Antibiotic resistance in Acinetobacter spp. isolated from sewers receiving waste effluent from a hospital and a pharmaceutical plant

Eliminating ciprofloxacin antibiotic contamination from water with a novel submerged thermal plasma technology

Thermal plasma is successfully used to degrade the model pharmaceutical wastewater ciprofloxacin (CIP) under submerged operating conditions at atmospheric pressure. The model aqueous solution is prepared for two different concentrations (10 and 25 mg/L) and treated separately at 7 kW discharge power with two different plasma-forming gas compositions, Ar/Air and Ar/CO₂. A direct current (DC) hollow cathode plasma torch produces a thermal plasma jet inside the solution. The effect of plasma gas compositions on the CIP degradation process is investigated, and the corresponding degradation and mineralisation efficiencies for different treatment times are systematically compared using high-performance liquid chromatography (HPLC) and total organic carbon (TOC) analysis, respectively. Submerged Ar/CO₂ plasma shows higher degradation and mineralisation efficiency than the Ar/Air plasma. Energy yields of 74.32 mg/kWh and 176.98 mg/kWh are achieved for a 5-min treatment by Ar/CO₂ submerged thermal plasma at concentrations of 10 mg/L and 25 mg/L, respectively. The degradation of CIP by submerged plasma shows a resemblance with first-order reaction kinetics having reaction rates 0.149 min^-1 and 0.073 min^-1 for Ar/CO₂ and Ar/Air, respectively. Density Functional Theory (DFT) calculations are used to identify the various reactive sites on CIP, and the results are consistent with the formation of various intermediates detected through liquid chromatography-mass spectrometry (LC-MS) analysis. These findings suggest that reactive species formed through thermal and photochemical processes in submerged thermal plasma play a significant role in the degradation of CIP. This study also offers a possible way of using CO₂ gas in wastewater treatment using submerged thermal plasma.

Medical Household Waste as a Potential Environmental Hazard: An Ecological and Epidemiological Approach

Nowadays, the contamination caused by emerging pollutants is a global concern due to the lack of scientific evidence to demonstrate the risk or toxicity to humans due to the presence of pharmaceutical residues in the environment. This study aimed to identify and describe the disposal practices of unused and unwanted medications, as well as to analyze and identify the most frequent drugs determined on water bodies adjacent to the biggest urban population in Mexico. A two-phase study with an epidemiological and an ecological assessment was performed. The epidemiological phase was carried out with a descriptive cross-sectional study among citizens from Mexico City and the metropolitan area using an electronic survey applied to 719 subjects aimed to assess practices in which pharmaceutical products are disposed. The ecological phase included a review of scientific reports. The results show that nearly 83.5% of those surveyed use inappropriate practices for disposal medicines, the main ones are through the municipal dump or directly in the drain. The ecological approach was carried out by a systematic literature review of original reports published between 2013 to 2023; information about the class of drugs, active substance, environmental compartments, location, and concentration was extracted and presented. Fifty-one different types of pharmaceutical residues were detected in wastewater in Mexico City in the last decade. The results of this study can contribute to the application of public policies for waste management authorities to mitigate the socio-environmental risks due to the inappropriate disposal of medicines.

Antimicrobial resistant Escherichia coli in Scottish wild deer: Prevalence and risk factors

Antimicrobial resistance (AMR) is a recognised threat to global health. Obtaining data on the prevalence of AMR in environmental bacteria is key to understanding drivers and routes of transmission. Here, 325 Shiga toxin negative deer faecal samples-gathered from across the Scottish mainland-were screened for the presence of AMR Escherichia coli and investigated for potential risk factors associated with AMR occurrence. E. coli with resistance to antimicrobials of clinical health concern, including carbapenems and 3rd generation cephalosporins, were targeted. Ninety-nine percent of samples yielded E. coli, and the prevalence of resistant E. coli at the level of faecal samples was 21.8% (n = 71) for tetracycline, 6.5% (n = 21) for cefpodoxime, 0.3% for ciprofloxacin (n = 1), with no recorded resistance to meropenem. Potential risk factors for tetracycline and cefpodoxime resistance were investigated. The presence of broadleaved woodlands was significantly associated with both AMR phenotypes, which may relate to land use within or around such woodlands. Associated risk factors varied across resistance phenotype and deer species, with proximity or density of horses an indicator of significantly decreased and increased risk, respectively, or tetracycline and cefpodoxime resistance in E. coli from roe deer, but not from red deer. Distance from wastewater treatment plants was a significant risk factor for tetracycline resistance in E. coli from red deer but not from roe deer. Data indicated that AMR E. coli can occur in wild deer populations that are not directly exposed to the selective pressure exerted by antimicrobial treatment. Overall, resistance to critically important antimicrobials was found to be low in the studied population, suggesting no immediate cause for concern regarding human health. Utilising existing culling frameworks, wild deer in Scotland could function well as a sentinel species for the surveillance of AMR in the Scottish environment.

Global Distribution and Diversity of Prevalent Sewage Water Plasmidomes

Sewage water from around the world contains an abundance of short plasmids, several of which harbor antimicrobial resistance genes (ARGs). The global dynamics of plasmid-derived antimicrobial resistance and functions are only starting to be unveiled. Here, we utilized a previously created data set of 159,332 assumed small plasmids from 24 different global sewage samples. The detailed phylogeny, as well as the interplay between their protein domains, ARGs, and predicted bacterial host genera, were investigated to understand sewage plasmidome dynamics globally. A total of 58,429 circular elements carried genes encoding plasmid-related features, and MASH distance analyses showed a high degree of diversity. A single (yet diverse) cluster of 520 predicted Acinetobacter plasmids was predominant among the European sewage water. Our results suggested a prevalence of plasmid-backbone gene combinations over others. This could be related to selected bacterial genera that act as bacterial hosts. These combinations also mirrored the geographical locations of the sewage samples. Our functional domain network analysis identified three groups of plasmids. However, these backbone domains were not exclusive to any given group, and Acinetobacter was the dominant host genus among the theta-replicating plasmids, which contained a reservoir of the macrolide resistance gene pair msr(E) and mph(E). Macrolide resistance genes were the most common in the sewage plasmidomes and were found in the largest number of unique plasmids. While msr(E) and mph(E) were limited to Acinetobacter, erm(B) was disseminated among a range of Firmicutes plasmids, including Staphylococcus and Streptococcus, highlighting a potential reservoir of antibiotic resistance for these pathogens from around the globe. IMPORTANCE Antimicrobial resistance is a global threat to human health, as it inhibits our ability to treat infectious diseases. This study utilizes sewage water plasmidomes to identify plasmid-derived features and highlights antimicrobial resistance genes, particularly macrolide resistance genes, as abundant in sewage water plasmidomes in Firmicutes and Acinetobacter hosts. The emergence of macrolide resistance in these bacteria suggests that macrolide selective pressure exists in sewage water and that the resident bacteria can readily acquire macrolide resistance via small plasmids.

Evaluating the Role of Wastewaters as Reservoirs of Antibiotic-Resistant ESKAPEE Bacteria Using Phenotypic and Molecular Methods

Introduction

Methodology

Results

Conclusion

Cefotaxime removal enhancement via bio-nanophotocatalyst α-Fe2O3 using photocatalytic degradation technique and its echo-biomedical applications

The present paper evaluates the photocatalytic degradation (PCD) performance of the biofabricated hematite nanoparticles (α-HNPs) for the degradation approach of the Cefotaxime (Cfm). The optimum pH of the solution to achieve the best PCD was found to be 10.5. The kinetics study for the PCD of the Cfm via α-HNPs has been investigated and the reaction was found to be fellow pseudo-first-order at R² = 0.992. The mass loading impact of α-HNPs was investigated and estimated for the maximum degradation of Cfm 0.4 mg/mL. UV–Vis confirmed that α-HNPs had a direct transition bandgap at 3.78 eV at a maximum absorption wavelength of 362 nm with suspension stability for 7 days. The probable mechanism of the Cfm PCD via α-HNPs and the degradation pathway was conducted. The validation of the suspension stability of the α-HNPs (−68.6 ± 11.8 mV) was determined using the zeta potential investigation test. XRD investigation was conducted after Cfm PCD showing an average crystallite size of 27.0 nm. XRD, TEM, SEM, EDX, and FT-IR analyses have been conducted for the α-HNPs before and after Cfm PCD confirming the high efficiency for the reusability of the current biocatalyst α-HNPs for further use. TEM results of the particle sizes of α-HNPs were found at 19.2 ± 4.4 and 20.6 ± 7.4 nm respectively before and after Cfm PCD. The efficiency of the Cfm PCD was found to be 99.1% after 6 h. High potent as an antibacterial agent of α-HNPs was investigated either α-HNPs alone or after its PCD activity against Cfm. The antibacterial activity revealed high sensitivity, especially toward Gram-positive species indicating its promising ability against pathogenic issues. Interestingly, Cfm@α-HNPs showed superior anti-proliferative activity as tested by MTT assay and were able to induce apoptosis in MCF7 and HepG2 cell lines using the flow cytometry technique at 20.7% and 17% respectively. Also, The IC₅₀ of hydrogen peroxide scavenging was estimated and it was manifested that 635.8 and 665.6 μg/mL of α-HNPs before and after the PCD process of Cfm respectively.

