Carbapenem-resistant bacteria over a wastewater treatment process: Carbapenem-resistant Enterobacteriaceae in untreated wastewater and intrinsically-resistant bacteria in final effluent

Araújo, Susana; Sousa, Margarida; Tacão, Marta; Baraúna, Rafael A.; Silva, A.; Ramos, Rommel Thiago Jucá; Alves, Artur; Manaia, Célia M.; Henriques, Isabel

doi:10.1016/j.scitotenv.2021.146892

Cited by 20 publications

(20 citation statements)

References 87 publications

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“…We suspect that as blaGES carbapenemases are typically carried by class 1 integrons, as confirmed by previous studies (53), a co-selection phenomenon (3,54) might play a role in increasing their spread also in here. In this scenario, residues of antibiotics other than carbapenems would cause the co-selection of blaGES.…”

Section: Discussionsupporting

confidence: 82%

Metagenomic analysis of the abundance and composition of antibiotic resistance genes in hospital wastewater in Benin, Burkina Faso, and Finland

Markkanen

Haukka

Pärnänen

et al. 2021

Preprint

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Antimicrobial resistance (AMR) is one of the greatest global threats to human health, but substantial gaps in AMR data exist in West African countries. To obtain in-depth data, we explored the presence of antimicrobial resistance genes (ARGs) in the hospital wastewaters (HWW) of nine hospitals in Benin and Burkina Faso and, for comparison, of four hospitals in Finland. The highest total relative abundance of ARGs in HWWs was observed in Benin and the lowest in Finland. HWW resistomes were more similar to each other in Benin and Burkina Faso than in Finland. Different clinically relevant carbapenemases were detected in varying abundances, especially in HWWs from Burkina Faso and Finland. The most widespread carbapenemase gene in the Beninese hospitals, blaGES, was also found in water used for handwashing. blaNDM was present in the HWW of one Beninese hospital and was also detected in the stools of a hospitalized patient. Mobile colistin ARGs were detected in the HWWs of all the three studied countries, with mcr-5 variants being the most common. These and other mcr genes were observed in very high abundance in treated wastewater released into rivers in Burkina Faso. In Benin, only little is done to treat wastewaters, including HWWs. The results provide evidence for public health decision-makers in Benin and Burkina Faso for the dire need to increase wastewater treatment capacity, with particular attention to HWWs.SynopsisMetagenomic analysis of HWWs revealed high abundances of ARGs and their potential transmission to other environments in Benin and Burkina Faso.

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Section: Discussionsupporting

confidence: 82%

Metagenomic analysis of the abundance and composition of antibiotic resistance genes in hospital wastewater in Benin, Burkina Faso, and Finland

Markkanen

Haukka

Pärnänen

et al. 2021

Preprint

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“…Recent research has shed light on the environmental risk assessment of both AMRB and AMSB [ 8 , 35 , 112 , 116 ]. In addition, AMRB carrying antimicrobial-resistance genes (AMRGs) are also present in wastewater and river water and act as potential factors that promote the formation of new AMRB in the aquatic environment through transformations [ 117 , 118 , 119 ]. The risk of infection by AMRB in water and via the ecosystem and the development of AMRB in the presence of residual antimicrobials or AMRGs in the water environment are now being assessed [ 113 , 114 , 120 ].…”

Section: Resultsmentioning

confidence: 99%

Inactivation of Antibiotic-Resistant Bacteria in Wastewater by Ozone-Based Advanced Water Treatment Processes

