Swiss River Resistome:
Resistenzen aus Kläranlagen in Schweizer Bächen und Flüssen
Antibiotikaresistente Bakterien, die mit gereinigtem Abwasser in Bäche und Flüsse gelangen, bergen Risiken für den Menschen. Um diese abzuschätzen, müssen wir verstehen, wie sich die Resistenzen in Gewässern verbreiten und wie stabil sie dort sind. Normale Abwasserreinigungsanlagen entfernen nicht alle resistenten Bakterien aus dem Abwasser. Wir untersuchen, welche Bakterien mit welchen Resistenzen so in Schweizer Bäche und Flüsse gelangen und wo sie sich wiederfinden. Besonderes Augenmerk richten wir dabei auf Wassertiere, Sedimente und sogenannte Biofilme: Bakterienrasen an Wasser- und Bodenoberflächen. Zudem erheben wir, wie weit Resistenzen transportiert werden und wie beständig sie sind. Aufgrund dieser Erkenntnisse entwickeln wir anschliessend Modelle, um die Belastung von Fliessgewässern entlang der Fliessstrecke vorherzusagen. Diese sollen aufzeigen, wo Menschen mit Resistenzen aus Abwasserreinigungsanlagen in Kontakt kommen können. Unsere Daten und Modelle schaffen Entscheidungs- und Handlungsgrundlagen, um Massnahmen gegen die Verbreitung von Antibiotikaresistenzen durch Fliessgewässer zu ergreifen.
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title => protected'Wastewater bypass is a major temporary point-source of antibiotic resistance genes and multi-resistance risk factors in a Swiss river' (133 chars)
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categories => protected'antimicrobial resistance; stormwater events; wastewater bypass; metagenomics ; river' (83 chars)
description => protected'Untreated combined sewage (bypass) is often discharged by wastewater treatme nt plants to receiving rivers during stormwater events, where it may contrib ute to increased levels of antibiotic resistance genes (ARGs) and multi-resi stance risk factors (multi-resistant bacteria and multi-resistance genomic d eterminants (MGDs)) in the receiving water. Other contamination sources, suc h as soil runoff and resuspended river sediment could also play a role durin g stormwater events. Here we report on stormwater event-based sampling campa igns to determine temporal dynamics of ARGs and multi-resistance risk factor s in bypass, treated effluent, and the receiving river, as well as complimen tary data on catchment soils and surface sediments. Both indicator ARGs (qPC R) and resistome (ARG profiles revealed by metagenomics) indicated bypass as the main contributor to the increased levels of ARGs in the river during st ormwater events. Furthermore, we showed for the first time that the risk of exposure to bypass-borne multi-resistance risk factors increase under stormw ater events and that many of these MGDs were plasmid associated and thus pot entially mobile. In addition, elevated resistance risk factors persisted for some time (up to 22 h) in the receiving water after stormwater events, lik ely due to inputs from distributed overflows in the catchment. This indicate s temporal dynamics should be considered when interpreting the risks of expo sure to resistance from event-based contamination. We propose that reducing bypass from wastewater treatment plants may be an important intervention opt ion for reducing dissemination of antibiotic resistance.' (1652 chars)
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authors => protected'Lee, J.; Ju, F.; Maile-Moskowitz, A.; Beck, K.; Maccagna n, A.; McArdell, C. S.; Dal Molin, M.; Fenicia, F.; Vikesland, P.; Pruden, A.; Stamm, C.; Bürgmann, H.' (224 chars)
title => protected'Unraveling the riverine antibiotic resistome: the downstream fate of anthrop ogenic inputs' (89 chars)
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categories => protected'antimicrobial resistance; wastewater; river system; metagenomics; transport; degradation' (88 chars)
description => protected'River networks are one of the main routes by which the public could be expos ed to environmental sources of antibiotic resistance, that may be introduced e.g. via treated wastewater. In this study, we applied a comprehensive inte grated analysis encompassing mass-flow concepts, chemistry, bacterial plate counts, resistance gene quantification and shotgun metagenomics to track the fate of the resistome (collective antibiotic resistance genes (ARGs) in a m icrobial community) of treated wastewater in two Swiss rivers at the kilomet er scale. The levels of certain ARGs and the class 1 integron integrase gene (<em>intI1</em>) commonly associated with anthropogenic sources of ARGs dec reased quickly over short distances (2-2.5 km) downstream of wastewater disc harge points. Mass-flow analysis based on conservative tracers suggested thi s decrease was attributable mainly to dilution but ARG loadings frequently a lso decreased (e.g., 55.0-98.5 % for <em>ermB</em> and <em>tetW</em>) over t he longest studied distances (6.8 and 13.7 km downstream). Metagenomic analy sis confirmed that ARG of wastewater-origin did not persist in rivers