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Verburg I, Hernández Leal L, Waar K, Rossen JWA, Schmitt H, García-Cobos S. Klebsiella pneumoniae species complex: From wastewater to the environment. One Health 2024; 19:100880. [PMID: 39263320 PMCID: PMC11387367 DOI: 10.1016/j.onehlt.2024.100880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 08/15/2024] [Accepted: 08/15/2024] [Indexed: 09/13/2024] Open
Abstract
Klebsiella pneumoniae plays a significant role in nosocomial infections and spreading antibiotic resistance, and therefore forms a major threat to public health. In this study, we investigated the role of the wastewater pathway in the spread of pathogenic bacteria and more specifically, in the spread of antibiotic resistant Klebsiella pneumoniae subspecies. Whole-genome sequencing was performed of 185 K. pneumoniae isolates collected from hospital, nursing home, and community wastewater, the receiving wastewater treatment plant (WWTP), and clinical isolates from the investigated hospital. K. pneumoniae isolates from different sources were not genetically related, except for WWTP influent (46.5%) and effluent (62.5%), revealing survival of bacteria from wastewater treatment. The content of antibiotic resistance (ARGs), virulence, and plasmid replicon genes differed between K. pneumoniae subspecies and their origin. While chromosomal bla genes were specific for each K. pneumoniae subspecies, bla genes predicted in plasmid contigs were found in several K. pneumoniae subspecies, implying possible gene transfer between subspecies. Transferable ARGs were most abundant in patients and hospital isolates (70%), but the average number of plasmid replicon genes per isolate was similar across all sources, showing plasmid content being more relevant than plasmid quantity. Most patient (90%) and hospital wastewater (34%) isolates were K. pneumoniae subsp. pneumoniae, and the yersiniabactin cluster genes ybt, fyuA, and irp12 were only found in this subspecies, as were the IncFII(pECLA), IncHI2A, and IncHI2 plasmid replicon genes, suggesting the clinical origin of these type of plasmids.
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Affiliation(s)
- Ilse Verburg
- Wetsus, European Centre of Excellence for Sustainable Water Technology, 8900, CC, Leeuwarden, the Netherlands
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9713, GZ, Groningen, the Netherlands
| | - Lucia Hernández Leal
- Wetsus, European Centre of Excellence for Sustainable Water Technology, 8900, CC, Leeuwarden, the Netherlands
| | - Karola Waar
- Certe Medische Microbiologie Friesland, 8900, JA, Leeuwarden, the Netherlands
| | - John W A Rossen
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9713, GZ, Groningen, the Netherlands
| | - Heike Schmitt
- Wetsus, European Centre of Excellence for Sustainable Water Technology, 8900, CC, Leeuwarden, the Netherlands
- Institute for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3721, MA, Bilthoven, the Netherlands
| | - Silvia García-Cobos
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9713, GZ, Groningen, the Netherlands
- Laboratorio de Referencia e Investigación en Resistencia a Antibióticos e Infecciones Relacionadas con la Asistencia Sanitaria, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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2
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Galarde-López M, Velazquez-Meza ME, Godoy-Lozano EE, Carrillo-Quiroz BA, Cornejo-Juárez P, Sassoé-González A, Ponce-de-León A, Saturno-Hernández P, Alpuche-Aranda CM. Presence and Persistence of ESKAPEE Bacteria before and after Hospital Wastewater Treatment. Microorganisms 2024; 12:1231. [PMID: 38930614 PMCID: PMC11206169 DOI: 10.3390/microorganisms12061231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/02/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024] Open
Abstract
The metagenomic surveillance of antimicrobial resistance in wastewater has been suggested as a methodological tool to characterize the distribution, status, and trends of antibiotic-resistant bacteria. In this study, a cross-sectional collection of samples of hospital-associated raw and treated wastewater were obtained from February to March 2020. Shotgun metagenomic sequencing and bioinformatic analysis were performed to characterize bacterial abundance and antimicrobial resistance gene analysis. The main bacterial phyla found in all the samples were as follows: Proteobacteria, Bacteroides, Firmicutes, and Actinobacteria. At the species level, ESKAPEE bacteria such as E. coli relative abundance decreased between raw and treated wastewater, but S. aureus, A. baumannii, and P. aeruginosa increased, as did the persistence of K. pneumoniae in both raw and treated wastewater. A total of 172 different ARGs were detected; blaOXA, blaVEB, blaKPC, blaGES, mphE, mef, erm, msrE, AAC(6'), ant(3″), aadS, lnu, PBP-2, dfrA, vanA-G, tet, and sul were found at the highest abundance and persistence. This study demonstrates the ability of ESKAPEE bacteria to survive tertiary treatment processes of hospital wastewater, as well as the persistence of clinically important antimicrobial resistance genes that are spreading in the environment.
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Affiliation(s)
- Miguel Galarde-López
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Morelos 62100, Mexico; (M.G.-L.); (E.E.G.-L.); (B.A.C.-Q.)
| | - Maria Elena Velazquez-Meza
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Morelos 62100, Mexico; (M.G.-L.); (E.E.G.-L.); (B.A.C.-Q.)
| | - Elizabeth Ernestina Godoy-Lozano
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Morelos 62100, Mexico; (M.G.-L.); (E.E.G.-L.); (B.A.C.-Q.)
| | - Berta Alicia Carrillo-Quiroz
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Morelos 62100, Mexico; (M.G.-L.); (E.E.G.-L.); (B.A.C.-Q.)
| | - Patricia Cornejo-Juárez
- Departamento de Infectología, Instituto Nacional de Cancerología, Tlalpan, Mexico City 14080, Mexico;
| | - Alejandro Sassoé-González
- Unidad de Inteligencia Epidemiológica, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca 56530, Mexico;
| | - Alfredo Ponce-de-León
- Laboratorio Nacional de Máxima Seguridad para el Estudio de Tuberculosis y Enfermedades Emergentes, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Mexico City 14080, Mexico;
| | - Pedro Saturno-Hernández
- Centro de Investigación en Evaluación de Encuestas, Instituto Nacional de Salud Pública, Morelos 62100, Mexico;
| | - Celia Mercedes Alpuche-Aranda
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Morelos 62100, Mexico; (M.G.-L.); (E.E.G.-L.); (B.A.C.-Q.)
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3
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Skof A, Koller M, Baumert R, Hautz J, Treiber F, Kittinger C, Zarfel G. Comparison of the Antibiotic Resistance of Escherichia coli Populations from Water and Biofilm in River Environments. Pathogens 2024; 13:171. [PMID: 38392909 PMCID: PMC10891912 DOI: 10.3390/pathogens13020171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
Antibiotic-resistant, facultative pathogenic bacteria are commonly found in surface water; however, the factors influencing the spread and stabilization of antibiotic resistance in this habitat, particularly the role of biofilms, are not fully understood. The extent to which bacterial populations in biofilms or sediments exacerbate the problem for specific antibiotic classes or more broadly remains unanswered. In this study, we investigated the differences between the bacterial populations found in the surface water and sediment/biofilm of the Mur River and the Drava River in Austria. Samples of Escherichia coli were collected from both the water and sediment at two locations per river: upstream and downstream of urban areas that included a sewage treatment plant. The isolates were subjected to antimicrobial susceptibility testing against 21 antibiotics belonging to seven distinct classes. Additionally, isolates exhibiting either extended-spectrum beta-lactamase (ESBL) or carbapenemase phenotypes were further analyzed for specific antimicrobial resistance genes. E. coli isolates collected from all locations exhibited resistance to at least one of the tested antibiotics; on average, isolates from the Mur and Drava rivers showed 25.85% and 23.66% resistance, respectively. The most prevalent resistance observed was to ampicillin, amoxicillin-clavulanic acid, tetracycline, and nalidixic acid. Surprisingly, there was a similar proportion of resistant bacteria observed in both open water and sediment samples. The difference in resistance levels between the samples collected upstream and downstream of the cities was minimal. Out of all 831 isolates examined, 13 were identified as carrying ESBL genes, with 1 of these isolates also containing the gene for the KPC-2 carbapenemase. There were no significant differences between the biofilm (sediment) and open water samples in the occurrence of antibiotic resistance. For the E. coli populations in the examined rivers, the different factors in water and the sediment do not appear to influence the stability of resistance. No significant differences in antimicrobial resistance were observed between the bacterial populations collected from the biofilm (sediment) and open-water samples in either river. The different factors in water and the sediment do not appear to influence the stability of resistance. The minimal differences observed upstream and downstream of the cities could indicate that the river population already exhibits generalized resistance.