Analysis of the Occurrence of Antibiotic Resistant Bacteria in the Hospital’s Effluent and its Receiving Environment

The use of antibiotics on a regular and excessive basis is a major factor in the spread of antibiotic-resistant bacteria. Patients discharge un-metabolized or relatively low doses of non-metabolized antibiotics through urine and stool, which might enter into the environment through sewage disposal and promote the emergence of antibiotic resistant bacteria. This study is designed to investigate how excessive use of antibiotics in the hospital sector and their release into hospital wastes contribute to the spread of antibiotic-resistant bacteria in different environmental settings. In this study, liquid hospital waste was collected from the sewage of Chittagong Medical College Hospital (CMCH), Bangladesh as well as from its distribution position in Chittagong city, Bangladesh. A total of 5 samples were collected from different positions in Chittagong city, including CMCH liquid waste. After collection, total bacteria and total cefixime resistant bacteria were counted by the total viable count (TVC) method. The result of bacteriological enumeration showed that a high magnitude of cefixime-resistant bacteria were available in all the hospital’s associated waste samples. The highest proportion of cefixime resistant bacteria (23.35%) was found in sample 2, whereas 17.4%, 7.6%, 5%, and 1.32% were found in samples 1, 3, 4, and 5, respectively. The total number of cefixime-resistant bacteria decreased with the increase in distance between the sample collection site and the hospital drain. This means that resistant bacteria developed in the hospital effluent are transferred to the environmental distribution sites.

The ß-ketoadipate pathway of Acinetobacter baumannii is involved in complement resistance and affects resistance against aromatic antibiotics

Acinetobacter baumannii can thrive on a broad range of substrates such as sugars, alcohols, lipids, amino acids and aromatic compounds. The latter three are abundant in the human host and are potential candidates as carbon sources for the metabolic adaptation of A. baumannii to the human host. In this study we determined the biodegradative activities of A. baumannii AYE with monocyclic aromatic compounds. Deletion of genes encoding the key enzymes of the ß-ketoadipate pathway, the protocatechuate-3,4-dioxygenase (ΔpcaHG) and the catechol-1,2-dioxygenase (ΔcatA), led to a complete loss of growth on benzoate and p-hydroxybenzoate, suggesting that these substrates are metabolized via the two distinct branches (pca and cat) of this pathway. Furthermore, we investigated the potential role of these gene products in host adaptation by analyzing the capability of the mutants to resist complement-mediated killing. These studies revealed that the mutants exhibit a decreased complement resistance, but a dramatic increase in survival in normal human serum in the presence of p-hydroxybenzoate or protocatechuate. These results indicate that the ß-ketoadipate pathway plays a role in adaptation of A. baumannii to the human host. Moreover, the single and double mutants exhibited increased antibiotic resistances indicating a link between the two dioxygenases and antibiotic resistance.

A review on non-thermal plasma treatment of water contaminated with antibiotics

Large amounts of antibiotics are produced and consumed worldwide, while wastewater treatment is still rather inefficient, leading to considerable water contamination. Concentrations of antibiotics in the environment are often sufficiently high to exert a selective pressure on bacteria of clinical importance that increases the prevalence of resistance. Since the drastic reduction in the use of antibiotics is not envisaged, efforts to reduce their input into the environment by improving treatment of contaminated wastewater is essential to limit uncontrollable spread of antibiotic resistance. This paper reviews recent progress on the use of non-thermal plasma for the degradation of antibiotics in water. The target compounds removal, the energy efficiency and the mineralization are analyzed as a function of discharge configuration and the most important experimental parameters. Various ways to improve the plasma process efficiency are addressed. Based on the identified reaction intermediates, degradation pathways are proposed for various classes of antibiotics and the degradation mechanisms of these chemicals under plasma conditions are discussed.

Abiotic mechanism changing tetracycline resistance in root mucus layer of floating plant: The role of antibiotic-exudate complexation

Antibiotic contamination and antibiotic resistance have caused growing concerns in different aquatic environments. This work investigated the complexation between tetracycline chloride (TCH) and the molecular weight (MW)-fractionated root exudates - the key abiotic mechanism impacting antibiotic fate and antibiotic resistance in rhizosphere. Results show that the affinity of TCH to the high MW exudates (≥10 kDa) facilitated the TCH deposition on roots and meanwhile reinforced the expression of certain tetracycline resistance genes (i.e. tetA) and the growth of tetracycline resistant bacteria. The interaction between TCH and the lower MW exudates (<10 kDa) completely inhibited the bacteria growth even below the minimum inhibitory concentration of TCH. In microcosms, the abiotic interaction between TCH and root exudates made effects along with biotic processes. Persistent TCH stimulation (≥50 µg/L, 7 d) induced the change of tet gene abundance and bacteria phyla composition though the mediation of root exudates made the rhizosphere less sensitive to the TCH stress. Summarily, the affinity of antibiotics to root exudates varied with MWs, which was closely related to (i) the antibiotic fate in the root mucus layer, (ii) the bacteria inhibition capacity of antibiotics, and (iii) the antibiotic resistance and bacterial community.

A novel electrochemiluminescence aptasensor for sensitive detection of kanamycin based on the synergistic enhancement effects between black phosphorus quantum dots and silver-decorated high-luminescence polydopamine nanospheres

Black phosphorus quantum dots (BPQDs), as a new type of nanomaterial, have excellent electrical and optical properties. In this work, an efficient monitoring method for kanamycin (KAN) was developed based on a sensitive and selective electrochemiluminescence (ECL) aptasensor. The construction of the ECL illuminant was based on BPQDs loaded on silver-nanoparticle modified high-luminescence polydopamine nanospheres (HLPNs@Ag). HLPNs possessed a large specific surface area and strong adhesion, which could support a great deal of BPQDs. Meanwhile, Ag NPs could accelerate the electron-transfer (ET) rate of the sensor and amplify the ECL signal of the BPQDs. Based on the synergistic enhancement effects between the above materials, the as-fabricated nanocomposites exhibited superior ECL performance. With the assistance of a KAN aptamer, the sensor can detect KAN sensitively and selectively. Under optimal conditions, the aptasensor could detect KAN in a wide linear range from 1 × 10^-12 to 1.0 × 10^-7 M with a detection limit of 1.7 × 10^-13 M (S/N = 3). More importantly, this ultra-sensitive and rapid ECL aptasensor-based KAN detection system provided excellent applicability for the monitoring of environmental safety.

Long-Term Temporal Stability of the Resistome in Sewage from Copenhagen

The Copenhagen sewage resistome is surprisingly stable in time. The implication is that, at least for cities that are comparable to Copenhagen in terms of sewer infrastructure, few or even single samples provide a robust picture of the resistome within a city.

Antimicrobial resistance (AMR) is a major threat to global health, and it is crucial to understand the epidemiological aspects in order to predict the emergence and propagation of AMR genes. The aim of this study was to assess the variability and medium-term AMR trends within the mostly healthy human population of a single city. We monitored over 36 months (November 2015 to November 2018) the AMR level in the city of Copenhagen, Denmark, by taking bi-weekly sewage samples from the inlets of the three main water treatment plants, extracting the DNA, performing metagenomic sequencing, and read-mapping against a database of known AMR genes. We found that the AMR level was surprisingly stable with no periodic variability and no signs of drift over the measured period. We found, however, that the seemingly random variations at each site correlate in time with each other, suggesting that the variations we see are due to real environmental changes in the occurrence of AMR.

