Moving from the traditional paradigm of pathogen inactivation to controlling antibiotic resistance in water - Role of ultraviolet irradiation

The synergistic bactericidal effect of simultaneous 222 nm krypton-chlorine excilamp and 307 nm UVB light treatment on sliced cheese and its mechanisms

In this study, we investigated the combined effect of 222 nm krypton-chlorine excilamp (EX) and 307 nm ultraviolet-B (UVB) light on the inactivation of Salmonella Typhimurium and Listeria monocytogenes on sliced cheese. The data confirmed that simultaneous exposure to EX and UVB irradiation for 80 s reduced S. Typhimurium and L. monocytogenes population by 3.50 and 3.20 log CFU/g, respectively, on sliced cheese. The synergistic cell count reductions in S. Typhimurium and L. monocytogenes in the combined treatment group were 0.88 and 0.59 log units, respectively. The inactivation mechanism underlying the EX and UVB combination treatment was evaluated using fluorescent staining. The combination of EX and UVB light induced the inactivation of reactive oxygen species (ROS) defense enzymes (superoxide dismutase) and synergistic ROS generation, resulting in synergistic lipid peroxidation and destruction of the cell membrane. There were no significant (P > 0.05) differences in the color, texture, or sensory attributes of sliced cheese between the combination treatment and control groups. These results demonstrate that combined treatment with EX and UVB light is a potential alternative strategy for inactivating foodborne pathogens in dairy products without affecting their quality.

Microbial inactivation kinetics of UV LEDs and effect of operating conditions: A methodological critical analysis

Tiny ultraviolet (UV) light-emitting diodes (LED)s that are replacing the conventional energy-intensive mercury UV lamps have gained interest since the early 2000's because of their promising advantages. In the context of microbial inactivation (MI) of waterborne microbes, disinfection kinetics of those LEDs exhibited variations among studies, in terms of varying the UV wavelength, the exposure time, power, and dose (UV fluence) as well as other operational conditions. While reported results may appear contradictory when examined separately, they probably are not when analyzed collectively. As such, in this study, we carry out a quantitative collective regression analysis of the reported data to shed light on the kinetics of MI by the emerging UV LEDs technology alongside the effects of varying operational conditions. The main goal is to identify dose response requirements for UV LEDs and to compare them to traditional UV lamps in addition to ascertaining optimal settings that could help in achieving the optimal inactivation outcome for comparable UV doses. The analysis showed that kinetically, UV LEDs are as effective as conventional mercury lamps for water disinfection, and at times more effective, especially for UV resistant microbes. We defined the maximal efficiency at two wavelengths, 260-265 nm and 280 nm, among a wide range of available LED wavelengths. We also defined the UV fluence per log inactivation of tested microbes. At the operational level, we identified existing gaps and developed a framework for a comprehensive analysis program for future needs.

Inactivation of the waterborne marine pathogen Vibrio alginolyticus by photo-chemical processes driven by UV-A, UV-B, or UV-C LED combined with H2O2 or HSO5. WATER RESEARCH 2023;232:119686. [PMID: 36764105 DOI: 10.1016/j.watres.2023.119686]

Ultraviolet (UV) radiation is a well-implemented process for water disinfection. The development of emergent UV sources, such as light-emitting diodes (LEDs), has afforded new possibilities for advanced oxidation processes. The emission wavelength is considered to be an important factor for photo-chemical processes in terms of both biological damage and energetic efficiency, as the inactivation mechanisms and mode-of-action may differ according to the wavelength that is applied. In addition, these processes merit exploration for inactivating emerging pathogens, such as marine vibrios, that are important bacteria to control in maritime activities. The main goal of this study was to compare the disinfection efficacy of several UV-LED driven processes with different modes of action. First, the effect of UV-LEDs was assessed at different UV ranges (UV-A, UV-B, or UV-C). Second, the possible enhancement of a combination with hydrogen peroxide (H₂O₂) or peroxymonosulfate salt (HSO₅^-) was investigated under two different application strategies, i.e. simultaneous or sequential. The results obtained indicate a high sensitivity of Vibrio alginolyticus to UV radiation, especially under UV-B (k_obs = 0.24 cm²/mJ) and UV-C (k_obs = 1.47 cm²/mJ) irradiation. The highest inactivation rate constants were obtained for UV/HSO₅^- (k_obs (cm²/mJ)=0.0007 (UV-A); 0.39 (UV-B); 1.79 (UV-C)) with respect to UV/H₂O₂ (k_obs (cm²/mJ)=0.0006 (UV-A); 0.26 (UV-B); and 1.54 (UV-C)) processes, however, regrowth was avoided only with UV/H₂O₂. Additionally, the disinfection enhancement caused by a chemical addition was more evident in the order UV-A > UV-B > UV-C. By applying H₂O₂ (10 mg/L) or HSO₅^- (2.5 mg/L) in a sequential mode before the UV, negligible effects were obtained in comparison with the simultaneous application. Finally, promising electrical energy per order (EE_O) values were obtained as follows: UV/HSO₅^- (EE_O (kWh/m³)=1.68 (UV-A); 0.20 (UV-B); 0.04 (UV-C)) and UV/H₂O₂ (EE_O (kWh/m³)=2.15 (UV-A); 0.32 (UV-B); 0.04 (UV-C)), demonstrating the potential of UV-LEDs for disinfection in particular activities such as the aquaculture industry or maritime transport.