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Affiliation(s)
- Aline Skof
- Institute of Molecular Biosciences, University of Graz, 8010 Graz, Austria; (A.S.); (F.T.)
| | - Michael Koller
- Diagnostic and Research Center for Molecular Biomedicine, Medical University of Graz, 8010 Graz, Austria; (M.K.); (R.B.); (J.H.); (C.K.)
| | - Rita Baumert
- Diagnostic and Research Center for Molecular Biomedicine, Medical University of Graz, 8010 Graz, Austria; (M.K.); (R.B.); (J.H.); (C.K.)
| | - Jürgen Hautz
- Diagnostic and Research Center for Molecular Biomedicine, Medical University of Graz, 8010 Graz, Austria; (M.K.); (R.B.); (J.H.); (C.K.)
| | - Fritz Treiber
- Institute of Molecular Biosciences, University of Graz, 8010 Graz, Austria; (A.S.); (F.T.)
| | - Clemens Kittinger
- Diagnostic and Research Center for Molecular Biomedicine, Medical University of Graz, 8010 Graz, Austria; (M.K.); (R.B.); (J.H.); (C.K.)
| | - Gernot Zarfel
- Diagnostic and Research Center for Molecular Biomedicine, Medical University of Graz, 8010 Graz, Austria; (M.K.); (R.B.); (J.H.); (C.K.)
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Lepper HC, Perry MR, Wee BA, Wills D, Nielsen H, Otani S, Simon M, Aarestrup FM, Woolhouse MEJ, van Bunnik BAD. Distinctive hospital and community resistomes in Scottish urban wastewater: Metagenomics of a paired wastewater sampling design. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 902:165978. [PMID: 37544442 DOI: 10.1016/j.scitotenv.2023.165978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/26/2023] [Accepted: 07/30/2023] [Indexed: 08/08/2023]
Abstract
The wastewater microbiome contains a multitude of resistant bacteria of human origin, presenting an opportunity for surveillance of resistance in the general population. However, wastewater microbial communities are also influenced by clinical sources, such as hospitals. Identifying signatures of the community and hospital resistome in wastewater is needed for interpretation and risk analysis. In this study, we compare the resistome and microbiome of hospital, community, and mixed municipal wastewater to investigate how and why the composition of these different sites differ. We conducted shotgun metagenomic analysis on wastewater samples from eight wastewater treatment plants (WWTPs), four hospitals, and four community sites in Scotland, using a paired sampling design. Cluster analysis and source attribution random forest models demonstrated that the hospital resistome was distinct from community and WWTP resistomes. Hospital wastewater had a higher abundance and diversity of resistance genes, in keeping with evidence that hospitals act as a reservoir and enricher of resistance. However, this distinctive 'hospital' signature appeared to be weak in the resistome of downstream WWTPs, likely due to dilution. We conclude that hospital and community wastewater resistomes differ, with the hospital wastewater representing a reservoir of patient- and hospital environment-associated bacteria. However, this 'hospital' signature is transient and does not overwhelm the community signature in the resistome of the downstream WWTP influent.
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Affiliation(s)
- Hannah C Lepper
- Usher Institute, University of Edinburgh, Ashworth Laboratories, Charlotte Auerbach Road, Edinburgh EH9 3FL, United Kingdom.
| | - Meghan R Perry
- Usher Institute, University of Edinburgh, Ashworth Laboratories, Charlotte Auerbach Road, Edinburgh EH9 3FL, United Kingdom; Clinical Infection Research Group, NHS Lothian Infection Service, Edinburgh, United Kingdom.
| | - Bryan A Wee
- Roslin Institute, University of Edinburgh, Easter Bush Campus, Midlothian EH25 9RG, United Kingdom.
| | - David Wills
- Scottish Water, Currie, Edinburgh EH14 4AP, United Kingdom.
| | - Hanne Nielsen
- National Food Institute, The Technical University of Denmark, Kemitorvet Bygning 202, 2800 Kongens Lyngby, Denmark.
| | - Saria Otani
- National Food Institute, The Technical University of Denmark, Kemitorvet Bygning 202, 2800 Kongens Lyngby, Denmark.
| | - Moray Simon
- Scottish Water, Currie, Edinburgh EH14 4AP, United Kingdom.
| | - Frank M Aarestrup
- National Food Institute, The Technical University of Denmark, Kemitorvet Bygning 202, 2800 Kongens Lyngby, Denmark.
| | - Mark E J Woolhouse
- Usher Institute, University of Edinburgh, Ashworth Laboratories, Charlotte Auerbach Road, Edinburgh EH9 3FL, United Kingdom.
| | - Bram A D van Bunnik
- Roslin Institute, University of Edinburgh, Easter Bush Campus, Midlothian EH25 9RG, United Kingdom.
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5
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Milligan EG, Calarco J, Davis BC, Keenum IM, Liguori K, Pruden A, Harwood VJ. A Systematic Review of Culture-Based Methods for Monitoring Antibiotic-Resistant Acinetobacter, Aeromonas, and Pseudomonas as Environmentally Relevant Pathogens in Wastewater and Surface Water. Curr Environ Health Rep 2023:10.1007/s40572-023-00393-9. [PMID: 36821031 DOI: 10.1007/s40572-023-00393-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE OF REVIEW Mounting evidence indicates that habitats such as wastewater and environmental waters are pathways for the spread of antibiotic-resistant bacteria (ARB) and mobile antibiotic resistance genes (ARGs). We identified antibiotic-resistant members of the genera Acinetobacter, Aeromonas, and Pseudomonas as key opportunistic pathogens that grow or persist in built (e.g., wastewater) or natural aquatic environments. Effective methods for monitoring these ARB in the environment are needed to understand their influence on dissemination of ARB and ARGs, but standard methods have not been developed. This systematic review considers peer-reviewed papers where the ARB above were cultured from wastewater or surface water, focusing on the accuracy of current methodologies. RECENT FINDINGS Recent studies suggest that many clinically important ARGs were originally acquired from environmental microorganisms. Acinetobacter, Aeromonas, and Pseudomonas species are of interest because their ability to persist and grow in the environment provides opportunities to engage in horizontal gene transfer with other environmental bacteria. Pathogenic strains of these organisms resistant to multiple, clinically relevant drug classes have been identified as an urgent threat. However, culture methods for these bacteria were generally developed for clinical samples and are not well-vetted for environmental samples. The search criteria yielded 60 peer-reviewed articles over the past 20 years, which reported a wide variety of methods for isolation, confirmation, and antibiotic resistance assays. Based on a systematic comparison of the reported methods, we suggest a path forward for standardizing methodologies for monitoring antibiotic resistant strains of these bacteria in water environments.
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Affiliation(s)
- Erin G Milligan
- Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, 24061, USA.,Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24061, USA
| | - Jeanette Calarco
- Department of Integrative Biology, University of South Florida, Tampa, FL, 33620, USA
| | - Benjamin C Davis
- Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Ishi M Keenum
- Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Krista Liguori
- Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Amy Pruden
- Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, 24061, USA. .,Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Virginia Polytechnic Institute and State University, Blacksburg, VA, 24061, USA.
| | - Valerie J Harwood
- Department of Integrative Biology, University of South Florida, Tampa, FL, 33620, USA.
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Karengera A, Bao C, Bovee TFH, Dinkla IJT, Murk AJ. A Multiplex Gene Expression Assay for Direct Measurement of RNA Transcripts in Crude Lysates of the Nematode Caenorhabditis elegans Used as a Bioanalytical Tool. ENVIRONMENTAL TOXICOLOGY AND CHEMISTRY 2023; 42:130-142. [PMID: 36282018 PMCID: PMC10107722 DOI: 10.1002/etc.5505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/19/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Gene expression profiling in Caenorhabditis elegans has been demonstrated to be a potential bioanalytical tool to detect the toxic potency of environmental contaminants. The RNA transcripts of genes responding to toxic exposure can be used as biomarkers for detecting these toxins. For routine application in environmental quality monitoring, an easy-to-use multiplex assay is required to reliably quantify expression levels of these biomarkers. In the present study, a bead-based assay was developed to fingerprint gene expression in C. elegans by quantitating messenger RNAs (mRNAs) of multiple target genes directly from crude nematode lysates, circumventing RNA extraction and purification steps. The assay uses signal amplification rather than target amplification for direct measurement of toxin-induced RNA transcripts. Using a 50-gene panel, the expression changes of four candidate reference genes and 46 target mRNAs for various contaminants and wastewaters were successfully measured, and the expression profiles indicated the type of toxin present. Moreover, the multiplex assay response was in line with previous results obtained with more time-consuming reverse-transcription quantitative polymerase chain reaction and microarray analyses. In addition, the transcriptomic profiles of nematodes exposed to wastewater samples and extracts prepared from tissues of swimming crabs were evaluated. The profiles indicated the presence of organic pollutants. The present study illustrates the successful development of a multiplex fluorescent bead-based approach using nematode C. elegans crude lysates for gene expression profiling of target RNAs. This method can be used to routinely fingerprint the presence of toxic contaminants in environmental samples and to identify the most biologically active fraction of the contaminant mixture in a toxicity identification and evaluation approach. Environ Toxicol Chem 2023;42:130-142. © 2022 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.