IMPORTANCE The Copenhagen sewage resistome is surprisingly stable in time. The implication is that, at least for cities that are comparable to Copenhagen in terms of sewer infrastructure, few or even single samples provide a robust picture of the resistome within a city.

Assessing the Pyloric Caeca and Distal Gut Microbiota Correlation with Flesh Color in Atlantic Salmon (Salmo salar L., 1758)

The Atlantic salmon (Salmo salar L., 1758) is a temperate fish species native to the northern Atlantic Ocean. The distinctive pink–red flesh color (i.e., pigmentation) significantly affects the market price. Flesh paleness leads to customer dissatisfaction, a loss of competitiveness, a drop in product value and, consequently, severe economic losses. This work extends our knowledge on salmonid carotenoid dynamics to include the interaction between the gut microbiota and flesh color. A significant association between the flesh color and abundance of specific bacterial communities in the gut microbiota suggests that color may be affected either by seeding resilient beneficial bacteria or by inhibiting the negative effect of pathogenic bacteria. We sampled 96 fish, which covered all phenotypes of flesh color, including the average color and the evenness of color of different areas of the fillet, at both the distal intestine and the pyloric caeca of each individual, followed by 16S rRNA sequencing at the V3-V4 region. The microbiota profiles of these two gut regions were significantly different; however, there was a consistency in the microbiota, which correlated with the flesh color. Moreover, the pyloric caeca microbiota also showed high correlation with the evenness of the flesh color (beta diversity index, PERMANOVA, p = 0.002). The results from the pyloric caeca indicate that Carnobacterium, a group belonging to the lactic acid bacteria, is strongly related to the flesh color and the evenness of the color between the flesh areas.

Occurrence of antibiotics residues in hospital wastewater, wastewater treatment plant, and in surface water in Nairobi County, Kenya

The occurrence of 17 antibiotics belonging to sulfonamides, β-lactams, macrolides and aminoglycosides classes, and trimethoprim in raw hospital wastewater, wastewater treatment plant (WWTP), and surface water was determined. Residual antibiotics were quantified by LC/MS/MS. Residues of antibiotics in hospital wastewater were 3-10 times higher than that detected in WWTP and surface water. Trimethoprim, spectinomycin, ampicillin, and oxacillin were detected in all the sampled water. Sulfamethoxazole was detected at the highest concentration of 20.6, 7.8, and 6.8 μg L^-1 in hospital wastewater, WWTP and in surface water, respectively. Other detected sulfonamides were sulfamethazine, sulfadiazine, and sulfanilamide at a concentration range of 0.4-15.7 μg L^-1. Detected trimethoprim ranged from 0.4-6.6 μg L^-1, the rest of the detected antibiotics were up to 1.0 μg L^-1. The speciation of the sulfonamides at pH values relevant to sampled water was evaluated by use of pKa values. These compounds existed largely as anionic and neutral species indicating high mobility as these speciation forms are less sorbed in environmental matrices. Continuous monitoring of antibiotics residues in wastewater, surface water, and other environmental matrices is very important due to their adverse health and environmental effects. The information is useful in designing strategies for antibiotics pollution control and also in policy formulation.

Acquisition of Extracellular DNA by Acinetobacter baylyi ADP1 in Response to Solar and UV-C254nm Disinfection

Extracellular DNA (eDNA) cannot be effectively removed by most of the existing wastewater treatment technologies and can contribute to the gain of new functional traits when transformed into competent bacteria present in downstream environments. This study evaluates the contributions of solar and UV-C_254nm irradiation to the transformation of eDNA in Acinetobacter baylyi ADP1. Solar irradiation was evaluated because it is a natural environmental stressor to which eDNA would be exposed during wastewater reuse. UV-C_254nm was evaluated as an alternative to a chlorine-based disinfection strategy. Our findings showed that solar disinfection increased the natural transformation frequency by up to 2.0-fold after irradiance at 153 mJ/cm². This was largely mediated by reactive oxygen species generation, which was correlated with an upregulation of both DNA repair (recA and ddrR) and competence (comA and pilX) genes. In contrast, even though UV-C_254nm exposure was accompanied by the upregulation of DNA repair (recA, ddrR, and uvrB) genes and, hence, possibly higher integration rates of eDNA, we observed a concentration-dependent decrease in transformation rates. This decrease in transformation was likely due to the UV dimerization of eDNA, which resulted in the integration of damaged genes that cannot be transcribed into any functional gene products. These results imply that even though sunlight stimulates eDNA uptake and integration in the natural environment, UV disinfection implemented at a treatment plant can potentially minimize subsequent detrimental effects by damaging the extracellular genetic material and ensuring that there is no substantial expression of these transformed genes.

Water Disinfection Byproducts Increase Natural Transformation Rates of Environmental DNA in Acinetobacter baylyi ADP1

The process of natural transformation allows for the stable uptake, integration, and functional expression of extracellular DNA. This mechanism of horizontal gene transfer has been widely linked to the acquisition of antibiotic resistance and virulence factors. Here, we demonstrate that bromoacetic acid (BAA)-a regulated drinking water disinfection byproduct (DBP)-can stimulate natural transformation rates in the model organism Acinetobacter baylyi ADP1. We demonstrate that transformation stimulation in response to BAA is concentration-dependent and is linked to the ability of this compound to generate DNA damage via oxidative stress. In presence of BAA, transcription of recA was upregulated 20-40% compared to the nontreated controls, indicating that this component of the DNA damage response could be associated with the increase in transformation. Other genes associated with DNA translocation across the cytoplasmic membrane (i.e., pilX, comA) did not exhibit increased transcription in the presence of BAA, indicating that the enhancement of transformation is not associated with increased translocation rates of environmental DNA. Overall, these results lead us to speculate that elevated recA transcription levels could lead to increased integration rates of foreign DNA within the recipient cell during DNA repair. Lastly, we show that an artificial DBP cocktail simulating the environmental concentrations of five water DBP classes stimulates natural transformation by almost 2-fold. The results of this study suggest that mutagens like DBPs may play an important role in enhancing the fixation rates of extracellular DNA in the environmental metagenome.

Biodegradation of enrofloxacin by microbial consortia obtained from rhizosediments of two estuarine plants

This study aimed to investigate the potential of microbial communities from the rhizosediment of two plants - Phragmites australis and Juncus maritimus - occurring in an estuarine area subjected to a high anthropogenic impact, to biodegrade ENR, a commonly used veterinary antibiotic. An enrichment process with 1 mgL^-1 of ENR was conducted during ca. 9 months, using acetate as a co-substrate. After this, the enriched microbial consortia were challenged with higher ENR concentrations of 2 and 3 mgL^-1. Microbial cultures enriched with 1 mgL^-1 of ENR were capable of biodegrading this antibiotic, though not completely. By the end of the enrichment phase, microbial cultures were defluorinating an average of 50% of the ENR supplemented. Higher ENR concentrations led to lower biodegradation performances, suggesting a possible toxic/inhibitory effect in the microbial cultures. Phylogenetic identification of the microorganisms isolated from microbial cultures enriched with ENR revealed a high taxonomical diversity, with microorganisms belonging mainly to Proteobacteria and Bacteroidetes phyla. Assemblage of the obtained isolated strains (according to the enriched cultures from which they were isolated) revealed that the resulting consortia were also capable of degrading ENR, indicating that the main microbial players in the biodegradation of this antibiotic were isolated. These consortia also showed to be more robust to degrade higher concentrations of ENR than the corresponding enriched cultures. This study shows that microorganisms derived from rhizosediments of the selected plants, exhibit capacity to biodegrade ENR, though not completely for the concentrations tested, and may be further explored for the development of bioremediation strategies for the treatment of this antibiotic.

