Antibiotic resistance in European wastewater treatment plants mirrors the pattern of clinical antibiotic resistance prevalence

Katariina Pärnänen(University of Helsinki), Carlos Narciso‐da‐Rocha(Universidade Católica Portuguesa), David Kneis(Technische Universität Dresden), Thomas U. Berendonk(Technische Universität Dresden), Damiano Cacace(Technische Universität Dresden), Thị Thùy(National University of Ireland, Maynooth), Christian Elpers(Karlsruhe University of Education), Despo Fatta‐Kassinos(Cyprus International University), Isabel Henriques(University of Aveiro), Thomas Jaeger(Karlsruhe Institute of Technology), Antti Karkman(University of Helsinki), José Luis Martínez(Centro Nacional de Biotecnología), Stella G. Michael(Cyprus International University), I. Michael-Kordatou(Cyprus International University), Kristin O’Sullivan(Norwegian University of Life Sciences), Sara Rodríguez‐Mozaz(Catalan Institute for Water Research), Thomas Schwartz(Karlsruhe Institute of Technology), Hongjie Sheng(Chinese Academy of Sciences), Henning Sørum(Norwegian University of Life Sciences), Robert D. Stedtfeld(Michigan State University), James M. Tiedje(Michigan State University), Saulo Varela Della Giustina(Catalan Institute for Water Research), Fiona Walsh(National University of Ireland, Maynooth), Ivone Vaz‐Moreira(Universidade Católica Portuguesa), Marko Virta(University of Helsinki), Célia M. Manaia(Universidade Católica Portuguesa)
Science Advances
March 1, 2019
10.1126/sciadv.aau9124
Cited by 583Open Access
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Abstract

Integrated antibiotic resistance (AR) surveillance is one of the objectives of the World Health Organization global action plan on antimicrobial resistance. Urban wastewater treatment plants (UWTPs) are among the most important receptors and sources of environmental AR. On the basis of the consistent observation of an increasing north-to-south clinical AR prevalence in Europe, this study compared the influent and final effluent of 12 UWTPs located in seven countries (Portugal, Spain, Ireland, Cyprus, Germany, Finland, and Norway). Using highly parallel quantitative polymerase chain reaction, we analyzed 229 resistance genes and 25 mobile genetic elements. This first trans-Europe surveillance showed that UWTP AR profiles mirror the AR gradient observed in clinics. Antibiotic use, environmental temperature, and UWTP size were important factors related with resistance persistence and spread in the environment. These results highlight the need to implement regular surveillance and control measures, which may need to be appropriate for the geographic regions.

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