estuaries is indicative of relevant risk, resistant bacteria/ARGs spread or potential health concern and may result environmental pathogen bloom if appropriate research-based strategies are not implemented to remove these lethal genetic materials. Despite reports and knowledge-based strategies for removal, the challenge yet persists. This study aims to appraise the impact/contribution of related studies and emphasize the necessity for applying combined research-based/practitioners approach in addressing the expanding challenge of ARGs/MGEs in wastewater/waterbodies. The study describes a bibliometric assessment of antibiotic resistance determinants annual scientific publications on the Web of Science, an annual growth rate of related articles, top articles per citations with search topics and content-review analysis to evaluate the methods of removal of ARGs/MGEs. A total of 1301 articles of wastewater treatment systems were retrieved with date range of 1997-2019. A description of the study Annual Growth Rate of 37.82% at R² of 0.7863 was observed with an increasing article publication and a decreasing total citation rate indicating persistent reports of dispersion on ARGs/MGEs studies in the water bodies and environment. Although there abound extensive studies and reports of ARGs and MGEs in water nexus and wastewater release with research based removal strategies, the impact of such reports have not been fully actualized amongst wastewater system practitioners. A lucid drive towards implementing ARGs/MGEs removal strategies from the environment by applying affirmed research-based methods are suggestive.

Microbial Water Quality through a Full-Scale Advanced Wastewater Treatment Demonstration Facility

The fates of viruses, bacteria, and antibiotic resistance genes during advanced wastewater treatment are important to assess for implementation of potable reuse systems. Here, a full-scale advanced wastewater treatment demonstration facility (ozone, biological activated carbon filtration, micro/ultrafiltration, reverse osmosis, and advanced oxidation) was sampled over three months. Atypically, no disinfectant residual was applied before the microfiltration step. Microbial cell concentrations and viability were assessed via flow cytometry and adenosine triphosphate (ATP). Concentrations of bacteria (16S rRNA gene), viruses (human adenovirus and JC polyomavirus), and antibiotic resistance genes (sul1 and bla _TEM ) were assessed via quantitative PCR following the concentration of large sample volumes by dead-end ultrafiltration. In all membrane filtration permeates, microbial concentrations were higher than previously reported for chloraminated membranes, and log₁₀ reduction values were lower than expected. Concentrations of 16S rRNA and sul1 genes were reduced by treatment but remained quantifiable in reverse osmosis permeate. It is unclear whether sul1 in the RO permeate was from the passage of resistance genes or new growth of microorganisms, but the concentrations were on the low end of those reported for conventional drinking water distribution systems. Adenovirus, JC polyomavirus, and bla _TEM genes were reduced below the limit of detection (∼10^-2 gene copies per mL) by microfiltration. The results provide insights into how treatment train design and operation choices affect microbial water quality as well as the use of flow cytometry and ATP for online monitoring and process control.

Removal of Antibiotic Resistance Genes, Class 1 Integrase Gene and Escherichia coli Indicator Gene in a Microalgae-Based Wastewater Treatment System

Microalgae-based wastewater treatment systems (AWWTS) have recently shown promise in the mitigation of antibiotic resistance genes (ARGs) from municipal wastewater (MWW). However, due to the large number of ARGs that exist in MWW, the use of indirect conventional water quality parameters to monitor ARGs reduction in wastewater would make the process less burdensome and economically affordable. In order to establish a robust relationship between the ARGs and water quality parameters, the current study employed different microalgae strains in monoculture (CM2, KL10) and multi-species combinations (CK and WW) for the MWW treatment under outdoor environmental conditions. The studied genes were quantified in the MWW influents and effluents using real-time PCR. All the cultures substantially improved the physicochemical qualities of the MWW. Out of the 14 genes analyzed in this study, tetO, tetW, tetX and ermB were decreased beyond detection within the first 4 days of treatment in all the cultures. Other genes, including blaCTX, sul1, cmlA, aadA, int1 and uidA were also decreased beyond a 2 log reduction value (LRV). The mobile genetic element, int1, correlated positively with most of the ARGs, especially sul1 (r ≤ 0.99, p < 0.01) and aadA (r ≤ 0.97, p < 0.01). Similarly, the Escherichia coli indicator gene, uidA, correlated positively with the studied genes, especially with aadA, blaCTX, blaTEM and cmlA (r ≤ 0.99 for each, p < 0.01). Some of the studied genes also correlated positively with total dissolved solids (TDS) (r ≤ 0.98, p < 0.01), and/or negatively with total suspended solids (TSS) (r ≤ −0.98, p < 0.01) and pH (r ≤ −0.98, p < 0.01). Among the tested cultures, both monocultures, i.e., KL10 and CM2 were found to be more consistent in gene suppression than their multi-species counterparts. The findings revealed water quality parameters such as TDS, TSS and E. coli as reliable proxies for ARGs mitigation in AWWTS and further highlight the superiority of monocultures over multi-species cultures in terms of gene suppression from the MWW stream.

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.

Experimental and Theoretical Study of Sorption Capacity of Hexagonal Boron Nitride Nanoparticles: Implication for Wastewater Purification from Antibiotics