Life cycle energy use and greenhouse gas emissions for a novel algal-osmosis membrane system versus conventional advanced potable water reuse processes: Part I

This study applied a life cycle assessment (LCA) methodology for a comparative environmental analysis between an innovative algae resource recovery and near zero-liquid discharge potable reuse system (i.e., the main system) versus a conventional potable reuse system (i.e., the benchmark system) through energy use and greenhouse gas (GHG) emissions. The objective of this study is to demonstrate that pilot-scale data coupled with LCA would provide valuable information for system optimization, integration, and improvements for the design of environmentally sustainable full-scale systems. This study also provides decision-makers valuable information regarding the energy demand and environmental impact of this innovative main system compared to a typical tried-and-true system for potable water reuse. The main system consists of a novel algal-based wastewater treatment coupled with a dual forward osmosis and seawater reverse osmosis (Algal FO-SWRO) membranes system for potable water recovery and hydrothermal liquefaction (HTL) to recover biofuels and valuable nutrients from the harvested algal biomass. The benchmark system refers to the current industry standard technologies for potable water reuse and waste management including a secondary biological treatment, microfiltration (MF), brackish water reverse osmosis (BWRO), ultraviolet/advanced oxidation process (UV-AOP), and granular activated carbon (GAC), as well as anaerobic digestion for sludge treatment. Respective energy and GHG emissions of both systems were normalized and compared considering 1 m³ of water recovered. Based on an overall water recovery of 76% designed for the benchmark system, the energy consumption totaled 4.83 kWh/m³, and the system was estimated to generate 2.42 kg of CO₂ equivalent/m³ with most of the emissions coming from the biological treatment. The main system, based on an overall water recovery of 88%, was estimated to consume 4.76 kWh/m³ and emit 1.49 kg of CO₂ eq/m³. The main system has high environmental resilience and can recover bioenergy and nutrients from wastewater with zero waste disposal. With the application of energy recovery devices for the HTL and the SWRO, increase in water recovery of the FO membrane, and replacement of the SWRO membrane with BWRO, the main system provides an energy-competitive and environmentally positive alternative with an energy demand of 2.57 kWh/m³ and low GHG emissions of 0.94 kg CO₂ eq/m³.

Inactivation of antibiotic-resistant bacteria and antibiotic-resistance genes in wastewater streams: Current challenges and future perspectives

The discovery of antibiotics, which was once regarded as a timely medical intervention now leaves a bitter aftertaste: antimicrobial resistance (AMR), due to the unregulated use of these compounds and the poor management receiving wastewaters before discharge into pristine environments or the recycling of such treated waters. Wastewater treatment plants (WWTPs) have been regarded a central sink for the mostly unmetabolized or partially metabolised antibiotics and is also pivotal to the incidence of antibiotic resistance bacteria (ARBs) and their resistance genes (ARGs), which consistently contribute to the global disease burden and deteriorating prophylaxis. In this regard, we highlighted WWTP-antibiotics consumption-ARBs-ARGs nexus, which might be critical to understanding the epidemiology of AMR and also guide the precise prevention and remediation of such occurrences. We also discovered the unsophistication of conventional WWTPs and treatment techniques for adequate treatment of antibiotics, ARBs and ARGs, due to their lack of compliance with environmental sustainability, then ultimately assessed the prospects of cold atmospheric plasma (CAP). Herein, we observed that CAP technologies not only has the capability to disinfect wastewater polluted with copious amounts of chemicals and biologicals, but also have a potential to augment bioelectricity generation, when integrated into bio electrochemical modules, which future WWTPs should be retrofitted to accommodate. Therefore, further research should be conducted to unveil more of the unknowns, which only a snippet has been highlighted in this study.

New and traditional methods for antibiotic resistance genes removal: Constructed wetland technology and photocatalysis technology

Antibiotic resistance genes (ARGs) are a new environmental contaminant that poses a major hazard to humans and the environment. This research discusses the methods and drawbacks of two ARG removal approaches, constructed wetlands (CWs) and photocatalysis. CWs primarily rely on the synergistic effects of substrate adsorption, plant uptake, and microbial processes to remove ARGs. The removal of ARGs can be influenced by wetland plants, substrate type, wetland type, and hydraulic conditions. The absolute abundance of ARGs in effluent decreased, but their relative abundance increased. Photocatalysis deactivates ARGs predominantly through reactive oxygen species, with removal effectiveness determined by catalyst type, radiation type, and radiation intensity. The drawback is that it exposes intracellular resistance genes, perhaps increasing the risk of ARG spread. To address the current shortcomings, this paper proposes the feasibility of combining a constructed wetland with photocatalysis technology, which provides a novel strategy for ARG removal.

Removal of persistent organic pollutants and disinfection of pathogens from secondary treated municipal wastewater using advanced oxidation processes

An affordable and sustainable tertiary treatment is imperative to solve the secondary contamination issues related to wastewater reuse. To decontaminate and disinfect the actual secondary treated wastewater, various types of advanced oxidation processes (AOPs) have been studied. The optimization of the oxidant and catalyst is carried out to identify the best-performing system. Under selected experimental conditions, UV/peroxymonosulfate (PMS), O₃/PMS, UV/MnO₂, O₃/MnO₂, UV/O₃/H₂O₂, O₃/MnO₂/H₂O₂, UV/MnO₂/H₂O₂, and UV/O₃/MnO₂ has been identified as an efficient treatment option for simultaneous decontamination (>90% COD removal) and disinfection (100% inactivation of the total viable count of bacteria). The techno-economic assessment revealed that UV/MnO₂ (23.5 $ kg^-1 of COD) UV/O₃/MnO₂ (37.4 $ kg^-1 of COD), UV/H₂O₂/MnO₂ (36.4 $ kg^-1 of COD), and O₃/MnO₂/H₂O₂ (32.5 $ kg^-1 of COD) are comparatively low-cost treatment processes. Overall, UV/MnO₂, UV/H₂O₂/MnO₂, and O₃/MnO₂/H₂O₂ are the three best treatments. Nevertheless, further investigation on by-product and catalyst toxicity/recovery is needed. The results showed that AOPs are a technologically feasible treatment for simultaneously removing persistent organic pollutants and pathogens from secondary treated wastewater.

