The Role of Wastewater Treatment Plants in Dissemination of Antibiotic Resistance: Source, Measurement, Removal and Risk Assessment
Abstract
:1. Introduction
Antibiotic Resistance in Wastewater
2. Approaches for Identifying Antimicrobial Resistance Factors in WWTPs and the Environment
2.1. Identifying ARB and ARGs
2.2. Identifying Antibiotics
3. Effects of Wastewater Treatment Processes on ARGs Released from WWTPs
3.1. Primary Wastewater Treatment
3.2. Secondary Wastewater Treatment
3.3. Tertiary Wastewater Treatment
3.3.1. Chlorination Disinfection
3.3.2. Ultra-Violet Disinfection
3.3.3. Ozone Treatment
3.3.4. Membrane Filtration
4. Assessing the Risk of Antibiotic Resistance from WWTPs in the Environment
4.1. Interactions between ARB, ARGs, MGEs and Co-Occurrence Genes for Risk Scafolding
4.2. A Proposed Pathway to Informed Risk Scaffolds for Antibiotic Resistance from WWTPs
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
Publication | Study Focus | Treatment in WWTP | Location | ARG Detection Method | ARGs Identified in Influent | Changes to ARG Relative Abundance in Effluent |
---|---|---|---|---|---|---|
Chen and Zhang, 2013 [45]. | Effect of treatment on ARGs | Activated Sludge | China | qPCR (abundance relative to 16s) | TETM, TETO, TETQ, TETW, SULI, SULII, INTI1 | TETM, TETO, TETQ, TETW, SULI, SULII, INTI1 |
constructed wetland | qPCR (abundance relative to 16s) | TETM, TETO, TETQ, TETW, SULI, SULII, INTI1 | TETM, TETO, TETQ, TETW, SULI, SULII, INTI1 | |||
ultraviolet (UV) disinfection | qPCR (abundance relative to 16s) | TETM, TETO, TETQ, TETW, SULI, SULII, INTI1 | TETM, TETO, TETQ, TETW, SULI, SULII, INTI1 | |||
Conco, et al, 2022 [35]. | ARGs identified in hospital waste | Chlorination | South Africa | WGS | Resistome identified | SULI, AADA4–5, TEM-1D Several ARGs were downregulated |
Czekalski, et al, 2012 [31]. | Multi-drug resistant bacteria in wastewater stream | Activated Sludge | Switzerland | Bacterial culture, antibiotic sensitivity testing, and qPCR | SULI, SULII | SULI, SULII |
Czekalski, et al., 2016 [88] | Escherichia coli | ozonation | Germany | Bacterial culture, and qPCR | SULI | SULI |
Gao, et al., 2012 [71]. | tetracycline and sulfonamide resistance genes | Activated Sludge | USA | qPCR (abundance relative to 16s) | TETO, TETW, SULI | SULI, TETO, TETW |
Ju, et al., 2019 [59]. | Resistome | Activated Sludge | Switzerland | WGS (abundance relative to total sequences) | Resistome identified | Several ARGs for multi-drug, beta-lactam, aminoglycoside, tetracycline, trimethoprim, vancomycin, bacitracin, chloramphenicol, rifamycin, sulfonamide, macrolide. |
Karkman, et al., 2016 [26]. | Resistome | Activated Sludge and biofilters | Finland | qPCR (abundance relative to 16s) | ERMF, blaTEM, TETA, TNPA, ERMB, SULII, AACC, TNPA, MEXF, TNPA, TETO, TETW, STRB, AADA | blaTEM, TETA, TNPA, ERMB |
Lee, et al., 2017 [78]. | Impact of UV disinfection on ARGs and ARB | ultraviolet (UV) disinfection | China | qPCR (abundance relative to 16s) | TETX, TETM, TETA, SULI, SULII, ERMB, QNRD, blaTEM | TETA, TETX, TETM, SULI, SULII, ERMB, QNRD, blaTEM |
Li, et al., 2015 [36]. | Relationship of Antibiotics to ARGs | ultraviolet (UV) disinfection and constructed wetland | China | qPCR (abundance relative to 16s) | TETA, TETB, TETC, TETG, TETL, TETM, TETO, TETQ, TETW, TETX, SULI, SULII | TETC, TETG, TETM, TETX, SULI, INTI1, TETA, TETB, TETL, TETO, TETQ, TETW, SULII |