Antimicrobial activity of trans-cinnamic acid and commonly used antibiotics against important fish pathogens and nonpathogenic isolates

AIMS

Antibiotics and several other chemicals have been used to prevent fish diseases. However, this situation results in economic loss for the companies in the aquaculture industry and most importantly it pollutes the environment. Cinnamic acid is a naturally occurring aromatic acid and is considered to be safe for human consumption. Therefore, in this study, the antibacterial activity of trans-cinnamic acid and commonly used antibiotics, namely chloramphenicol, vancomycin, streptomycin and erythromycin, were tested against 32 bacteria, including fish pathogens, nonpathogenic isolates and collection strains.

METHODS AND RESULTS

Trans-cinnamic acid was applied against the bacteria using the disc diffusion and microdilution method under in vitro conditions. Antibiotics were also tested under similar conditions against all tested bacteria using the disc diffusion method. The results show that among 32 bacterial strains trans-cinnamic acid exhibited potent inhibitory effect on the Gram-negative fish pathogen Aeromonas sobria. In addition, a moderate inhibition of trans-cinnamic acid of fish pathogens Aeromonas salmonicida, Vibrio (Listonella) anguillarum, Vibrio crassostreae and Yersinia ruckeri was also observed for trans-cinnamic acid in our study. On the contrary, the majority of nonpathogenic intestinal isolates were resistant to trans-cinnamic acid.

CONCLUSIONS

To the best of our knowledge, this is the first report on the antimicrobial activity of trans-cinnamic acid on 24 of the studied bacteria isolated from fish. In conclusion, trans-cinnamic acid can be used as an environmentally friendly alternative additive to prevent and control primarily A. sobria, as well as other pathogenic bacteria such as A. salmonicida, V. anguillarum, V. crassostreae and Y. ruckeri.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study indicated that trans-cinnamic acid may present an environmentally friendly alternative therapeutic agent against A. sobria infections in the aquaculture industry.

Effect of UVA/LED/TiO2 photocatalysis treated sulfamethoxazole and trimethoprim containing wastewater on antibiotic resistance development in sequencing batch reactors

Controlling of antibiotics is the crucial step for preventing antibiotic resistance genes (ARGs) dissemination; UV photocatalysis has been identified as a promising pre-treatment technology for antibiotics removal. However, information about the effects of intermediates present in the treated antibiotics wastewater on the downstream biological treatment processes or ARGs development is very limited. In the present study, continuous UVA/LED/TiO₂ photocatalysis removed more than 90% of 100 ppb sulfamethoxazole (SMX)/trimethoprim (TMP), the treated wastewater was fed into SBR systems for over one year monitoring. Residual SMX/TMP (2-3 ppb) and intermediates present in the treated wastewater did not adversely affect SBR performance in terms of TOC and TN removal. SMX and TMP resistance genes (sulI, sulII, sulIII, dfrII, dfrV and dfr13) were also quantified in SBRs microbial consortia. Results suggested that continuous feeding of treated SMX/TMP containing wastewaters did not trigger any ARGs promotion during the one year operation. By stopping the input of 100 ppb SMX/TMP, abundance of sulII and dfrV genes were reduced by 83% and 100%, respectively. sulI gene was identified as the most persistence ARG, and controlling of 100 ppb SMX input did not achieve significant removal of sulI gene. A significant correlation between sulI gene and class 1 integrons was found at the level of p = 1.4E-10 (r = 0.94), and sulII gene positively correlated with the plasmid transfer efficiency (r = 2.442E-10, r = 0.87). Continuous input of 100 ppb SMX enhanced plasmid transfer efficiency in the SBR system, resulting in sulII gene abundance increasing more than 40 times.

Characterization of Bacterial Communities and Their Antibiotic Resistance Profiles in Wastewaters Obtained from Pharmaceutical Facilities in Lagos and Ogun States, Nigeria

In Nigeria, pharmaceutical wastewaters are routinely disseminated in river waters; this could be associated with public health risk to humans and animals. In this study, we characterized antibiotic resistant bacteria (ARB) and their antibiotic resistance profile as well as screening for sul1 and sul2 genes in pharmaceutical wastewater effluents. Bacterial composition of the wastewater sources was isolated on non-selective media and characterized by the polymerase chain reaction (PCR) amplification of the 16S rRNA genes, with subsequent grouping using restriction fragment length polymorphism (RFLP) and sequencing. The antibiotics sensitivity profiles were investigated using the standard disk diffusion plate method and the minimum inhibitory concentrations (MICs) of selected antibiotics on the bacterial isolates. A total of 254 bacterial strains were isolated, and majority of the isolates were identified as Acinetobacter sp., Klebsiella pneumonia, Proteus mirabilis, Enterobacter sp. and Bacillus sp. A total of 218 (85.8%) of the bacterial isolates were multidrug resistant. High MICs values were observed for all antibiotics used in the study. The result showed that 31.7%, 21.7% and 43.3% of the bacterial isolates harbored sul1, sul2, and Intl1 genes, respectively. Pharmaceuticals wastewaters are potential reservoirs of ARBs which may harbor resistance genes with possible risk to public health.

Antibiotic Susceptibility of Non-Cholera Vibrios Isolated from Farmed and Wild Marine Fish (Argyrosomus japonicus), Implications for Public Health

This study aimed to evaluate the antibiogram and antibiotic resistance genes (ARGs) of Vibrio isolates recovered from a marine fish (Argyrosomus japonicus) and water samples from two commercial dusky kob aquaculture farms and the Kariega estuary, South Africa, and to evaluate these findings for their public health implications. A total of 277 molecularly confirmed Vibrio isolates consisting of 126 Vibrio fluvialis, 45 Vibrio vulnificus, 30 Vibrio Parahaemolyticus, and 76 vibrios belonging to species of the genus other than Vibrio cholerae were subjected to susceptibility testing to 15 antibiotics by the disc diffusion method. Multiple antibiotic resistance index (MARI) was used to determine the antibiotic resistance-associated health risk, while polymerase chain reaction was used to evaluate the presence of 14 ARGs for nonsusceptible strains. Highest resistances were recorded to amoxicillin (76.2%), ampicillin (67.5%), erythromycin (38.3%), and doxycycline (35.0%), while susceptibilities were highest to gentamicin (100%), followed by norfloxacin (97.8%), florfenicol (90.3%), tetracycline (87.7%), and chloramphenicol (87.4%). We recorded a 58.5% multidrug resistance (resistance to ≥2 antimicrobial classes). MARI did not vary significantly between sites (p > 0.05); however, values of >0.2 were recorded in 40% (108/277) of all strains tested. ARG markers, ampC, blaOXA, tetA, tetM, dfr1, sul1, sul2, ermB, nptII, strA, and SXT integrase, were detected in one or more strains with ermB (82.5%), sul2 (53.8%), strA (44%), dfr1 (42.3%), and tetM (38.3%) being the most abundant. Healthy marine finfish (dusky kob) and their environment can serve as reservoirs for antibiotic resistant vibrios and ARGs, which could be disseminated to humans and other susceptible bacteria and this therefore becomes a public health concern.

Negative environmental impacts of antibiotic-contaminated effluents from pharmaceutical industries

Effluents from pharmaceutical industries are recognized as significant contributors to aquatic pollution with antibiotics. Although such pollution has been mostly reported in Asia, knowledge on industrial discharges in other regions of the world, including Europe, and on the effects associated with such exposures is still limited. Thus, we performed chemical, microbiological and ecotoxicological analyses of effluents from two Croatian pharmaceutical industries during four seasons. In treated effluents of the company synthesizing macrolide antibiotic azithromycin (AZI), the total concentration of AZI and two macrolide by-products from its synthesis was 1-3 orders of magnitude higher in winter and springtime (up to 10.5 mg/L) than during the other two seasons (up to 638 μg/L). Accordingly, the highest total concentrations (up to 30 μg/L) in the recipient river were measured in winter and spring. Effluents from second company formulating veterinary antibiotics contained fluoroquinolones, trimethoprim, sulfonamides and tetracyclines ranging from low μg/L to approx. 200 μg/L. Low concentrations of these antibiotics, from below the limit of quantification to approx. few μg/L, have also been measured in the recipient stream. High frequency of culturable bacteria resistant to AZI (up to 83%) or sulfamethazine (up to 90%) and oxytetracycline (up to 50%) were also found in studied effluents. Finally, we demonstrated that toxicity to algae and water fleas often exceeded the permitted values. Most highly contaminated effluents induced multiple abnormalities in zebrafish embryos. In conclusion, using a wide array of analyses we have demonstrated that discharges from pharmaceutical industries can pose a significant ecological and public health concern due to their toxicity to aquatic organisms and risks for promoting development and spread of antibiotic resistance.