Solar-light driven photodegradation of antimicrobials, their transformation by-products and antibiotic resistance determinants in treated wastewater

This study aimed to assess the possibility of using solar light-driven photolysis and TiO₂-based photocatalysis to remove (1) antibiotic residues, (2) their transformation products (TPs), (3) antibiotic resistance determinants, and (4) genes identifying the indicator bacteria in a treated wastewater (secondary effluent). 16 antimicrobials belonging to the different classes and 45 their transformation by-products were selected for the study. The most susceptible to photochemical decomposition was tetracycline, which was completely removed in the photocatalysis process and in more than 80% in the solar light-driven photolysis. 83.8% removal (on average) was observed using photolysis and 89.9% using photocatalysis in the case of the tested genes, among which the genes sul1, uidA, and intI1 showed the highest degree of removal by both methods. The study revealed that applied methods promisingly remove the tested antibiotics, their TPs and genes even in such a complex matrix including treated wastewater and photocatalysis process had a higher removal efficiency of antibiotics, TPs and genes tested. Moreover, the high percentage removal of the intI1 gene (>93%) indicates the possibilities of use of the solar light-driven photolysis and TiO₂-based photocatalysis in minimizing the antibiotic resistance genes transfer by mobile genetic elements.

Fate of antibiotic resistant genes in wastewater environments and treatment strategies - A review

Antibiotic-resistant bacteria (ARB) and antibiotic-resistant genes (ARGs) have emerged in aquatic environments through the discharge of large amounts of antibiotics into wastewater. Well-designed wastewater treatment plants (WWTPs) with effective treatment processes are essential to prevent the release of ARGs directly into the environment. Although some systematic sequential treatment methods are used to remove ARGs, considerable gaps in removal mechanisms will be discussed. Therefore, deep analysis and discussion of various treatment methods are required to understand the ARGs removal mechanisms. In this manuscript, the role of antibiotics and the resistance mechanism of ARB are discussed in depth. In addition, the fate of ARGs in an aquatic environment and detection methods are compared comprehensively and discussed. In particular, the advantages and disadvantages of various methods are summarized and reviewed critically. Finally, combined technologies, such as advanced oxidation process (AOP) with biochemical systems, membrane separation with electrochemical AOP, ultrafiltration (UF) membrane coupled with photocatalytic treatment, and UF membrane separation coupled with sonication, are introduced. Overall, low-energy anaerobic treatment reactors with any of the above combined treatments might reduce the discharge of large quantities of ARGs into the environment. Finally, this review provides valuable insights for better ARG removal technologies by introducing combined effective treatment strategies used in real WWTPs.

Retention and Inactivation of Quality Indicator Bacteria Using a Photocatalytic Membrane Reactor

The development of effective disinfection treatment processes is crucial to help the water industry cope with the inevitable challenges resulting from the increase in human population and climate change. Climate change leads to heavy rainfall, flooding and hot weather events that are associated with waterborne diseases. Developing effective treatment technologies will improve our resilience to cope with these events and our capacity to safeguard public health. A submerged hybrid reactor was used to test the efficiency of membrane filtration, direct photolysis (using ultraviolet-C low-pressure mercury lamps, as well as ultraviolet-C and ultraviolet-A light-emitting diodes panels) and the combination of both treatment processes (membrane filtration and photolysis) to retain and inactivate water quality indicator bacteria. The developed photocatalytic membranes effectively retained the target microorganisms that were then successfully inactivated by photolysis and advanced oxidation processes. The new hybrid reactor could be a promising approach to treat drinking water, recreational water and wastewater produced by different industries in small-scale systems. Furthermore, the results obtained with membranes coated with titanium dioxide and copper combined with ultraviolet-A light sources show that the process may be a promising approach to guarantee water disinfection using natural sunlight.

Simultaneous removal of antibiotic resistant bacteria and antibiotic resistance genes by molybdenum carbide assisted electrochemical disinfection

Considering conventional disinfection methods are not effective in simultaneously removing ARB and ARGs, a novel electrochemical disinfection (ED) process assisted by molybdenum carbide (Mo₂C) electrodes was developed in this study. The established ED process was proved to effectively inactivate multi-resistant ARB (i.e. Escherichia coli K-12 LE392 with resistance to kanamycin, ampicillin, and tetracycline) and to degrade ARGs (including tetA and bla_TEM in the form of both intracellular (iARGs) and extracellular ARGs (eARGs)). Specifically, within 15 min treatment by the Mo₂C-assisted ED under 2.0 V, a 5-log ARB removal was realized, without any ARB regrowth observed, indicating a permanent inactivation of ARB by the process. Moreover, degradation of the iARGs (0.4-log reduction of the bla_TEM and 3.1-log reduction of the tetA) and the eARGs (4.2-log reduction of the bla_TEM and 1.1-log reduction of the tetA) were achieved within 60 min, further underpinning the viability of the Mo₂C-based ED. While e^-, H₂O₂, and •O₂^- played leading roles in the entire process of ED, H⁺ and •OH contributed to bacterial inactivation in the early and late stages of ED, respectively. The reactive species induced by electrolysis posed pressure to the ARB strains, which enhanced oxidative stress response, triggered higher reactive oxygen species generation, induced membrane damage and changed cellular structure. Collectively, the Mo₂C-assisted ED demonstrated in the present study represents an attractive alternative to the traditional disinfection methods in combating the spread of antibiotic resistance.