The constant accumulation of antibiotics and their degradation products in wastewater as a result of human activity poses a serious threat to humanity and other living beings. To contribute to solving this important problem, hollow hexagonal boron nitride nanoparticles (BNNPs) with a spherical shape and smooth surface were synthesized, which were characterized as an efficient adsorbent for wastewater treatment from three types of antibiotics: ciprofloxacin (CIP), tetracycline (TC), and benzylpenicillin (BP). As follows from DFT calculations, the interaction of antibiotic molecules (AM) with the BN surface is neither purely physical nor purely chemical, and negative binding energy (BE) indicates that the adsorption process is spontaneous and endothermic. The calculated electron density redistributions at the AM/BN interfaces show that antibiotics interact with BN mainly through oxygen-containing groups. In addition, this interaction causes the BN surface to bend, which increases both the BE and the contact area. The removal efficiency of antibiotics (Re, %) depends on their initial concentration. At an initial concentration of 10 µg/mL, Re₅₀ and Re₁₀₀ were observed after 24 h and 14 days, respectively. With an increase in the initial concentration to 40 μg/mL, Re₅₀ and Re₁₀₀ were achieved after 5 and 28 days (with the exception of ciprofloxacin (~80% Re)). The maximum sorption capacity of BNNPs (q_e) was determined to be 297.3 mg/g (TC), 254.8 mg/g (BP), and 238.2 mg/g (CIP), which is significantly superior to many other systems. Tetracycline is adsorbed much faster than the other two antibiotics, which is confirmed by both theoretical and experimental data. Based on the results of the DFT analysis, a simple and efficient sorbent regeneration strategy was proposed, which ensures complete removal of antibiotics after 14 (BP), 21 (TC), and 10 (CIP) days. Thus, the obtained results clearly show that BNNPs are promising sorbents for various classes of antibiotics, including aminoglycosides, tetracyclines, and β-lactams.

The elimination of cell-associated and non-cell-associated antibiotic resistance genes during membrane filtration processes: A review

With increasing water reuse as a sustainable water management strategy, antibiotic resistance genes (ARGs) which have been identified as emerging contaminants in wastewater are attracting global attentions. Given that wastewater treatment plants are now well-established as a sink and source of ARGs in both cell-associated and non-cell-associated forms, a need is acknowledged to reduce their proliferation and protect public health. Due to their different characteristics, cell-associated and non-cell-associated ARGs may have distinct responses to membrane filtration processes which are widely used as advanced treatment to the secondary effluent. This review improves the understanding of the abundance of cell-associated and non-cell-associated ARGs in wastewaters and the secondary effluents and compares the elimination of ARGs in cell-associated and non-cell-associated forms by low-pressure and high-pressure membrane filtration processes. The former process reduces the concentration of cell-associated ARGs by more than 2-logs on average. An increase of the retention efficiency of non-cell-associated ARGs is observed with decreasing molecular weight cut-offs in ultrafiltration. The high-pressure membrane filtration (i.e., nanofiltration and reverse osmosis) can effectively eliminate both cell-associated and non-cell-associated ARGs, with averagely more than 4.6-log reduction. In general, the two forms of ARGs can be removed from water by the membrane filtration processes via the effects of size exclusion, adsorption, and electrostatic repulsion. The size and conformation of cell-associated and non-cell-associated ARGs, characteristics of membranes, coexisting substances, and biofilm formation influence ARG retention. Accumulation and potential proliferation of cell-associated and non-cell-associated ARGs in foulants and concentrate and corresponding control strategies warrant future research.

The balance between treatment efficiency and receptor quality determines wastewater impacts on the dissemination of antibiotic resistance

This study investigated the balance between treatment efficiency and impact caused by urban wastewater treatment plants (UWTPs) on the dissemination of antibiotic resistance. Four full-scale UWTPs (PT1-PT4) and the receiving river were sampled over four campaigns. The 16 S rRNA gene, two mobile genetic elements (MGEs), eight antibiotic resistance genes (ARGs), and culturable bacteria were monitored over different treatment stages and in hospital effluent. The bacterial and antibiotic resistance load was not significantly different in the inflow of the four UWTPs (p > 0.01). Biological treatment promoted ARGs reduction values up to 2.5 log-units/mL, while UV (PT1, PT2) or sand filtration/ozonation (PT3) led to removal values < 0.6 log-units/mL. The final effluent of PT3, with the highest removal rates and significantly lower ARGs abundance, was not significantly different from the receiving water body. Emerging ARGs (e.g., bla_VIM, bla_OXA-48, and bla_KPC) were sporadically detected in the river, although more frequent downstream. Hospital effluent might contribute for the occurrence of some, but not all these ARGs in the river. A major conclusion was that the impact of the UWTPs on the river was not only determined by treatment efficiency and final effluent quality, but also by the background contamination of the river and/or dilution rate.

Spatial distribution of antibiotic resistance genes of the Zaohe-Weihe Rivers, China: exerting a bottleneck in the hyporheic zone

The hyporheic zone (HZ) is an active biogeochemical region where groundwater and surface water mix and a potential reservoir for antibiotic resistance genes (ARGs). In this paper, the relative abundance and spatial distribution of ARGs in the HZ media were investigated, taking into consideration both the five speciation of six metals and the local characteristics. The samples of surface water, groundwater, and sediment were collected from Zaohe-Weihe Rivers of Xi'an City, which is a representative city with characteristics of the northwest region of China. Of 271 ARGs associated with 9 antibiotics, 228 ARGs were detected, with a total detection rate of 84%. Sulfonamide and aminoglycoside ARGs were the dominant types of ARGs. The top 6 ARGs and mobile genetic elements (MGEs) in terms of abundance were tnpA-04, cepA, sul1, aadA2-03, sul2 and intI1. The results of principal component analysis (PCA) showed that the distribution characteristics of ARGs were not associated with the sampling sites but with the environmental medias. Similarity in the water phases and significant differences in the water and sediment phases were found. The redundancy analysis (RDA) identified the key factors controlling ARG pollution, including dissolved oxygen (DO) in surface water, total nitrogen (TN) in groundwater, and total organic carbon (TOC) in sediment. In terms of the speciation of heavy metals, we further revealed the promotion effect between ARGs and heavy metals, especially the residual fraction of Ni. In terms of horizontal transfer mechanism, ARGs were significantly correlated with tnpA-03 in water phase and tnpA-04 in sediment. In the three media, intI1 and ARGs all show a significant correlation. These findings showed that hyporheic zone exerted a bottleneck effect on the distribution and transfer of ARGs.