after 5 ∼ 6.8 km downstream distance. <em>sul1</em> and <em>intI1</em> levels an d loadings were more variable and even increased sharply at 5 ∼ 6.8 km dow nstream distance on one occasion. While input from agriculture and in-situ p ositive selection pressure for organisms carrying ARGs cannot be excluded, i n-system growth of biomass is a more probable explanation. The potential for direct human exposure to the resistome of wastewater-origin thus appeared t o typically abate rapidly in the studied rivers. However, the riverine aquat ic resistome was also dynamic, as evidenced by the increase of certain gene markers downstream, without obvious sources of anthropogenic contamination. This study provides new insight into drivers of riverine resistomes and pinp oints key monitoring targets indicative of where human sources and exposures are likely to be most a...' (2005 chars)
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authors => protected'Yuan, L.; Wang, Y.; Zhang, L.; Palomo, A.; Zhou, J. ; Smets, B. F.; Bürgmann, H.; Ju, F.' (133 chars)
title => protected'Pathogenic and indigenous denitrifying bacteria are transcriptionally active and key multi-antibiotic-resistant players in wastewater treatment plants' (150 chars)
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categories => protected'antibiotic resistance; wastewater treatment plant; denitrifying and pathogen ic bacteria; genome-centric metatranscriptomics; metagenome-assembled genome' (152 chars)
description => protected'The global rise and spread of antibiotic resistance greatly challenge the tr eatment of bacterial infections. Wastewater treatment plants (WWTPs) harbor and discharge antibiotic resistance genes (ARGs) as environmental contaminan ts. However, the knowledge gap on the host identity, activity, and functiona lity of ARGs limits transmission and health risk assessment of the WWTP resi stome. Hereby, a genome-centric quantitative metatranscriptomic approach was exploited to realize high-resolution qualitative and quantitative analyses of bacterial hosts of ARGs (i.e., multiresistance, pathogenicity, activity, and niches) in the 12 urban WWTPs. We found that ∼45% of 248 recovered gen omes expressed ARGs against multiple classes of antibiotics, among which bac itracin and aminoglycoside resistance genes in Proteobacteria were the most prevalent scenario. Both potential pathogens and indigenous denitrifying bac teria were transcriptionally active hosts of ARGs. The almost unchanged rela tive expression levels of ARGs in the most resistant populations (66.9%) and the surviving ARG hosts including globally emerging pathogens (e.g., <em>Al iarcobacter cryaerophilus</em>) in treated WWTP effluent prioritize future e xamination on the health risks related to resistance propagation and human e xposure in the receiving environment.' (1329 chars)
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authors => protected'Marano, R. B. M.; Fernandes, T.; Manaia, C. M. ; Nunes, O.; Morrison, D.; Berendonk, T. U.; Kreuzinger, N.; Telson, T.; Corno, G.; Fatta-Kassinos, D.; Bürgman n, H.; Beck, K.; Cytryn, E.' (270 chars)
title => protected'A global multinational survey of cefotaxime-resistant coliforms in urban was tewater treatment plants' (100 chars)
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description => protected'The World Health Organization Global Action Plan recommends integrated surve illance programs as crucial strategies for monitoring antibiotic resistance. Although several national surveillance programs are in place for clinical a nd veterinary settings, no such schemes exist for monitoring antibiotic-resi stant bacteria in the environment. In this transnational study, we developed , validated, and tested a low-cost surveillance and easy to implement approa ch to evaluate antibiotic resistance in wastewater treatment plants (WWTPs) by targeting cefotaxime-resistant (CTX-R) coliforms as indicators. The ratio nale for this approach was: i) coliform quantification methods are internati onally accepted as indicators of fecal contamination in recreational waters and are therefore routinely applied in analytical labs; ii) CTX-R coliforms are clinically relevant, associated with extended-spectrum β-lactamases (ES BLs), and are rare in pristine environments. We analyzed 57 WWTPs in 22 coun tries across Europe, Asia, Africa, Australia, and North America. CTX-R colif orms were ubiquitous in raw sewage and their relative abundance varied signi
large proportions of CTX-R coliforms, loads over 10<sup>3</sup> colony-formi ng units per mL were occasionally observed in final effluents. We demonstrat e that CTX-R coliform monitoring is a feasible and affordable approach to as sess wastewater antibiotic resistance status.' (1565 chars)
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authors => protected'Ju, F.; Beck, K.; Yin, X.; Maccagnan, A.; McArdell,  ;C. S.; Singer, H. P.; Johnson, D. R.; Zhang, T.; Bürgmann, H.' (174 chars)