Extended spectrum and metalo beta-lactamase producing airborne Pseudomonas aeruginosa and Acinetobacter baumanii in restricted settings of a referral hospital: a neglected condition

BACKGROUND

Frequently encountered multidrug-resistant bacterial isolates of P. aeruginosa and A. baumannii are common and prevalent in a hospital environment. The aim of this study was to determine the prevalence and pattern of antibiotic resistance, extended spectrum and metallo beta-lactamase producing P. aeruginosa and A. baumannii isolates from restricted settings of indoor air hospital environment.

METHODS

A hospital-based cross-sectional study was conducted in Wolaita Sodo University Teaching and referral Hospital, Ethiopia from December 1/2015 to April 30/2015. The Air samples were collected from delivery room, intensive care unit and operation theatre of the hospital by active, Anderson six slate sampler technique during the first week of the months, twice a week during Monday's and Friday's. Standard microbiological procedures were followed to isolate P. aeruginosa and A. baumannii. Susceptibility testing was performed on isolates using the Kirby-Bauer disk diffusion technique. Extended spectrum beta lactamase production was detected by double disc synergy test and Imipenem-resistant isolates were screened for producing Metallo-beta lactamase.

RESULTS

A total number of 216 indoor air samples were collected from the delivery room, intensive care unit, and operation room. Correspondingly, 43 A. baumannii isolates were identified (13 from delivery room, 21 from intensive care unit and 9 from operation room). Likewise 24 P. aeruginosa isolates were obtained (4 from delivery room, 13 from intensive care unit and 7 from operation room). Extended spectrum beta lactamase and metalo-beta lactamase production were observed in 24 (55.8%) and 13 (30.2%) isolates of A. baumannii respectively, whereas P. aeruginosa showed 15 (62.5%) extended spectrum beta lactamase and 9 (37.5%) metallo-beta lactamase production.

CONCLUSIONS

Extended spectrum beta lactamase and metallo-beta lactamase producing bacteria in hospital air is a new dimension for specific setting of the study area where antimicrobial resistance is increasing and surgical site infection is prevalent. So, identification of these microorganisms has a great role in reducing the burden of antibiotic resistance and could also provide a significant input for framing hospital infection control policies.

Antimicrobial Susceptibility of Staphylococcus aureus Isolated from Recreational Waters and Beach Sand in Eastern Cape Province of South Africa

Background: Resistance of Staphylococcus aureus to commonly used antibiotics is linked to their ability to acquire and disseminate antimicrobial-resistant determinants in nature, and the marine environment may serve as a reservoir for antibiotic-resistant bacteria. This study determined the antibiotic sensitivity profile of S.aureus isolated from selected beach water and intertidal beach sand in the Eastern Cape Province of South Africa. Methods: Two hundred and forty-nine beach sand and water samples were obtained from 10 beaches from April 2015 to April 2016. Staphylococcus aureus was isolated from the samples using standard microbiological methods and subjected to susceptibility testing to 15 antibiotics. Methicillin-resistant Staphylococcus aureus (MRSA) was detected by susceptibility to oxacillin and growth on Brilliance MRSA II agar. Antibiotic resistance genes including mecA, femA rpoB, blaZ, ermB, ermA, ermC, vanA, vanB, tetK and tetM were screened. Results: Thirty isolates (12.3%) were positive for S. aureus by PCR with over 50% showing phenotypic resistance to methicillin. Resistance of S. aureus to antibiotics varied considerably with the highest resistance recorded to ampicillin and penicillin (96.7%), rifampicin and clindamycin (80%), oxacillin (73.3%) and erythromycin (70%). S.aureus revealed varying susceptibility to imipenem (96.7%), levofloxacin (86.7%), chloramphenicol (83.3%), cefoxitin (76.7%), ciprofloxacin (66.7%), gentamycin (63.3%), tetracycline and sulfamethoxazole-trimethoprim (56.7%), and vancomycin and doxycycline (50%). All 30 (100%) S. aureus isolates showed multiple antibiotic-resistant patterns (resistant to three or more antibiotics). The mecA, femA, rpoB, blaZ, ermB and tetM genes were detected in 5 (22.7%), 16 (53.3%), 11 (45.8%), 16 (55.2%), 15 (71.4%), and 8 (72.7%) isolates respectively; Conclusions: Results from this study indicate that beach water and sand from the Eastern Cape Province of South Africa may be potential reservoirs of antibiotic-resistant S. aureus which could be transmitted to exposed humans and animals.

Occurrence of antibiotic resistance genes and mobile genetic elements in enterococci and genomic DNA during anaerobic digestion of pharmaceutical waste sludge with different pretreatments

Pharmaceutical waste sludge harbors large amounts of antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs), and it is necessary to study the reduction of ARGs and MGEs during sludge treatment. Therefore, the antibiotic resistance phenotypes and genotypes of enterococci, and the ARGs and MGEs in genomic DNA were investigated during anaerobic digestion (AD) with microwave (MW), thermal hydrolysis (TH) and ozone pretreatment. Results showed that sludge pretreatment increased the occurrence of the resistance phenotypes and genotypes of enterococci. During AD, the resistance of enterococci to macrolides decreased, except for in the MW-pretreated sludge. Horizontal gene transfer and co-occurrence of ermB and tetM in enterococci resulted in increased tetracycline resistance of enterococci throughout the sludge treatment. MGEs such as intI1, ISCR1 and Tn916/1545 had a significant effect on the distribution of ARGs. AD with pretreatment, especially TH pretreatment, resulted in greater ARGs and MGEs reduction and improved methane production.

Decomposition of sulfamethoxazole and trimethoprim by continuous UVA/LED/TiO2 photocatalysis: Decomposition pathways, residual antibacterial activity and toxicity

In this study, continuous LED/UVA/TiO₂ photocatalytic decomposition of sulfamethoxazole (SMX) and trimethoprim (TMP) was investigated. More than 90% of SMX and TMP were removed within 20min by the continuous photoreactor (with the initial concentration of 400ppb for each). The removal rates of SMX and TMP decreased with higher initial antibiotics loadings. SMX was much easier decomposed in acidic condition, while pH affected little on TMP's decomposition. 0.003% was found to be the optimum H₂O₂ dosage to enhance SMX photocatalytic decomposition. Decomposition pathways of SMX and TMP were proposed based on the intermediates identified by using LC-MS-MS and GC-MS. Aniline was identified as a new intermediate generated during SMX photocatalytic decomposition. Antibacterial activity study with a reference Escherichia coli strain was also conducted during the photocatalytic process. Results indicated that with every portion of TMP removed, the residual antibacterial activity decreased by one portion. However, the synergistic effect between SMX and TMP tended to slow down the antibacterial activity removal of SMX and TMP mixture. Chronic toxicity studies conducted with Vibrio fischeri exhibited 13-20% bioluminescence inhibition during the decomposition of 1ppm SMX and 1ppm TMP, no acute toxicity to V. fischeri was observed during the photocatalytic process.

Broad spectrum screening of 463 organic contaminants in rivers in Macedonia

Target screening of 463 organic contaminants in surface water using ultra high performance liquid chromatography quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS) with direct injection was performed in spring of 2015 in northern Macedonia, at six sampling sites in four rivers belonging to Vardar basin: Kriva, Zletovska, Bregalnica and Vardar. The aim of the study was to differentiate between various types of organic contamination characteristic for different types of anthropogenic activities, such as mining, agriculture, and urbanization. Depending on the studied river, 9-16% of analyzed compounds were detected. The highest total levels of organic contaminants were recorded in agriculturally impacted Bregalnica River (1839-1962ngL^-1) and Vardar River downstream from the city of Skopje (1945ngL^-1), whereas the lowest level was found in the mining impacted Zletovska River (989ngL^-1). The principal organic contaminants of the Bregalnica River were herbicides (45-55% of all detected compounds; 838-1094ngL^-1), with the highest concentrations of bentazone (407-530ngL^-1) and molinate (84-549ngL^-1), common herbicides in rice cultivation. The main organic contaminants in the other rivers were drugs (70-80% of all detected compounds), with antibiotics as a predominant drug class. The highest drug concentrations were measured in the Vardar River, downstream from Skopje (1544ngL^-1). Screening of surface water by UHPLC-QTOF-MS was proven as a practical tool for fast collection of comprehensive preliminary information on organic contamination of natural waters, which can present a significant contribution in the monitoring and preservation of good ecological status of freshwater ecosystems.

