Irreversible inactivation of carbapenem-resistant Klebsiella pneumoniae and its genes in water by photo-electro-oxidation and photo-electro-Fenton - Processes action modes

First evidence that antibiotic-resistant bacteria are inactivated by chemical species produced through the solar photosensitization of ciprofloxacin in water

For the first time, using a chemical pollutant (an antibiotic) as a photosensitizer to improve the elimination of a microbiological contaminant of emerging concern (antibiotic-resistant bacteria) is presented. The effect of ciprofloxacin (CIP) on the inactivation of three light-promoted antibiotic-resistant bacteria (ARB) was evaluated. Ciprofloxacin-resistant Escherichia coli, ciprofloxacin-resistant Staphylococcus aureus, and carbapenem-resistant Klebsiella pneumoniae. Firstly, the photosensitizing effect of CIP on E. coli inactivation was studied. Irradiated CIP (1 ppm) induced superoxide anion radical formation (confirmed through EPR analyses), and the combination of these reactive oxygen species (ROS) with ongoing solar radiation exposure enhanced bacterial inactivation. CIP enhanced the disinfection of antibiotic-resistant E. coli (by 1.84 log units at 120 min of irradiation) and improved the inactivation of K. pneumoniae (by 3.48 log units at 135 min)-both Gram-negative bacteria. Conversely, the photo-inactivation of the Gram-positive bacteria S. aureus did not significantly change (just a slight reduction of 0.42 log units at 120 min) by the presence of CIP. Showing the bacterial structure influences the disinfection process. Another critical factor was antibiotic concentration. A high CIP concentration (10 ppm) induced an interfering screen effect, while a low concentration promoted bacteria inactivation via photosensitization (in Gram-negative bacteria). Interestingly, no photosensitizing effect was observed when CIP was replaced by levofloxacin (LEV, another fluoroquinolone antibiotic), indicating a strong dependence on antibiotic structure. Additionally, the effect of the light source on photosensitized inactivation was evaluated, substituting sunlight with UVC irradiation. Under UVC light, CIP worsened ARB photo-inactivation, suggesting disinfection was mainly due to direct light action on microorganisms rather than photosensitization. Finally, the influence of water components on sunlight-photosensitized disinfection was examined using simulated urine and freshwater. The ARB inactivation decreased as matrix complexity increased. Thus, the effectiveness order was Milli-Q water > freshwater > urine.

Simultaneous degradation of contaminants of emerging concern and disinfection by solar photoelectro-Fenton process at circumneutral pH in a solar electrochemical raceway pond reactor

Simultaneous contaminants of emerging concern (CECs) removal and wild microorganisms' inactivation was evaluated by applying solar photoelectro-Fenton (SPEF) process in actual secondary effluent collected from a real municipal wastewater treatment plant (MWWTP). 20 L of a mixture of four CECs was used as model pollutants (200 μg/L of acetaminophen, caffeine, sulfamethazine, and sulfamethoxazole each one). The SPEF process was carried out on fully sunny days, at circumneutral pH using the complex Fe3+-EDDS, in a solar electrochemical - raceway pond reactor (SEC-RPR). Initially, the optimal conditions for CECs degradation were determined using a response surface model based on current density, iron complex concentration and Fe3+-EDDS addition time (to allow previous accumulation of H2O2) as model inputs. A current density of 24.6 mA/cm2, a Fe3+-EDDS complex concentration of 0.089 mM and 3.8 min of previous H2O2 accumulation were the resulting optimum conditions that were afterwards applied for the simultaneous degradation of the CECs synthetic mixture and wild microorganisms inactivation in actual secondary effluent. About 85% CECs removal and complete E. coli inactivation were achieved in 30 min, approximately, while E. faecalis and total coliforms could be inactivated under detection limit in 60 min and 75 min, respectively.

Application of electrochemical oxidation for the enhancement of antibiotic resistant bacteria removal in stormwater bioretention cells

Recently, increasing attention has been paid to the removal of antibiotic resistant bacteria (ARB) during electrochemical advanced oxidation processes. However, there is still no available literature about the application of electrochemical oxidation (EO) to enhance ARB removal in stormwater bioretention cells. Batch experiments were conducted to investigate target ARB (E. coli K-12 carrying blaTEM, tetR and aphA) removals in bioretention cells with different current densities and ratios of air to water (A/W). ARB removals for bioretention cells with 17.6 μA/m² of current density and 24:1 of A/W ratio was the largest with 5.28 log reduction, which was obviously higher than the one (3.68 log reduction) in the control (without EO). H₂O₂ production could be responsible for ARB removals in the used bioretention cells, where H₂O₂ levels increased at first and then decreased with the increase of current densities and A/W ratios. The evaluation for the application of EO implied that the highest antibiotic resistance (AR) conjugation frequency (3.8 × 10^-3) at 3.5 μA/m² of current density and 48:1 of A/W ratios was 124.5 % of the one in the control, while the largest AR transformation frequencies at 17.6 μA/m² of current density and 48:1 of A/W ratios was 366.9 % (tetR) and 216.2 % (aphA) of the corresponding in the control, and there were still stable for both dominant microflora and metabolic activities in bioretention cells with electricity and aeration, suggesting that EO could be promising for the enhancement of ARB removals in bioretention cells.