title => protected'Wastewater treatment plant resistomes are shaped by bacterial composition, g enetic exchange, and upregulated expression in the effluent microbiomes' (147 chars)
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description => protected'Wastewater treatment plants (WWTPs) are implicated as hotspots for the disse mination of antibacterial resistance into the environment. However, the in s itu processes governing removal, persistence, and evolution of resistance ge nes during wastewater treatment remain poorly understood. Here, we used quan titative metagenomic and metatranscriptomic approaches to achieve a broad-sp ectrum view of the flow and expression of genes related to antibacterial res istance to over 20 classes of antibiotics, 65 biocides, and 22 metals. All c ompartments of 12 WWTPs share persistent resistance genes with detectable tr anscriptional activities that were comparatively higher in the secondary eff luent, where mobility genes also show higher relative abundance and expressi on ratios. The richness and abundance of resistance genes vary greatly acros s metagenomes from different treatment compartments, and their relative and absolute abundances correlate with bacterial community composition and bioma ss concentration. No strong drivers of resistome composition could be identi fied among the chemical stressors analyzed, although the sub-inhibitory conc entration (hundreds of ng/L) of macrolide antibiotics in wastewater correlat es with macrolide and vancomycin resistance genes. Contig-based analysis sho ws considerable co-localization between resistance and mobility genes and im plies a history of substantial horizontal resistance transfer involving huma n bacterial pathogens. Based on these findings, we propose future inclusion of mobility incidence (M%) and host pathogenicity of antibiotic resistance g enes in their quantitative health risk ranking models with an ultimate goal to assess the biological significance of wastewater resistomes with regard t o disease control in humans or domestic livestock.' (1798 chars)
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title => protected'New insight into effect of antibiotics concentration and process configurati on on the removal of antibiotics and relevant antibiotic resistance genes' (149 chars)
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categories => protected'antibiotic resistance genes (ARGs); anoxic/oxic-membrane bioreactor; sequenc ing batch reactor; bacterial community' (114 chars)
description => protected'To compare the performance and antibiotic-resistance character in different process configurations under different levels of antibiotics, anoxic/oxic-me mbrane bioreactors (MBR) 1#, MBR2# and a sequencing batch reactor (SBR) were operated with identical operating parameters. MBR1# and SBR were operated u nder high and increasing levels of antibiotics, MBR2# received constant and low concentration of antibiotics. Microbiological community and antibiotic r esistance genes (ARGs) were investigated using <i>16S rDNA</i> gene high-thr oughput sequencing and qPCR. More than 90% of penicillin and chlortetracycli ne were removed due to strong hydrolysis, followed by sulfamethoxazole (69.2 7%–86.25%) through biodegradation and norfloxacin (28.66%–53.86%) throug h adsorption. Process configuration affected total nitrogen removal more, wh ile antibiotics concentration affected total phosphorus removal more. MBR1# outperformed SBR in reducing sulfamethoxazole, norfloxacin and ARGs due to t he retention effect of the membrane module. Retention efficiency of ARGs in MBRs increased along the operation. Compared to the operational taxonomic un it (OTU) number before antibiotics addition, the OTU number in MBR1# and SBR decreased by 23.7% and 28.7%, while that in MBR2# kept relatively stable. P rocess configuration contributed to higher dissimilarity of microbial commun ity than antibiotics concentration. The research provides an insight into th e influence factors of antibiotics-containing wastewater treatment.' (1511 chars)
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Wastewater bypass is a major temporary point-source of antibiotic resistance genes and multi-resistance risk factors in a Swiss river
Untreated combined sewage (bypass) is often discharged by wastewater treatment plants to receiving rivers during stormwater events, where it may contribute to increased levels of antibiotic resistance genes (ARGs) and multi-resistance risk factors (multi-resistant bacteria and multi-resistance genomic determinants (MGDs)) in the receiving water. Other contamination sources, such as soil runoff and resuspended river sediment could also play a role during stormwater events. Here we report on stormwater event-based sampling campaigns to determine temporal dynamics of ARGs and multi-resistance risk factors in bypass, treated effluent, and the receiving river, as well as complimentary data on catchment soils and surface sediments. Both indicator ARGs (qPCR) and