Wastewater treatment plants, an “escape gate” for ESCAPE pathogens
Antibiotics are an essential tool of modern medicine, contributing to significantly decreasing mortality and morbidity rates from infectious diseases. However, persistent misuse of these drugs has accelerated the evolution of antibiotic resistance, negatively impacting clinical practice. The environ...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-05-01
|
| Series: | Frontiers in Microbiology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2023.1193907/full |
| _version_ | 1797821477229166592 |
|---|---|
| author | Luminita Gabriela Marutescu Luminita Gabriela Marutescu Marcela Popa Irina Gheorghe-Barbu Irina Gheorghe-Barbu Ilda Czobor Barbu Ilda Czobor Barbu Daloha Rodríguez-Molina Daloha Rodríguez-Molina Daloha Rodríguez-Molina Fanny Berglund Fanny Berglund Hetty Blaak Carl-Fredrik Flach Carl-Fredrik Flach Merel Aurora Kemper Beate Spießberger Beate Spießberger Beate Spießberger Laura Wengenroth D. G. Joakim Larsson D. G. Joakim Larsson Dennis Nowak Dennis Nowak Katja Radon Ana Maria de Roda Husman Andreas Wieser Andreas Wieser Andreas Wieser Heike Schmitt Gratiela Pircalabioru Gradisteanu Gratiela Pircalabioru Gradisteanu Gratiela Pircalabioru Gradisteanu Corneliu Ovidiu Vrancianu Mariana Carmen Chifiriuc Mariana Carmen Chifiriuc Mariana Carmen Chifiriuc |
| author_facet | Luminita Gabriela Marutescu Luminita Gabriela Marutescu Marcela Popa Irina Gheorghe-Barbu Irina Gheorghe-Barbu Ilda Czobor Barbu Ilda Czobor Barbu Daloha Rodríguez-Molina Daloha Rodríguez-Molina Daloha Rodríguez-Molina Fanny Berglund Fanny Berglund Hetty Blaak Carl-Fredrik Flach Carl-Fredrik Flach Merel Aurora Kemper Beate Spießberger Beate Spießberger Beate Spießberger Laura Wengenroth D. G. Joakim Larsson D. G. Joakim Larsson Dennis Nowak Dennis Nowak Katja Radon Ana Maria de Roda Husman Andreas Wieser Andreas Wieser Andreas Wieser Heike Schmitt Gratiela Pircalabioru Gradisteanu Gratiela Pircalabioru Gradisteanu Gratiela Pircalabioru Gradisteanu Corneliu Ovidiu Vrancianu Mariana Carmen Chifiriuc Mariana Carmen Chifiriuc Mariana Carmen Chifiriuc |
| author_sort | Luminita Gabriela Marutescu |
| collection | DOAJ |
| description | Antibiotics are an essential tool of modern medicine, contributing to significantly decreasing mortality and morbidity rates from infectious diseases. However, persistent misuse of these drugs has accelerated the evolution of antibiotic resistance, negatively impacting clinical practice. The environment contributes to both the evolution and transmission of resistance. From all anthropically polluted aquatic environments, wastewater treatment plants (WWTPs) are probably the main reservoirs of resistant pathogens. They should be regarded as critical control points for preventing or reducing the release of antibiotics, antibiotic-resistant bacteria (ARB), and antibiotic-resistance genes (ARGs) into the natural environment. This review focuses on the fate of the pathogens Enterococcus faecium, Staphylococcus aureus, Clostridium difficile, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacteriaceae spp. (ESCAPE) in WWTPs. All ESCAPE pathogen species, including high-risk clones and resistance determinants to last-resort antibiotics such as carbapenems, colistin, and multi-drug resistance platforms, were detected in wastewater. The whole genome sequencing studies demonstrate the clonal relationships and dissemination of Gram-negative ESCAPE species into the wastewater via hospital effluents and the enrichment of virulence and resistance determinants of S. aureus and enterococci in WWTPs. Therefore, the efficiency of different wastewater treatment processes regarding the removal of clinically relevant ARB species and ARGs, as well as the influence of water quality factors on their performance, should be explored and monitored, along with the development of more effective treatments and appropriate indicators (ESCAPE bacteria and/or ARGs). This knowledge will allow the development of quality standards for point sources and effluents to consolidate the WWTP barrier role against the environmental and public health AR threats. |
| first_indexed | 2024-03-13T09:53:16Z |
| format | Article |
| id | doaj.art-1d191de9c45243fa84aa7fcc42ff4aba |
| institution | Directory Open Access Journal |
| issn | 1664-302X |
| language | English |
| last_indexed | 2024-03-13T09:53:16Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Microbiology |