Distribution characteristics of antibiotic resistance bacteria and related genes in urban recreational lakes replenished by different supplementary water source

The distribution characteristics of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in urban recreational water from different water-supply sources might be different. In this study, water samples were collected to detect the antibiotic resistance of heterotrophic bacteria to five antibiotics, and the content, phenotype, gene type and species distribution of resistant bacteria were analyzed. The results showed that the changes of bacteria resistance rate in two lakes to five kinds of antibiotics were synchronous with time, and it would reach its maximum in autumn. The detection of ARGs and int I in 80 resistance strains showed that the detection rate of tetG, tetA and int I was high. Here, 51.25% of the bacteria were doubly resistant to AMP-CTX. The 80 isolate strains were of nine genera and 19 species, among which Bacillus cereus, Escherichia coli, Aeromonas veronii, Aeromonas caviae and Raoultella ornithinolytica were the common ARB species in two lakes. Correlation analysis showed that the water temperature was significantly correlated with the content of ARB in sulfamethoxazole (SMZ) and cefotaxime (CTX) (p < 0.05), and the total phosphorus (TP) in FQ lake was significantly correlated with the content of AMP-resistant bacteria (p < 0.05), while there were no other correlations between the changes of other water quality indexes and the content of ARB (p > 0.05).

Metagenomic community composition and resistome analysis in a full-scale cold climate wastewater treatment plant

BACKGROUND

Wastewater treatment plants are an essential part of maintaining the health and safety of the general public. However, they are also an anthropogenic source of antibiotic resistance genes. In this study, we characterized the resistome, the distribution of classes 1-3 integron-integrase genes (intI1, intI2, and intI3) as mobile genetic element biomarkers, and the bacterial and phage community compositions in the North End Sewage Treatment Plant in Winnipeg, Manitoba. Samples were collected from raw sewage, returned activated sludge, final effluent, and dewatered sludge. A total of 28 bacterial and viral metagenomes were sequenced over two seasons, fall and winter. Integron-integrase genes, the 16S rRNA gene, and the coliform beta-glucuronidase gene were also quantified during this time period.

RESULTS

Bacterial classes observed above 1% relative abundance in all treatments were Actinobacteria (39.24% ± 0.25%), Beta-proteobacteria (23.99% ± 0.16%), Gamma-proteobacteria (11.06% ± 0.09%), and Alpha-proteobacteria (9.18 ± 0.04%). Families within the Caudovirales order: Siphoviridae (48.69% ± 0.10%), Podoviridae (23.99% ± 0.07%), and Myoviridae (19.94% ± 0.09%) were the dominant phage observed throughout the NESTP. The most abundant bacterial genera (in terms of average percent relative abundance) in influent, returned activated sludge, final effluent, and sludge, respectively, includes Mycobacterium (37.4%, 18.3%, 46.1%, and 7.7%), Acidovorax (8.9%, 10.8%, 5.4%, and 1.3%), and Polaromonas (2.5%, 3.3%, 1.4%, and 0.4%). The most abundant class of antibiotic resistance in bacterial samples was tetracycline resistance (17.86% ± 0.03%) followed by peptide antibiotics (14.24% ± 0.03%), and macrolides (10.63% ± 0.02%). Similarly, the phage samples contained a higher prevalence of macrolide (30.12% ± 0.30%), peptide antibiotic (10.78% ± 0.13%), and tetracycline (8.69% ± 0.11%) resistance. In addition, intI1 was the most abundant integron-integrase gene throughout treatment (1.14 × 104 gene copies/mL) followed by intI3 (4.97 × 103 gene copies/mL) while intI2 abundance remained low (6.4 × 101 gene copies/mL).

CONCLUSIONS

Wastewater treatment successfully reduced the abundance of bacteria, DNA phage and antibiotic resistance genes although many antibiotic resistance genes remained in effluent and biosolids. The presence of integron-integrase genes throughout treatment and in effluent suggests that antibiotic resistance genes could be actively disseminating resistance between both environmental and pathogenic bacteria.

Effective Treatment Strategies for the Removal of Antibiotic-Resistant Bacteria, Antibiotic-Resistance Genes, and Antibiotic Residues in the Effluent From Wastewater Treatment Plants Receiving Municipal, Hospital, and Domestic Wastewater: Protocol for a Systematic Review

Background

The widespread and unrestricted use of antibiotics has led to the emergence and spread of antibiotic-resistant bacteria (ARB), antibiotic-resistance genes (ARGs), and antibiotic residues in the environment. Conventional wastewater treatment plants (WWTPs) are not designed for effective and adequate removal of ARB, ARGs, and antibiotic residues, and therefore, they play an important role in the dissemination of antimicrobial resistance (AMR) in the natural environment.

Objective

We will conduct a systematic review to determine the most effective treatment strategies for the removal of ARB, ARGs, and antibiotic residues from the treated effluent disposed into the environment from WWTPs that receive municipal, hospital, and domestic discharge.

Methods

We will search the MEDLINE, EMBASE, Web of Science, World Health Organization Global Index Medicus, and ProQuest Environmental Science Collection databases for full-text peer-reviewed journal articles published between January 2001 and December 2020. We will select only articles published in the English language. We will include studies that measured (1) the presence, concentration, and removal rate of ARB/ARGs going from WWTP influent to effluent, (2) the presence, concentration, and types of antibiotics in the effluent, and (3) the possible selection of ARB in the effluent after undergoing treatment processes in WWTPs. At least two independent reviewers will extract data and perform risk of bias assessment. An acceptable or narrative synthesis method will be followed to synthesize the data and present descriptive characteristics of the included studies in a tabular form. The study has been approved by the Ethics Review Board at the International Centre for Diarrhoeal Disease Research, Bangladesh (protocol number: PR-20113).

Results

This protocol outlines our proposed methodology for conducting a systematic review. Our results will provide an update to the existing literature by searching additional databases.

Conclusions

Findings from our systematic review will inform the planning of proper treatment methods that can effectively reduce the levels of ARB, ARGs, and residual antibiotics in effluent, thus lowering the risk of the environmental spread of AMR and its further transmission to humans and animals.