Fate and removal of various antibiotic resistance genes in typical pharmaceutical wastewater treatment systems

The high levels of antibiotic residues in pharmaceutical wastewater treatment plants (PWWTPs) make these plants the hotspots for the proliferation of antibiotic resistance genes (ARGs). This study investigated the fate and removal of 11 ARG subtypes for sulfonamide, tetracycline, β-lactam, and macrolide resistance in each processing stage of two full-scale PWWTPs in northern China. The levels of typical ARG subtypes in the final effluents ranged from (2.56 ± 0.13) × 10(1) to (2.36 ± 0.11) × 10(7) copies/ml. The absolute abundance of ARGs in effluents accounted for only 0.03-78.1 % of influents of the two PWWTPs, while the majority of the ARGs were transported to the dewatered sludge with concentrations from (2.65 ± 0.43) × 10(5) to (4.27 ± 0.03) × 10(10) copies/g dry weight (dw). The total loads of ARGs discharged through dewatered sludge plus effluent was 1.01-14.09-fold higher than that in the raw influents, suggesting the proliferation of ARGs occurred in the wastewater treatment. The proliferation of ARGs mainly occurs in biological treatment process, such as aeration tank, anoxic tank, sequencing batch reactor (SBR), and bio-contact oxidation, facilitates the proliferation of various ARGs, implying significant replication of certain ARG subtypes may be attributable to microbial growth. Chemical oxidation seems promising to remove ARGs, with removal efficiency ranged from 29.3 to 85.7 %, while the partial correlation analysis showed significant correlations between antibiotic concentration and ARG removal. Thus, the high antibiotic residues within the PWWTPs may have an influence on the proliferation, fate, and removal of the associated ARG subtypes.

Pollution from drug manufacturing: review and perspectives

As long ago as the sixteenth century, Paracelsus recognized that ‘the dose makes the poison’. Indeed, environmental concentrations of pharmaceuticals excreted by humans are limited, most importantly because a defined dose is given to just a fraction of the population. By contrast, recent studies have identified direct emission from drug manufacturing as a source of much higher environmental discharges that, in some cases, greatly exceed toxic threshold concentrations. Because production is concentrated in specific locations, the risks are not linked to usage patterns. Furthermore, as the drugs are not consumed, metabolism in the human body does not reduce concentrations. The environmental risks associated with manufacturing therefore comprise a different, wider set of pharmaceuticals compared with those associated with risks from excretion. Although pollution from manufacturing is less widespread, discharges that promote the development of drug-resistant microorganisms can still have global consequences. Risk management also differs between production and excretion in terms of accountability, incentive creation, legal opportunities, substitution possibilities and costs. Herein, I review studies about industrial emissions of pharmaceuticals and the effects associated with exposure to such effluents. I contrast environmental pollution due to manufacturing with that due to excretion in terms of their risks and management and highlight some recent initiatives.

Fate and proliferation of typical antibiotic resistance genes in five full-scale pharmaceutical wastewater treatment plants

This study investigated the characteristics of 10 subtypes of antibiotic resistance genes (ARGs) for sulfonamide, tetracycline, β-lactam and macrolide resistance and the class 1 integrase gene (intI1). In total, these genes were monitored in 24 samples across each stage of five full-scale pharmaceutical wastewater treatment plants (PWWTPs) using qualitative and real-time quantitative polymerase chain reactions (PCRs). The levels of typical ARG subtypes in the final effluents ranged from (2.08±0.16)×10(3) to (3.68±0.27)×10(6) copies/mL. The absolute abundance of ARGs in effluents accounted for only 0.6%-59.8% of influents of the five PWWTPs, while the majority of the ARGs were transported to the dewatered sludge with concentrations from (9.38±0.73)×10(7) to (4.30±0.81)×10(10) copies/g dryweight (dw). The total loads of ARGs discharged through dewatered sludge was 7-308 folds higher than that in the raw influents and 16-638 folds higher than that in the final effluents. The proliferation of ARGs mainly occurs in the biological treatment processes, such as conventional activated sludge, cyclic activated sludge system (CASS) and membrane bio-reactor (MBR), implying that significant replication of certain subtypes of ARGs may be attributable to microbial growth. High concentrations of antibiotic residues (ranging from 0.14 to 92.2 mg/L) were detected in the influents of selected wastewater treatment systems and they still remain high residues in the effluents. Partial correlation analysis showed significant correlations between the antibiotic concentrations and the associated relative abundance of ARG subtypes in the effluent. Although correlation does not prove causation, this study demonstrates that in addition to bacterial growth, the high antibiotic residues within the pharmaceutical WWTPs may influence the proliferation and fate of the associated ARG subtypes.

Characterization of Pharmaceuticals and Personal Care products in hospital effluent and waste water influent/effluent by direct-injection LC-MS-MS

Two USEPA Regional Laboratories developed direct-injection LC/MS/MS methods to measure Pharmaceuticals and Personal Care Products (PPCPs) in water matrices. Combined, the laboratories were prepared to analyze 185 PPCPs (with 74 overlapping) belonging to more than 20 therapeutical categories with reporting limits at low part-per-trillion. In partnership with Suffolk County in NY, the laboratories conducted PPCP analysis on 72 samples belonging to 4 Water Systems (WS). Samples were collected at different stages of the WS (hospital effluents, WWTP influents/effluents) to assess PPCP relevance in hospital discharges, impact on WWTP performance and potential ecological risk posed by analytes not eliminated during treatment. Major findings include: a) acceptable accuracy between the two laboratories for most overlapping PPCPs with better agreement for higher concentrations; b) the measurement of PPCPs throughout all investigated WS with total PPCP concentrations ranging between 324 and 965 μg L(-1) for hospital effluent, 259 and 573 μg L(-1) for WWTP influent and 19 and 118 μg L(-1) for WWTP effluent; c) the variable contribution of hospital effluents to the PPCP loads into the WWTP influents (contribution ranging between 1% (WS-2) and 59% (WS-3); d) the PPCP load reduction after treatment for all WS reaching more than 95% for WS using activated sludge processes (WS-2 and WS-4), with inflow above 6500 m(3) d(-1), and having a lower percentage of hospital effluent in the WWTP influent; e) the relevance of four therapeutical categories for the PPCP load in WWTP effluents (analgesics, antidiabetics, antiepileptics and psychoanaleptics); and f) the risk quotients calculated using screening-level Predicted Non Effect Concentration indicate that WWTP effluents contain 33 PPCPs with potential medium to high ecological risk. To our knowledge no other monitoring investigation published in the scientific literature uses direct-injection methods to cover as many PPCPs and therapeutical categories in different types of WS.

Antibiotic resistance of Gram-negative benthic bacteria isolated from the sediments of Kardzhali Dam (Bulgaria)

The aim of the present study was to carry out a preliminary assessment for the occurrence of bacterial strains resistant to frequently used antibiotics in the sediments beneath the sturgeon cage farm in Kardzhali Dam (Bulgaria). Samples were taken from the top 2 cm of sediments under a fish farm and from a control station in the aquatory of the reservoir in the period July–October 2011. Surveillance of bacterial susceptibility to 16 antimicrobial agents was performed for 160 Gram-negative strains (Pseudomonas mandelii – 100 strains; Hafnia alvei – 30 strains; and Raoultella ornithinolytica – 30 strains). No significant differences in the resistance to the tested antibiotics were observed between the strains isolated from the two stations (analysis of variance, P > 0.05). Widespread resistance to penicillins and certain cephalosporin antibiotics was observed in both stations. None of the studied strains showed resistance to the aminoglycoside antibiotics gentamicin and amikacin, or to ciprofloxacin. Minimal Inhibitory Concentrations (MIC) were determined for five of the tested antimicrobial agents by the microdilution antibiotic sensitivity assay. The data indicate that amikacin, tetracycline and ciprofloxacin effectively suppress the growth of the tested micro-organisms. The isolates from genus Pseudomonas showed the highest MIC and were characterized by the highest percentage of antibiotic resistance.

tet genes as indicators of changes in the water environment: relationships between culture-dependent and culture-independent approaches

The aim of this study was to identify tetracycline resistance determinants that could be used as molecular indicators of anthropogenic changes in aquatic environments. Two parallel approaches were used to examine the prevalence of tet genes: a culture-based method involving standard PCR and a method relying on quantitative PCR. The studied site was the Łyna River in Olsztyn (Poland). The culture-dependent method revealed that the concentrations of doxycycline-resistant bacteria harboring the tet(B) gene were higher in wastewater and downstream river samples than in upstream water samples. The tet(B) gene was transferred from environmental bacteria to Escherichia coli. The results generated by the culture-independent method validated statistically significant differences in tet(B) concentrations between upstream and downstream river sections, and revealed that tet(B) levels were correlated with the presence of other tetracycline resistance genes, dissolved oxygen concentrations, temperature and doxycycline concentrations in water. Our findings indicate that doxycycline-resistant bacteria, in particular E. coli harboring tet(B) or increased concentrations of tet(B), are potentially robust indicators of changes in water environments.