Persistence of wastewater-associated antibiotic resistant bacteria in river microcosms

The spread of antibiotic-resistant bacteria (ARB) associated with wastewater is a significant environmental concern, but little is known about the persistence and proliferation of these organisms in receiving water bodies after discharge. To address this knowledge gap, we performed a series of microcosm experiments in which river water was amended with either untreated or treated wastewater, and the abundance of viable ciprofloxacin-, Bactrim-, and erythromycin-resistant bacteria was monitored for 72 h. Both types of wastewater amendments significantly increased the initial abundance of ARB compared to microcosms containing only river water (all p < 0.03). The increase was greatest with untreated wastewater, but that effect decreased steadily over time. In contrast, microcosms amended with treated wastewater saw a smaller initial increase and more complex temporal dynamics. Following a brief lag, ARB abundance bloomed for all three of the antibiotics that we considered. This suggests that ARB that survive wastewater treatment are particularly hardy and may proliferate in riverine conditions after a short recovery period. To determine how interactions with the native river microbial community impacted the persistence of wastewater-associated ARB, an additional set of microcosms was prepared using filter-sterilized river water. Peak abundance in these microcosms was significantly higher by 1-2 orders of magnitude compared to microcosms containing an intact river microbial community (all p < 0.05), which suggests that biotic interactions play a significant role in regulating the persistence and proliferation of ARB. The data presented in this paper are among the first available that specifically consider persistence of viable ARB and represent an important step toward understanding AR-related human health risks downstream from wastewater discharge points and following sewer overflow events. Additional studies that consider longer time scales and the interplay of biotic and abiotic variables are essential for modeling public health risks associated with wastewater inputs of ARB to rivers and other aquatic environments.

Effect of ozonation-based disinfection methods on the removal of antibiotic resistant bacteria and resistance genes (ARB/ARGs) in water and wastewater treatment: a systematic review

Antibiotic resistance is considered a universal health threat of the 21st century which its distribution and even development are mainly mediated by water-based media. Disinfection processes with the conventional methods are still the most promising options to combat such crises in aqueous matrices especially wastewater. Knowing that the extent of effectiveness and quality of disinfection is of great importance, this paper aimed to systematically review and discuss ozonation (as one of the main disinfectants with large scale application) effect on removing antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) from aqueous solutions, for which no study has been reported. For this, a comprehensive literature survey was performed within the international databases using appropriate keywords which yielded several studies involving different aspects and the effectiveness extent of ozonation on ARB & ARGs. The results showed that no definite conclusion could be drawn about the superiority of ozone alone or in a hybrid form. Mechanism of action was carefully evaluated and discussed although it is still poorly understood. Evaluation of the studies from denaturation and repairment perspectives showed that regrowth cannot be avoided after ozonation, especially for some ARB & ARGs variants. In addition, the comparison of the effectiveness on ARB & ARGs showed that ozonation is more effective for resistant bacteria than their respective genes. The degradation efficiency was found to be mainly influenced by operational parameters of CT (i.e. ozone dose & contact time), solids, alkalinity, pH, and type of pathogens and genes. Moreover, the correlation between ARB & ARGs removal and stressors (such as antibiotic residuals, heavy metals, aromatic matters, microcystins, opportunistic pathogens, etc.) has been reviewed to give the optimal references for further in-depth studies. The future perspectives have also been reported.

Effects and relevant mechanisms of non-antibiotic factors on the horizontal transfer of antibiotic resistance genes in water environments: A review

Antibiotic resistance has created obstacles in the treatment of infectious diseases with antibiotics. The horizontal transfer of antibiotic resistance genes (ARGs) can exacerbate the dissemination of antibiotic resistance in water environments. In addition to antibiotic selective pressure, multiple non-antibiotic factors can affect the horizontal transfer of ARGs. Herein, we seek to comprehensively review the effects and relevant mechanisms of non-antibiotic factors on the horizontal transfer of ARGs in water environments, especially contaminants from human activities and water treatment processes. Four pathways have been identified to accomplish horizontal gene transfer (HGT), i.e., conjugation, transformation, transduction, and vesiduction. Changes in conjugative frequencies by non-antibiotic factors are mainly related to their concentrations, which conform to hormesis. Relevant mechanisms involve the alteration in cell membrane permeability, reactive oxygen species, SOS response, pilus, and mRNA expression of relevant genes. Transformation induced by extracellular DNA may be more vulnerable to non-antibiotic factors than other pathways. Except bacteriophage infection, the effects of non-antibiotic factors on transduction exhibit many similarities with that of conjugation. Given the secretion of membrane vesicles stimulated by non-antibiotic factors, their effects on vesiduction can be inferred. Furthermore, contaminants from human activities at sub-inhibitory or environmentally relevant concentrations usually promote HGT, resulting in further dissemination of antibiotic resistance. The horizontal transfer of ARGs is difficult to be inhibited by individual water treatment processes (e.g., chlorination, UV treatment, and photocatalysis) unless they attain sufficient intensity. Accordingly, the synergistic application containing two or more water treatment processes is recommended. Overall, we believe this review can elucidate the significance for risk assessments of contaminants from human activities and provide insights into the development of environment-friendly and cost-efficient water treatment processes to inhibit the horizontal transfer of ARGs.

From Conventional Disinfection to Antibiotic Resistance Control-Status of the Use of Chlorine and UV Irradiation during Wastewater Treatment

Extensive use of antibiotics for humans and livestock has led to an enhanced level of antibiotic resistance in the environment. Municipal wastewater treatment plants are regarded as one of the main sources of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in the aquatic environment. A significant amount of research has been carried out to understand the microbiological quality of wastewater with respect to its antibiotic resistance potential over the past several years. UV disinfection has primarily been used to achieve disinfection, including damaging DNA, but there has been an increasing use of chlorine and H₂O₂-based AOPs for targeting genes, including ARGs, considering the higher energy demands related to the greater UV fluences needed to achieve efficient DNA damage. This review focuses on some of the most investigated processes, including UV photolysis and chlorine in both individual and combined approaches and UV advanced oxidation processes (AOPs) using H₂O₂. Since these approaches have practical disinfection and wastewater treatment applications globally, the processes are reviewed from the perspective of extending their scope to DNA damage/ARG inactivation in full-scale wastewater treatment. The fate of ARGs during existing wastewater treatment processes and how it changes with existing treatment processes is reviewed with a view to highlighting the research needs in relation to selected processes for addressing future disinfection challenges.

