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Marano, R.B.M. - Department of Agroecology and Plant Health, The Robert H. Smith, Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel; Department of Soil Chemistry, Plant Nutrition and Microbiology, Institute of Soil Water and Environmental Sciences, Volcani Center, Agricultural Research Organization, Rishon Lezion, Israel.

Fernandes, T. - cUniversidade Católica Portuguesa, CBQF – Centro de Biotecnologia e Química Fina – Laboratório Associado, Escola Superior de Biotecnologia, Rua Arquiteto Lobão Vital, 172, Porto, 4200-374, Portugal

Manaia, C.M. - cUniversidade Católica Portuguesa, CBQF – Centro de Biotecnologia e Química Fina – Laboratório Associado, Escola Superior de Biotecnologia, Rua Arquiteto Lobão Vital, 172, Porto, 4200-374, Portugal

Nunes, O. - LEPABE, Laboratório de Engenharia de Processos, Ambiente, Biotecnologia e Energia, Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, Porto, 4200-465, Portugal

Morrison, D. - School Applied Sciences, Edinburgh Napier University, EH11 4BN, United Kingdom

Berendonk, T.U. - Institute of Hydrobiology, TU Dresden, Dresden, Germany

Kreuzinger, N. - Vienna University of Technology, Institute for Water Quality and Resources Management, Vienna, Austria

Telson, T. - Institute of Technology, University of Tartu, Estonia

Corno, G. - CNR-IRSA Molecular Ecology Group, Largo Tonolli 50, Verbania, 28922, Italy

Fatta-Kassinos, D. - Civil and Environmental Engineering Department and Nireas International Water Research Center, University of Cyprus, P.O. Box 20537, Nicosia, CY-1678, Cyprus

Merlin, C. - UMR 7564 University of Lorraine-CNRS (LCPME), France

Topp, E. - Agriculture and Agri-Food Canada, London Research and Development Centre (ON), Canada; Department of Biology, University of Western Ontario, London, ON, Canada

Jurkevitch, E. - Department of Agroecology and Plant Health, The Robert H. Smith, Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel

Henn, L. - School Applied Sciences, Edinburgh Napier University, EH11 4BN, United Kingdom

Scott, A. - Agriculture and Agri-Food Canada, London Research and Development Centre (ON), Canada

Heß, S. - Institute of Hydrobiology, TU Dresden, Dresden, Germany; Institute of Microbiology, TU Dresden, Dresden, Germany

Slipko, K. - Vienna University of Technology, Institute for Water Quality and Resources Management, Vienna, Austria

Laht, M. - Institute of Technology, University of Tartu, Estonia; Estonian Environmental Research Centre, Estonia

Kisand, V. - Institute of Technology, University of Tartu, Estonia

Di Cesare, A. - CNR-IRSA Molecular Ecology Group, Largo Tonolli 50, Verbania, 28922, Italy

Karaolia, P. - Civil and Environmental Engineering Department and Nireas International Water Research Center, University of Cyprus, P.O. Box 20537, Nicosia, CY-1678, Cyprus

Michael, S.G. - Civil and Environmental Engineering Department and Nireas International Water Research Center, University of Cyprus, P.O. Box 20537, Nicosia, CY-1678, Cyprus

Petre, A.L. - Department of Chemical Engineering, University of Alcalá, Alcalá de Henares, Madrid E-28871, Spain

Rosal, R. - Department of Chemical Engineering, University of Alcalá, Alcalá de Henares, Madrid E-28871, Spain

Pruden, A. - Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, United States

Riquelme, V. - Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, United States

Agüera, A. - Solar Energy Research Centre (CIESOL), Joint Centre University of Almería-CIEMAT, Almería, 04120, Spain

Esteban, B. - Solar Energy Research Centre (CIESOL), Joint Centre University of Almería-CIEMAT, Almería, 04120, Spain

Luczkiewicz, A. - Faculty of Civil and Environmental Engineering, Gdansk University of Technology, G. Narutowicza 11/12 street, Gdańsk, 80-233, Poland

Kalinowska, A. - Faculty of Civil and Environmental Engineering, Gdansk University of Technology, G. Narutowicza 11/12 street, Gdańsk, 80-233, Poland

Leonard, A. - sUniversity of Exeter Medical School, European Centre for Environment and Human Health, Environment and Sustainability Institute, University of Exeter, Penryn campus, TR10 9FE, United Kingdom

Gaze, W.H. - University of Exeter Medical School, European Centre for Environment and Human Health, Environment and Sustainability Institute, University of Exeter, Penryn campus, TR10 9FE, United Kingdom