International Registered Report Identifier (IRRID)

PRR1-10.2196/33365

Beta-lactam resistance development during the treatment processes of municipal wastewater treatment plants

This work monitored the effect of a municipal and a village wastewater treatment plant (WWTP) technology on the fate of beta-lactam resistance genes in bacterial populations in different phases of the wastewater treatment process. In case of the municipal WWTP1, the bacteria possessing a high ampicillin resistance (minimal inhibitory concentration (MIC) values of 20 mg/mL) accumulated in the sedimentation tank, which was accompanied with a higher concentration of ampicillin in the wastewater samples (28.09 ng/L) and an increase in the relative abundance of the blaTEM gene in the bacterial population. However, an opposite trend was revealed with the blaNDM-1 gene, making the sedimentation processes of WWTP1 crucial only for the accumulation of the blaTEM gene. Similarly, the comparison with the WWTP2 showed that the accumulation of the ampicillin resistance in bacterial population probably depended on the WWTP technology and wastewater composition. Out of the four tested resistance genes (blaTEM, blaKPC, blaNDM-1, and blaOXA-48), blaTEM and blaNDM-1 genes were the only two detected in this study. According to NGS analysis of bacterial 16 S rRNA gene, Gammaproteobacteria dominated the ampicillin-resistant bacteria of the WWTP sedimentation tanks. Their relative abundance in the bacterial population also increased during the sedimentation processes in WWTP1. It could indicate the role of the bacterial taxon in ampicillin resistance accumulation in this WWTP and show that only 9.29% of the original bacterial population from the nitrification tank is involved in the documented shifts in beta-lactam resistance of the bacterial population.

Spatiotemporal profiling of antibiotics and resistance genes in a river catchment: Human population as the main driver of antibiotic and antibiotic resistance gene presence in the environment

Studies to understand the role wastewater treatment plants (WWTPs) play in the dissemination of antibiotics (ABs), and in the emergence of antibiotic resistance (ABR), play an important role in tackling this global crisis. Here we describe the abundance and distribution of 16 ABs, and 4 corresponding antibiotic resistance genes (ARGs), sampled from the influent to five WWTPs within a single river catchment. We consider four classes of antibiotics: fluroquinolones, macrolides, sulfamethoxazole and chloramphenicol, as well the corresponding antibiotic resistance genes qnrS, ermB, sul1 and catA. All antibiotics, apart from four fluroquinolones (besifloxacin, lomefloxacin, ulifloxacin, prulifloxacin), were detected within all influent wastewater from the 5 cities (1 city = 1 WWTP), as were the corresponding antibiotic resistance genes (ARGs). Strong correlations were observed between the daily loads of ABs and ARGs versus the size of the population served by each WWTP, as well as between AB and ARG loads at a single site. The efficiency of ABs and ARGs removal by the WWTPs varied according to site (and treatment process utilized) and target, although strong correlations were maintained between the population size served by WWTPs and daily loads of discharged ABs and ARGs into the environment. We therefore conclude that population size is the main determinant of the magnitude of AB and ARG burden in the environment.

Treatment of pharmaceutical wastewater by ionizing radiation: Removal of antibiotics, antimicrobial resistance genes and antimicrobial activity

In present study, the treatment of real pharmaceutical wastewater from an erythromycin (ERY) production factory by gamma irradiation was investigated. Results showed that a variety of antimicrobial resistance genes (ARGs), involving MLSB, tet, bla, multidrug, sul, MGEs and van genes and plentiful 9 bacterial phyla were identified in the raw wastewater. In addition to ERY, sulfamethoxazole (SMX) and tetracycline (TC) were also identified with the concentration of 3 order of magnitude lower than ERY. Results showed that the abatement of ARGs and antibiotics was much higher than that of antimicrobial activity and COD. With the absorbed dose of 50 kGy, the removal percentage of ARGs, ERY, antimicrobial activity and COD was 96.5-99.8%, 90.0%, 47.8% and 10.3%, respectively. The culturable bacteria were abated fast and completely at 5.0 kGy during gamma irradiation. The genus Pseudomonas was predominant in raw wastewater (56.7%) and its relative abundance decreased after gamma irradiation, to 1.3% at 50 kGy. With addition of peroxymonosulfate (PMS, 50 mM), the antimicrobial activity disappeared completely and ERY removal reached as high as 99.2% at the lower absorbed dose of 25 kGy. Ionizing radiation-coupled technique is a potential option to treat pharmaceutical wastewater for reduction of antibiotics, ARGs and antimicrobial activity.

Mitigating Antibiotic Resistance Genes in Wastewater by Sequential Treatment with Novel Nanomaterials

Wastewater (WW) has been widely recognized as the major sink of a variety of emerging pathogens (EPs), antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs), which may disseminate and impact wider environments. Improving and maximizing WW treatment efficiency to remove these microbial hazards is fundamentally imperative. Despite a variety of physical, biological and chemical treatment technologies, the efficiency of ARG removal is still far from satisfactory. Within our recently accomplished M-ERA.NET project, novel functionalized nanomaterials, i.e., molecularly imprinted polymer (MIP) films and quaternary ammonium salt (QAS) modified kaolin microparticles, were developed and demonstrated to have significant EP removal effectiveness on both Gram-positive bacteria (GPB) and Gram-negative bacteria (GNB) from WW. As a continuation of this project, we took the further step of exploring their ARG mitigation potential. Strikingly, by applying MIP and QAS functionalized kaolin microparticles in tandem, the ARGs prevalent in wastewater treatment plants (WWTPs), e.g., blaCTXM, ermB and qnrS, can be drastically reduced by 2.7, 3.9 and 4.9 log (copies/100 mL), respectively, whereas sul1, tetO and mecA can be eliminated below their detection limits. In terms of class I integron-integrase I (intI1), a mobile genetic element (MGE) for horizontal gene transfer (HGT), 4.3 log (copies/100 mL) reduction was achieved. Overall, the novel nanomaterials exhibit outstanding performance on attenuating ARGs in WW, being superior to their control references. This finding provides additional merit to the application of developed nanomaterials for WW purification towards ARG elimination, in addition to the proven bactericidal effect.