Prevalence of Bacteria and Antimicrobial Resistance Genes in Hospital Water and Surfaces

Purpose

Antimicrobial resistance (AMR) has become a worldwide environmental and public health problem, causing more than 250,000 deaths per year. Unregulated usage, unsafe hospital practices, and misuse in veterinary contribute to the development of multidrug resistance in various bacteria. Hospital water was hypothesized to be a hotspot for AMR transmission because of (1) increased exposure to antibiotic load, (2) poor drainage and sanitation system, (3) interaction between environmental and clinical microbes. The purpose of the research was to assess the biodiversity and AMR in hospital tap waters.

Methodology

In this study, the microflora of the hospital tap water and hospital surfaces was observed by obtaining water samples from the intensive care unit (ICU), surgical wards, and washrooms. These were processed through membrane filtration and spread on seven different media (Aeromonas Medium, Azide Dextrose Agar, MacConkey Agar, Mannitol Salt Agar, Pseudomonas Cetrimide Agar, Salmonella Shigella Agar, and Thiosulfate Citrate Bile Salts Sucrose Agar). Surface samples were collected from the faucet, basin, and drain and directly spread on the media plates. Isolates were identified using standard bacteriological and biochemical tests.

Kirby-Bauer disk diffusion method was performed using 21 antibiotic disks from 10 different antibiotic classes. They included ampicillin (AMP), amoxicillin (AML), piperacillin-tazobactam (TZP), cefipime (FEP), cefoxitin (FOX), ceftazidime (CAZ), ceftriaxone (CRO), imipenem (IMP), meropenem (MEM), ciprofloxacin (CIP), moxifloxacin (MXF), levofloxacin (LEV), amikacin (AK), gentamicin (CN), tigecycline (TGC), aztreonam (ATM), erythromycin (E), clindamycin (DA), rifampicin (RD), colistin (CT), and chloramphenicol (C). The results were interpreted according to EUCAST guidelines for the antibiogram of the isolates; 38 isolates were selected out of 162 based on different parameters for genotyping and detection of six beta-lactamase genes (blaSHV, blaTEM, blaCTX-M, blaOXA, blaKPC, blaNDM).

Results

Among these 162 isolates, 82 were obtained from water sources and 80 were collected from surfaces (faucet, basin, drain). The isolates included a variety of bacteria including Aeromonas spp. (20%), Klebsiella spp. (13%), Staphylococcus aureus (13%), Pseudomonas spp.(10%), Escherichia coli (9%), Vibrio spp. (8%), Enterococcus spp. (6%), Shigella spp. (6%), Salmonella spp. (4%), Acinetobacter spp. (3%), Staphylococcus epidermitis (3%), Streptococci spp. (2%), Proteus spp. (1%), Citrobacter spp. (1%), and Serratia spp. (1%). A diverse range of microbes were identified including clinically relevant bacteria, which shows that the urban water cycle is already contaminated with multidrug-resistant microflora of the hospital settings. Macrolide and lincosamide showed the highest resistance followed by penicillin, monobactam, and cephalosporins. blaSHV and blaTEM were prevalent in samples. blaNDM was also found which manifests as a real threat since it causes resistance against carbapenems and colistin, antibiotics reserved as a last resort against infections.

Conclusions

This study presented the ground reality of antibiotic resistance in Pakistan and how its subsequent spread poses a great threat to the strides made in the field of medicine and public health. Strict regulations regarding antibiotic usage, hospital effluent, and urban water sanitation must be imposed to curb the devastating effects of this increasing phenomenon.

Deactivation of Caenorhabditis elegans nematodes in drinking water by PMS/UV-C: efficiency and mechanisms

The occurrence and infestations of chlorine-resistant invertebrates in drinking water distributions have attracted concerns on water quality in China, making effective deactivation imperative. This study presents a novel strategy for nematode (Caenorhabditis elegans) deactivation using peroxymonosulfate (PMS)/UV-C. The results indicated that 100% deactivation efficiency was obtained under optimal conditions. An acidic pH and 0.25 mg/L Fe(II) were beneficial to the PMS/UV-C-triggered deactivation of nematodes. A mechanism study demonstrated that [Formula: see text] was activated by UV-C to produce ·OH and [Formula: see text], which resulted in oxidative stress and stimulated the occurrence of cell apoptosis, leading to nematode deactivation. The results reveal PMS/UV-C as an alternative to chlorination in water treatment plants (WTP) or an emergency application when chlorine-resistant invertebrates breed in a second-supply water tank is a promising strategy for disinfection. This approach possessed the advantages of avoiding the production of chlorine disinfection by-products (DBP) and greater efficacy of nematode deactivation. This work will provide ideas for on-going research efforts into chlorine-resistant invertebrate deactivation and eventually achieve the direct drinking of municipal tap water.

ClO2-Loaded Aerogels with Biocide Effect

In this work, the mechanism of chlorine dioxide's (ClO₂) interaction with aerogel surfaces is described for the first time. To determine the mechanism, three types of aerogels (namely, silica, titania, and zirconia composites) were synthesized and characterized using N₂ sorption isotherm analysis, X-ray diffraction analysis, scanning electron microscopy, and X-ray photoelectron spectroscopy. The kinetics of the ClO₂ interaction mechanism was investigated via ClO₂-controlled sorption and desorption at different temperatures. The process was studied through the theoretical calculation of ClO₂ interaction with the aerogel surface. The biocide efficiency of the as-synthesized ClO₂-loaded aerogels on different bacteria strains was investigated, and efficient microorganism extermination was demonstrated. This system is a disinfectant that can find potential applications in various fields.