Isolation and characterization of multiple drug resistance bacterial pathogens from waste water in hospital and non-hospital environments, Northwest Ethiopia

Background

The importance of bacterial isolates from waste water environment as a reservoir of antibiotic resistance and a potential source of novel resistance genes to clinical pathogens is underestimated. This study is aimed at to isolate and characterize public health important bacteria from waste water in hospital and non- hospital environments and evaluate the distribution of multiple drug resistance bacteria in the study area.

Methods

A cross-sectional study was conducted at Gondar from January-June 2012. The hospital waste water was taken from different sections of the Gondar University Teaching Hospital. Non- hospital environment samples were taken at different sites of the university campuses, Gondar College of Teachers education, and soft drink factory in Gondar. Samples were aseptically collected, transported and processed with in two hours following standard procedure. Identified organisms were assessed for different antibiotics following Kirby-Bauer disk diffusion method. All data was registered and entered in to SPSS version 16 computer program. P-values less than 0.05 were taken as statistically significant.

Result

A total of 60 waste water samples were processed for the presence of drug resistance pathogens. Among the total samples 113 bacterial isolates were recovered and of these 65 (57.5%) were from hospital environment and 48 (42.5%) were from non-hospital environment. The most frequently identified bacterium was Klebsiella spp. 30 (26.6%) followed by Pseudomonas spp. 19(16.8%), E. coli (11.5%) and Citrobacter spp (11.5%), and Staphylococcus aureus (8.2%). The over all prevalence of multiple drug resistance (MDR) in this study was 79/113 (69.9%). MDR in hospital environment was found to be 53/68 (81.5%) while in non hospital environment was found to be 26/48 (54.2%).

Conclusions

Multiple drug resistance to the commonly used antibiotics is high in the study area. The contamination of waste water by antibiotics or other pollutants lead to the rise of resistance due to selection pressure. The presence of antibiotic resistance organisms in this waste water should not be overlooked. Since this organisms may be vital to the safety and well-being of patients who are hospitalized and individual susceptible to infection. Therefore, proper waste water treatment plant should be established and improved sanitary measure should be practice.

Role of house flies in the ecology of Enterococcus faecalis from wastewater treatment facilities

Enterococci are important nosocomial pathogens, with Enterococcus faecalis most commonly responsible for human infections. In this study, we used several measures to test the hypothesis that house flies, Musca domestica (L.), acquire and disseminate antibiotic-resistant and potentially virulent E. faecalis from wastewater treatment facilities (WWTF) to the surrounding urban environment. House flies and sludge from four WWTF (1-4) as well as house flies from three urban sites close to WWTF-1 were collected and cultured for enterococci. Enterococci were identified, quantified, screened for antibiotic resistance and virulence traits, and assessed for clonality. Of the 11 antibiotics tested, E. faecalis was most commonly resistant to tetracycline, doxycycline, streptomycin, gentamicin, and erythromycin, and these traits were intra-species horizontally transferrable by in vitro conjugation. Profiles of E. faecalis (prevalence, antibiotic resistance, and virulence traits) from each of WWTF sludge and associated house flies were similar, indicating that flies successfully acquired these bacteria from this substrate. The greatest number of E. faecalis with antibiotic resistance and virulence factors (i.e., gelatinase, cytolysin, enterococcus surface protein, and aggregation substance) originated from WWTF-1 that processed meat waste from a nearby commercial meat-processing plant, suggesting an agricultural rather than human clinical source of these isolates. E. faecalis from house flies collected from three sites 0.7-1.5 km away from WWTF-1 were also similar in their antibiotic resistance profiles; however, antibiotic resistance was significantly less frequent. Clonal diversity assessment using pulsed-field gel electrophoresis revealed the same clones of E. faecalis from sludge and house flies from WWTF-1 but not from the three urban sites close to WWTF-1. This study demonstrates that house flies acquire antibiotic-resistant enterococci from WWTF and potentially disseminate them to the surrounding environment.

Photocatalytic degradation of agricultural antibiotics using a UV-LED light source

With a view to developing a UV-LED photocatalytic reactor for small and remote water systems, the degradation of three representative agriculturally produced contaminants, two antibiotics and an endocrine disruptor hormone, was evaluated in a bench 365 nm LED photoreactor using a slurry of the well-known Degussa P25® (TiO2) as photocatalyst. Use of an additional electron capture additives O2 and H2O2 was also assessed. Loss of the parent organic compounds was tracked by HPLC or UV absorbance and mineralization, where feasible, was studied with TOC analysis with conventional instrumentation. In all cases, degradation is significant with moderate light dose. Lab data suggest log reduction with light delivery less than 2.2 kWhr per cubic meter light delivery.

The long-term effects of phage concentration on the inhibition of planktonic bacterial cultures

Since the early 1920s there has been an interest in using bacteriophages (phages) for the control of bacterial pathogens. While there are many factors that have limited the success of phage bio-control, one particular problem is the variability of outcomes between phages and bacteria. Specifically, there is a significant need for a better understanding of how initial phage concentrations affect long-term bacterial inhibition. In work reported herein three phages were isolated for Escherichia coli K12, Pseudomonas aeruginosa PAO1, as well as Bacillus cereus and bio-control experiments were performed with phage concentrations ranging from 10(5) to 10(8) plaque forming units per mL over the course of 72 h. For four of the nine phages isolated there was a linear relationship between inhibition and phage concentration, suggesting the effect of phage concentration is important at longer time scales. For three of the isolated phages, phage concentrations had no effect on bacterial inhibition suggesting that even at the lowest concentration the method of action was saturated and lower concentrations might still be effective. Additionally, a cocktail was created and was compared to the previously isolated phages. There was no statistical difference between the cocktail and the best performing phage highlighting the importance of selecting the appropriate phages for treatment. These results suggest that, for certain phages, there is a strong relationship between phage concentration and long-term bacterial growth inhibition and the initial phage concentration is an important indicator of the long-term outcome.

Degradation of antibiotic activity during UV/H2O2 advanced oxidation and photolysis in wastewater effluent

Trace levels of antibiotics in treated wastewater effluents may present a human health risk due to the rise of antibacterial activity in the downstream environments. Advanced oxidation has a potential to become an effective treatment technology for transforming trace antibiotics in wastewater effluents, but residual or newly generated antibacterial properties of transformation products are a concern. This study demonstrates the effect of UV photolysis and UV/H2O2 advanced oxidation on transformation of 6 antibiotics, each a representative of a different structural class, in pure water and in two different effluents and reports new or confirmatory photolysis quantum yields and hydroxyl radical rate constants. The decay of the parent compound was monitored with HPLC/ITMS, and the corresponding changes in antibacterial activity were measured using bacterial inhibition assays. No antibacterially active products were observed following treatment for four of the six antibiotics (clindamycin, ciprofloxacin, penicillin-G, and trimethoprim). The remaining two antibiotics (erythromycin and doxycycline) showed some intermediates with antibacterial activity at low treatment doses. The antibacterially active products lost activity as the UV dose increased past 500 mJ/cm(2). Active products were observed only in wastewater effluents and not in pure water, suggesting that complex secondary reactions controlled by the composition of the matrix were responsible for their formation. This outcome emphasizes the importance of bench-scale experiments in realistic water matrices. Most importantly, the results indicate that photosensitized processes during high dose wastewater disinfection may be creating antibacterially active transformation products from some common antibiotics.

