Antimicrobial-resistant microorganisms and their genetic determinants in stormwater: A systematic review

Hamilton, Kerry A.; Garner, Emily; Joshi, Sayalee; Ahmed, Warish; Ashbolt, Nicholas J.; Medema, Gertjan; Pruden, Amy

doi:10.1016/j.coesh.2020.02.012

Cited by 24 publications

(15 citation statements)

References 83 publications

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“…Studies tend to vary with respect to the efficiency in which resistant organisms are removed during the treatment process, the microbial species expressing resistance in the effluent, and the antimicrobial agents to which the organisms express resistance. It also should be noted that different WWTP unit operations will affect the overall removal efficiency and ultimately antibiotic resistant bacteria discharge to the environment ( Sayah et al, 2005 ; Janezic et al, 2013 ; Hamilton et al, 2020 ). Czekalski et al (2012) found that while WWTPs reduced total bacterial loads in the effluent, there was an observed increase in multidrug resistant bacteria and ARG which were then found to accumulate in the sediment of the plant outlet.…”

Section: Introductionmentioning

confidence: 99%

“…Aeromonas and Pseudomonas aeruginosa isolates obtained from some water reservoirs were found to express 50 and 100% multi-drug resistance, respectively ( Blasco et al, 2008 ). A recent review also suggests the importance of accounting for stormwater as a key source of ARG propagation considering the cumulative impact stormwater runoff may have as it comes in contact with overflows from untreated wastewater, sewer and sanitary discharges, among others ( Hamilton et al, 2020 ). Understanding of the impacts of urbanization and wastewater effluent on the presence of antibiotic resistance in the environment will aid in future efforts to address antibiotic resistance through treatment plant process design - establishing more informed guidelines and proper regulations surrounding WWTP practices.…”

Section: Introductionmentioning

confidence: 99%

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Increased Antimicrobial and Multidrug Resistance Downstream of Wastewater Treatment Plants in an Urban Watershed

et al. 2021

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Development and spread of antimicrobial resistance (AMR) and multidrug resistance (MDR) through propagation of antibiotic resistance genes (ARG) in various environments is a global emerging public health concern. The role of wastewater treatment plants (WWTPs) as hot spots for the dissemination of AMR and MDR has been widely pointed out by the scientific community. In this study, we collected surface water samples from sites upstream and downstream of two WWTP discharge points in an urban watershed in the Bryan-College Station (BCS), Texas area, over a period of nine months. E. coli isolates were tested for resistance to ampicillin, tetracycline, sulfamethoxazole, ciprofloxacin, cephalothin, cefoperazone, gentamycin, and imipenem using the Kirby-Bauer disc diffusion method. Antimicrobial resistant heterotrophic bacteria were cultured on R2A media amended with ampicillin, ciprofloxacin, tetracycline, and sulfamethoxazole for analyzing heterotrophic bacteria capable of growth on antibiotic-containing media. In addition, quantitative real-time polymerase chain reaction (qPCR) method was used to measure eight ARG – tetA, tetW, aacA, ampC, mecA, ermA, blaTEM, and intI1 in the surface water collected at each time point. Significant associations (p < 0.05) were observed between the locations of sampling sites relative to WWTP discharge points and the rate of E. coli isolate resistance to tetracycline, ampicillin, cefoperazone, ciprofloxacin, and sulfamethoxazole together with an increased rate of isolate MDR. The abundance of antibiotic-resistant heterotrophs was significantly greater (p < 0.05) downstream of WWTPs compared to upstream locations for all tested antibiotics. Consistent with the results from the culture-based methods, the concentrations of all ARG were substantially higher in the downstream sites compared to the upstream sites, particularly in the site immediately downstream of the WWTP effluent discharges (except mecA). In addition, the Class I integron (intI1) genes were detected in high amounts at all sites and all sampling points, and were about ∼20 times higher in the downstream sites (2.5 × 107 copies/100 mL surface water) compared to the upstream sites (1.2 × 106 copies/100 mL surface water). Results suggest that the treated WWTP effluent discharges into surface waters can potentially contribute to the occurrence and prevalence of AMR in urban watersheds. In addition to detecting increased ARG in the downstream sites by qPCR, findings from this study also report an increase in viable AMR (HPC) and MDR (E. coli) in these sites. This data will benefit establishment of improved environmental regulations and practices to help manage AMR/MDR and ARG discharges into the environment, and to develop mitigation strategies and effective treatment of wastewater.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Increased Antimicrobial and Multidrug Resistance Downstream of Wastewater Treatment Plants in an Urban Watershed

et al. 2021

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“…Records including titles and abstracts were imported into a shared Zotero library. Titles and abstracts were manually screened for relevance based on the following inclusion criteria, consistent with previously published systematic review criteria (Boehm et al ., 2018; Hamilton et al ., 2020): (i) the article presents primary research, (ii) the abstract and full text are available in English, (iii) the paper was peer‐reviewed or published by a major government organization, (iv) the material was published before the date of the conducted search (7 January 2021), (v) the article contains quantitative or presence/absence data on concentrations of ARB or ARGs or metagenomic results for ARGs from sequencing studies, (vi) samples were collected from recycled water in planned reuse scenarios (i.e., treated wastewater intended for reuse), and (vii) the article describes methods to enumerate the target that are clearly described and are logical and justifiable for the target ARB or ARG. Studies that dosed ARB or ARGs into bench or pilot scale reactors were excluded.…”