Disinfection Performance of a Drinking Water Bottle System With a UV Subtype C LED Cap Against Waterborne Pathogens and Heterotrophic Contaminants

The purgaty One systems (cap+bottle) are portable stainless-steel water bottles with UV subtype C (UVC) disinfection capability. This study examines the bottle design, verifies disinfection performance against Escherichia coli, Pseudomonas aeruginosa, Vibrio cholerae, and heterotrophic contaminants, and addresses the public health relevance of heterotrophic bacteria. Bottles were inoculated with deliberately contaminated potable water and disinfection efficacy examined using colony forming unit (CFU) assay for each bacterial strain. The heterotrophic plate count (HPC) method was used to determine the disinfection performance against environmental contaminants at day 0 and after 3days of water in stationary condition without prior UVC exposure. All UVC irradiation experiments were performed under stationary conditions to confirm that the preset application cycle of 55s offers the desired disinfection performance under-tested conditions. To determine effectiveness of purgaty One systems (cap+bottle) in disinfection, inactivation efficacy or log reduction value (LRV) was determined using bacteria concentration between UVC ON condition and controls (UVC OFF). The study utilized the 16S ribosomal RNA (rRNA) gene for characterization of isolates by identifying HPC bacteria to confirm if they belong to groups that are of public health concern. Purgaty One systems fitted with Klaran UVC LEDs achieved 99.99% inactivation (LRV4) efficacy against E. coli and 99.9% inactivation (LRV3) against P. aeruginosa, V. cholerae, and heterotrophic contaminants. Based on the 16S rRNA gene analyses, the study determined that the identified HPC isolates from UVC irradiated water are of rare public health concern. The bottles satisfactorily inactivated the target pathogenic bacteria and HPC contaminants even after 3days of water in stationary condition.

Direct oxidation of peroxymonosulfate under natural solar radiation: Accelerating the simultaneous removal of organic contaminants and pathogens from water

This study investigates the effectiveness of non-activated peroxymonosulfate (PMS) as oxidative agent for water purification in the presence and absence of natural solar radiation. The inactivation of three pathogens (Escherichia coli, Enterococcus faecalis and Pseudomonas aeruginosa) and degradation of three Contaminants of Emerging Concern (CECs) (Trimethoprim-TMP, Sulfamethoxazole-SMX and Diclofenac-DCF) was simultaneously assessed in isotonic water (IW) by testing a wide range of PMS concentrations (from 0.0001 to 0.01 mM). A significant oxidative effect of PMS in darkness was obtained for both bacteria and CEC abatement, but when irradiated with solar light, results demonstrated a great enhancement on all bacterial kinetic rates, reaching >5 Log reduction in 30 min (1.5 kJL^-1 of Q_UV) with 0.005 mM of oxidant as the best concentration. For CECs, higher degradation performance was obtained with 0.01 mM, 80% removal of DCF, SMX and TMP was achieved in 16 min (1.5 kJL^-1), 27 min (9.4 kJL^-1) and 150 min (16.8 kJL^-1), respectively. Besides, the influence of inorganic species on the global PMS/solar system performance was assessed by testing its effectiveness in distilled water (DW), natural well water (WeW) and diluted well water (d-WeW) at 0.01 mM. Results revealed that (i) high chloride concentration (IW) has an important positive effect, (ii) the presence of a complex inorganic chemical water composition reduced the system efficiency (WeW), and (iii) no differences were obtained from the presence of low or high contents of carbonates/bicarbonates (WeW versus d-WeW), obtaining the following global PMS/solar efficiency performance order: IW > DW > WeW = d-WeW.

UV-C Peroxymonosulfate Activation for Wastewater Regeneration: Simultaneous Inactivation of Pathogens and Degradation of Contaminants of Emerging Concern

This study explores the capability of Sulfate Radical-based Advanced Oxidation Processes (SR-AOPs) for the simultaneous disinfection and decontamination of urban wastewater. Sulfate and hydroxyl radicals in solution were generated activating peroxymonosulfate (PMS) under UV-C irradiation at pilot plant scale. The efficiency of the process was assessed toward the removal of three CECs (Trimethoprim (TMP), Sulfamethoxazole (SMX), and Diclofenac (DCF)) and three bacteria (Escherichia coli, Enterococcus spp., and Pseudomonas spp.) in actual urban wastewater (UWW), obtaining the optimal value of PMS at 0.5 mmol/L. Under such experimental conditions, bacterial concentration ≤ 10 CFU/100 mL was reached after 15 min of UV-C treatment (0.03 kJ/L of accumulative UV-C radiation) for natural occurring bacteria, no bacterial regrowth was observed after 24 and 48 h, and 80% removal of total CECs was achieved after 12 min (0.03 kJ/L), with a release of sulfate ions far from the limit established in wastewater discharge. Moreover, the inactivation of Ampicillin (AMP), Ciprofloxacin (CPX), and Trimethoprim (TMP) antibiotic-resistant bacteria (ARB) and reduction of target genes (ARGs) were successfully achieved. Finally, a harmful effect toward the receiving aquatic environment was not observed according to Aliivibrio fischeri toxicity tests, while a slightly toxic effect toward plant growth (phytotoxicity tests) was detected. As a conclusion, a cost analysis demonstrated that the process could be feasible and a promising alternative to successfully address wastewater reuse challenges.

Antimicrobials and Food-Related Stresses as Selective Factors for Antibiotic Resistance along the Farm to Fork Continuum

Antimicrobial resistance (AMR) is a global problem and there has been growing concern associated with its widespread along the animal-human-environment interface. The farm-to-fork continuum was highlighted as a possible reservoir of AMR, and a hotspot for the emergence and spread of AMR. However, the extent of the role of non-antibiotic antimicrobials and other food-related stresses as selective factors is still in need of clarification. This review addresses the use of non-antibiotic stressors, such as antimicrobials, food-processing treatments, or even novel approaches to ensure food safety, as potential drivers for resistance to clinically relevant antibiotics. The co-selection and cross-adaptation events are covered, which may induce a decreased susceptibility of foodborne bacteria to antibiotics. Although the available studies address the complexity involved in these phenomena, further studies are needed to help better understand the real risk of using food-chain-related stressors, and possibly to allow the establishment of early warnings of potential resistance mechanisms.