Adegoke, A.A. - Institute for Water and Wastewater Technology, Durban University of Technology, Durban, South Africa; Department of Microbiology, University of Uyo, Uyo, Nigeria

Stenstrom, T.A. - Institute for Water and Wastewater Technology, Durban University of Technology, Durban, South Africa

Pollice, A. - CNR-IRSA, Viale F. De Blasio 5, Bari, 70132, Italy.
Salerno, C. - CNR-IRSA, Viale F. De Blasio 5, Bari, 70132, Italy


Schwermer, C.U. - Norwegian Institute for Water Research, Gaustadalléen 21, Oslo, N-0349, Norway.
Krzeminski, P. - Norwegian Institute for Water Research, Gaustadalléen 21, Oslo, N-0349, Norway

Guilloteau, H. - UMR 7564 University of Lorraine-CNRS (LCPME), France

Donner, E. - Future Industries Institute, University of South Australia, Adelaide, SA 5001, Australia

Drigo, B. - Future Industries Institute, University of South Australia, Adelaide, SA 5001, Australia

Libralato, G. - Department of Biology, University of Naples Federico II, via Cinthia 21, Naples, 80126, Italy

Guida, M. - Department of Biology, University of Naples Federico II, via Cinthia 21, Naples, 80126, Italy

Bürgmann, H. - Eawag, Swiss Federal Institute of Aquatic Science and Technology, Kastanienbaum, 6047, Switzerland

Beck, K. - Eawag, Swiss Federal Institute of Aquatic Science and Technology, Kastanienbaum, 6047, Switzerland

Garelick, H. - Department of Natural Sciences, Middlesex University, London, NW4 4BT, United Kingdom

Tacão, M. - acCESAM and Department of Biology, University of Aveiro, Campus Universitário de Santiago, 3810-193, Portugal

Henriques, I. - CESAM and Department of Biology, University of Aveiro, Campus Universitário de Santiago, 3810-193, Portugal; University of Coimbra, Department of Life Sciences, Calçada Martim de Freitas, Coimbra, 3000-456, Portugal

Martínez-Alcalá, I. - Department of Civil Engineering, Av. de los Jerónimos, 135, Guadalupe, Murcia 30107, Spain

Guillén-Navarro, J.M. - Department of Civil Engineering, Av. de los Jerónimos, 135, Guadalupe, Murcia 30107, Spain

Popowska, M. - aeInstitute of Microbiology, Department of Applied Microbiology, Faculty of Biology, University of Warsaw, Poland

Piotrowska, M. - aeInstitute of Microbiology, Department of Applied Microbiology, Faculty of Biology, University of Warsaw, Poland

Quintela-Baluja, M. - School of Engineering, Newcastle University, Newcastle Upon Tyne, United Kingdom

Bunce, J.T. - School of Engineering, Newcastle University, Newcastle Upon Tyne, United Kingdom.
Polo-López, M.I. - Solar Energy Research Centre (CIESOL), Joint Centre University of Almería-CIEMAT, Almería, 04120, Spain; Plataforma Solar de Almería – CIEMAT, P.O. Box 22, Tabernas, Almería, 04200, Spain

Nahim–Granados, S. - Solar Energy Research Centre (CIESOL), Joint Centre University of Almería-CIEMAT, Almería, 04120, Spain; Plataforma Solar de Almería – CIEMAT, P.O. Box 22, Tabernas, Almería, 04200, Spain

Pons, M.-N. - Université de Lorraine, CNRS, LRGP, Nancy, F-54000, France

Milakovic, M. - Rudjer Boskovic Institute, Bijenicka 54, Zagreb, Croatia

Udikovic-Kolic, N. - Rudjer Boskovic Institute, Bijenicka 54, Zagreb, Croatia

Ory, J. - Laboratoire “Microorganisme: Génome et Environnement”, Université Clermont Auvergne, BP 10448, Clermont-Ferrand, F-63000, France; CNRS, UMR 6023, LMGE, F-63170 Campus Universitaire des Cézeaux, Clermont-Ferrand, France; Service d'hygiène hospitalière, CHU Clermont-Ferrand, Clermont-Ferrand, France.
Ousmane, T. - Laboratoire “Microorganisme: Génome et Environnement”, Université Clermont Auvergne, BP 10448, Clermont-Ferrand, F-63000, France; CNRS, UMR 6023, LMGE, F-63170 Campus Universitaire des Cézeaux, Clermont-Ferrand, France; Service d'hygiène hospitalière, CHU Clermont-Ferrand, Clermont-Ferrand, Franceaj,ak,al,
Caballero, P. - Laboratori EMATSA, Ctra Valls Km 3, Tarragona, 43130, Spain