Urban wastewater as a conduit for pathogenic Gram-positive bacteria and genes encoding resistance to β-lactams and glycopeptides

The emergence and spread of clinical pathogens, antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in the environment pose a direct threat to human and animal health worldwide. In this study, we analyzed qualitatively and quantitatively urban sewage resistome for the occurrence of genes encoding resistance to β-lactams and glycopeptides in the genomes of culturable bacteria, as well as in the wastewater metagenome of the Central Wastewater Treatment Plant in Koziegłowy (Poland). Moreover, we estimated the presence of pathogenic Gram-positive bacteria in wastewater based on analysis of species-specific virulence genes in the wastewater metagenome. The results show that the final effluent contains alarm pathogens with particularly dangerous mechanisms of antibiotic resistance, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). We also noticed that during the wastewater treatment, there is an increase in the frequency of MRSA and VRE. Furthermore, the results prove the effective removal of vanA, but at the same time show that wastewater treatment increases the relative abundance of mecA and virulence genes (groES and sec), indicating the presence of clinical pathogens E. faecalis and S. aureus in the effluent released to surface waters. We also observed an increase in the relative abundance of mecA and vanA genes already in the aeration tank, which suggests accumulation of contaminants affecting enhanced selection and HGT processes in the activated sludge. Moreover, we found a relation between the taxonomic composition and the copy number of ARGs as well as the presence of pathogens at various stages of wastewater treatment. The presence of clinically relevant pathogens, ARB, including multi-resistant bacteria, and ARGs in the effluent indicates that wastewater treatment plant play a key role in the existence of pathogens and antimicrobial resistance spreading pathway in the environment and human communities, which is a direct threat to public health and environmental protection.

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.

Recent advances in photodegradation of antibiotic residues in water

Antibiotics are widely present in the environment due to their extensive and long-term use in modern medicine. The presence and dispersal of these compounds in the environment lead to the dissemination of antibiotic residues, thereby seriously threatening human and ecosystem health. Thus, the effective management of antibiotic residues in water and the practical applications of the management methods are long-term matters of contention among academics. Particularly, photocatalysis has attracted extensive interest as it enables the treatment of antibiotic residues in an eco-friendly manner. Considerable progress has been achieved in the implementation of photocatalytic treatment of antibiotic residues in the past few years. Therefore, this review provides a comprehensive overview of the recent developments on this important topic. This review primarily focuses on the application of photocatalysis as a promising solution for the efficient decomposition of antibiotic residues in water. Particular emphasis was laid on improvement and modification strategies, such as augmented light harvesting, improved charge separation, and strengthened interface interaction, all of which enable the design of powerful photocatalysts to enhance the photocatalytic removal of antibiotics.

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.

Ferrate effectively removes antibiotic resistance genes from wastewater through combined effect of microbial DNA damage and coagulation

The widespread of antibiotic resistance genes (ARGs) in the environment can pose severe threats to public health. The wastewater treatment plant (WWTP) is regarded as an important hotspot of ARGs in the urban environment, but the removal of ARGs through conventional treatment techniques has been proven not sufficient. In this study, ferrate (Fe(VI)) was applied for the first time to remove intracellular ARGs from the secondary effluent of the WWTP. The results showed that Fe(VI) treatment could effectively remove 15 ARGs covering eight different types as well as intI1, the most common integron important to ARGs horizontal transfer. The removal efficiencies of tested genes could reach 1.10-4.37 log at the Fe(VI) dosage of 10 mg-Fe/L, which is significantly higher than those achieved through traditional disinfection methods. The DNA gel electrophoresis suggested that Fe(VI) could induce microbial DNA damage and consequently resulted in ARGs elimination. The presence of ARGs in settled residues indicated that coagulation initiated by Fe(VI) reduction products also contributed to ARGs removal from wastewater. In addition, the viability and relative abundances of potential ARGs hosts in the wastewater were decreased after Fe(VI) treatment. This study suggested a promising prospect for applying Fe(VI) to efficiently remove ARGs from wastewater, and consequently to control their proliferation and transfer in the environment.

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

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

Mitigation of antibiotic resistance in a pilot-scale system treating wastewater from high-speed railway trains

Wastewater from high-speed railway trains represents a mobile reservoir of microorganisms with antibiotic resistance. It harbors abundant and diverse antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs). This study investigated the removal of ARB and ARGs in a pilot-scale reactor, which consisted of an anaerobic/anoxic/oxic process, anaerobic/anoxic/aerobic process, and ozone-based disinfection to treat 1 m³/day wastewater from an electric multiple unit high-speed train. Further, the high prevalence of two mobile genetic elements (intI1 and Tn916/615) and five ARGs (tetA, tetG, qnrA, qnrS, bla_NDM-1, and ermF) was investigated using quantitative PCR. Significant positive correlations between ARGs (tetA, bla_NDM-1, and qnrA) and intI1 were identified (R² of 0.94, 0.85, and 0.70, respectively, P < 0.01). Biological treatment could significantly reduce Tn916/1545 (2.57 logs reduction) and Enterococci (2.56 logs reduction of colony forming unit (CFU)/mL), but the qnrS abundance increased (1.19 logs increase). Ozonation disinfection could further significantly decrease ARGs and Enterococci in wastewater, with a reduction of 1.67-2.49 logs and 3.16 logs CFU/mL, respectively. Moreover, food-related bacteria families which may contain opportunistic or parasitic pathogens (e.g., Moraxellaceae, Carnobacteriaceae, and Ruminococcaceae) were detected frequently. Enterococci filtered in this study shows multi-antibiotic resistance. Our study highlights the significance to mitigate antibiotic resistance from wastewater generated from high-speed railway trains, as a mobile source.