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Affiliation(s)
- Antoine Karengera
- Department of Animal Sciences, Marine Animal Ecology GroupWageningen UniversityWageningenThe Netherlands
- Wetsus, European Centre of Excellence for Sustainable Water TechnologyLeeuwardenThe Netherlands
| | - Cong Bao
- Department of Animal Sciences, Marine Animal Ecology GroupWageningen UniversityWageningenThe Netherlands
- Department of Analysis and Testing CenterYangtze Delta Region Institute of Tsinghua UniversityJiaxingChina
| | - Toine F. H. Bovee
- Wageningen Food Safety Research, Team Bioassays & BiosensorsWageningen University & ResearchWageningenThe Netherlands
| | - Inez J. T. Dinkla
- Wetsus, European Centre of Excellence for Sustainable Water TechnologyLeeuwardenThe Netherlands
| | - Albertinka J. Murk
- Department of Animal Sciences, Marine Animal Ecology GroupWageningen UniversityWageningenThe Netherlands
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Klatt M, Beyer F, Einfeldt J. Hospital wastewater treatment and the role of membrane filtration - removal of micropollutants and pathogens: A review. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2022; 86:2213-2232. [PMID: 36378176 DOI: 10.2166/wst.2022.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Dissemination of multiresistant bacteria and high concentrations of micropollutants by hospitals and other medical facilities can be significantly reduced by a wide variety of on-site treatment approaches. Membrane filtration technologies, ranging from microfiltration to reverse osmosis, have been adapted in many studies and offer multiple purposes in advanced wastewater treatment configurations. While the direct rejection of pharmaceutical compounds and pathogens can only be achieved with nanofiltration and reverse osmosis processes, porous membranes are known for their pathogen removal capabilities and can be used in combination with other advanced treatment approaches, such as oxidation and adsorption processes. This review was conducted to systematically assess studies with membrane filtration technologies that are used as either stand-alone or hybrid systems for the treatment of hospital wastewater. In this review, four different databases were screened with a pre-set of search strings to thoroughly investigate the application of membrane filtration technology in hospital wastewater treatment. Hybrid systems that combine multiple treatment technologies seem to be the most promising way of consistently removing micropollutants and pathogens from hospital wastewater, but additional economic assessments are needed for an extensive evaluation.
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Affiliation(s)
- Marten Klatt
- Department of Environmental Engineering, Hamburg University of Applied Sciences, Hamburg, Germany E-mail: ; ; Institute of Wastewater Management and Water Protection, Hamburg University of Technology, Hamburg, Germany
| | - Falk Beyer
- Department of Process Engineering, Hamburg University of Applied Sciences, Hamburg, Germany
| | - Jörn Einfeldt
- Department of Environmental Engineering, Hamburg University of Applied Sciences, Hamburg, Germany E-mail: ;
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8
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Karengera A, Verburg I, Sterken MG, Riksen JAG, Murk AJ, Dinkla IJT. Determining Toxic Potencies of Water-Soluble Contaminants in Wastewater Influents and Effluent Using Gene Expression Profiling in C. elegans as a Bioanalytical Tool. ARCHIVES OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2022; 83:284-294. [PMID: 36190544 PMCID: PMC9556352 DOI: 10.1007/s00244-022-00959-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
With chemical analysis, it is impossible to qualify and quantify the toxic potency of especially hydrophilic bioactive contaminants. In this study, we applied the nematode C. elegans as a model organism for detecting the toxic potency of whole influent wastewater samples. Gene expression in the nematode was used as bioanalytical tool to reveal the presence, type and potency of molecular pathways induced by 24-h exposure to wastewater from a hospital (H), nursing home (N), community (C), and influent (I) and treated effluent (E) from a local wastewater treatment plant. Exposure to influent water significantly altered expression of 464 genes, while only two genes were differentially expressed in nematodes treated with effluent. This indicates a significant decrease in bioactive pollutant-load after wastewater treatment. Surface water receiving the effluent did not induce any genes in exposed nematodes. A subset of 209 genes was differentially expressed in all untreated wastewaters, including cytochromes P450 and C-type lectins related to the nematode's xenobiotic metabolism and immune response, respectively. Different subsets of genes responded to particular waste streams making them candidates to fingerprint-specific wastewater sources. This study shows that gene expression profiling in C. elegans can be used for mechanism-based identification of hydrophilic bioactive compounds and fingerprinting of specific wastewaters. More comprehensive than with chemical analysis, it can demonstrate the effective overall removal of bioactive compounds through wastewater treatment. This bioanalytical tool can also be applied in the process of identification of the bioactive compounds via a process of toxicity identification evaluation.
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Affiliation(s)
- Antoine Karengera
- Department of Animal Sciences, Marine Animal Ecology Group, Wageningen University, Droevendaalsesteeg 1, 6708 PB Wageningen, The Netherlands
- Wetsus, European Centre of Excellence for Sustainable Water Technology, Oostergoweg 9, 8911 MA Leeuwarden, The Netherlands
| | - Ilse Verburg
- Wetsus, European Centre of Excellence for Sustainable Water Technology, Oostergoweg 9, 8911 MA Leeuwarden, The Netherlands
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
| | - Mark G. Sterken
- Plant Sciences, Laboratory of Nematology, Wageningen University, Droevendaalsesteeg 1, 6708 PB Wageningen, The Netherlands
| | - Joost A. G. Riksen
- Plant Sciences, Laboratory of Nematology, Wageningen University, Droevendaalsesteeg 1, 6708 PB Wageningen, The Netherlands
| | - Albertinka J. Murk
- Department of Animal Sciences, Marine Animal Ecology Group, Wageningen University, Droevendaalsesteeg 1, 6708 PB Wageningen, The Netherlands
| | - Inez J. T. Dinkla
- Wetsus, European Centre of Excellence for Sustainable Water Technology, Oostergoweg 9, 8911 MA Leeuwarden, The Netherlands
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9
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Degradation of Bacterial Antibiotic Resistance Genes during Exposure to Non-Thermal Atmospheric Pressure Plasma. Antibiotics (Basel) 2022; 11:antibiotics11060747. [PMID: 35740152 PMCID: PMC9219888 DOI: 10.3390/antibiotics11060747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 11/16/2022] Open
Abstract
Bacterial resistance to antibiotics has become a major public health problem in recent years. The occurrence of antibiotics in the environment, especially in wastewater treatment plants, has contributed to the development of antibiotic-resistant bacteria (ARB) and the spread of antibiotic resistance genes (ARGs). Despite the potential of some conventional processes used in wastewater treatment plants, the removal of ARB and ARGs remains a challenge that requires further research and development of new technologies to avoid the release of emerging contaminants into aquatic environments. Non-thermal atmospheric pressure plasmas (NTAPPs) have gained a significant amount of interest for wastewater treatment due to their oxidizing potential. They have shown their effectiveness in the inactivation of a wide range of bacteria in several fields. In this review, we discuss the application of NTAPPs for the degradation of antibiotic resistance genes in wastewater treatment.