2022

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The inactivating effect of ozone (O3)-based advanced oxidation processes (AOPs) (O3/H2O2, O3/UV, and O3/UV/H2O2 systems) on antimicrobial-resistant bacteria (AMRB) and antimicrobial-susceptible bacteria (AMSB) in sewage treatment plant (STP) wastewater was investigated. The AMRB were grouped into six classes: carbapenem-resistant Enterobacteriaceae (CRE), extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E), multidrug-resistant Acinetobacter (MDRA), multidrug-resistant Pseudomonas aeruginosa (MDRP), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus (VRE); these classes constituted the World Health Organization (WHO) global priority list of AMRB. The results indicate that O3-based advanced wastewater treatment inactivated all AMRB and AMSB (>99.9%) after 10 min of treatment, and significant differences (p < 0.5) were not observed in the disinfection of AMRB and AMSB by each treatment. Altered taxonomic diversity of micro-organisms based on 16S rRNA gene sequencing via O3/UV and O3/UV/H2O2 treatment showed that advanced wastewater treatments not only inactivated AMRB but also removed antimicrobial resistance genes (AMRGs) in the wastewater. Consequently, this study recommends the use of advanced wastewater treatments for treating the STP effluent, reducing environmental pollution, and alleviating the potential hazard to human health caused by AMRB, AMSB, and infectious diseases. Overall, this study provides a new method for assessing environmental risks associated with the spread of AMRB and AMSB in aquatic environments, while keeping the water environment safe and maintaining human health.

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“…Based on the research results presented in this study, it was found that one of the carbapenem resistance genes, occurring in abundance in wastewater in both studied treatment plants, was bla GES . The literature indicates the occurrence of carbapenemaseresistance subtypes of bla GES in both wastewater (Conte et al, 2017;Wang et al, 2020) and bacterial strains isolated from wastewater (Kim, 2016;Araújo et al, 2021). As regards another carbapenemase-encoding gene (bla IMP ), a significant increase in its amount was found in wastewater from both treatment plants after the biological treatment stage, which contributed to an increase in its occurrence in treated wastewater.…”

Section: Discussionmentioning

confidence: 99%

Impact of Hospital Wastewater on the Occurrence and Diversity of Beta-Lactamase Genes During Wastewater Treatment with an Emphasis on Carbapenemase Genes: A Metagenomic Approach

Hubeny

Ciesielski

Harnisz

et al. 2021

Front. Environ. Sci.

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The diversity of beta-lactam antibiotic resistance genes, with particular emphasis on carbapenemase genes, during the treatment process at two wastewater treatment plants (WWTPs) with different levels of hospital wastewater inflow was investigated using high-throughput sequencing. An additional aspect of the study was to determine the taxonomic diversity of microorganisms in the studied samples. The obtained results suggest that bacteria of the Fusobacteriaceae family, not associated to date with this phenomenon, may be involved in the spread of antibiotic resistance in the environment. In samples from both wastewater treatment plants, the dominant beta-lactamase genes included blaOXA, blaGES, blaBEL, blaCfxA, and blaTEM. It is worth noting that the blaKPC and blaNDM genes were only found in untreated municipal wastewater with a higher hospital wastewater content. Moreover, an increase in the abundance of the blaIMP gene after the biological treatment stage in the studied treatment plants was found. In wastewater characterized by a higher proportion of hospital wastewater, 94 correlations were observed, while in wastewater with its lower proportion, 41 correlations were noted. Considering the above, the current research indicates that the inflow of hospital wastewater contributes to the spread of antibiotic resistance in the aquatic environment.

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Carbapenem-resistant bacteria over a wastewater treatment process: Carbapenem-resistant Enterobacteriaceae in untreated wastewater and intrinsically-resistant bacteria in final effluent

Cited by 20 publications

References 87 publications

Metagenomic analysis of the abundance and composition of antibiotic resistance genes in hospital wastewater in Benin, Burkina Faso, and Finland

Metagenomic analysis of the abundance and composition of antibiotic resistance genes in hospital wastewater in Benin, Burkina Faso, and Finland

Inactivation of Antibiotic-Resistant Bacteria in Wastewater by Ozone-Based Advanced Water Treatment Processes

Impact of Hospital Wastewater on the Occurrence and Diversity of Beta-Lactamase Genes During Wastewater Treatment with an Emphasis on Carbapenemase Genes: A Metagenomic Approach

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