Metagenomic analysis of β-lactamase and carbapenemase genes in the wastewater resistome

The emergence and spread of resistance to antibiotics among bacteria is the most serious global threat to public health in recent and coming decades. In this study, we characterized qualitatively and quantitatively β-lactamase and carbapenemase genes in the wastewater resistome of Central Wastewater Treatment Plant in Koziegłowy, Poland. The research concerns determination of the frequency of genes conferring resistance to β-lactam and carbapenem antibiotics in the genomes of culturable bacteria, as well as in the wastewater metagenome at three stages of treatment: raw sewage, aeration tank, and final effluent. In the final effluent we found bacteria with genes that pose the greatest threat to public health, including genes of extended spectrum β-lactamases - bla_CTX-M, carbapenemases - bla_NDM, bla_VIM, bla_GES, bla_OXA-48, and showed that during the wastewater treatment their frequency increased. Moreover, the wastewater treatment process leads to significant increase in the relative abundance of bla_TEM and bla_GES genes and tend to increase the relative abundance of bla_CTX-M, bla_SHV and bla_OXA-48 genes in the effluent metagenome. The biodiversity of bacterial populations increased during the wastewater treatment and there was a correlation between the change in the composition of bacterial populations and the variation of relative abundance of β-lactamase and carbapenemase genes. PCR-based quantitative metagenomic analysis combined with analyses based on culture methods provided significant information on the routes of ARBs and ARGs spread through WWTP. The limited effectiveness of wastewater treatment processes in the elimination of antibiotic-resistant bacteria and resistance genes impose the need to develop an effective strategy and implement additional methods of wastewater disinfection, in order to limit the increase and the spread of antibiotic resistance in the environment.

Seasonal variations in antibiotic resistance genes in estuarine sediments and the driving mechanisms

Estuary sediments are chemically contaminated by adjacent coastal industrial cities, but the impact of organic pollutants on antibiotic resistance genes (ARGs) in estuarine sediments is unknown. We comprehensively analyzed the complex interactions between chemical pollutants (heavy metals and organic pollutants), mobile genetic elements (MGEs), and ARGs in estuarine sediments during various seasons. The results indicate that under the effects of the chemically polluted river water, the number of different estuarine sediment ARGs increased by 76.9%-92.3% in summer and 5.9%-35.3% in winter, and the abundance of these ARGs increased by 29-5195 times in summer and 48-239 times in winter. The abundance of sediment ARGs in distinct estuaries showed different seasonal trends. Seasonal changes had a greater impact on the abundance of estuarine sediment ARGs than on their diversity. The diversity of estuarine sediment ARGs was positively correlated with the chemical pollution levels. Furthermore, chemical pollution was positively correlated with MGEs, and MGEs were correlated with ARG abundance. These results indicate that ARGs are enriched in bacteria via horizontal gene transfer triggered by chemical pollution, promoting multi-antibiotic resistance in estuarine sediment bacteria. These findings have implications for our understanding of the distribution and propagation of ARGs in chemically polluted estuarine sediments.

Inactivation kinetics of antibiotic resistant Escherichia coli in secondary wastewater effluents by peracetic and performic acids

While disinfection processes have been central for public health protection, new concerns have been raised with respect to their ability to control the spread of antibiotic resistance in the environment. In this study, we report the inactivation kinetics by peracetic and performic acids of a typical indicator, Escherichia coli and its corresponding antibiotic-resistant subpopulation, in secondary settled wastewater effluent. Performic acid always showed greater inactivation efficiency than peracetic acid, whether or not the indicator was Ampicillin-resistant. Observed inactivation data, fitted with an exposure-based inactivation model, predicted very well the inactivation profile of both total and ampicillin resistant Escherichia coli. Notably, the antibiotic resistance percentage decreased significantly in treated wastewater compared to untreated wastewater thus making the peracid-based disinfection processes beneficial in controlling antibiotic resistance in secondary settled wastewater. Moreover, the minimum inhibitory concentration values remained unchanged. Finally, antibiotic-resistant-specific inactivation kinetics were used to predict the disinfection efficiency in continuous-flow reactors under ideal and non-ideal hydraulics thus providing useful information for future design and operation of disinfection process in antibiotic-resistance controlling mode.

Clinical class 1 integron-integrase gene - A promising indicator to monitor the abundance and elimination of antibiotic resistance genes in an urban wastewater treatment plant

In this study, 295 antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs) from the influent, activated sludge (AS), and membrane bioreactor (MBR) permeate were primarily examined in the wastewater treatment plant (WWTP) biweekly over 13 months. The absolute concentrations of ARGs and MGEs respectively ranged from 1.27 × 10¹⁰ to 1.94 × 10¹¹ and 8.00 × 10⁹ to 1.24 × 10¹¹ copies/L in the influent, of which were reduced by 2 to 3 orders of magnitude in the permeate. No significant seasonal variation of ARGs and MGEs was found in the WWTP, except that the absolute abundance of ARGs and MGEs in the AS was peaked during spring. The antibiotics affected neither ARGs nor MGEs significantly, suggesting their concentrations may be not high enough to pose a selective pressure. In contrast, the bacterial community had direct effect on the MGEs variation, meanwhile the MGEs influenced the ARG abundance directly. Class 1 integron-integrase gene (intI1), clinical intI1, and Tn21 associated more frequently with ARGs in the AS over long-term, suggesting the potential of them involved in horizontal gene transfer. Both intI1 and clinical intI1 had significantly positive associations with the overall abundance of ARGs, as well as significantly negative relationships with the overall removal rates of ARGs in the MBR. However, the abundances between intI1 and clinical intI1 were significantly different. Meanwhile, clinical intI1 remained rather consistent proportion with the ARG abundance in the AS and permeate, was stronger correlated with human pathogens, and was associated with greater number of ARGs over time. Moreover, clinical intI1 was significantly associated with the removal efficiency of ARGs from all classes. Taken together, clinical intI1 can be adopted as an indicator for the abundance and removal efficiency of ARGs in the WWTP.