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10
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Azizi D, Arif A, Blair D, Dionne J, Filion Y, Ouarda Y, Pazmino AG, Pulicharla R, Rilstone V, Tiwari B, Vignale L, Brar SK, Champagne P, Drogui P, Langlois VS, Blais JF. A comprehensive review on current technologies for removal of endocrine disrupting chemicals from wastewaters. ENVIRONMENTAL RESEARCH 2022; 207:112196. [PMID: 34634314 DOI: 10.1016/j.envres.2021.112196] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 09/22/2021] [Accepted: 10/06/2021] [Indexed: 05/25/2023]
Abstract
In the recent years, endocrine disrupting compounds (EDCs) has received increasing attention due to their significant toxic effects on human beings and wildlife by affecting their endocrine systems. As an important group of emerging pollutant, EDCs have been detected in various aquatic environments, including surface waters, groundwater, wastewater, runoff, and landfill leachates. Their removal from water resources has also been an emerging concern considering growing population as well as reducing access to fresh water resources. EDC removal from wastewaters is highly dependent on physicochemical properties of the given EDCs present in each wastewater types as well as various aquatic environments. Due to chemical, physical and physicochemical diversities in these parameters, variety of technologies consisting of physical, biological, electrochemical, and chemical processes have been developed for their removal. This review highlights that the effectiveness of EDC removal is highly dependent of selecting the appropriate technology; which decision is made upon a full wastewater chemical characterization. This review aims to provide a comprehensive perspective about all the current technologies used for EDCs removal from various aquatic matrices along with rising challenges such as the antimicrobial resistance gene transfer during EDC treatment.
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Affiliation(s)
- Dariush Azizi
- Centre Eau, Terre et Environnement (ETE), Institut National de la Recherche Scientifique (INRS), Université du Québec, 490 Rue de la Couronne, Québec, QC, G1K 9A9, Canada
| | - Ayman Arif
- Beaty Water Research Centre, Department of Civil Engineering, Union Street, Queen's University, Kingston, K7L 3Z6, Canada
| | - David Blair
- Beaty Water Research Centre, Department of Civil Engineering, Union Street, Queen's University, Kingston, K7L 3Z6, Canada
| | - Justine Dionne
- Centre Eau, Terre et Environnement (ETE), Institut National de la Recherche Scientifique (INRS), Université du Québec, 490 Rue de la Couronne, Québec, QC, G1K 9A9, Canada
| | - Yves Filion
- Beaty Water Research Centre, Department of Civil Engineering, Union Street, Queen's University, Kingston, K7L 3Z6, Canada
| | - Yassine Ouarda
- Centre Eau, Terre et Environnement (ETE), Institut National de la Recherche Scientifique (INRS), Université du Québec, 490 Rue de la Couronne, Québec, QC, G1K 9A9, Canada
| | - Ana Gisell Pazmino
- Centre Eau, Terre et Environnement (ETE), Institut National de la Recherche Scientifique (INRS), Université du Québec, 490 Rue de la Couronne, Québec, QC, G1K 9A9, Canada
| | - Rama Pulicharla
- Department of Civil Engineering, Lassonde School of Engineering, York University, Canada
| | - Victoria Rilstone
- Beaty Water Research Centre, Department of Civil Engineering, Union Street, Queen's University, Kingston, K7L 3Z6, Canada
| | - Bhagyashree Tiwari
- Centre Eau, Terre et Environnement (ETE), Institut National de la Recherche Scientifique (INRS), Université du Québec, 490 Rue de la Couronne, Québec, QC, G1K 9A9, Canada
| | - Leah Vignale
- Beaty Water Research Centre, Department of Civil Engineering, Union Street, Queen's University, Kingston, K7L 3Z6, Canada
| | - Satinder Kaur Brar
- Department of Civil Engineering, Lassonde School of Engineering, York University, Canada
| | - Pascale Champagne
- Centre Eau, Terre et Environnement (ETE), Institut National de la Recherche Scientifique (INRS), Université du Québec, 490 Rue de la Couronne, Québec, QC, G1K 9A9, Canada; Beaty Water Research Centre, Department of Civil Engineering, Union Street, Queen's University, Kingston, K7L 3Z6, Canada
| | - Patrick Drogui
- Centre Eau, Terre et Environnement (ETE), Institut National de la Recherche Scientifique (INRS), Université du Québec, 490 Rue de la Couronne, Québec, QC, G1K 9A9, Canada
| | - Valerie S Langlois
- Centre Eau, Terre et Environnement (ETE), Institut National de la Recherche Scientifique (INRS), Université du Québec, 490 Rue de la Couronne, Québec, QC, G1K 9A9, Canada
| | - Jean-François Blais
- Centre Eau, Terre et Environnement (ETE), Institut National de la Recherche Scientifique (INRS), Université du Québec, 490 Rue de la Couronne, Québec, QC, G1K 9A9, Canada.
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11
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Antimicrobial Resistance Patterns and Clonal Distribution of E. coli, Enterobacter spp. and Acinetobacter spp. Strains Isolated from Two Hospital Wastewater Plants. Antibiotics (Basel) 2022; 11:antibiotics11050601. [PMID: 35625245 PMCID: PMC9137823 DOI: 10.3390/antibiotics11050601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 02/01/2023] Open
Abstract
The objective of this study was to determine the presence and persistence of antimicrobial-resistant enterobacteria and their clonal distribution in hospital wastewater. A descriptive cross-sectional study was carried out in wastewater from two Mexico City tertiary level hospitals. In February and March of 2020, eight wastewater samples were collected and 26 isolates of enterobacteria were recovered, 19 (73.1%) isolates were identified as E. coli, 5 (19.2%) as Acinetobacter spp. and 2 (7.7%) as Enterobacter spp. Antimicrobial susceptibility profiles were performed using the VITEK 2® automated system and bacterial identification was performed by the Matrix-Assisted Laser Desorption/Ionization-Time of Flight mass spectrometry (MALDI-TOF MS®). ESBL genes were detected by polymerase chain reaction (PCR) and clonal distributions of isolates were determined by pulsed-field gel electrophoresis (PFGE). E. coli susceptibility to different classes of antimicrobials was analyzed and resistance was mainly detected as ESBLs and fluoroquinolones. One E. coli strain was resistant to doripenem, ertapenem, imipenem and meropenem. The analysis by PCR showed the presence of specific β-lactamases resistance genes (blaKPC, blaCTX-M). The PFGE separated the E. coli isolates into 19 different patterns (A–R). PFGE results of Acinetobacter spp. showed the presence of a majority clone A. Surveillance of antimicrobial resistance through hospital wastewater is an important tool for early detection of clonal clusters of clinically important bacteria with potential for dissemination.
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12
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Li Y, Zhang C, Mou X, Zhang P, Liang J, Wang Z. Distribution characteristics of antibiotic resistance bacteria and related genes in urban recreational lakes replenished by different supplementary water source. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2022; 85:1176-1190. [PMID: 35228362 DOI: 10.2166/wst.2022.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
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).
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Affiliation(s)
- Yongqiang Li
- School of Environmental and Municipal Engineering, Xi'an University of Architecture and Technology, Xi'an, 710055, China E-mail: ; Key Lab of Northwest Water Resource, Environment and Ecology, Ministry of Education, Shaanxi Key Laboratory of Environmental Engineering, Xi'an University of Architecture and Technology, Xi'an, 710055, China
| | - Chongmiao Zhang
- School of Environmental and Municipal Engineering, Xi'an University of Architecture and Technology, Xi'an, 710055, China E-mail: ; Key Lab of Northwest Water Resource, Environment and Ecology, Ministry of Education, Shaanxi Key Laboratory of Environmental Engineering, Xi'an University of Architecture and Technology, Xi'an, 710055, China; International Science and Technology Cooperation Center for Urban Alternative Water Resources Development, Xi'an University of Architecture and Technology, Xi'an, 710055, China
| | - Xiao Mou
- Shaanxi Institute for Food and Drug Control, Xi'an, 710065, China
| | - Peipei Zhang
- School of Environmental and Municipal Engineering, Xi'an University of Architecture and Technology, Xi'an, 710055, China E-mail: ; Key Lab of Northwest Water Resource, Environment and Ecology, Ministry of Education, Shaanxi Key Laboratory of Environmental Engineering, Xi'an University of Architecture and Technology, Xi'an, 710055, China
| | - Jie Liang
- School of Environmental and Municipal Engineering, Xi'an University of Architecture and Technology, Xi'an, 710055, China E-mail: ; Key Lab of Northwest Water Resource, Environment and Ecology, Ministry of Education, Shaanxi Key Laboratory of Environmental Engineering, Xi'an University of Architecture and Technology, Xi'an, 710055, China
| | - Zhen Wang
- School of Environmental and Municipal Engineering, Xi'an University of Architecture and Technology, Xi'an, 710055, China E-mail: ; Key Lab of Northwest Water Resource, Environment and Ecology, Ministry of Education, Shaanxi Key Laboratory of Environmental Engineering, Xi'an University of Architecture and Technology, Xi'an, 710055, China
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13
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Homeier-Bachmann T, Schütz AK, Dreyer S, Glanz J, Schaufler K, Conraths FJ. Genomic Analysis of ESBL-Producing E. coli in Wildlife from North-Eastern Germany. Antibiotics (Basel) 2022; 11:antibiotics11020123. [PMID: 35203726 PMCID: PMC8868512 DOI: 10.3390/antibiotics11020123] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 02/06/2023] Open
Abstract
Antimicrobial resistance (AMR) is a serious global health threat and extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales are a major contributor. This study aimed to gain a deeper insight into the AMR burden of wild animals. In total, 1595 fecal samples were collected by two systematic searches in Mecklenburg-Western Pomerania, north-east Germany. Samples were screened for ESBL-carrying Escherichia (E.) coli and isolates found were further analyzed using antimicrobial susceptibility testing and whole-genome sequencing. We found an estimated prevalence of 1.2% ESBL-producing E. coli in wild boar and 1.1% in wild ruminants. CTX-M-1 was the most abundant CTX-M type. We also examined fecal samples from wild boar and wild ruminants using shotgun metagenomics to gain insight into the resistome in wild animals. The latter revealed significantly lower normalized counts for AMR genes in wildlife samples compared to farm animals. The AMR gene levels were lower in wild ruminants than in wild boar. In conclusion, our study revealed a low prevalence of ESBL-producing E. coli and a low overall AMR gene burden in wild boar and wild ruminants, probably due to the secluded location of the search area.
