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Antibiotic Resistance Elements in Wastewater Treatment Plants: Scope and Potential Impacts

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Wastewater Reuse and Current Challenges

Part of the book series: The Handbook of Environmental Chemistry ((HEC,volume 44))

Abstract

Antibiotic resistance is considered to be one of the most significant public health concerns of the twenty-first century. Although traditionally the propagation of antibiotic resistance was considered to be limited to hospitals and other clinical environments, there is a growing realization that it is also associated with anthropogenically impacted environmental reservoirs. Wastewater treatment plants are considered to be significant reservoirs of antibiotic resistance because they combine extremely high levels of fecal- and environmental-derived bacteria with residual concentrations of antibiotic compounds believed to induce selection. These bacteria are primarily congregated in dense biofilms that are “hot spots” for horizontal gene transfer, which can facilitate inter- and intraspecies transfer of antibiotic genes, potentially resulting in the development of multidrug-resistant strains. Several studies have demonstrated that although wastewater treatment plants significantly reduce bacterial concentrations, relatively high levels of antibiotic-resistant bacteria and resistance genes are still present in effluents released to aquatic and soil environments and that under certain circumstances these resistance elements may persist for long periods of time in downstream environments. These elements may have significant epidemiological ramifications, especially when effluents enter drinking water and food webs; and henceforth, antibiotic resistance genes have recently been characterized as contaminants of emerging concern. This chapter summarizes current understanding of antibiotic resistance in wastewater treatment plants and downstream environments, presents knowledge gaps that need to be bridged in order to better understand the potential ramifications of this phenomenon, overviews the effect of disinfection treatments on antibiotic resistance elements, and finally discusses policy guidelines that should be implemented in the future to reduce the risks of antibiotic resistance from wastewater treatment plants.

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Abbreviations

AR:

Antibiotic resistance

ARB:

Antibiotic-resistant bacteria

ARGs:

Antibiotic resistance genes

BHR:

Broad host range

CFU:

Colony-forming units

CIs:

Chromosomal integrons

E-COFF:

Epidemiological cutoff

ERIC:

Enterobacterial repetitive intergenic consensus

ESBL:

Extended spectrum beta-lactamase

GC:

Gene cassettes

GFP:

Green fluorescent protein

HGT:

Horizontal gene transfer

IS:

Insertion sequences

ISCR:

Insertion sequence common regions

MAR:

Multiple antibiotic resistance

MDR:

Multiple drug resistance

MGEs:

Mobile genetic elements

MIC:

Minimal inhibitory concentration

MIs:

Mobile integrons

MLST:

Multilocus sequence typing

MRIs:

Multidrug-resistant integrons

NGS:

Next-generation sequencing

Pc:

Promoter

PCR:

Polymerase chain reaction

qPCR:

Quantitative polymerase chain reaction

RIs:

Resistant integrons

TRACA:

Transposon-aided capture

UV:

Ultraviolet

VRE:

Vancomycin-resistant Enterococcus faecium

WW:

Wastewater

WWTPs:

Wastewater treatment plants

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Authors and Affiliations

  1. Department of Soil and Water, The Hebrew University of Jerusalem, Rehovot, Israel

    Joao Gatica

  2. Institute of Soil, Water and Environmental Sciences, Agriculture Research Organization, The Volcani Center, Bet-Dagan, Israel

    Joao Gatica, Ella Kaplan & Eddie Cytryn

  3. Department of Agroecology, Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel

    Ella Kaplan

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  1. Joao Gatica
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  2. Ella Kaplan
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  3. Eddie Cytryn
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Correspondence to Eddie Cytryn .

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Editors and Affiliations

  1. Department of Civil and Environmental Engineering, University of Cyprus, Nicosia, Cyprus

    Despo Fatta-Kassinos

  2. Department of Biomedical, Chemical and Environmental Engineering, University of Cincinnati, Cincinnati, Ohio, USA

    Dionysios D. Dionysiou

  3. Institute of Sustainable and Environmental Chemistry, Leuphana University Lüneburg, Lüneburg, Niedersachsen, Germany

    Klaus Kümmerer

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Gatica, J., Kaplan, E., Cytryn, E. (2015). Antibiotic Resistance Elements in Wastewater Treatment Plants: Scope and Potential Impacts. In: Fatta-Kassinos, D., Dionysiou, D., Kümmerer, K. (eds) Wastewater Reuse and Current Challenges . The Handbook of Environmental Chemistry, vol 44. Springer, Cham. https://doi.org/10.1007/698_2015_361

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