| spelling | doaj.art-1d191de9c45243fa84aa7fcc42ff4aba2023-05-24T05:30:34ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2023-05-011410.3389/fmicb.2023.11939071193907Wastewater treatment plants, an “escape gate” for ESCAPE pathogensLuminita Gabriela Marutescu0Luminita Gabriela Marutescu1Marcela Popa2Irina Gheorghe-Barbu3Irina Gheorghe-Barbu4Ilda Czobor Barbu5Ilda Czobor Barbu6Daloha Rodríguez-Molina7Daloha Rodríguez-Molina8Daloha Rodríguez-Molina9Fanny Berglund10Fanny Berglund11Hetty Blaak12Carl-Fredrik Flach13Carl-Fredrik Flach14Merel Aurora Kemper15Beate Spießberger16Beate Spießberger17Beate Spießberger18Laura Wengenroth19D. G. Joakim Larsson20D. G. Joakim Larsson21Dennis Nowak22Dennis Nowak23Katja Radon24Ana Maria de Roda Husman25Andreas Wieser26Andreas Wieser27Andreas Wieser28Heike Schmitt29Gratiela Pircalabioru Gradisteanu30Gratiela Pircalabioru Gradisteanu31Gratiela Pircalabioru Gradisteanu32Corneliu Ovidiu Vrancianu33Mariana Carmen Chifiriuc34Mariana Carmen Chifiriuc35Mariana Carmen Chifiriuc36Department of Microbiology and Immunology, Faculty of Biology, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, RomaniaEarth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, RomaniaEarth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, RomaniaDepartment of Microbiology and Immunology, Faculty of Biology, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, RomaniaEarth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, RomaniaDepartment of Microbiology and Immunology, Faculty of Biology, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, RomaniaEarth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, RomaniaInstitute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, GermanyInstitute for Medical Information Processing, Biometry, and Epidemiology – IBE, LMU Munich, Munich, GermanyPettenkofer School of Public Health, Munich, GermanyDepartment of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, SwedenCentre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, Gothenburg, SwedenCentre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, NetherlandsDepartment of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, SwedenCentre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, Gothenburg, SwedenCentre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, NetherlandsGerman Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany0Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, Munich, Germany1Department of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Munich, GermanyInstitute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, GermanyDepartment of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, SwedenCentre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, Gothenburg, SwedenInstitute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany2Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, GermanyInstitute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, GermanyCentre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, NetherlandsGerman Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany0Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, Munich, Germany1Department of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Munich, GermanyCentre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, NetherlandsDepartment of Microbiology and Immunology, Faculty of Biology, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, RomaniaEarth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania3Romanian Academy of Sciences, Bucharest, RomaniaDepartment of Microbiology and Immunology, Faculty of Biology, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, RomaniaDepartment of Microbiology and Immunology, Faculty of Biology, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, RomaniaEarth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania4The Romanian Academy, Bucharest, RomaniaAntibiotics are an essential tool of modern medicine, contributing to significantly decreasing mortality and morbidity rates from infectious diseases. However, persistent misuse of these drugs has accelerated the evolution of antibiotic resistance, negatively impacting clinical practice. The environment contributes to both the evolution and transmission of resistance. From all anthropically polluted aquatic environments, wastewater treatment plants (WWTPs) are probably the main reservoirs of resistant pathogens. They should be regarded as critical control points for preventing or reducing the release of antibiotics, antibiotic-resistant bacteria (ARB), and antibiotic-resistance genes (ARGs) into the natural environment. This review focuses on the fate of the pathogens Enterococcus faecium, Staphylococcus aureus, Clostridium difficile, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacteriaceae spp. (ESCAPE) in WWTPs. All ESCAPE pathogen species, including high-risk clones and resistance determinants to last-resort antibiotics such as carbapenems, colistin, and multi-drug resistance platforms, were detected in wastewater. The whole genome sequencing studies demonstrate the clonal relationships and dissemination of Gram-negative ESCAPE species into the wastewater via hospital effluents and the enrichment of virulence and resistance determinants of S. aureus and enterococci in WWTPs. Therefore, the efficiency of different wastewater treatment processes regarding the removal of clinically relevant ARB species and ARGs, as well as the influence of water quality factors on their performance, should be explored and monitored, along with the development of more effective treatments and appropriate indicators (ESCAPE bacteria and/or ARGs). This knowledge will allow the development of quality standards for point sources and effluents to consolidate the WWTP barrier role against the environmental and public health AR threats.https://www.frontiersin.org/articles/10.3389/fmicb.2023.1193907/fullESCAPE pathogensantibiotic resistancewastewater treatment plantsantibiotic resistance genesESCAPE species disseminationhigh-risk clones |