Elimination of micropollutants during post-treatment of hospital wastewater with powdered activated carbon, ozone, and UV

A pilot-scale hospital wastewater treatment plant consisting of a primary clarifier, membrane bioreactor, and five post-treatment technologies including ozone (O3), O3/H2O2, powdered activated carbon (PAC), and low pressure UV light with and without TiO2 was operated to test the elimination efficiencies for 56 micropollutants. The extent of the elimination of the selected micropollutants (pharmaceuticals, metabolites and industrial chemicals) was successfully correlated to physical-chemical properties or molecular structure. By mass loading, 95% of all measured micropollutants in the biologically treated hospital wastewater feeding the post-treatments consisted of iodinated contrast media (ICM). The elimination of ICM by the tested post-treatment technologies was 50-65% when using 1.08 g O3/gDOC, 23 mg/L PAC, or a UV dose of 2400 J/m(2) (254 nm). For the total load of analyzed pharmaceuticals and metabolites excluding ICM the elimination by ozonation, PAC, and UV at the same conditions was 90%, 86%, and 33%, respectively. Thus, the majority of analyzed substances can be efficiently eliminated by ozonation (which also provides disinfection) or PAC (which provides micropollutants removal, not only transformation). Some micropollutants recalcitrant to those two post-treatments, such as the ICM diatrizoate, can be substantially removed only by high doses of UV (96% at 7200 J/m(2)). The tested combined treatments (O3/H2O2 and UV/TiO2) did not improve the elimination compared to the single treatments (O3 and UV).

Occurrence and abundance of antibiotics and resistance genes in rivers, canal and near drug formulation facilities--a study in Pakistan

Antibiotic resistance (AR) is a global phenomenon that has severe epidemiological ramifications world-wide. It has been suggested that antibiotics that have been discharged into the natural aquatic environments after usage or manufacture can promote the occurrence of antibiotic resistance genes (ARG). These environmental ARGs could serve as a reservoir and be horizontally transferred to human-associated bacteria and thus contribute to AR proliferation. The aim of this study was to investigate the anthropogenic load of antibiotics in Northern Pakistan and study the occurrence of ARGs in selected samples from this region. 19 sampling sites were selected; including six rivers, one dam, one canal, one sewage drain and four drug formulation facilities. Our results show that five of the rivers have antibiotic levels comparable to surface water measurements in unpolluted sites in Europe and the US. However, high levels of antibiotics could be detected in the downstream river in close vicinity of the 10 million city Lahore, 1100, 1700 and 2700 ng L⁻¹ for oxytetracycline, trimethoprim, and sulfamethoxazole respectively. Highest detected levels were at one of the drug formulation facilities, with the measured levels of 1100, 4100, 6200, 7300, 8000, 27000, 28000 and 49000 ng L⁻¹ of erythromycin, lincomycin, ciprofloxacin, ofloxacin, levofloxacin, oxytetracycline, trimethoprim and sulfamethoxazole respectively. ARGs were also detected at the sites and the highest levels of ARGs detected, sulI and dfrA1, were directly associated with the antibiotics detected at the highest concentrations, sulfamethoxazole and trimethoprim. Highest levels of both antibiotics and ARGs were seen at a drug formulation facility, within an industrial estate with a low number of local residents and no hospitals in the vicinity, which indicates that the levels of ARGs at this site were associated with the environmental levels of antibiotics.

Bacterial flora and antimicrobial resistance in raw frozen cultured seafood imported to Denmark

Intensified aquaculture includes the use of antimicrobials for disease control. In contrast to the situation in livestock, Escherichia coli and enterococci are not part of the normal gastrointestinal flora of fish and shrimp and therefore not suitable indicators of antimicrobial resistance in seafood. In this study, the diversity and phenotypic characteristics of the bacterial flora in raw frozen cultured and wild-caught shrimp and fish were evaluated to identify potential indicators of antimicrobial resistance. The bacterial flora cultured on various agar media at different temperatures yielded total viable counts of 4.0 × 10(4) to 3.0 × 10(5) CFU g(-1). Bacterial diversity was indicated by 16S rRNA sequence analysis of 84 isolates representing different colony types; 24 genera and 51 species were identified. Pseudomonas spp. (23% of isolates), Psychrobacter spp. (17%), Serratia spp. (13%), Exiguobacterium spp. (7%), Staphylococcus spp. (6%), and Micrococcus spp. (6%) dominated. Disk susceptibility testing of 39 bacterial isolates to 11 antimicrobials revealed resistance to ampicillin, amoxicillin-clavulanic acid, erythromycin, and third generation cephalosporins. Resistance to third generation cephalosporins was found in Pseudomonas, a genus naturally resistant to most β-lactam antibiotics, and in Staphylococcus hominis. Half of the isolates were susceptible to all antimicrobials tested. Results indicate that identification of a single bacterial resistance indicator naturally present in seafood at point of harvest is unlikely. The bacterial flora found likely represents a processing rather than a raw fish flora because of repeated exposure of raw material to water during processing. Methods and appropriate indicators, such as quantitative PCR of resistance genes, are needed to determine how antimicrobials used in aquaculture affect resistance of bacteria in retailed products.

Occurrence of antibiotics as emerging contaminant substances in aquatic environment

The occurrence of pharmaceutical residues in the environment has become a subject of growing concern. Due to the constant input of the emerging contaminants in the surface water via wastewater which leads to the long-term adverse effects on the aquatic and terrestrial organisms, special attention is being paid to their presence in the aquatic environment. Most of the emerging substances, especially pharmaceuticals, could not be completely removed using the wastewater treatment. Pharmaceuticals are usually water soluble and poorly degradable. They can pass through all natural filtrations and then reach the groundwater and, finally, the drinking water. The trace levels of antibiotics could have a negative impact on the environment and public health because of their inherent bioactivity. This article is an overview of the presence of the antibiotic residual concentrations, methods and levels of detection and possible risks to both health and environment.

Culturable gut microbiota diversity in zebrafish

The zebrafish (Danio rerio) is an increasingly used laboratory animal model in basic biology and biomedicine, novel drug development, and toxicology. The wide use has increased the demand for optimized husbandry protocols to ensure animal health care and welfare. The knowledge about the correlation between culturable zebrafish intestinal microbiota and health in relation to environmental factors and management procedures is very limited. A semi-quantitative level of growth of individual types of bacteria was determined and associated with sampling points. A total of 72 TAB line zebrafish from four laboratories (Labs A-D) in the Zebrafish Network Norway were used. Diagnostic was based on traditional bacterial culture methods and biochemical characterization using commercial kits, followed by 16S rDNA gene sequencing from pure subcultures. Also selected Gram-negative isolates were analyzed for antibiotic susceptibility to 8 different antibiotics. A total of 13 morphologically different bacterial species were the most prevalent: Aeromonas hydrophila, Aeromonas sobria, Vibrio parahaemolyticus, Photobacterium damselae, Pseudomonas aeruginosa, Pseudomonas fluorescens, Pseudomonas luteola, Comamonas testosteroni, Ochrobactrum anthropi, Staphylococcus cohnii, Staphylococcus epidermidis, Staphylococcus capitis, and Staphylococcus warneri. Only Lab B had significantly higher levels of total bacterial growth (OR=2.03), whereas numbers from Lab C (OR=1.01) and Lab D (OR=1.12) were found to be similar to the baseline Lab A. Sexually immature individuals had a significantly higher level of harvested total bacterial growth than mature fish (OR=0.82), no statistically significant differences were found between male and female fish (OR=1.01), and the posterior intestinal segment demonstrated a higher degree of culturable bacteria than the anterior segment (OR=4.1). Multiple antibiotic (>3) resistance was observed in 17% of the strains. We propose that a rapid conventional diagnostic bacteriological assay on the culturable microbiota profiles can be designed and used as quality measure of the husbandry routines of a zebrafish facility to ensure a bacterial standard safeguarding the zebrafish health and welfare.