Key Laboratory of Pollution Processes and Environmental Criteria of the Ministry of Education, Tianjin Key Laboratory of Environmental Remediation and Pollution Control, College of Environmental Science and Engineering, Nankai University, Tianjin 300350, China; State Key Laboratory of Urban Water Resource and Environment, School of Environment, Harbin Institute of Technology, Harbin, Heilongjiang Province 150090, China.
Key Laboratory of Pollution Processes and Environmental Criteria of the Ministry of Education, Tianjin Key Laboratory of Environmental Remediation and Pollution Control, College of Environmental Science and Engineering, Nankai University, Tianjin 300350, China.
Sci Total Environ. 2022 Sep 10;838(Pt 4):156544. doi: 10.1016/j.scitotenv.2022.156544. Epub 2022 Jun 6.
This study aims to discuss the following: (1) occurrence and proliferation of antibiotic resistance in wastewater treatment plants (WWTPs); (2) factors influencing antibiotic resistance bacteria and genes in WWTPs; (3) tools to assess antibiotic resistance in WWTPs; (4) environmental contamination of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) from WWTPs; (5) effects of ARB and ARGs from WWTPs on human health; and (6) treatment strategies. In general, resistant and multi-resistant bacteria, including Enterobacteriaceae, Pseudomonas aeruginosa, and Escherichia coli, exist in various processes of WWTPs. The existence of ARB and ARGs results from the high concentration of antibiotics in wastewater, which promote selective pressures on the local bacteria present in WWTPs. Thus, improving wastewater treatment technology and avoiding the misuse of antibiotics is critical to overcoming the threat of proliferation of ARBs and ARGs. Numerous factors can affect the development of ARB and ARGs in WWTPs. Abiotic factors can affect the bacterial community dynamics, thereby, affecting the applicability of ARB during the wastewater treatment process. Furthermore, the organic loads and other nutrients influence bacterial survival and growth. Specifically, molecular methods for the rapid characterization and detection of ARBs or their genes comprise DNA sequencing, real-time PCR, simple and multiplex PCR, and hybridization-based technologies, including micro- and macro-arrays. The reuse of effluent from WWTPs for irrigation is an efficient method to overcome water scarcity. However, there are also some potential environmental risks associated with this practice, such as increase in the levels of antibiotic resistance in the soil microbiome. Human mortality rates may significantly increase, as ARB can lead to resistance among several types of antibiotics or longer treatment times. Some treatment technologies, such as anaerobic and aerobic treatment, coagulation, membrane bioreactors, and disinfection processes, are considered potential techniques to restrict antibiotic resistance in the environment.
（1）污水处理厂（WWTP）中抗生素耐药性的发生和增殖；（2）影响 WWTP 中抗生素耐药菌和基因的因素；（3）评估 WWTP 中抗生素耐药性的工具；（4）WWTP 中抗生素耐药菌（ARB）和抗生素耐药基因（ARGs）的环境污染；（5）WWTP 中 ARB 和 ARGs 对人类健康的影响；以及（6）处理策略。一般来说，包括肠杆菌科、铜绿假单胞菌和大肠杆菌在内的耐药和多重耐药菌存在于 WWTP 的各个处理过程中。ARB 和 ARGs 的存在是由于废水中抗生素浓度高，这对 WWTP 中存在的当地细菌产生了选择压力。因此，提高废水处理技术和避免抗生素的滥用对于克服 ARB 和 ARGs 增殖的威胁至关重要。许多因素可以影响 WWTP 中 ARB 和 ARGs 的发展。非生物因素会影响细菌群落的动态，从而影响 ARB 在废水处理过程中的适用性。此外，有机负荷和其他营养物质会影响细菌的生存和生长。具体而言，用于快速表征和检测 ARB 或其基因的分子方法包括 DNA 测序、实时 PCR、简单和多重 PCR 以及基于杂交的技术，包括微阵列和宏阵列。将 WWTP 的出水再用于灌溉是克服水资源短缺的有效方法。然而，这种做法也存在一些潜在的环境风险，例如土壤微生物组中抗生素耐药性水平的增加。由于 ARB 可能导致多种抗生素耐药或治疗时间延长，人类死亡率可能会显著增加。一些处理技术，如厌氧和好氧处理、混凝、膜生物反应器和消毒过程，被认为是限制环境中抗生素耐药性的潜在技术。
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