Microbial electro-Fenton: A promising system for antibiotics resistance genes degradation and energy generation

The widespread use of antibiotics has accelerated the development of antibiotic resistance genes (ARGs), which are now recognized as emerging environmental contaminants that pose a high risk to public health. In this study, simultaneous antibiotic and ARGs removal and bioelectricity generation was explored in a microbial electro-Fenton system using erythromycin (ERY) as a model antibiotic compound. The results showed that ERY could be degraded, with an average removal efficiency of 88.73% in 48 h, and the average removal efficiency of chemical oxygen demand in the microbial electro-Fenton with 50 μg L^-1 ERY reached 86.84% in 48 h, which was lower than that in the control group (89.11%). The produced ARGs were analyzed and degraded in a cathode chamber. The quantity of ermB was significantly reduced, with log removal reaching a value of 1.96. More importantly, all erm genes (ermB, ermC, ermG) showed a tendency to be degraded. Furthermore, the maximum power density obtained with respect to the electrode area was 0.193 W m^-2 when ERY was added, corresponding to a current density of 0.583 A m^-2 (external resistor = 1000 Ω), which was 14% larger than that of the control group (0.169 W m^-2). The results of this study demonstrate the potential of microbial electro-Fenton for ERY and ARGs removal.

Distribution of antibiotic resistance genes and bacteria from six atmospheric environments: Exposure risk to human

Antibiotic resistance genes (ARGs), as an emerging environmental pollutant, have received widespread attention. There are many studies on ARGs in water and soil. However, there are few studies on airborne ARGs. We used qPCR to detect 19 ARG subtypes in six atmospheric environments. Among the different atmospheric environments including wastewater treatment plant (fine screens and sludge thickener), bathroom, laboratory, hospital and outdoor, the highest total concentration of ARGs is detected in the haze outdoor (9 × 10⁵ copies/m³), while the lowest is in the bathroom atmosphere (4.2 × 10⁴ copies/m³). Furthermore, β-lactam ARGs are found to be the dominant ARGs in these 6 atmospheric environments. Due to the large number and widespread use of antibiotics, the airborne ARGs in hospital have the highest diversity and equitability. The β-lactam ARGs are significantly positively correlated with sulfonamides ARGs, indicating the mechanism of co-resistance since these two ARGs may be on the same genetic elements and thus simultaneously exhibit both resistances. The network analysis provides potential host information between the airborne ARGs and the coexisted microbial taxa. Sphingomonas and Bradyhizoblum strains presumably host for tetracycline and β-lactam ARGs, respectively. The ADD_outdoor of bla_TEM-1 was 7.8 × 10⁵ copies/d/kg, more than the ADD (7.6 × 10³ copies/d/kg) of bla_TEM-1 by drinking water. We can't ignore ARGs in the atmospheric environments.

Prevalence of Antibiotic Resistance Genes and Their Association with Antibiotics in a Wastewater Treatment Plant: Process Distribution and Analysis

Effluents from wastewater treatment plants has been identified as a main point-source of antibiotics and antibiotic resistance genes in natural water environments. In this study, a typical municipal sewage treatment system in south China was taken as the research object to investigate the effects of each treatment unit on eight target antibiotics (sulfamethoxazole, sulfamethazine, tetracycline hydrochloride, oxytetracycline dihydrate, norfloxacin, ofloxacin, clarithromycin, roxithromycin), 17 antibiotic resistance genes (ARGs) and class 1 integron genes in the system using Accelerated Solvent Extraction-Solid phase extraction-Ultra high Performance Liquid Chromatography-Tandem mass spectrometry (ASE-SPE-UPLC-MS/MS) and real-time fluorescent quantitative PCR (qPCR) and the correlation between them. Seven antibiotics (mainly sulfonamides and tetracyclines, 4.19–141.97 ng·L−1) were detected in the influent, while only sulfamethoxazole, sulfamethazine, ofloxacin, and clarithromycin were detected in the effluent (3.11–16.61 ng·L−1). The tetracycline antibiotics in the wastewater treatment plant (WWTP) were transferred to the sludge phase by adsorption, in which tetracycline hydrochloride and oxytetracycline dihydrate were mostly removed in the aerobic and anaerobic stages, while sulfamethoxazole was mainly removed through biological transformation. Sul I was the most abundant resistance gene, but the WWTP had no obvious effect on its removal. Anaerobic treatment was found to play an important role in tetA, tetQ, and tetX removal. Moreover, correlation analysis revealed that the relative abundance of tetX was significantly correlated with clarithromycin (p = 0.039) and ofloxacin (p = 0.028), while that of tetQ was significantly correlated with sulfamethazine (p = 0.007) and sulfamethoxazole (p = 0.001), and that of tetC was significantly correlated with the class 1 integron gene (p = 0.014). Overall, the results presented herein provide a reference for improving the antibiotics and ARGs removal efficiency of WWTPs in south China.

Growth and antibiotic resistance acquisition of Escherichia coli in a river that receives treated sewage effluent

Wastewater treatment plants could discharge Escherichia coli and antibiotic resistant bacteria to the environment adjacent to, or downstream of their discharge point. However, their discharge also contains nutrients which could promote growth of E. coli in water environments. This study was done to clarify the potential of growth and antibiotic resistance acquisition of E. coli in a river environment. Levels of E. coli were monitored in a river that receives treated sewage effluent for over four years. River water, periphyton and sediment samples were collected at sites upstream and downstream of treated sewage inflow. Concentrations of E. coli increased in river water and periphyton at the sites downstream of the treated sewage inflow, although levels of E. coli were very low or below detection limit in the treated sewage samples. Concentrations of Chlorophyll a increased at the downstream sites, likely due to nutrient input from the treated sewage. Based on pulsed field gel electrophoresis, identical genotype occurred at multiple sites both upstream and downstream of the treated sewage inflow. However, strains resistant to antibiotics such as ampicillin, cefazolin, ciprofloxacin, and chloramphenicol were more frequently obtained from the downstream sites than the upstream sites. Multidrug resistant E. coli strains were detected in periphyton and sediment samples collected at the downstream sites. Non-resistant strains with PDGE genotype identical to the multi-drug strains were also detected, indicating that E. coli might have become resistant to antibiotics by acquiring resistance genes via horizontal gene transfer. Laboratory incubation experiment showed the growth of E. coli in periphyton or sediment-fed river water samples. These results suggest that the wastewater treatment inflow did not directly provide E. coli to the river water, but could promote the growth of periphyton, which could lead to the elevated levels of E. coli and the emergence of antibiotic resistant E. coli.

