Marine Biology Institute, Shantou University, Shantou, Guangdong Province, China.
Biosystems and Environmental Engineering Research Group, Department of Soil Science and Agricultural Engineering, University of Zimbabwe, P.O. Box MP167, Mt. Pleasant, Harare, Zimbabwe.
Sci Total Environ. 2019 Jun 15;669:785-797. doi: 10.1016/j.scitotenv.2019.03.162. Epub 2019 Mar 12.
In recent years, there has been a growing interest on the occurrence of antibiotic-resistant bacteria (ARB) and antibiotic resistant genes (ARGs) in treated and untreated drinking water. ARB and ARGs pose a public health concern when they transfer antibiotic resistance (AR) to human pathogens. However, it is still unclear whether the presence of environmental ARB and ARGs in source water, drinking water treatment plants, and drinking water distribution systems has any significant impact on human exposure to pathogenic ARB. In this review, we critically examine the occurrence of AR in groundwater, surface water, and treated distributed water. This offered a new perspective on the human health threat posed by AR in drinking water and helped in crafting a strategy for monitoring AR effectively. Using existing data on removal of ARB and ARGs in drinking water treatment plants, presence and proliferation of AR in drinking water distribution systems, and mechanisms and pathways of AR transfer in drinking water treatment plants, we conclude that combining UV-irradiation with advanced oxidative processes (such as UV/chlorine, UV/HO, and HO/UV/TiO) may enhance the removal of ARB and ARGs, while disinfection may promote horizontal gene transfer from environmental ARB to pathogens. The potential human health risks of AR were determined by examining human exposure to antibiotic resistant human pathogens and re-evaluating waterborne disease outbreaks and their links to environmental AR. We concluded that integrating disease outbreak analysis, human exposure modelling, and clinical data could provide critical information that can be used to estimate the dose-response relationships of pathogenic ARB in drinking water, which is required for accurate risk assessments.
近年来，人们对处理和未处理饮用水中抗生素耐药细菌（ARB）和抗生素耐药基因（ARGs）的出现越来越感兴趣。当 ARB 和 ARGs 将抗生素耐药性（AR）转移到人类病原体时，它们会对公共健康构成威胁。然而，目前尚不清楚水源、饮用水处理厂和饮用水分配系统中环境 ARB 和 ARGs 的存在是否会对人类接触致病性 ARB 产生任何重大影响。在这篇综述中，我们批判性地检查了地下水、地表水和处理过的分配水中的 AR 的存在情况。这为饮用水中 AR 对人类健康的威胁提供了新的视角，并有助于制定有效的 AR 监测策略。利用饮用水处理厂中 ARB 和 ARGs 的去除、饮用水分配系统中 AR 的存在和增殖以及饮用水处理厂中 AR 转移的机制和途径的现有数据，我们得出结论，将紫外线照射与先进的氧化工艺（如 UV/氯、UV/HO 和 HO/UV/TiO）相结合可能会增强 ARB 和 ARGs 的去除效果，而消毒可能会促进环境 ARB 向病原体的水平基因转移。通过检查人类暴露于抗生素耐药性人类病原体以及重新评估与环境 AR 相关的水源性疾病暴发及其联系，确定了 AR 的潜在人类健康风险。我们得出的结论是，将疾病暴发分析、人类暴露建模和临床数据相结合，可以提供关键信息，用于估计饮用水中致病性 ARB 的剂量-反应关系，这是进行准确风险评估所必需的。