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

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

Multiscale Metal Oxide Particles to Enhance Photocatalytic Antimicrobial Activity against Escherichia coli and M13 Bacteriophage under Dual Ultraviolet Irradiation

Antimicrobial activity of multiscale metal oxide (MO) particles against Escherichia coli (E. coli) and M13 bacteriophage (phage) was investigated under dual ultraviolet (UV) irradiation. Zinc oxide (ZnO), magnesium oxide (MgO), cuprous oxide (Cu₂O), and cupric oxide (CuO) were selected as photocatalytic antimicrobials in MO particles. Physicochemical properties including morphology, particle size/particle size distribution, atomic composition, crystallinity, and porosity were evaluated. Under UV-A and UV-C irradiation with differential UV-C intensities, the antimicrobial activity of MO particles was monitored in E. coli and phage. MO particles had nano-, micro- and nano- to microscale sizes with irregular shapes, composed of atoms as ratios of chemical formulae and presented crystallinity as pure materials. They had wide-range specific surface area levels of 0.40–46.34 m²/g. MO particles themselves showed antibacterial activity against E. coli, which was the highest among the ZnO particles. However, no viral inactivation by MO particles occurred in phage. Under dual UV irradiation, multiscale ZnO and CuO particles had superior antimicrobial activities against E. coli and phage, as mixtures of nano- and microparticles for enhanced photocatalytic antimicrobials. The results showed that the dual UV-multiscale MO particle hybrids exhibit enhanced antibiotic potentials. It can also be applied as a next-generation antibiotic tool in industrial and clinical fields.

Treatment Processes for Microbial Resistance Mitigation: The Technological Contribution to Tackle the Problem of Antibiotic Resistance

Advances generated in medicine, science, and technology have contributed to a better quality of life in recent years; however, antimicrobial resistance has also benefited from these advances, creating various environmental and health problems. Several determinants may explain the problem of antimicrobial resistance, such as wastewater treatment plants that represent a powerful agent for the promotion of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARG), and are an important factor in mitigating the problem. This article focuses on reviewing current technologies for ARB and ARG removal treatments, which include disinfection, constructed wetlands, advanced oxidation processes (AOP), anaerobic, aerobic, or combined treatments, and nanomaterial-based treatments. Some of these technologies are highly intensive, such as AOP; however, other technologies require long treatment times or high doses of oxidizing agents. From this review, it can be concluded that treatment technologies must be significantly enhanced before the environmental and heath problems associated with antimicrobial resistance can be effectively solved. In either case, it is necessary to achieve total removal of bacteria and genes to avoid the possibility of regrowth given by the favorable environmental conditions at treatment plant facilities.

Problems of conventional disinfection and new sterilization methods for antibiotic resistance control

The problem of bacterial antibiotic resistance has attracted considerable research attention, and the effects of water treatment on antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) are being increasingly investigated. As an indispensable part of the water treatment process, disinfection plays an important role in controlling antibiotic resistance. At present, there were many studies on the effects of conventional and new sterilization methods on ARB and ARGs. However, there is a lack of literature relating to the limitations of conventional methods and analysis of new techniques. Therefore, this review focuses on analyzing the deficiencies of conventional disinfection and the development of new methods for antibiotic resistance control to guide future research. Firstly, we analyzed the effects and drawbacks of conventional disinfection methods, such as chlorine (Cl), ultraviolet (UV) and ozone on antibiotic resistance control. Secondly, we discuss the research progress and shortcomings of new sterilization methods in antibiotic resistance. Finally, we propose suggestions for future research directions. There is an urgent need for new effective and low-cost sterilization methods. Disinfection via UV and chlorine in combination, UV/chlorine showed greater potential for controlling ARGs.

A comparison of photolytic, photochemical and photocatalytic processes for disinfection of recirculation aquaculture systems (RAS) streams

The development of technologically advanced recirculation aquaculture systems (RAS) implies the reuse of water in a high recirculation rate (>90%). One of the most important phases for water management in RAS involves water disinfection in order to avoid proliferation of potential pathogens and related fish diseases. Accordingly, different approaches have been assessed in this study by performing a comparison of photolytic (UV-LEDs) at different wavelengths (λ = 262, 268 and 262 + 268 nm), photochemical (UV-LEDs/H₂O₂, UV-LEDs/HSO₅^- and UV-LEDs/S₂O₈^2-) and photocatalytic (TiO₂/SiO₂/UV-LEDs and ZnO/SiO₂/UV-LEDs) processes for the disinfection of water in RAS streams. Different laboratory tests were performed in batch scale with real RAS stream water and naturally occurring bacteria (Aeromonas hydrophyla and Citrobacter gillenii) as target microorganisms. Regarding photolytic processes, higher inactivation rates were obtained by combining λ_262+268 in front of single wavelengths. Photochemical processes showed higher efficiencies by comparison with a single UV-C process, especially at 10 mg L^-1 of initial oxidant dose. The inactivation kinetic rate constant was improved in the range of 15-38%, with major efficiency for UV/H₂O₂ ∼ UV/HSO₅^- > UV/S₂O₈^2-. According to photocatalytic tests, higher efficiencies were obtained by improving the inactivation kinetic rate constant up to 55% in comparison with a single UV-C process. Preliminary cost estimation was conducted for all tested disinfection methods. Those results suggest the potential application of UV-LEDs as promoter of different photochemical and photocatalytic processes, which are able to enhance disinfection in particular cases, such as the aquaculture industry.