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Affiliation(s)
- Timo Homeier-Bachmann
- Friedrich-Loeffler-Institut, Institute of Epidemiology, 17493 Greifswald–Insel Riems, Germany; (A.K.S.); (J.G.); (F.J.C.)
- Correspondence: ; Tel.: +49-38351-71505
| | - Anne K. Schütz
- Friedrich-Loeffler-Institut, Institute of Epidemiology, 17493 Greifswald–Insel Riems, Germany; (A.K.S.); (J.G.); (F.J.C.)
| | - Sylvia Dreyer
- Friedrich-Loeffler-Institut, Institute of International Animal Health/One Health, 17493 Greifswald–Insel Riems, Germany;
| | - Julien Glanz
- Friedrich-Loeffler-Institut, Institute of Epidemiology, 17493 Greifswald–Insel Riems, Germany; (A.K.S.); (J.G.); (F.J.C.)
- Wildlife Research Unit, Agricultural Centre Baden-Württemberg, 88326 Aulendorf, Germany
| | - Katharina Schaufler
- Institute of Pharmacy, University of Greifswald, 17489 Greifswald, Germany;
- Institute of Infection Medicine, Christian-Albrecht University and University Medical Center Schleswig-Holstein, 24118 Kiel, Germany
| | - Franz J. Conraths
- Friedrich-Loeffler-Institut, Institute of Epidemiology, 17493 Greifswald–Insel Riems, Germany; (A.K.S.); (J.G.); (F.J.C.)
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14
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Hassoun-Kheir N, Stabholz Y, Kreft JU, de la Cruz R, Dechesne A, Smets BF, Romalde JL, Lema A, Balboa S, García-Riestra C, Torres-Sangiao E, Neuberger A, Graham D, Quintela-Baluja M, Stekel DJ, Graham J, Pruden A, Nesme J, Sørensen SJ, Hough R, Paul M. EMBRACE-WATERS statement: Recommendations for reporting of studies on antimicrobial resistance in wastewater and related aquatic environments. One Health 2021; 13:100339. [PMID: 34746357 PMCID: PMC8554267 DOI: 10.1016/j.onehlt.2021.100339] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 10/17/2021] [Accepted: 10/17/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A One Health approach requires integrative research to elucidate antimicrobial resistance (AMR) in the environment and the risks it poses to human health. Research on this topic involves experts from diverse backgrounds and professions. Shortcomings exist in terms of consistent, complete, and transparent reporting in many environmental studies. Standardized reporting will improve the quality of scientific papers, enable meta-analyses and enhance the communication among different experts. In this study, we aimed to generate a consensus of reporting standards for AMR research in wastewater and related aquatic environments. METHODS Based on a risk of bias assessment of the literature in a systematic review, we proposed a set of study quality indicators. We then used a multistep modified Delphi consensus to develop the EMBRACE-WATERS statement (rEporting antiMicroBial ResistAnCE in WATERS), a checklist of recommendations for reporting in studies of AMR in wastewater and related aquatic environments. FINDINGS Consensus was achieved among a multidisciplinary panel of twenty-one experts in three steps. The developed EMBRACE-WATERS statement incorporates 21 items. Each item contains essential elements of high-quality reporting and is followed by an explanation of their rationale and a reporting-example. The EMBRACE-WATERS statement is primarily intended to be used by investigators to ensure transparent and comprehensive reporting of their studies. It can also guide peer-reviewers and editors in evaluation of manuscripts on AMR in the aquatic environment. This statement is not intended to be used to guide investigators on the methodology of their research. INTERPRETATION We are hopeful that this statement will improve the reporting quality of future studies of AMR in wastewater and related aquatic environments. Its uptake would generate a common language to be used among researchers from different disciplines, thus advancing the One Health approach towards understanding AMR spread across aquatic environments. Similar initiatives are needed in other areas of One Health research.
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Affiliation(s)
- Nasreen Hassoun-Kheir
- Infectious Diseases Institute, Rambam Health Care Campus, HaAliya HaShniya St 8, Haifa 3109601, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Efron St 1, Haifa 3109601, Israel
| | - Yoav Stabholz
- Infectious Diseases Institute, Rambam Health Care Campus, HaAliya HaShniya St 8, Haifa 3109601, Israel
| | - Jan-Ulrich Kreft
- School of Biosciences, Institute of Microbiology and Infection (IMI), Centre for Computational Biology (CCB), University of Birmingham, Birmingham, UK
| | - Roberto de la Cruz
- School of Biosciences, Institute of Microbiology and Infection (IMI), Centre for Computational Biology (CCB), University of Birmingham, Birmingham, UK
| | - Arnaud Dechesne
- Technical University of Denmark, Department of Environmental Engineering, bygning 115, Bygningstorvet, 2800 Kongens Lyngby, Denmark
| | - Barth F. Smets
- Technical University of Denmark, Department of Environmental Engineering, bygning 115, Bygningstorvet, 2800 Kongens Lyngby, Denmark
| | - Jesús L. Romalde
- Department of Microbiology and Parasitology, CIBUS-Faculty of Biology, Universidade de Santiago de Compostela, Santiago de Compostela 15782, Spain
- CRETUS, Universidade de Santiago de Compostela, Santiago de Compostela 15782, Spain
| | - Alberto Lema
- Department of Microbiology and Parasitology, CIBUS-Faculty of Biology, Universidade de Santiago de Compostela, Santiago de Compostela 15782, Spain
| | - Sabela Balboa
- CRETUS, Universidade de Santiago de Compostela, Santiago de Compostela 15782, Spain
| | - Carlos García-Riestra
- Department of Microbiology and Parasitology, University Hospital Complex of Santiago (CHUS), Spain
| | - Eva Torres-Sangiao
- Escherichia coli Group, Research Foundation Institute (FIDIS), University Hospital Complex (CHUS), Santiago de Compostela, ES, Spain
| | - Ami Neuberger
- Infectious Diseases Institute, Rambam Health Care Campus, HaAliya HaShniya St 8, Haifa 3109601, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Efron St 1, Haifa 3109601, Israel
| | - David Graham
- School of Engineering, Newcastle University, Newcastle upon Tyne, UK
| | | | - Dov J. Stekel
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, College Road, Loughborough LE12 5RD, UK
| | - Jay Graham
- University of California, Berkeley School of Public Health, Berkeley, CA, USA
| | - Amy Pruden
- The Charles Edward Via, Jr. Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, USA
| | - Joseph Nesme
- Section of Microbiology, Department of Biology, Faculty of Science, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Søren Johannes Sørensen
- Section of Microbiology, Department of Biology, Faculty of Science, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Rupert Hough
- Information and Computational Sciences, The James Hutton Institute, Aberdeen AB15 8QH, Scotland, UK
| | - Mical Paul
- Infectious Diseases Institute, Rambam Health Care Campus, HaAliya HaShniya St 8, Haifa 3109601, Israel
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Efron St 1, Haifa 3109601, Israel
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15
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Bojar B, Sheridan J, Beattie R, Cahak C, Liedhegner E, Munoz-Price LS, Hristova KR, Skwor T. Antibiotic resistance patterns of Escherichia coli isolates from the clinic through the wastewater pathway. Int J Hyg Environ Health 2021; 238:113863. [PMID: 34662851 DOI: 10.1016/j.ijheh.2021.113863] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 10/13/2021] [Accepted: 10/13/2021] [Indexed: 11/26/2022]
Abstract
Antimicrobial resistance (AMR) remains one of the leading global health threats. This study compared antimicrobial resistance patterns among E. coli isolates from clinical uropathogenic Escherichia coli (UPEC) to hospital wastewater populations and throughout an urban wastewater treatment facility - influent, pre- and post-chlorinated effluents. Antibiotic susceptibility of 201 isolates were analyzed against eleven different antibiotics, and the presence of twelve antibiotic resistant genes and type 1 integrase were identified. AMR exhibited the following pattern: UPEC (46.8%) > hospital wastewater (37.8%) > urban post-chlorinated effluent (27.6%) > pre-chlorinated effluent (21.4%) > urban influent wastewater (13.3%). However, multi-drug resistance against three or more antimicrobial classes was more prevalent among hospital wastewater populations (29.7%) compared to other sources. E. coli from wastewaters disinfected with chlorine were significantly correlated with increased trimethoprim-sulfamethoxazole resistance in E. coli compared to raw and treated wastewater populations. blaCTX-M-1 group was the most common extended spectrum beta-lactamase in E. coli from hospital wastewater (90%), although UPEC strains also encoded blaCTX-M-1 group (50%) and blaTEM (100%) genes. Among tetracycline-resistant populations, tetA and tetB were the only resistance genes identified throughout wastewater populations that were associated with increased phenotypic resistance. Further characterization of the E. coli populations identified phylogroup B2 predominating among clinical UPEC populations and correlated with the highest AMR, whereas the elevated rate of multi-drug resistance among hospital wastewater was mostly phylogroup A. Together, our findings highlight hospital wastewater as a rich source of AMR and multi-drug resistant bacterial populations.