Li, et al., 2018 [14]. | pharmaceutical wastewater treatment plant | Activated Sludge | China | qPCR (abundance relative to 16s) | TETB, TETW, SULI, SULII, GYRA, QEPA, ERMB, ERMF, INTI1, INTI2 | TETB, SULI, SULII, GYRA, INTI1, ERMB, ERMF, QEPA, INTI2 |
Lin, et al., 2021 [92]. | Relationship of Antibiotics to ARGs | Membrane bioreactors | China | qPCR (abundance relative to 16s) | Unspecified 319 ARGs | APHA3, MERA, DFRA14, APH3-III, ERMF, ARR-2, TET32, CEFA, blaTEM, AACC2, DFRA1, CN1A5, AADA16, AADA6, AAC(6)-LB, COPA, MEFA, ERMQ, INU(F), AADA_99, AAC(6), CATB3, QACH_351, AADA5, blaVEB, AADA21, EREB, AADA17, MSRE, ERMB, TETM, TETW, TETA, SULI, MPHA, Expression of all other ARGs was maintained or downregulated |
Liu, et al., 2019 [7]. | Relationship of Antibiotics to ARGs | ultraviolet (UV) disinfection | China | qPCR (abundance relative to 16s) | TETA, TETC, TETQ, TETW, TETX, SULI, SULII, SULIII, INTI 1 | TETA, TETC, TETQ, TETW, TETX, SULI, SULII, SULIII, INTI1 |
Liu, et al., 2018 [85]. | Intracellular and extracellular ARGs | Chlorination | China | qPCR (abundance relative to 16s) | VANA, DFRA1, CATA1, KATG, RPOB1, APH(2′)-ID, AADA, QNRA, GYRA, AMPC, blaTEM, ERMB, ERMA, SULIII, SULII, SULI, TETX, TETQ, TETM, TETC, TETB, TETA | ERMB, TETA, TETB, TETC, SULI, SULII, SULIII, AMPC, APH(2’)-ID, KATG, VANA, DFRA1, CATA1, KATG, RPOB1, AADA, QNRA, GYRA, blaTEM, ERMA, TETX, TETQ, TETM |
Mao, et al., 2015 [61]. | Relationship of Antibiotics and Heavy metals to ARGs | Chlorination | China | qPCR (abundance relative to 16s) | TETA, TETB, TETC, TETD, TETE, TETG, TETH, TETJ, TETK, TETL, TETM, TETO, TETQ, TETT, TETW, TETX, TETZ, SULI, SULII, SULIII, SULA, QNRA, QNRB, QNRD, QNRS, ERMB, ERMC | TETA, TETB, TETE, TETG, TETH, TETS, TETT, TETX, SULI, SULII, QNRB, ERMC, TETC, TETD, TETJ, TETK, TETL, TETM, TETO, TETQ, TETW, TETZ, SULIII, SULA, QNRA, QNRD, QNRS, ERMB |
Machado, et al., 2023 [77]. | Effect of different treatment types | Activated Sludge | Brazil | Bacterial culture, antibiotic sensitivity testing, and qPCR | INT1, blaTEM, TETA, SULI, QNRB, EMRB | INT1, blaTEM, TETA, SULI, QNRB, EMRB |
anaerobic sludge blanket Reactor | blaTEM, TETA, QNRB, INT1, SULI, EMRB | |||||
ultraviolet (UV) disinfection | QNRB, EMRB, INT1, blaTEM, TETA, SULI | |||||
Munir, et al., 2011 [72]. | Effect of different treatment types | Activated Sludge | USA | qPCR (abundance relative to 16s) | TETW, TETO, SULI | TETW, TETO, SULI |
Oxidative Ditch | TETW, TETO, SULI | |||||
Membrane bioreactors | TETW, TETO, SULI | |||||
Narciso-da-Rocha, et al., 2018 [68]. | Effect of treatment on ARGs | ultraviolet (UV) disinfection | Portugal | qPCR (abundance relative to 16s) | INTI1, blaTEM, blaOXA-A, blaSHV, blaCTX-M, SULI, SULII, QNRS | blaTEM, blaOXA-A, QNRS, INTI1, SULI, blaSHV, blaCTX-M, SULII |
Neudorf, et al., 2017 [32]. | Effect of treatment type | constructed wetland | Canada | qPCR (abundance relative to 16s) | INT1, SULI, SULII, TETO, ERMB, MECA, blaCTX-M, blaTEM, QNRS | SULI, SULII, MECA, TETO, QNRS |
Osińska, et al., 2019 [15]. | Culture-based identification | Activated Sludge, Plus Anerobic-aerobic reactor | Poland | Bacterial culture, antibiotic sensitivity testing, and qPCR | blaTEM, blaSHV, blaOXA, TETA, TETM | TETA, TETM, blaTEM, blaSHV, blaOXA |
Plus mechanical & biological system | Poland | Bacterial culture, antibiotic sensitivity testing, and qPCR | blaTEM, blaSHV, blaOXA, TETA, TETM | TETM, TETA, blaTEM, blaSHV, blaOXA | ||
Plus Sequencing batch reactor | Poland | Bacterial culture, antibiotic sensitivity testing, and qPCR | blaTEM, blaSHV, blaOXA, TETA, TETM | TETM, TETA, blaTEM, blaSHV, blaOXA | ||