| spellingShingle | Luminita Gabriela Marutescu Luminita Gabriela Marutescu Marcela Popa Irina Gheorghe-Barbu Irina Gheorghe-Barbu Ilda Czobor Barbu Ilda Czobor Barbu Daloha Rodríguez-Molina Daloha Rodríguez-Molina Daloha Rodríguez-Molina Fanny Berglund Fanny Berglund Hetty Blaak Carl-Fredrik Flach Carl-Fredrik Flach Merel Aurora Kemper Beate Spießberger Beate Spießberger Beate Spießberger Laura Wengenroth D. G. Joakim Larsson D. G. Joakim Larsson Dennis Nowak Dennis Nowak Katja Radon Ana Maria de Roda Husman Andreas Wieser Andreas Wieser Andreas Wieser Heike Schmitt Gratiela Pircalabioru Gradisteanu Gratiela Pircalabioru Gradisteanu Gratiela Pircalabioru Gradisteanu Corneliu Ovidiu Vrancianu Mariana Carmen Chifiriuc Mariana Carmen Chifiriuc Mariana Carmen Chifiriuc Wastewater treatment plants, an “escape gate” for ESCAPE pathogens Frontiers in Microbiology ESCAPE pathogens antibiotic resistance wastewater treatment plants antibiotic resistance genes ESCAPE species dissemination high-risk clones |
| title | Wastewater treatment plants, an “escape gate” for ESCAPE pathogens |
| title_full | Wastewater treatment plants, an “escape gate” for ESCAPE pathogens |
| title_fullStr | Wastewater treatment plants, an “escape gate” for ESCAPE pathogens |
| title_full_unstemmed | Wastewater treatment plants, an “escape gate” for ESCAPE pathogens |
| title_short | Wastewater treatment plants, an “escape gate” for ESCAPE pathogens |
| title_sort | wastewater treatment plants an escape gate for escape pathogens |
| topic | ESCAPE pathogens antibiotic resistance wastewater treatment plants antibiotic resistance genes ESCAPE species dissemination high-risk clones |
| url | https://www.frontiersin.org/articles/10.3389/fmicb.2023.1193907/full |
| work_keys_str_mv | AT luminitagabrielamarutescu wastewatertreatmentplantsanescapegateforescapepathogens AT luminitagabrielamarutescu wastewatertreatmentplantsanescapegateforescapepathogens AT marcelapopa wastewatertreatmentplantsanescapegateforescapepathogens AT irinagheorghebarbu wastewatertreatmentplantsanescapegateforescapepathogens AT irinagheorghebarbu wastewatertreatmentplantsanescapegateforescapepathogens AT ildaczoborbarbu wastewatertreatmentplantsanescapegateforescapepathogens AT ildaczoborbarbu wastewatertreatmentplantsanescapegateforescapepathogens AT daloharodriguezmolina wastewatertreatmentplantsanescapegateforescapepathogens AT daloharodriguezmolina wastewatertreatmentplantsanescapegateforescapepathogens AT daloharodriguezmolina wastewatertreatmentplantsanescapegateforescapepathogens AT fannyberglund wastewatertreatmentplantsanescapegateforescapepathogens AT fannyberglund wastewatertreatmentplantsanescapegateforescapepathogens AT hettyblaak wastewatertreatmentplantsanescapegateforescapepathogens AT carlfredrikflach wastewatertreatmentplantsanescapegateforescapepathogens AT carlfredrikflach wastewatertreatmentplantsanescapegateforescapepathogens AT merelaurorakemper wastewatertreatmentplantsanescapegateforescapepathogens AT beatespießberger wastewatertreatmentplantsanescapegateforescapepathogens AT beatespießberger wastewatertreatmentplantsanescapegateforescapepathogens AT beatespießberger wastewatertreatmentplantsanescapegateforescapepathogens AT laurawengenroth wastewatertreatmentplantsanescapegateforescapepathogens AT dgjoakimlarsson wastewatertreatmentplantsanescapegateforescapepathogens AT dgjoakimlarsson wastewatertreatmentplantsanescapegateforescapepathogens AT dennisnowak wastewatertreatmentplantsanescapegateforescapepathogens AT dennisnowak wastewatertreatmentplantsanescapegateforescapepathogens AT katjaradon wastewatertreatmentplantsanescapegateforescapepathogens AT anamariaderodahusman wastewatertreatmentplantsanescapegateforescapepathogens AT andreaswieser wastewatertreatmentplantsanescapegateforescapepathogens AT andreaswieser wastewatertreatmentplantsanescapegateforescapepathogens AT andreaswieser wastewatertreatmentplantsanescapegateforescapepathogens AT heikeschmitt wastewatertreatmentplantsanescapegateforescapepathogens AT gratielapircalabiorugradisteanu wastewatertreatmentplantsanescapegateforescapepathogens AT gratielapircalabiorugradisteanu wastewatertreatmentplantsanescapegateforescapepathogens AT gratielapircalabiorugradisteanu wastewatertreatmentplantsanescapegateforescapepathogens AT corneliuovidiuvrancianu wastewatertreatmentplantsanescapegateforescapepathogens AT marianacarmenchifiriuc wastewatertreatmentplantsanescapegateforescapepathogens AT marianacarmenchifiriuc wastewatertreatmentplantsanescapegateforescapepathogens AT marianacarmenchifiriuc wastewatertreatmentplantsanescapegateforescapepathogens |