resistome (ARG profiles revealed by metagenomics) indicated bypass as the main contributor to the increased levels of ARGs in the river during stormwater events. Furthermore, we showed for the first time that the risk of exposure to bypass-borne multi-resistance risk factors increase under stormwater events and that many of these MGDs were plasmid associated and thus potentially mobile. In addition, elevated resistance risk factors persisted for some time (up to 22 h) in the receiving water after stormwater events, likely due to inputs from distributed overflows in the catchment. This indicates temporal dynamics should be considered when interpreting the risks of exposure to resistance from event-based contamination. We propose that reducing bypass from wastewater treatment plants may be an important intervention option for reducing dissemination of antibiotic resistance.
Lee, J.; Beck, K.; Bürgmann, H. (2022) Wastewater bypass is a major temporary point-source of antibiotic resistance genes and multi-resistance risk factors in a Swiss river, Water Research, 208, 117827 (12 pp.), doi:10.1016/j.watres.2021.117827, Institutional Repository
Unraveling the riverine antibiotic resistome: the downstream fate of anthropogenic inputs
River networks are one of the main routes by which the public could be exposed to environmental sources of antibiotic resistance, that may be introduced e.g. via treated wastewater. In this study, we applied a comprehensive integrated analysis encompassing mass-flow concepts, chemistry, bacterial plate counts, resistance gene quantification and shotgun metagenomics to track the fate of the resistome (collective antibiotic resistance genes (ARGs) in a microbial community) of treated wastewater in two Swiss rivers at the kilometer scale. The levels of certain ARGs and the class 1 integron integrase gene (intI1) commonly associated with anthropogenic sources of ARGs decreased quickly over short distances (2-2.5 km) downstream of wastewater discharge points. Mass-flow analysis based on conservative tracers suggested this decrease was attributable mainly to dilution but ARG loadings frequently also decreased (e.g., 55.0-98.5 % for ermB and tetW) over the longest studied distances (6.8 and 13.7 km downstream). Metagenomic analysis confirmed that ARG of wastewater-origin did not persist in rivers after 5 ∼ 6.8 km downstream distance. sul1 and intI1 levels and loadings were more variable and even increased sharply at 5 ∼ 6.8 km downstream distance on one occasion. While input from agriculture and in-situ positive selection pressure for organisms carrying ARGs cannot be excluded, in-system growth of biomass is a more probable explanation. The potential for direct human exposure to the resistome of wastewater-origin thus appeared to typically abate rapidly in the studied rivers. However, the riverine aquatic resistome was also dynamic, as evidenced by the increase of certain gene markers downstream, without obvious sources of anthropogenic contamination. This study provides new insight into drivers of riverine resistomes and pinpoints key monitoring targets indicative of where human sources and exposures are likely to be most acute.
Lee, J.; Ju, F.; Maile-Moskowitz, A.; Beck, K.; Maccagnan, A.; McArdell, C. S.; Dal Molin, M.; Fenicia, F.; Vikesland, P.; Pruden, A.; Stamm, C.; Bürgmann, H. (2021) Unraveling the riverine antibiotic resistome: the downstream fate of anthropogenic inputs, Water Research, 197, 117050 (12 pp.), doi:10.1016/j.watres.2021.117050, Institutional Repository
Pathogenic and indigenous denitrifying bacteria are transcriptionally active and key multi-antibiotic-resistant players in wastewater treatment plants
The global rise and spread of antibiotic resistance greatly challenge the treatment of bacterial infections. Wastewater treatment plants (WWTPs) harbor and discharge antibiotic resistance genes (ARGs) as environmental contaminants. However, the knowledge gap on the host identity, activity, and functionality of ARGs limits transmission and health risk assessment of the WWTP resistome. Hereby, a genome-centric quantitative metatranscriptomic approach was exploited to realize high-resolution qualitative and quantitative analyses of bacterial hosts of ARGs (i.e., multiresistance, pathogenicity, activity, and niches) in the 12 urban WWTPs. We found that ∼45% of 248 recovered genomes expressed ARGs against multiple classes of antibiotics, among which bacitracin and aminoglycoside resistance genes in Proteobacteria were the most prevalent scenario. Both potential pathogens and indigenous denitrifying bacteria were transcriptionally active hosts of ARGs. The almost unchanged relative expression levels of ARGs in the most resistant populations (66.9%) and the surviving ARG hosts including globally emerging pathogens (e.g., Aliarcobacter cryaerophilus) in treated WWTP effluent prioritize future examination on the health risks related to resistance propagation and human exposure in the receiving environment.