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Affiliation(s)
- Brandon Bojar
- Department of Biomedical Sciences, College of Health Sciences, University of Wisconsin - Milwaukee, Milwaukee, WI, 53211, USA
| | - Jennifer Sheridan
- Department of Biomedical Sciences, College of Health Sciences, University of Wisconsin - Milwaukee, Milwaukee, WI, 53211, USA
| | - Rachelle Beattie
- Department of Biological Sciences, Marquette University, Milwaukee, WI, 53233, USA
| | - Caitlin Cahak
- Wisconsin Diagnostic Laboratories, Milwaukee, WI, 53226, USA
| | - Elizabeth Liedhegner
- Department of Biomedical Sciences, College of Health Sciences, University of Wisconsin - Milwaukee, Milwaukee, WI, 53211, USA
| | | | | | - Troy Skwor
- Department of Biomedical Sciences, College of Health Sciences, University of Wisconsin - Milwaukee, Milwaukee, WI, 53211, USA.
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16
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Schmiege D, Zacharias N, Sib E, Falkenberg T, Moebus S, Evers M, Kistemann T. Prevalence of multidrug-resistant and extended-spectrum beta-lactamase-producing Escherichia coli in urban community wastewater. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 785:147269. [PMID: 33932656 DOI: 10.1016/j.scitotenv.2021.147269] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 05/28/2023]
Abstract
Antibiotic resistance (ABR) and the spread of multidrug-resistant and extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli via wastewater to environmental compartments are of rapidly growing global health concern. Health care facilities, industries and slaughterhouses discharge high loads of ABR bacteria with their wastewater. However, the general community is often the biggest indirect discharger. Yet, research focusing explicitly on this important diffuse source is rather scarce raising questions about variations in the occurrence of ESBL-producing E. coli in wastewater from different communities and over time. Between April 2019 and March 2020, wastewater from three socio-spatially different districts in the Ruhr Metropolis, Germany, and the receiving wastewater treatment plant was sampled monthly and analysed for the occurrence of ESBL-producing E. coli via culture-based methods. Isolates were validated with matrix assisted laser desorption ionization time of flight mass spectrometry and antibiotic resistance profiles were analysed via microdilution. Results were interpreted using the European Committee on Antimicrobial Susceptibility Testing criteria. The German Commission for Hospital Hygiene and Infection Prevention criteria were used for multidrug-resistance categorization. Phenotypic ESBL-producing E. coli could be isolated from every wastewater sample demonstrating that the general community is an important indirect discharger. The socio-spatially disadvantaged area displayed higher absolute loads of ESBL-producing E. coli compared to the other two areas, as well as higher adjusted loads for domestic discharge and inhabitants, particularly during winter, indicating a higher ABR burden. Thirty-two isolates (28.6%) were characterized as multidrug-resistant Gram-negative bacteria (3MRGN). Resistance profiles varied only for those antibiotics, which can be administered in outpatient care. Resistance levels tended to be around 10% lower in the socio-spatially advantaged area. This study shows that spatial and seasonal influences regarding the occurrence of ESBL-producing E. coli in wastewater from socio-spatially different communities are identifiable.
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Affiliation(s)
- Dennis Schmiege
- Department of Geography, University of Bonn, Meckenheimer Allee 166, 53115 Bonn, Germany; Institute for Hygiene and Public Health, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Center for Development Research, University of Bonn, Genscherallee 3, 53113 Bonn, Germany; Institute for Urban Public Health, Essen University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.
| | - Nicole Zacharias
- Institute for Hygiene and Public Health, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Esther Sib
- Institute for Hygiene and Public Health, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
| | - Timo Falkenberg
- Institute for Hygiene and Public Health, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Center for Development Research, University of Bonn, Genscherallee 3, 53113 Bonn, Germany.
| | - Susanne Moebus
- Institute for Urban Public Health, Essen University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.
| | - Mariele Evers
- Department of Geography, University of Bonn, Meckenheimer Allee 166, 53115 Bonn, Germany.
| | - Thomas Kistemann
- Department of Geography, University of Bonn, Meckenheimer Allee 166, 53115 Bonn, Germany; Institute for Hygiene and Public Health, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Center for Development Research, University of Bonn, Genscherallee 3, 53113 Bonn, Germany.
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17
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Homeier-Bachmann T, Heiden SE, Lübcke PK, Bachmann L, Bohnert JA, Zimmermann D, Schaufler K. Antibiotic-Resistant Enterobacteriaceae in Wastewater of Abattoirs. Antibiotics (Basel) 2021; 10:antibiotics10050568. [PMID: 34065908 PMCID: PMC8150771 DOI: 10.3390/antibiotics10050568] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/08/2021] [Accepted: 05/09/2021] [Indexed: 11/16/2022] Open
Abstract
Antibiotic-resistant Enterobacteriaceae are regularly detected in livestock. As pathogens, they cause difficult-to-treat infections and, as commensals, they may serve as a source of resistance genes for other bacteria. Slaughterhouses produce significant amounts of wastewater containing antimicrobial-resistant bacteria (AMRB), which are released into the environment. We analyzed the wastewater from seven slaughterhouses (pig and poultry) for extended-spectrum β-lactamase (ESBL)-carrying and colistin-resistant Enterobacteriaceae. AMRB were regularly detected in pig and poultry slaughterhouse wastewaters monitored here. All 25 ESBL-producing bacterial strains (19 E. coli and six K. pneumoniae) isolated from poultry slaughterhouses were multidrug-resistant. In pig slaughterhouses 64% (12 of 21 E. coli [57%] and all four detected K. pneumoniae [100%]) were multidrug-resistant. Regarding colistin, resistant Enterobacteriaceae were detected in 54% of poultry and 21% of pig water samples. Carbapenem resistance was not detected. Resistant bacteria were found directly during discharge of wastewaters from abattoirs into water bodies highlighting the role of slaughterhouses for environmental surface water contamination.