Galvanic Replacement-Enabled Synthesis of In(OH)3/Ag/C Nanocomposite as an Effective Photocatalyst for Ultraviolet C Degradation of Methylene Blue

Sub-10 nm indium metal nanoparticles (In NPs) stabilized on conductive carbon were reacted with silver nitrate in dark conditions in water at room temperature in a galvanic replacement manner to produce an indium hydroxide/silver/carbon nanocomposite (In(OH)3/Ag/C). The chosen carbon imparted colloidal stability, high surface area, and water dispersibility suitable for photodegradation of harmful dyes in water. The size and shape of indium hydroxide and silver nanoparticles produced were found to be 6.6 ± 0.9 nm, similar to that of the In NPs that were started with. The nanocomposite was characterized by transmission electron microscopy, energy dispersive X-ray spectroscopy, powder X-ray diffraction, and thermogravimetric analysis. The galvanic reaction between In NPs and silver nitrate was tracked with UV-vis spectroscopy in a control experiment without a carbon substrate to confirm that the reaction was indeed thermodynamically spontaneous as indicated by the positive electromotive force (EMF) of +1.14 V calculated for In/Ag+ redox couple. The photocatalytic performance of the nanocomposite was evaluated to be approximately 90% under UVC radiation when 10 ppm of methylene blue and 13 wt % of indium hydroxide/silver loading on carbon were used.

Efficacy of UVC-LED in water disinfection on Bacillus species with consideration of antibiotic resistance issue

Ultraviolet light emitting diode (UV-LED) has attracted extensive attention as a new technology to replace traditional mercury lamp for water disinfection. This study reported for the first time the application of UVC-LEDs in range of 200-280 nm for the treatment of two Gram-positive tetracycline resistant bacteria (TRB) from Bacillus species and their tetracycline resistant gene (TRG). The results showed that UVC-LEDs can inactivate TRB up to 5.7-log and inhibit TRG expression, especially at 268 nm. The required fluence was approximate to that of the referential non-resistant bacteria using the same UVC-LED, but far less than that of TRB using mercury lamp. After UVC-LED irradiation, photoreactivation was the dominant mechanism to repair TRB, just like non-resistant bacteria. But contrary to non-resistant bacteria, the regrowth ratio of TRB was remarkably high at 24 h since the end of the irradition, nevertheless the number of the regrown bacteria in the irradiated water was still less than that in the non-irradiated water. Whereas TRB restored resistance after repair even applying 268 nm at a fluence up to 46.08 mJ/cm² (maximum in this study). This study highlights the merits of UVC-LED to effectively inactivate TRB in a prompt, energy-efficient and resistance-reducing way, while future study on TRB regrowth and resistance resilience is needed.

Characterization and evolution of antibiotic resistance of Salmonella in municipal wastewater treatment plants

The objective of this study was to investigate the evolution of antibiotic resistance phenotypes, antibiotic resistance genes (ARGs) and Class 1 integron of Salmonella in municipal wastewater treatment plants (WWTPs). A total of 221 Salmonella strains were isolated from different stages of three WWTPs. After the susceptibility testing, high frequency of resistance was observed for tetracycline (TET, 47.5% of isolates) and sulfamethoxazole (SMZ, 38.5%), followed by ampicillin (AMP, 25.3%), streptomycin (STP, 17.6%), chloramphenicol (CHL, 15.4%), and gentamicin (GEN, 11.3%). Low prevalence of resistance was detected for norfloxacin (0.45%), ciprofloxacin (0.9%), and cefotaxime (0.9%). The tetA and sul3 genes were most frequently detected among the Salmonella isolates. Statistically significant correlations among AMP, CHL, GEN, and STP resistances were observed. High detection frequencies of Class 1 integron were observed in double antibiotic-resistant and multiple-antibiotic-resistant (MAR) Salmonella, which were 94.3% and 85.7%, respectively. The proliferation of MAR Salmonella and transfer of ARGs occurred in WWTPs. Class 1 integron plays a crucial role in the evolution of MAR Salmonella during WWTPs.

Antibiotic microbial resistance (AMR) removal efficiencies by conventional and advanced wastewater treatment processes: A review

The World Health Organization (WHO) has identified the spread of antibiotic resistance as one of the major risks to global public health. An important transfer route into the aquatic environment is the urban water cycle. In this paper the occurrence and transport of antibiotic microbial resistance in the urban water cycle are critically reviewed. The presence of antibiotic resistance in low impacted surface water is being discussed to determine background antibiotic resistance levels, which might serve as a reference for treatment targets in the absence of health-based threshold levels. Different biological, physical and disinfection/oxidation processes employed in wastewater treatment and their efficacy regarding their removal of antibiotic resistant bacteria and antibiotic resistance geness (ARGs) were evaluated. A more efficient removal of antibiotic microbial resistance abundances from wastewater effluents can be achieved by advanced treatment processes, including membrane filtration, ozonation, UV-irradiation or chlorination, to levels typically observed in urban surface water or low impacted surface water.

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

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

Elimination of antibiotic resistance genes and control of horizontal transfer risk by UV-based treatment of drinking water: A mini review

Antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) have been recognized as one of the biggest public health issues of the 21st century. Both ARB and ARGs have been determined in water after treatment with conventional disinfectants. Ultraviolet (UV) technology has been seen growth in application to disinfect the water. However, UV method alone is not adequate to degrade ARGs in water. Researchers are investigating the combination of UV with other oxidants (chlorine, hydrogen peroxide (H2O2), peroxymonosulfate (PMS), and photocatalysts) to harness the high reactivity of produced reactive species (Cl·, ClO·, Cl2·-, ·OH, and SO4·-) in such processes with constituents of cell (e.g., deoxyribonucleic acid (DNA) and its components) in order to increase the degradation efficiency of ARGs. This paper briefly reviews the current status of different UV-based treatments (UV/chlorination, UV/H2O2, UV/PMS, and UV-photocatalysis) to degrade ARGs and to control horizontal gene transfer (HGT) in water. The review also provides discussion on the mechanism of degradation of ARGs and application of q-PCR and gel electrophoresis to obtain insights of the fate of ARGs during UV-based treatment processes.