[Source: PLoS One, full page: (LINK). Abstract, edited.]
OPEN ACCESS / PEER-REVIEWED / RESEARCH ARTICLE
Carbapenemase-producing Enterobacteriaceae and Aeromonas spp. present in wastewater treatment plant effluent and nearby surface waters in the US
Dimitria A. Mathys, Dixie F. Mollenkopf, Sydnee M. Feicht, Rachael J. Adams, Amy L. Albers, David M. Stuever, Susan V. Grooters, Gregory A. Ballash, Joshua B. Daniels, Thomas E. Wittum
Published: June 26, 2019 / DOI: https://doi.org/10.1371/journal.pone.0218650
Carbapenemase-producing bacteria (CPB) are rare, multidrug resistant organisms most commonly associated with hospitalized patients. Metropolitan wastewater treatment plants (WWTP) treat wastewater from large geographic areas which include hospitals and may serve as epidemiologic reservoirs for the maintenance or expansion of CPB that originate from hospitals and are ultimately discharged in treated effluent. However, little is known about the potential impact of these WWTP CPB on the local surface water and their risk to the public health. In addition, CPB that are present in surface water may ultimately disseminate to intensively-managed animal agriculture facilities where there is potential for amplification by extended-spectrum cephalosporins. To better understand the role of WWTPs in the dissemination of CPB in surface waters, we obtained samples of treated effluent, and both upstream and downstream nearby surface water from 50 WWTPs throughout the US. A total of 30 CPB with clinically-relevant genotypes were recovered from 15 WWTPs (30%) of which 13 (50%) serviced large metropolitan areas and 2 (8.3%) represented small rural populations (P < 0.05). Recovery of CPB was lowest among WWTPs that utilized ultraviolet radiation for primary disinfection (12%), and higher (P = 0.11) for WWTPs that used chlorination (42%) or that did not utilize disinfection (50%). We did not detect a difference in CPB recovery by sampling site, although fewer CPB were detected in upstream (8%) compared to effluent (20%) and downstream (18%) samples. Our results indicate that WWTP effluent and nearby surface waters in the US are routinely contaminated with CPB with clinically important genotypes including those producing Klebsiella pneumoniae carbapenemase (KPC) and New Delhi metallo-beta-lactamase (NDM). This is a concern for both public health and animal agriculture because introduction of CPB into intensively managed livestock populations could lead to their amplification and foodborne dissemination.
Citation: Mathys DA, Mollenkopf DF, Feicht SM, Adams RJ, Albers AL, Stuever DM, et al. (2019) Carbapenemase-producing Enterobacteriaceae and Aeromonas spp. present in wastewater treatment plant effluent and nearby surface waters in the US. PLoS ONE 14(6): e0218650. https://doi.org/10.1371/journal.pone.0218650
Editor: Zhi Zhou, Purdue University, UNITED STATES
Received: September 22, 2018; Accepted: June 6, 2019; Published: June 26, 2019
Copyright: © 2019 Mathys et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: The data have been deposited with links to BioProject accession number PRJNA472583 in the NCBI BioProject database (https://www.ncbi.nlm.nih.gov/bioproject/).
Funding: Funding for this project was provided by the USDA NIFA award no. 2014-67005-21709 (TEW, JBD).
Competing interests: The authors have declared that no competing interests exist.
Keywords: Antibiotics; Drugs Resistance; Carbapenem; Enterobacteriaceae; Environmental pollution; USA: