Effects of activated sludge and UV disinfection processes on the bacterial community and antibiotic resistance profile in a municipal wastewater treatment plant

Effects of UVC doses on the removal of antimicrobial resistance elements from secondary treated sewage

Wastewater treatment plants (WWTPs) currently face major challenges toward the removal of microcontaminants and/or microbial matrices and consequently play an important role in the potential dissemination of biological resistance in freshwater. The ultraviolet (UV) system is a tertiary treatment strategy increasingly applied worldwide, although many studies have shown that disinfected effluent can still contain antibiotic-resistant bacteria and resistance genes. Therefore, to better understand the effects of UV radiation doses on the removal of all resistance elements (antibiotics, antibiotic-resistant bacteria, and antibiotic resistance genes), the present study was designed using a pilot-scale photoreactor. The UV doses could be varied to investigate whether there is an optimal UV dose capable of removing all resistance elements and also if the UV dose frequently applied in full-scale systems is able to reduce the resistance elements. The effect of different UV doses (A, 0-10 mJ/cm2; B, 10-15 mJ/cm2; and C, > 15 mJ/cm2) in a pilot-scale photoreactor on the removal of antibiotics, antibiotic-resistant bacteria, and genes from the effluent of a UASB reactor followed by a biological trickling filter system (UASB-TF) fed with real sanitary sewage was investigated. Samples of influent and effluent from the UVC photoreactor were collected, and the concentration levels of norfloxacin (NOR), ciprofloxacin (CIP), and levofloxacin (LEV) were assessed. The qnrB, sul1, ermB, integron-integrase (intI1), and 16S rRNA genes, total heterotrophic bacteria (THB), and bacterial resistance to azithromycin and sulfamethoxazole were also investigated. Results indicated that LEV and intI1 were found in the highest median concentrations in the photoreactor influent. Although most antibiotics (NOR and CIP) and ARGs (intI1, 16S rRNA, and qnrB) were apparently better removed with the highest UV dose (> 15 mJ/cm2) applied, except for LEV, sul1, and ermB genes, the Kruskal-Wallis test reported no significant difference between low and high doses. ARB removal (from 80 to 100%) was observed at all UV doses. Principal component analysis (PCA) suggested a clear pattern of pollutant groups, i.e., antibiotics, ARG, and ARB, which exhibited low (median of 8-16%), medium (37-96%), and high (> 97%) removal percentages, respectively. These results demonstrated that UVC photoreactors can be an alternative to complement biological treatment in sewage treatment plants at the dose normally applied in full-scale WWTPs (> 15 mJ/cm2). However, there was no optimal single dose capable of removing all the resistance elements investigated.

Aeromonas isolation reveals this genus's contribution to antimicrobial resistance fluxes across the wastewater-treated water-river interface

AIM

Aeromonas spp. are common members of water and wastewater microbiomes, but some are listed as opportunistic pathogens and are often reported to carry antimicrobial resistance (AMR) genes. We aimed to assess the performance of isolation media for capturing their distribution and their role in AMR dissemination into aquatic environments.

METHODS AND RESULTS

We investigated the abundance, diversity, and AMR profile of Aeromonas isolates from wastewater and receiving water bodies at five municipal wastewater treatment plants in Denmark using three isolation media. This was then compared with the diversity estimated from community-wide 16S rRNA gene amplicon sequencing and resistance patterns inferred from high-throughput qPCR of resistance genes. Isolates from ampicillin sheep blood agar were the most phylogenetically diverse, but the overall Aeromonas recovery on the three media was similarly good and matched the dominant amplicon sequence variants. While the dominant phylotypes were ubiquitous, some types were only detected in treated wastewater and the receiving rivers. The resistance prevalence was moderate and mostly to beta-lactams and tetracyclines. Isolates resistant to piperacilin-tazobactam, cefepime, and tetracycline downstream of the plants were linked to wastewater origin.

CONCLUSION

Overall, our work demonstrates Aeromonas and Aeromonas-mediated AMR fluxes at the wastewater/environment interfaces and provides methodological bases for monitoring aeromonads in wastewater and surface waters.

Chlorine and UV combination sequence: Effects on antibiotic resistance control and health risks of ARGs

The effective control of antibiotic resistance in aquatic environments is urgent. The combined chlorine and UV processes (Cl2-UV, UV/Cl2, and UV-Cl2) are considered potential control processes for controlling antibiotic resistance. This study compared the effectiveness of these three processes in real water bodies and the potential health risks associated with antibiotic resistance genes (ARGs) after treatments. The removal of various antibiotic-resistant bacteria (ARB) and ARGs by the combined processes was analysed. The UV/Cl2 process was less effective than the others in inactivating β-lactam-resistant bacteria (BRB) and sulfamethoxazole-resistant bacteria (SRB), which are more challenging to remove, though its performance might improve with increased UV fluence. Nevertheless, the UV/Cl2 process showed an advantage in removing ARGs. The absolute abundance of aminoglycoside resistance genes (AmRGs), sulfonamide resistance genes (SRGs), macrolide resistance genes (MRGs), and multidrug efflux-associated ARGs detected after the UV/Cl2 process was relatively low, and this process outperformed the others in removing a greater number of ARGs. Additionally, certain ARGs and bacterial genera were found to be enriched after the combined processes, with lower and more similar abundance levels of ARGs and genera observed after UV/Cl2 and UV-Cl2 processes compared to the Cl2-UV process. Health risk assessments indicated that the Cl2-UV process posed the highest risk, followed by UV/Cl2 and UV-Cl2 processes. Overall, the UV/Cl2 process may offer the most practical advantages for controlling antibiotic resistance.

Antibiotic resistance and pathogen spreading in a wastewater treatment plant designed for wastewater reuse

Climate change significantly contributes to water scarcity in various regions worldwide. While wastewater reuse is a crucial strategy for mitigating water scarcity, it also carries potential risks for human health due to the presence of pathogenic and antibiotic resistant bacteria (ARB). Antibiotic resistance represents a Public Health concern and, according to the global action plan on antimicrobial resistance, wastewater role in selecting and spreading ARB must be monitored. Our aim was to assess the occurrence of ARB, antibiotic resistance genes (ARGs), and potential pathogenic bacteria throughout a wastewater treatment plant (WWTP) designed for water reuse. Furthermore, we aimed to evaluate potential association between ARB and ARGs with antibiotics and heavy metals. The results obtained revealed the presence of ARB, ARGs and pathogenic bacteria at every stage of the WWTP. Notably, the most prevalent ARB and ARG were sulfamethoxazole-resistant bacteria (up to 7.20 log CFU mL-1) and sulII gene (up to 5.91 log gene copies mL-1), respectively. The dominant pathogenic bacteria included Arcobacter, Flavobacterium and Aeromonas. Although the abundance of these elements significantly decreased during treatment (influent vs. effluent, p < 0.05), they were still present in the effluent designated for reuse. Additionally, significant correlations were observed between heavy metal concentrations (copper, nickel and selenium) and antibiotic resistance elements (ampicillin-resistant bacteria, tetracycline-resistant bacteria, ARB total abundance and sulII) (p < 0.05). These results underscore the importance of monitoring the role of WWTP in spreading antibiotic resistance, in line with the One Health approach. Additionally, our findings suggest the need of interventions to reduce human health risks associated with the reuse of wastewater for agricultural purposes.

Quantitative distribution of antibiotic resistance genes and crAssphage in a tropical urbanized watershed

As antimicrobial resistance continues to pose a significant threat to global health, this study provided a focused examination of the prevalence and behavior of key antibiotic resistance genes in aquatic environments. We investigated the quantitative distribution of intI1, sul1, blaTEM, blaNDM, blaVIM, mcr-1, tetQ, and crAssphage within wastewater influents (n = 12), effluents (n = 12) and river water samples (n = 12), from three municipal wastewater treatment plants and three river locations in an urbanized watershed in Central Thailand over dry and wet seasons. The qPCR method demonstrated that intI1, sul1, blaTEM, and tetQ were the most abundant in all samples (2.71-7.89 mean log10 copies/100 mL), with all genes exhibiting consistently uniform levels across diverse locations, suggesting the potential for any site to act as a monitoring sentinel. Although there is a significant reduction of ARG concentrations by WWTPs (0.62 - >4.05 LRV), the persistence of these genes in effluents points to the limited effectiveness of existing treatment methodologies. Temporal data indicated stable ARG concentrations over time, but tetQ levels rose during the wet season, in alignment with the monsoonal climate in Thailand. Additionally, we identified crAssphage, a marker of human sewage contamination, exhibited strong correlations with the more abundant ARGs (rho 0.65 - 0.81), implying that human waste contributes significantly to the environmental burden of ARGs. The results of this research highlight the widespread nature of ARGs in water systems and the need for improved treatment and sanitation strategies to mitigate the public health threat posed by antimicrobial resistance.