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Affiliation(s)
- Timo Homeier-Bachmann
- Friedrich-Loeffler-Institut, Institute of Epidemiology, 17493 Greifswald-Insel Riems, Germany;
- Correspondence: ; Tel.: +49-38351-7-1505
| | - Stefan E. Heiden
- Institute of Pharmacy, University of Greifswald, 17489 Greifswald, Germany; (S.E.H.); (K.S.)
| | - Phillip K. Lübcke
- Friedrich-Loeffler-Institut, Institute of Epidemiology, 17493 Greifswald-Insel Riems, Germany;
- Institute of Pharmacy, University of Greifswald, 17489 Greifswald, Germany; (S.E.H.); (K.S.)
| | - Lisa Bachmann
- Leibniz-Institut für Nutztierbiologie, Institute of Nutritional Physiology “Oskar Kellner”, 18196 Dummerstorf, Germany;
| | - Jürgen A. Bohnert
- Friedrich Loeffler-Institute of Medical Microbiology, University Medicine Greifswald, 17475 Greifswald, Germany;
| | | | - Katharina Schaufler
- Institute of Pharmacy, University of Greifswald, 17489 Greifswald, Germany; (S.E.H.); (K.S.)
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18
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Verburg I, van Veelen HPJ, Waar K, Rossen JWA, Friedrich AW, Hernández Leal L, García-Cobos S, Schmitt H. Effects of Clinical Wastewater on the Bacterial Community Structure from Sewage to the Environment. Microorganisms 2021; 9:718. [PMID: 33807193 PMCID: PMC8065902 DOI: 10.3390/microorganisms9040718] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/21/2021] [Accepted: 03/26/2021] [Indexed: 12/30/2022] Open
Abstract
This study pertains to measure differences in bacterial communities along the wastewater pathway, from sewage sources through the environment. Our main focus was on taxa which include pathogenic genera, and genera harboring antibiotic resistance (henceforth referred to as "target taxa"). Our objective was to measure the relative abundance of these taxa in clinical wastewaters compared to non-clinical wastewaters, and to investigate what changes can be detected along the wastewater pathway. The study entailed a monthly sampling campaign along a wastewater pathway, and taxa identification through 16S rRNA amplicon sequencing. Results indicated that clinical and non-clinical wastewaters differed in their overall bacterial composition, but that target taxa were not enriched in clinical wastewater. This suggests that treatment of clinical wastewater before release into the wastewater system would only remove a minor part of the potential total pathogen load in wastewater treatment plants. Additional findings were that the relative abundance of most target taxa was decreased after wastewater treatment, yet all investigated taxa were detected in 68% of the treated effluent samples-meaning that these bacteria are continuously released into the receiving surface water. Temporal variation was only observed for specific taxa in surface water, but not in wastewater samples.
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Affiliation(s)
- Ilse Verburg
- Wetsus, European Centre of Excellence for Sustainable Water Technology, 8900 CC Leeuwarden, The Netherlands; (I.V.); (H.P.J.v.V.); (L.H.L.)
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (J.W.A.R.); (A.W.F.); (S.G.-C.)
| | - H. Pieter J. van Veelen
- Wetsus, European Centre of Excellence for Sustainable Water Technology, 8900 CC Leeuwarden, The Netherlands; (I.V.); (H.P.J.v.V.); (L.H.L.)
| | - Karola Waar
- Izore, Centrum Infectieziekten Friesland, 8900 JA Leeuwarden, The Netherlands;
| | - John W. A. Rossen
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (J.W.A.R.); (A.W.F.); (S.G.-C.)
| | - Alex W. Friedrich
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (J.W.A.R.); (A.W.F.); (S.G.-C.)
| | - Lucia Hernández Leal
- Wetsus, European Centre of Excellence for Sustainable Water Technology, 8900 CC Leeuwarden, The Netherlands; (I.V.); (H.P.J.v.V.); (L.H.L.)
| | - Silvia García-Cobos
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (J.W.A.R.); (A.W.F.); (S.G.-C.)
| | - Heike Schmitt
- Wetsus, European Centre of Excellence for Sustainable Water Technology, 8900 CC Leeuwarden, The Netherlands; (I.V.); (H.P.J.v.V.); (L.H.L.)
- Institute for Risk Assessment Sciences, Utrecht University, 3508 TD Utrecht, The Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3721 MA Bilthoven, The Netherlands
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19
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Gibbon MJ, Couto N, David S, Barden R, Standerwick R, Jagadeesan K, Birkwood H, Dulyayangkul P, Avison MB, Kannan A, Kibbey D, Craft T, Habib S, Thorpe HA, Corander J, Kasprzyk-Hordern B, Feil EJ. A high prevalence of blaOXA-48 in Klebsiella ( Raoultella) ornithinolytica and related species in hospital wastewater in South West England. Microb Genom 2021; 7:mgen000509. [PMID: 33416467 PMCID: PMC8190614 DOI: 10.1099/mgen.0.000509] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/20/2020] [Indexed: 12/15/2022] Open
Abstract
Klebsiella species occupy a wide range of environmental and animal niches, and occasionally cause opportunistic infections that are resistant to multiple antibiotics. In particular, Klebsiella pneumoniae (Kpne) has gained notoriety as a major nosocomial pathogen, due principally to the rise in non-susceptibility to carbapenems and other beta-lactam antibiotics. Whilst it has been proposed that the urban water cycle facilitates transmission of pathogens between clinical settings and the environment, the level of risk posed by resistant Klebsiella strains in hospital wastewater remains unclear. We used whole genome sequencing (WGS) to compare Klebsiella species in contemporaneous samples of wastewater from an English hospital and influent to the associated wastewater treatment plant (WWTP). As we aimed to characterize representative samples of Klebsiella communities, we did not actively select for antibiotic resistance (other than for ampicillin), nor for specific Klebsiella species. Two species, Kpne and K. (Raoultella) ornithinolytica (Korn), were of equal dominance in the hospital wastewater, and four other Klebsiella species were present in low abundance in this sample. In contrast, despite being the species most closely associated with healthcare settings, Kpne was the dominant species within the WWTP influent. In total, 29 % of all isolates harboured the blaOXA-48 gene on a pOXA-48-like plasmid, and these isolates were almost exclusively recovered from the hospital wastewater. This gene was far more common in Korn (68 % of isolates) than in Kpne (3.4 % of isolates). In general plasmid-borne, but not chromosomal, resistance genes were significantly enriched in the hospital wastewater sample. These data implicate hospital wastewater as an important reservoir for antibiotic-resistant Klebsiella, and point to an unsuspected role of species within the Raoultella group in the maintenance and dissemination of plasmid-borne blaOXA-48. This article contains data hosted by Microreact.
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Affiliation(s)
- Marjorie J. Gibbon
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Bath, UK
| | - Natacha Couto
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Bath, UK
| | - Sophia David
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | | | | | | | - Hollie Birkwood
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Bath, UK
| | - Punyawee Dulyayangkul
- University of Bristol, School of Cellular and Molecular Medicine, University Walk, Bristol BS8 1TD, UK
| | - Matthew B. Avison
- University of Bristol, School of Cellular and Molecular Medicine, University Walk, Bristol BS8 1TD, UK
| | - Andrew Kannan
- Department of Chemistry, University of Bath, Bath BA2 7AY, UK
| | - Dan Kibbey
- Department of Chemistry, University of Bath, Bath BA2 7AY, UK
| | - Tim Craft
- Department of R&D, Royal United Hospitals Bath, NHS Foundation Trust, Bath BA1 3NG, UK
| | - Samia Habib
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Bath, UK
| | - Harry A. Thorpe
- Department of Biostatistics, University of Oslo, N-0317, Oslo, Norway
| | - Jukka Corander
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
- Department of Biostatistics, University of Oslo, N-0317, Oslo, Norway
- Helsinki Institute for Information Technology, Department of Mathematics and Statistics, University of Helsinki, FIN-00014 Helsinki, Finland
| | | | - Edward J. Feil
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Bath, UK
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20
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Bairán G, Rebollar-Pérez G, Chávez-Bravo E, Torres E. Treatment Processes for Microbial Resistance Mitigation: The Technological Contribution to Tackle the Problem of Antibiotic Resistance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8866. [PMID: 33260585 PMCID: PMC7730199 DOI: 10.3390/ijerph17238866] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/24/2020] [Accepted: 11/24/2020] [Indexed: 12/18/2022]
Abstract
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.