Yuan, L.; Wang, Y.; Zhang, L.; Palomo, A.; Zhou, J.; Smets, B. F.; Bürgmann, H.; Ju, F. (2021) Pathogenic and indigenous denitrifying bacteria are transcriptionally active and key multi-antibiotic-resistant players in wastewater treatment plants, Environmental Science and Technology, 55(15), 10862-10874, doi:10.1021/acs.est.1c02483, Institutional Repository
A global multinational survey of cefotaxime-resistant coliforms in urban wastewater treatment plants
The World Health Organization Global Action Plan recommends integrated surveillance programs as crucial strategies for monitoring antibiotic resistance. Although several national surveillance programs are in place for clinical and veterinary settings, no such schemes exist for monitoring antibiotic-resistant bacteria in the environment. In this transnational study, we developed, validated, and tested a low-cost surveillance and easy to implement approach to evaluate antibiotic resistance in wastewater treatment plants (WWTPs) by targeting cefotaxime-resistant (CTX-R) coliforms as indicators. The rationale for this approach was: i) coliform quantification methods are internationally accepted as indicators of fecal contamination in recreational waters and are therefore routinely applied in analytical labs; ii) CTX-R coliforms are clinically relevant, associated with extended-spectrum β-lactamases (ESBLs), and are rare in pristine environments. We analyzed 57 WWTPs in 22 countries across Europe, Asia, Africa, Australia, and North America. CTX-R coliforms were ubiquitous in raw sewage and their relative abundance varied significantly (<0.1% to 38.3%), being positively correlated (p < 0.001) with regional atmospheric temperatures. Although most WWTPs removed large proportions of CTX-R coliforms, loads over 103 colony-forming units per mL were occasionally observed in final effluents. We demonstrate that CTX-R coliform monitoring is a feasible and affordable approach to assess wastewater antibiotic resistance status.
Marano, R. B. M.; Fernandes, T.; Manaia, C. M.; Nunes, O.; Morrison, D.; Berendonk, T. U.; Kreuzinger, N.; Telson, T.; Corno, G.; Fatta-Kassinos, D.; Bürgmann, H.; Beck, K.; Cytryn, E. (2020) A global multinational survey of cefotaxime-resistant coliforms in urban wastewater treatment plants, Environment International, 144, 106035 (11 pp.), doi:10.1016/j.envint.2020.106035, Institutional Repository
Wastewater treatment plant resistomes are shaped by bacterial composition, genetic exchange, and upregulated expression in the effluent microbiomes
Wastewater treatment plants (WWTPs) are implicated as hotspots for the dissemination of antibacterial resistance into the environment. However, the in situ processes governing removal, persistence, and evolution of resistance genes during wastewater treatment remain poorly understood. Here, we used quantitative metagenomic and metatranscriptomic approaches to achieve a broad-spectrum view of the flow and expression of genes related to antibacterial resistance to over 20 classes of antibiotics, 65 biocides, and 22 metals. All compartments of 12 WWTPs share persistent resistance genes with detectable transcriptional activities that were comparatively higher in the secondary effluent, where mobility genes also show higher relative abundance and expression ratios. The richness and abundance of resistance genes vary greatly across metagenomes from different treatment compartments, and their relative and absolute abundances correlate with bacterial community composition and biomass concentration. No strong drivers of resistome composition could be identified among the chemical stressors analyzed, although the sub-inhibitory concentration (hundreds of ng/L) of macrolide antibiotics in wastewater correlates with macrolide and vancomycin resistance genes. Contig-based analysis shows considerable co-localization between resistance and mobility genes and implies a history of substantial horizontal resistance transfer involving human bacterial pathogens. Based on these findings, we propose future inclusion of mobility incidence (M%) and host pathogenicity of antibiotic resistance genes in their quantitative health risk ranking models with an ultimate goal to assess the biological significance of wastewater resistomes with regard to disease control in humans or domestic livestock.