Hospital wastewater as source of human pathogenic bacteria: A phenotypic and genomic analysis of international high-risk clone VIM-2-producing Pseudomonas aeruginosa ST235/O11

Pseudomonas aeruginosa belong to the special pathogen group capable of causing serious infections, with high mortality rates. The aim of this study was to describe the antibiotic resistance and genomic characteristics of Pseudomonas aeruginosa belonging to international high-risk clone ST235 (GPAE0131 isolate), obtained from hospital wastewater. P. aeruginosa GPAE0131 was isolated from ward tertiary hospital in Brazil and the antibiotic resistance profile was determined by the disc-diffusion method. Genomic characteristics related to antibiotic resistance and virulence factors were evaluated by genomic DNA sequencing on the Illumina MiSeq platform and bioinformatic analysis. GPAE0131 isolate showed resistance to piperacillin-tazobactam, cefepime, ceftazidime, imipenem, meropenem, ciprofloxacin, levofloxacin and tobramycin. Resistome comprehend of resistance genes to β-lactams (blaVIM-2, blaOXA-4, blaOXA-488, blaPDC-35), aminoglycosides (aph(3')-IIb, aac(6')-IIc, aac(6')-Ib9, aadA1), fosfomycin (fosA), chloramphenicol (catB7) and sulfonamides (sul1). Genome comparisons evidence insertion of blaVIM-2 and blaOXA-4 genes. GPAE0131 isolate was predicted to be pathogenic to humans and several virulence factors were found, including encoding gene for ExoU and exotoxin A. All of these features into a pathogenic international high-risk clone (ST235), classified as critical priority, stands out as public health concern due to the widespread dispersal of human pathogens through wastewater. It is suggested that mitigating measures be implemented, such as the treatment of hospital sewage and the addition of tertiary treatment, to prevent the escape of pathogens at this level into the environment.

To what extent do water reuse treatments reduce antibiotic resistance indicators? A comparison of two full-scale systems

Water reuse is an essential strategy for reducing water demand from conventional sources, alleviating water stress, and promoting sustainability, but understanding the effectiveness of associated treatment processes as barriers to the spread of antibiotic resistance is an important consideration to protecting human health. We comprehensively evaluated the reduction of antibiotic resistance genes (ARGs) and antibiotic-resistant bacteria (ARB) in two field-operational water reuse systems with distinct treatment trains, one producing water for indirect potable reuse (ozone/biologically-active carbon/granular activated carbon) and the other for non-potable reuse (denitrification-filtration/chlorination) using metagenomic sequencing and culture. Relative abundances of total ARGs/clinically-relevant ARGs and cultured ARB were reduced by several logs during primary and secondary stages of wastewater treatment, but to a lesser extent during the tertiary water reuse treatments. In particular, ozonation tended to enrich multi-drug ARGs. The effect of chlorination was facility-dependent, increasing the relative abundance of ARGs when following biologically-active carbon filters, but generally providing a benefit in reduced bacterial numbers and ecological and human health resistome risk scores. Relative abundances of total ARGs and resistome risk scores were lowest in aquifer samples, although resistant Escherichia coli and Klebsiella pneumoniae were occasionally detected in the monitoring well 3-days downgradient from injection, but not 6-months downgradient. Resistant E. coli and Pseudomonas aeruginosa were occasionally detected in the nonpotable reuse distribution system, along with increased levels of multidrug, sulfonamide, phenicol, and aminoglycoside ARGs. This study illuminates specific vulnerabilities of water reuse systems to persistence, selection, and growth of ARGs and ARB and emphasizes the role of multiple treatment barriers, including aquifers and distribution systems.