Antibiotic resistance genes in treated wastewater and in the receiving water bodies: A pan-European survey of urban settings

There is increasing public concern regarding the fate of antibiotic resistance genes (ARGs) during wastewater treatment, their persistence during the treatment process and their potential impacts on the receiving water bodies. In this study, we used quantitative PCR (qPCR) to determine the abundance of nine ARGs and a class 1 integron associated integrase gene in 16 wastewater treatment plant (WWTP) effluents from ten different European countries. In order to assess the impact on the receiving water bodies, gene abundances in the latter were also analysed. Six out of the nine ARGs analysed were detected in all effluent and river water samples. Among the quantified genes, intI1 and sul1 were the most abundant. Our results demonstrate that European WWTP contribute to the enrichment of the resistome in the receiving water bodies with the particular impact being dependent on the effluent load and local hydrological conditions. The ARGs concentrations in WWTP effluents were found to be inversely correlated to the number of implemented biological treatment steps, indicating a possible option for WWTP management. Furthermore, this study has identified bla_OXA-58 as a possible resistance gene for future studies investigating the impact of WWTPs on their receiving water.

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.

Removal of amoxicillin from simulated hospital effluents by adsorption using activated carbons prepared from capsules of cashew of Para

High-surface-area activated carbons were prepared from an agroindustrial residue, Bertholletia excelsa capsules known as capsules of Para cashew (CCP), that were utilized for removing amoxicillin from aqueous effluents. The activated carbons were prepared with the proportion of CCP:ZnCl₂ 1:1, and this mixture was pyrolyzed at 600 (CCP-600) and 700 °C (CCP700). The CCP.600 and CCP.700 were characterized by CHN/O elemental analysis, the hydrophobic/hydrophilic ratio, FTIR, TGA, Boehm titration, total pore volume, and surface area. These analyses show that the adsorbents have different polar groups, which confers a hydrophilic surface. The adsorbents presented surface area and total pore volume of 1457 m² g^-1 and 0.275 cm³ g^-1 (CCP.600) and 1419 m² g^-1 and 0.285 cm³ g^-1 (CCP.700). The chemical and physical properties of the adsorbents were very close, indicating that the pyrolysis temperature of 600 and 700 °C does not bring relevant differences in the physical and chemical properties of these adsorbents. The adsorption data of kinetics and equilibrium were successfully adjusted to Avrami fractional-order and Liu isotherm model. The use of the adsorbents for treatment of simulated hospital effluents, containing different organic and inorganic compounds, showed excellent removals (up to 98.04% for CCP.600 and 98.60% CCP.700). Graphical abstract.

Enhanced inactivation of antibiotic-resistant bacteria isolated from secondary effluents by g-C3N4 photocatalysis

The extensive use of antibiotics has resulted in the development of antibiotic-resistant bacteria (ARB), which may not be completely removed by traditional wastewater treatment processes. More effective approaches to disinfection are needed to prevent the release of ARB into the surface water. The metal-free photocatalyst graphitic carbon nitride (g-C₃N₄) has aroused great interest as a possible agent for water and wastewater treatment, due to its low cytotoxicity and photoactivity with visible light. In this study, the efficacy of g-C₃N₄ was assessed as a possible means to enhance ARB inactivation by irradiation. ARB were isolated and purified from secondary effluents in 4 municipal wastewater treatment plants. Of these, 4 typical multi-drug ARB isolates, belonging to Enterobacteriaceae, were selected for irradiation experiments. Inactivation was seen to increase with irradiation time. At 60 min, the inactivation of the 4 ARB isolates by light at > 300 nm and > 400 nm was in the range of 0.25-0.39 log and 0.16-0.19 log, respectively. The use of g-C₃N₄-mediated photocatalysis at the same wavelengths significantly enhanced that to 0.64-1.26 log and 0.31-0.41 log, respectively. The antibiotic susceptibility of the ARB isolates remained unchanged either prior to or after irradiation and was independent of photon fluence, reaction time, and the presence of g-C₃N₄. This study establishes a baseline for understanding the effectiveness of g-C₃N₄ photocatalysis on inactivation of ARB in wastewaters and lays the foundation for further improvement in the use of photocatalysis for wastewater treatment.

Removal of antibiotic resistance genes in four full-scale membrane bioreactors

Antibiotic resistance genes (ARGs) discharged through wastewater treatment plants (WWTPs) has aroused growing public concern for its risk to human health and ecological safety. Membrane bioreactor (MBR) has been recognized as an effective approach to remove ARGs in full-scale WWTPs, but its advantage over traditional processes was not clearly quantified. To address this, we investigated four full-scale WWTPs containing parallel MBR and traditional processes (oxidation ditch or sequencing batch reactor) to compare the reduction of eight types of ARGs (bla_TEM, ermB, tetW, tetO, sul1, sul2, addD, and qnrS) and int1. In general, MBRs reduced the ARGs (1.1-7.3 log removal) better than parallel processes (0.4-4.2 log removal). Notably, the dominant ARGs in the influent, such as ermB, sul1 and int1 (10^6.39-10^7.79 copies/mL), were more effectively reduced by MBRs (1.5-7.3 log removal) than traditional processes (0.8-3.4 log removal). Meanwhile, the distribution of those ARGs in activated sludge was not significantly different between aforementioned processes (p > 0.05). The separation coefficient (K_sw) was proposed to represent the contribution of solid separation on ARG removal, subsequent analysis revealed surprisingly strong correlation between K_sw values of dominant ARGs (ermB, sul1 and int1) and their log removal by MBR (R = 0.79-0.96, p < 0.05), while such correlation was much weaker in traditional process (R = 0.33-0.37), indicating solid separation was the major pathway for removal of dominant ARGs and int1. According to the canonical correlation analysis between process operation and ARG removal in MBR, sludge retention time (SRT) seemed to be the major factor affecting removal of dominant ARGs and int1. This comparative study can be helpful for further understanding and operating MBR process to reduce the ARGs in effluent.