Ju, F.; Beck, K.; Yin, X.; Maccagnan, A.; McArdell, C. S.; Singer, H. P.; Johnson, D. R.; Zhang, T.; Bürgmann, H. (2019) Wastewater treatment plant resistomes are shaped by bacterial composition, genetic exchange, and upregulated expression in the effluent microbiomes, ISME Journal, 13(2), 346-360, doi:10.1038/s41396-018-0277-8, Institutional Repository
New insight into effect of antibiotics concentration and process configuration on the removal of antibiotics and relevant antibiotic resistance genes
To compare the performance and antibiotic-resistance character in different process configurations under different levels of antibiotics, anoxic/oxic-membrane bioreactors (MBR) 1#, MBR2# and a sequencing batch reactor (SBR) were operated with identical operating parameters. MBR1# and SBR were operated under high and increasing levels of antibiotics, MBR2# received constant and low concentration of antibiotics. Microbiological community and antibiotic resistance genes (ARGs) were investigated using 16S rDNA gene high-throughput sequencing and qPCR. More than 90% of penicillin and chlortetracycline were removed due to strong hydrolysis, followed by sulfamethoxazole (69.27%–86.25%) through biodegradation and norfloxacin (28.66%–53.86%) through adsorption. Process configuration affected total nitrogen removal more, while antibiotics concentration affected total phosphorus removal more. MBR1# outperformed SBR in reducing sulfamethoxazole, norfloxacin and ARGs due to the retention effect of the membrane module. Retention efficiency of ARGs in MBRs increased along the operation. Compared to the operational taxonomic unit (OTU) number before antibiotics addition, the OTU number in MBR1# and SBR decreased by 23.7% and 28.7%, while that in MBR2# kept relatively stable. Process configuration contributed to higher dissimilarity of microbial community than antibiotics concentration. The research provides an insight into the influence factors of antibiotics-containing wastewater treatment.
Yang, L.; Wen, Q.; Zhao, Y.; Chen, Z.; Wang, Q.; Bürgmann, H. (2019) New insight into effect of antibiotics concentration and process configuration on the removal of antibiotics and relevant antibiotic resistance genes, Journal of Hazardous Materials, 373, 60-66, doi:10.1016/j.jhazmat.2019.03.060, Institutional Repository
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authors => protected'Bürgmann, H.; Frigon, D.; Gaze, W.; Manaia, C.; Pruden, A.; Singer, A. C.; Smets, B.; Zhang, T.' (141 chars)
title => protected'Water and sanitation: an essential battlefront in the war on antimicrobial r esistance' (85 chars)
journal => protected'FEMS Microbiology Ecology' (25 chars)
year => protected2018 (integer)
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startpage => protected'fiy101 (14 pp.)' (15 chars)
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categories => protected'antimicrobial resistance; mitigation; policy; public health; risk assessment ; wastewater treatment' (98 chars)
description => protected'Water and sanitation represents a key battlefront in combating the spread of antimicrobial resistance (AMR). Basic water sanitation infrastructure is an essential first step to protecting public health, thereby limiting the spre ad of pathogens and the need for antibiotics. AMR presents unique human heal th risks, meriting new risk assessment frameworks specifically adapted to wa ter and sanitation-borne AMR. There are numerous exposure routes to AMR orig inating from human waste, each of which must be quantified for its relative risk to human health. Wastewater treatment plants (WWTPs) play a vital role in centralized collection and treatment of human sewage, but there are numer ous unresolved questions in terms of the microbial ecological processes occu rring within and the extent to which they attenuate or amplify AMR. Research is needed to advance understanding of the fate of resistant bacteria and an tibiotic resistance genes (ARGs) in various waste management systems, depend ing on the local constraints and intended re-use applications. WHO and natio nal AMR action plans would benefit from a more holistic 'One Water' understa nding. Here we provide a framework for research, policy, practice, and publi c engagement aimed at limiting the spread of AMR from water and sanitation i n both low-, medium- and high-income countries, alike.' (1346 chars)
serialnumber => protected'0168-6496' (9 chars)