Antibiotic resistant bacteria inactivation through metal-free electrochemical disinfection with carbon catalysts and its potential risks

Recently, increasing attention has been paid to the inactivation of antibiotic resistant bacteria (ARB) during the electrochemical disinfection. However, no available information could be found on ARB inactivation in water during metal-free electrochemical disinfection. In this study, polyvinylidene fluoride (PVDF)-based carbon catalyst (PPC) was chosen as working electrode. Batch experiments were conducted to investigate key design for ARB inactivation, effects of water matrix and potential risks after the disinfection under the pre-determined conditions. The disinfection with current density at 2.25 mA/cm² and Air/Water ratio of 10:1 was optimal with the largest ARB inactivation (5.0 log reduction for 40 min), which was in line with the profile and yield of hydrogen peroxide (H₂O₂) during the disinfection. Effects of water matrix analysis implied that ARB inactivation efficiencies during the disinfection in acidic solutions were better than the one in alkaline solutions, which could be due to rich CC levels on surface of PPC cathode. After the optimal disinfection, ARB counts increased slightly at the first 2 h and then tended to disappear, and there were no conjugation transfer and little transformation for target antibiotic resistance genes, indicating that potential risks could be blocked after the disinfection for 40 min. Furthermore, intermittent flow was more effective in inactivating ARB compared with continuous flow. These suggested that the application of metal-free electrochemical disinfection with PPC to inactivate ARB in water was feasible and desirable in this study.

Distribution and characteristics of carbapenem-resistant and extended-spectrum β-lactamase (ESBL) producing Escherichia coli in hospital effluents, sewage treatment plants, and river water in an urban area of Japan

Occurrence of profiles of the carbapenem-resistant Escherichia coli (CRE-E) and extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-E) in an urban river in a sub-catchment of the Yodo River Basin, one of the representative water systems of Japan was investigated. We conducted seasonal and year-round surveys for the antimicrobial-resistant bacteria (AMRB) and antimicrobial-resistance genes (AMRGs) in hospital effluents, sewage treatment plant (STP) wastewater, and river water; subsequently, contributions to wastewater discharge into the rivers were estimated by analyses based on the mass flux. Furthermore, the characteristics of AMRB in the water samples were evaluated on the basis of antimicrobial susceptibility tests. CRE-E and ESBL-E were detected in all water samples with mean values 11 and 1900 CFU/mL in the hospital effluent, 58 and 4550 CFU/mL in the STP influent, not detected to 1 CFU/mL in the STP effluent, and 1 and 1 CFU/mL in the STP discharge into the river, respectively. Contributions of the pollution load derived from the STP effluent discharged into the river water were 1 to 21%. The resistome profiles for bla_IMP, bla_TEM, and bla_CTX-M genes in each water sample showed that AMRGs were not completely removed in the wastewater treatment process in the STP, and the relative abundances of bla_IMP, bla_TEM, and bla_CTX-M genes were almost similar (P<0.05). Susceptibility testing of antimicrobial-resistant E. coli isolates showed that CRE-E and ESBL-E detected in wastewaters and river water were linked to the prevalence of AMRB in clinical settings. These results suggest the importance of conducting environmental risk management of AMRB and AMRGs in the river environment. To our knowledge, this is the first detailed study that links the medical environment to CRE-E and ESBL-E for evaluating the AMRB and AMRGs in hospital effluents, STP wastewater, and river water at the basin scale on the basis of mass flux as well as the contributions of CRE-E and ESBL-E to wastewater discharge into the river.

Recent advances on inactivation of waterborne pathogenic microorganisms by (photo) electrochemical oxidation processes: Design and application strategies

Compared with other conventional water disinfection processes, (photo) electrochemical oxidation (P/ECO) processes have the characteristics of environmental friendliness, convenient installation and operation, easy control and high efficiency of inactivating waterborne pathogenic microorganisms (PMs), so that more and more research work has been focused on this topic, but there is still a huge gap between the research and practical application. Here, the research network of inactivating PMs by P/ECO processes has been comprehensively summarized, and the electrode/reactor/process design strategies based on strengthening direct and indirect oxidation, enhancing mass transfer efficiency and electron transfer efficiency, and improving the effective dose of electrogenerated oxidants are discussed. Furthermore, the factors affecting the inactivation of PMs and the issues regarding to stability and lifetime of the electrode are discussed respectively. Finally, the important research priorities and possible research challenges of P/ECO processes are put forward to make significant progress of this technology.

Metagenomic analysis of MWWTP effluent treated via solar photo-Fenton at neutral pH: Effects upon microbial community, priority pathogens, and antibiotic resistance genes

The effectiveness of advanced technologies on eliminating antibiotic resistant bacteria (ARB) and resistance genes (ARGs) from wastewaters have been recently investigated. Solar photo-Fenton has been proven effective in combating ARB and ARGs from Municipal Wastewater Treatment Plant effluent (MWWTPE). However, most of these studies have relied solely on cultivable methods to assess ARB removal. This is the first study to investigate the effect of solar photo-Fenton upon ARB and ARGs in MWWTPE by high throughput metagenomic analysis (16S rDNA sequencing and Whole Genome Sequencing). Treatment efficiency upon priority pathogens and resistome profile were also investigated. Solar photo-Fenton (30 mg L-1 of Fe2+ intermittent additions and 50 mg L-1 of H2O2) reached 76-86% removal of main phyla present in MWWTPE. An increase in Proteobacteria abundance was observed after solar photo-Fenton and controls in which H2O2 was present as an oxidant (Fenton, H2O2 only, solar/H2O2). Hence, tolerance mechanisms presented by this group should be further assessed. Solar photo-Fenton achieved complete removal of high priority Staphylococcus and Enterococcus, as well as Klebsiella pneumoniae and Pseudomonas aeruginosa. Substantial reduction of intrinsically multi-drug resistant bacteria was detected. Solar photo-Fenton removed nearly 60% of ARGs associated with sulfonamides, macrolides, and tetracyclines, and complete removal of ARGs related to β-lactams and fluoroquinolones. These results indicate the potential of using solar-enhanced photo-Fenton to limit the spread of antimicrobial resistance, especially in developing tropical countries.