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Affiliation(s)
- Gabriela Bairán
- Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla 72570, Mexico;
| | - Georgette Rebollar-Pérez
- Facultad de Ingeniería Química, Benemérita Universidad Autónoma de Puebla, Puebla 72570, Mexico;
| | - Edith Chávez-Bravo
- Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla 72570, Mexico;
| | - Eduardo Torres
- Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Puebla 72570, Mexico;
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21
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Hassoun-Kheir N, Stabholz Y, Kreft JU, de la Cruz R, Romalde JL, Nesme J, Sørensen SJ, Smets BF, Graham D, Paul M. Comparison of antibiotic-resistant bacteria and antibiotic resistance genes abundance in hospital and community wastewater: A systematic review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 743:140804. [PMID: 32758846 DOI: 10.1016/j.scitotenv.2020.140804] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/04/2020] [Accepted: 07/05/2020] [Indexed: 05/10/2023]
Abstract
Antibiotic-resistant bacteria (ARB) and antibiotic-resistance genes (ARGs) are constantly shed into the aquatic environment, with hospital wastewater potentially acting as an important source for resistance spread into the environment. A systematic review was conducted aiming to investigate the role of hospital wastewater on dissemination of antimicrobial resistance in the aquatic environment. Studies included in the review compared the prevalence of ARB and/or ARGs in hospital versus community wastewater. Data were extracted on ARB and/or ARG prevalence. Data on sampling techniques, microbiological methodology and risk of bias of included studies were recorded. Thirty-seven studies were included. Higher frequencies of antibiotic resistance determinants were found in hospital wastewater compared to community sources in 30/37 (81%) of included studies. However, trends for specific multi-drug-resistant bacteria differed. Antibiotic-resistant Gram-negative were more prevalent in hospital compared to community wastewaters, with higher concentrations of extended-spectrum-beta-lactamase-producing pathogens and carbapenemase-producing Enterobacteriaceae in hospital sources in 9/9 studies and 6/7 studies, respectively. Hospitals did not contribute consistently to the abundance of vancomycin-resistant Enterococci (VRE); 5/10 studies found higher abundance of VRE in hospital compared to community wastewaters. Reporting on sampling methods, wastewater treatment processes and statistical analysis were at high risk of bias. Extreme heterogeneity in study methods and outcome reporting precluded meta-analysis. Current evidence concurs that hospital wastewater is an important source for antibiotic resistance in aquatic environments, mainly multidrug-resistant Gram-negative bacteria. Future research is needed to assess the effect of wastewater treatment processes on overall antibiotic resistance in the aquatic environment.
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Affiliation(s)
- Nasreen Hassoun-Kheir
- Infectious Diseases Institute, Rambam Health Care Campus, Haifa, Israel, HaAliya HaShniya St 8, Haifa 3109601, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Efron St 1, Haifa 3109601, Israel.
| | - Yoav Stabholz
- Infectious Diseases Institute, Rambam Health Care Campus, Haifa, Israel, HaAliya HaShniya St 8, Haifa 3109601, Israel
| | - Jan-Ulrich Kreft
- Institute of Microbiology and Infection & Centre for Computational Biology & School of Biosciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Roberto de la Cruz
- Institute of Microbiology and Infection & Centre for Computational Biology & School of Biosciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Jesús L Romalde
- Department of Microbiology and Parasitology, CIBUS-Faculty of Biology & Institute CRETUS, Universidade de Santiago de Compostela, Santiago de Compostela 15782, Spain
| | - Joseph Nesme
- Department of Biology, Section of Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Søren J Sørensen
- Department of Biology, Section of Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Barth F Smets
- Department of Environmental Engineering, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - David Graham
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | - Mical Paul
- Infectious Diseases Institute, Rambam Health Care Campus, Haifa, Israel, HaAliya HaShniya St 8, Haifa 3109601, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Efron St 1, Haifa 3109601, Israel
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22
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Kolokotsa A, Leotsinidis M, Kalavrouziotis I, Sazakli E. Effects of tourist flows on antibiotic resistance in wastewater of a Greek island. J Appl Microbiol 2020; 130:516-527. [PMID: 32743833 DOI: 10.1111/jam.14808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/09/2020] [Accepted: 07/24/2020] [Indexed: 12/01/2022]
Abstract
AIM Antibiotic resistance in wastewaters reflects the clinical resistome. This study aimed at investigating whether changes in the population size and composition in the popular tourist destination of Zakynthos island are associated with differentiation in the antibiotic resistance of environmental micro-organisms isolated from wastewater. METHODS AND RESULTS The resistance profiles of four species (Escherichia coli, Staphylococcus sp., Pseudomonas sp. and Enterococcus sp.) were studied in 124 raw and treated municipal wastewaters from November 2015 to August 2016. Isolates were tested against their susceptibility to several antibiotics of different antimicrobial categories. Data concerning the alteration in the population size and composition, due to the tourist mobility, were collected and logistic regression models were used to examine the relationships between antimicrobial resistance and population changes. The decrease in resistance of E. coli to amoxicillin-clavulanate, of enterococci to norfloxacin and ampicillin, and of pseudomonads to almost all antibiotics tested was associated with population increase due to tourist flows. In contrast, the presence of tourists was linked to an increase in quinupristin-dalfopristin resistant enterococci. Resistance of staphylococci did not change during the tourist period. CONCLUSION Changes in population composition in touristic areas are reflected in antibiotic resistance of environmental bacteria in wastewater. SIGNIFICANCE AND IMPACT OF THE STUDY In touristic areas, where people carrying different resistomes are merged, medication should be adapted accordingly.
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Affiliation(s)
- A Kolokotsa
- School of Science and Technology, Hellenic Open University, Patras, Greece
| | - M Leotsinidis
- Laboratory of Public Health, School of Medicine, University of Patras, Patras, Greece
| | - I Kalavrouziotis
- School of Science and Technology, Hellenic Open University, Patras, Greece
| | - E Sazakli
- School of Science and Technology, Hellenic Open University, Patras, Greece.,Laboratory of Public Health, School of Medicine, University of Patras, Patras, Greece
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23
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King TLB, Schmidt S, Essack SY. Antibiotic resistant Klebsiella spp. from a hospital, hospital effluents and wastewater treatment plants in the uMgungundlovu District, KwaZulu-Natal, South Africa. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 712:135550. [PMID: 31818599 DOI: 10.1016/j.scitotenv.2019.135550] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/08/2019] [Accepted: 11/14/2019] [Indexed: 05/22/2023]
Abstract
Hospital effluents are crucial hotspots for the dissemination of antibiotic resistant microorganisms. This study analysed hospital effluent and proximate wastewater treatment plants for the presence of antibiotic resistant Klebsiella spp. Water samples were obtained twice over a three-month period from an urban and rural hospital at three effluent points each, and from two proximate wastewater treatment plants (WWTPs) comprising influent and effluent and river water samples up/downstream the WWTPs. Presumptive Klebsiella spp. were enumerated, isolated, and phenotypically confirmed using a well-established commercial test system for Enterobacteriaceae (API20E). Clinical Klebsiella pneumoniae isolates were provided by a hospital for comparison. The antibiotic resistance profiles of Klebsiella spp. isolates to 16 selected antibiotics were established according to EUCAST (European Committee on Antimicrobial Susceptibility Testing). In addition, extended spectrum β-lactamase (ESBL) and carbapenemase production was analysed. A total of 93 confirmed Klebsiella spp. isolates from hospital effluents and 37 from WWTPs were obtained, comprising K. pneumoniae and K. oxytoca. The viable counts for confirmed Klebsiella spp. for hospital effluents ranged from 1.38 × 102 to 1.03 × 104, while those for WWTP influent were in a range of 1.76 × 103 to 5.10 × 103 CFU/ml. A higher proportion of Klebsiella spp. from urban hospital effluent was categorized as multidrug-resistant (MDR) (23%) compared to rural hospital effluent (9%). Resistance was observed to all antibiotic classes tested. Several clinical isolates presented resistance to four carbapenem antibiotics, while certain isolates from hospital effluent and WWTPs exhibited ertapenem and doripenem resistance. Fifteen Klebsiella spp. isolates (clinical and from urban hospital effluent) produced carbapenemases. Hospital effluents in South Africa contain antibiotic resistant Klebsiella spp. and may pose a risk to proximate informal communities if inadequately treated. Moreover, common phenotypic resistance profiles among isolates from the clinical-hospital effluent-wastewater works continuum suggest a need for further treatment of such effluent.
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Affiliation(s)
- Tracy L B King
- Discipline of Microbiology, School of Life Sciences, University of KwaZulu-Natal, Private Bag X01, Pietermaritzburg 3209, South Africa; Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa
| | - Stefan Schmidt
- Discipline of Microbiology, School of Life Sciences, University of KwaZulu-Natal, Private Bag X01, Pietermaritzburg 3209, South Africa.
| | - Sabiha Y Essack
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa
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