Section: Methodsmentioning

confidence: 99%

Towards risk assessment for antibiotic resistant pathogens in recycled water: a systematic review and summary of research needs

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Organiscak

Dieter

et al. 2021

Environmental Microbiology

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Risk assessment is critical for identifying target concentrations of antibiotic resistant pathogens necessary for mitigating potential harmful exposures associated with water reuse. However, there is currently limited available data characterizing the concentrations of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in recycled water to support robust efforts at risk assessment. The objective of this systematic review was to identify and synthesize the existing literature documenting the presence and abundance of ARB and ARGs in recycled water. In addition, this review identifies best practices and explores monitoring targets for studying ARB and ARGs in recycled water to guide future work and identifies key research needs aimed at better supporting quantitative microbial risk assessment focused on recycled water and antibiotic resistance. Future efforts to collect data about ARB and ARG prevalence in recycled water should report concentration data per unit volume. Sample metadata should also be provided, including a description of treatment approach, a description of planned water uses (e.g., potable, irrigation), methods for conveyance to the point of use, and available physicochemical water quality data. Additional research is needed aimed at identifying recommended ARB and ARG monitoring targets and for developing approaches to incorporate metagenomic data into risk assessment.

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“…As there are numerous ARGs that can be present in the environment with relevance to public health (Gatica et al, 2016), at sometimes high background levels can be detected even in "pristine" environments, there is not yet a risk-based consensus regarding which ARGs would be "high priority" for monitoring purposes (Hamilton et al, 2020). Therefore, assessing the correlation of ARGs with more commonly monitored factors provides value if surrogate monitoring targets could reasonably be used for assessing the antibiotic resistance impacts of stormwater on receiving water bodies.…”

Section: Multifactorial Grouping Urban Sites In Baseflow Conditionsmentioning

confidence: 99%

Antibiotic Resistance and Sewage-Associated Marker Genes in Untreated Sewage and a River Characterized During Baseflow and Stormflow

et al. 2021

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Since sewage is a hotspot for antibiotic resistance genes (ARGs), the identification of ARGs in environmental waters impacted by sewage, and their correlation to fecal indicators, is necessary to implement management strategies. In this study, sewage treatment plant (STP) influent samples were collected and analyzed using quantitative polymerase chain reaction (qPCR) to investigate the abundance and correlations between sewage-associated markers (i.e., Bacteroides HF183, Lachnospiraceae Lachno3, crAssphage) and ARGs indicating resistance to nine antibiotics (belonging to aminoglycosides, beta-lactams, sulfonamides, macrolides, and tetracyclines). All ARGs, except blaVIM, and sewage-associated marker genes were always detected in untreated sewage, and ermF and sul1 were detected in the greatest abundances. intl1 was also highly abundant in untreated sewage samples. Significant correlations were identified between sewage-associated marker genes, ARGs and the intl1 in untreated sewage (τ = 0.488, p = 0.0125). Of the three sewage-associated marker genes, the BIO-ENV procedure identified that HF183 alone best maximized correlations to ARGs and intl1 (τ = 0.590). Additionally, grab samples were collected from peri-urban and urban sites along the Brisbane River system during base and stormflow conditions, and analyzed for Escherichia coli, ARGs, the intl1, and sewage-associated marker genes using quantitative polymerase chain reaction (qPCR). Significant correlations were identified between E. coli, ARGs, and intl1 (τ = 0.0893, p = 0.0032), as well as with sewage-associated marker genes in water samples from the Brisbane River system (τ = 0.3229, p = 0.0001). Of the sewage-associated marker genes and E. coli, the BIO-ENV procedure identified that crAssphage alone maximized correlations with ARGs and intl1 in river samples (τ = 0.4148). Significant differences in E. coli, ARGs, intl1, and sewage-associated marker genes, and by flow condition (i.e., base vs. storm), and site types (peri-urban vs. urban) combined were identified (R = 0.3668, p = 0.0001), where percent dissimilarities between the multi-factorial groups ranged between 20.8 and 11.2%. Results from this study suggest increased levels of certain ARGs and sewage-associated marker genes in stormflow river water samples compared to base flow conditions. E. coli, HF183 and crAssphage may serve as potential indicators of sewage-derived ARGs under stormflow conditions, and this merits further investigation. Data presented in this study will be valuable to water quality managers to understand the links between sewage pollution and ARGs in urban environments.

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Antimicrobial-resistant microorganisms and their genetic determinants in stormwater: A systematic review

Cited by 24 publications

References 83 publications

Increased Antimicrobial and Multidrug Resistance Downstream of Wastewater Treatment Plants in an Urban Watershed

Increased Antimicrobial and Multidrug Resistance Downstream of Wastewater Treatment Plants in an Urban Watershed

Towards risk assessment for antibiotic resistant pathogens in recycled water: a systematic review and summary of research needs

Antibiotic Resistance and Sewage-Associated Marker Genes in Untreated Sewage and a River Characterized During Baseflow and Stormflow

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