Plus mechanical & biological nutrient removal | Poland | Bacterial culture, antibiotic sensitivity testing, and qPCR | blaTEM, blaSHV, blaOXA, TETA, TETM | TETM, TETA, blaTEM, blaSHV, blaOXA | ||
Pazda, et al., 2020 [79]. | Effect of different treatment types on tetracycline and sulfonamide resistance genes | Activated Sludge | Poland | qPCR (abundance relative to 16s) | TETA, TETB, TETC, TETG, TETL, TETM, TETO, TETQ, TETX, SULI, SULII, SULIII | TETB, TETG, TETH, TETS, TETT, TETX AND SULI, SULII |
constructed wetland | TETB, TETK, TETL, TETO, SULIII | |||||
Rafraf, et al., 2016 [86]. | Effect of different treatment types on resistance genes | Activated Sludge | Tunisia | qPCR (abundance relative to 16s) | blaCTX-M, blaTEM, QNRA, QNRS, SULI, ERMB, INTI1 | QNRS, ERMB |
constructed wetland | blaCTX-M, blaTEM, AND QNRA, INTI1 | |||||
Rodriguez-Mozaz, et al., 2015 [73]. | hospital-urban wastewater system | Activated Sludge | Spain | qPCR (abundance relative to 16s) | blaTEM, ERMB, QNRS, SULI, TETW | blaTEM, SULI, QNRS, ERMB, TETW |
Sui, et al., 2019 [80]. | Intracellular and extracellular ARGs | Activated Sludge | China | qPCR (abundance relative to 16s) | TETM, TETW, TETG, TETX, ERMB, ERMF, MEFA, EREA, SULI, SULI, blaTEM, INTI1 | MEFA, TETM, TETW, SULI, TETG, TETX, ERMB, ERMF, EREA, SULI, blaTEM, INTI1 |
Wang, et al., 2020 [91]. | Intracellular and extracellular ARGs | Membrane bioreactors | China | qPCR (abundance relative to 16s) | INTI, blaTEM, ERMB, TETO, TETW | INTI1, blaTEM, ERMB, TETO, TETW |
Wen, et al., 2016 [65]. | Effect of treatment on ARGs | ultraviolet (UV) disinfection | China | qPCR (abundance relative to 16s) | TETA, TETO, TETW, SULI, SULII, blaCTX-M, blaTEM, blaSHV, INTI1 | TETA, TETO, TETW, SULI, SULII, blaCTX-M, blaTEM, blaSHV, INTI1 |
Xu, et al., 2015 [63]. | Relationship of Antibiotics to ARGs | Activated Sludge | China | qPCR (abundance relative to 16s) | TETA, TETB, TETE, TETW, TETM, TETZ, SULI, SULII, SULIII, GRYA, PARC, QNRC, QNRD | QNRC, TETM, QNRD, PARC, GYRA, TETA, TETB, TETE, TETW, TETZ, SULI, SULII, SULIII |
Yang, et al., 2014 [37]. | Resistome | Activated Sludge | China | WGS (abundance relative to total sequences) | Resistome identified | ARGs for Sulfonamide, Quinolone and Chloramphenicol resistance. Beta-lactams, Tetracyclines, Aminoglycosides |
Yuan, et al., 2019 [81]. | Intracellular and extracellular ARGs | Activated Sludge | China | qPCR (abundance relative to 16s) | TETA, TETC, TETM, TETX, SULI, SULII, blaTEM, EREA, ERMB | TETA, TETC, TETM, TETX, SULI, SULII, blaTEM, EREA, ERMB |
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Drane, K.; Sheehan, M.; Whelan, A.; Ariel, E.; Kinobe, R. The Role of Wastewater Treatment Plants in Dissemination of Antibiotic Resistance: Source, Measurement, Removal and Risk Assessment. Antibiotics 2024, 13, 668. https://doi.org/10.3390/antibiotics13070668
Drane K, Sheehan M, Whelan A, Ariel E, Kinobe R. The Role of Wastewater Treatment Plants in Dissemination of Antibiotic Resistance: Source, Measurement, Removal and Risk Assessment. Antibiotics. 2024; 13(7):668. https://doi.org/10.3390/antibiotics13070668
Chicago/Turabian StyleDrane, Kezia, Madoc Sheehan, Anna Whelan, Ellen Ariel, and Robert Kinobe. 2024. "The Role of Wastewater Treatment Plants in Dissemination of Antibiotic Resistance: Source, Measurement, Removal and Risk Assessment" Antibiotics 13, no. 7: 668. https://doi.org/10.3390/antibiotics13070668