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authors => protected'Vikesland, P. J.; Pruden, A.; Alvarez, P. J. J .; Aga, D. S.; Buergmann, H.; Li, X.; Manaia, C.&nb sp;M.; Nambi, I. M.; Wigginton, K. R.; Zhang, T.; Z hu, Y.-G.' (242 chars)
title => protected'Towards a comprehensive strategy to mitigate dissemination of environmental sources of antibiotic resistance' (108 chars)
journal => protected'Environmental Science and Technology' (36 chars)
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description => protected'Antibiotic resistance is a pervasive global health threat. To combat the spr ead of resistance, it is necessary to consider all possible sources and unde rstand the pathways and mechanisms by which resistance disseminates. Best ma nagement practices are urgently needed to provide barriers to the spread of resistance and maximize the lifespan of antibiotics as a precious resource. Herein we advise upon the need for coordinated national and international st rategies, highlighting three essential components: 1) Monitoring, 2) Risk As sessment, and 3) Mitigation of antibiotic resistance. Central to all three c omponents is What exactly to monitor, assess, and mitigate? We address this question within an environmental framework, drawing from fundamental microbi al ecological processes driving the spread of resistance.' (817 chars)
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Water and sanitation: an essential battlefront in the war on antimicrobial resistance
Water and sanitation represents a key battlefront in combating the spread of antimicrobial resistance (AMR). Basic water sanitation infrastructure is an essential first step to protecting public health, thereby limiting the spread of pathogens and the need for antibiotics. AMR presents unique human health risks, meriting new risk assessment frameworks specifically adapted to water and sanitation-borne AMR. There are numerous exposure routes to AMR originating from human waste, each of which must be quantified for its relative risk to human health. Wastewater treatment plants (WWTPs) play a vital role in centralized collection and treatment of human sewage, but there are numerous unresolved questions in terms of the microbial ecological processes occurring within and the extent to which they attenuate or amplify AMR. Research is needed to advance understanding of the fate of resistant bacteria and antibiotic resistance genes (ARGs) in various waste management systems, depending on the local constraints and intended re-use applications. WHO and national AMR action plans would benefit from a more holistic 'One Water' understanding. Here we provide a framework for research, policy, practice, and public engagement aimed at limiting the spread of AMR from water and sanitation in both low-, medium- and high-income countries, alike.
Bürgmann, H.; Frigon, D.; Gaze, W.; Manaia, C.; Pruden, A.; Singer, A. C.; Smets, B.; Zhang, T. (2018) Water and sanitation: an essential battlefront in the war on antimicrobial resistance, FEMS Microbiology Ecology, 94(9), fiy101 (14 pp.), doi:10.1093/femsec/fiy101, Institutional Repository
Towards a comprehensive strategy to mitigate dissemination of environmental sources of antibiotic resistance
Antibiotic resistance is a pervasive global health threat. To combat the spread of resistance, it is necessary to consider all possible sources and understand the pathways and mechanisms by which resistance disseminates. Best management practices are urgently needed to provide barriers to the spread of resistance and maximize the lifespan of antibiotics as a precious resource. Herein we advise upon the need for coordinated national and international strategies, highlighting three essential components: 1) Monitoring, 2) Risk Assessment, and 3) Mitigation of antibiotic resistance. Central to all three components is What exactly to monitor, assess, and mitigate? We address this question within an environmental framework, drawing from fundamental microbial ecological processes driving the spread of resistance.
Vikesland, P. J.; Pruden, A.; Alvarez, P. J. J.; Aga, D. S.; Buergmann, H.; Li, X.; Manaia, C. M.; Nambi, I. M.; Wigginton, K. R.; Zhang, T.; Zhu, Y.-G. (2017) Towards a comprehensive strategy to mitigate dissemination of environmental sources of antibiotic resistance, Environmental Science and Technology, 51(22), 13061-13069, doi:10.1021/acs.est.7b03623, Institutional Repository
PhD thesis
Lee, Jangwoo (2021) Tracking anthropogenic footprints of antimicrobial resistance in the river system: A Swiss perspective doi.org/10.3929/ethz-b-000514663
