Title: A global multinational survey of cefotaxime-resistant coliforms in urban wastewater treatment plants
Authors: Marano, Roberto  
Fernandes, Telma 
Manaia, Célia 
Nunes, Olga  
Morrison, Donald  
Berendonk, Thomas  
Kreuzinger, Norbert  
Tenson, Tanel  
Gianluca, Corno 
Fatta-Kassinos, Despo  
Merlin, Christophe 
Topp, Edward 
Jurkevitch, Edouard  
Henn, Leonie 
Scott, Andrew 
Heß, Stefanie 
Slipko, Katarzyna Anna 
Laht, Mailis  
Kisand, Veljo  
Cesare, Andrea 
Karaolia, Popi  
Michael, Stella  
Petre, Alice 
Rosal, Roberto  
Pruden, Amy  
Riquelme, Maria Virginia  
Agüera, Ana  
Esteban, Belen 
Luczkiewicz, Aneta  
Kalinowska, Agnieszka  
Leonard, Anne 
Gaze, William  
Adegoke, Anthony Ayodeji  
Stenstrom, Thor  
Pollice, Alfieri  
Salerno, Carlo  
Schwermer, Carsten Ulrich  
Krzeminski, Pawel  
Guilloteau, Hélène 
Donner, Erica  
Drigo, Barbara  
Libralato, Giovanni  
Guida, Marco  
Bürgmann, Helmut  
Beck, Karin 
Garelick, Hemda  
Tacão, Marta  
Henriques, Isabel  
Martínez-Alcalá, Isabel  
Guillén-Navarro, Jose 
Popowska, Magdalena  
Piotrowska, Marta 
Quintela-Baluja, Marcos  
Bunce, Joshua  
Polo-López, Maria 
Nahim-Granados, Samira  
Pons, Marie-Noëlle 
Milakovic, Milena 
Udikovic-Kolic, Nikolina  
Ory, Jérôme  
Traore, Ousmane  
Caballero, Pilar 
Oliver, Antoni 
Rodriguez-Mozaz, Sara  
Balcazar, Jose 
Jäger, Thomas  
Schwartz, Thomas 
Yang, Ying  
Zou, Shichun  
Lee, Yunho 
Yoon, Younggun 
Herzog, Bastian 
Mayrhofer, Heidrun 
Prakash, Om  
Nimonkar, Yogesh  
Heath, Ester  
Baraniak, Anna  
Abreu Silva, Joana  
Choudhury, Manika  
Munoz, Leonardo  
Krizanovic, Stela 
Brunetti, Gianluca  
Maile-Moskowitz, Ayella  
Brown, Connor 
Cytryn, Eddie  
Category: Original Research Article
Issue Date: 2020
Journal: Environment International 
ISSN: 0160-4120
Abstract: 
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 10^3 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.
Keywords: antibiotic resistance; coliforms; ESBLs; wastewater treatment; water reuse
DOI: 10.1016/j.envint.2020.106035
Organisation: E226-01 - Forschungsbereich Wassergütewirtschaft 
License: CC BY-NC-ND 4.0 CC BY-NC-ND 4.0
Publication Type: Article
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