Oliver, A. - Laboratori EMATSA, Ctra Valls Km 3, Tarragona, 43130, Spain

Rodriguez-Mozaz, S. - Catalan Institute for Water Research (ICRA), Girona, 17003, Spain

Balcazar, J.L. - Catalan Institute for Water Research (ICRA), Girona, 17003, Spain

Jäger, T. - Institute of Functional Interfaces (IFG), Karlsruhe Institute of Technology (KIT), Eggenstein-Leopoldshafen, Germany

Schwartz, T. - Institute of Functional Interfaces (IFG), Karlsruhe Institute of Technology (KIT), Eggenstein-Leopoldshafen, Germany

Yang, Y. - School of Marine Sciences, Sun Yat-sen University, Guangzhou, China

Zou, S. - School of Marine Sciences, Sun Yat-sen University, Guangzhou, China

Lee, Y. - School of Earth Sciences and Environmental Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, 61005, South Korea

Yoon, Y. - School of Earth Sciences and Environmental Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, 61005, South Korea

Herzog, B. - Chair of Urban Water Systems Engineering, Technical University of Munich (TUM), Germany

Mayrhofer, H. - Chair of Urban Water Systems Engineering, Technical University of Munich (TUM), Germany

Prakash, O. - National Centre for Microbial Resource (NCMR), National Centre for Cell Science, Pune, 411007, India

Nimonkar,  Y. -  National Centre for Microbial Resource (NCMR), National Centre for Cell Science, Pune, 411007, India

Heath, E. - Jozef Stefan Institute, Jamova 39, Ljubljana, 1000, Slovenia

Baraniak, A. - National Medicines Institute, Department of Molecular Microbiology, Chelmska 30/34, Warsaw, 00-725, Poland

Abreu-Silva, J. - Universidade Católica Portuguesa, CBQF – Centro de Biotecnologia e Química Fina – Laboratório Associado, Escola Superior de Biotecnologia, Rua Arquiteto Lobão Vital, 172, Porto, 4200-374, Portugal.
Choudhury, M. - abDepartment of Natural Sciences, Middlesex University, London, NW4 4BT, United Kingdom

Munoz, L.P. - Department of Natural Sciences, Middlesex University, London, NW4 4BT, United Kingdom

Krizanovic, S. - Rudjer Boskovic Institute, Bijenicka 54, Zagreb, Croatia

Brunetti, G. - Future Industries Institute, University of South Australia, Adelaide, SA 5001, Australia

Maile-Moskowitz, A. - p, Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, United States
Brown, C. - Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, United States

 

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 103 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.

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A global multinational survey of cefotaxime-resistant coliforms in urban wastewater treatment plants
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Marano, R.B.M. - Department of Agroecology and Plant Health, The Robert H. Smith, Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel; Department of Soil Chemistry, Plant Nutrition and Microbiology, Institute of Soil Water and Environmental Sciences, Volcani Center, Agricultural Research Organization, Rishon Lezion, Israel.

Fernandes, T. - cUniversidade Católica Portuguesa, CBQF – Centro de Biotecnologia e Química Fina – Laboratório Associado, Escola Superior de Biotecnologia, Rua Arquiteto Lobão Vital, 172, Porto, 4200-374, Portugal

Manaia, C.M. - cUniversidade Católica Portuguesa, CBQF – Centro de Biotecnologia e Química Fina – Laboratório Associado, Escola Superior de Biotecnologia, Rua Arquiteto Lobão Vital, 172, Porto, 4200-374, Portugal

Nunes, O. - LEPABE, Laboratório de Engenharia de Processos, Ambiente, Biotecnologia e Energia, Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, Porto, 4200-465, Portugal

Morrison, D. - School Applied Sciences, Edinburgh Napier University, EH11 4BN, United Kingdom

Berendonk, T.U. - Institute of Hydrobiology, TU Dresden, Dresden, Germany

Kreuzinger, N. - Vienna University of Technology, Institute for Water Quality and Resources Management, Vienna, Austria

Telson, T. - Institute of Technology, University of Tartu, Estonia

Corno, G. - CNR-IRSA Molecular Ecology Group, Largo Tonolli 50, Verbania, 28922, Italy

Fatta-Kassinos, D. - Civil and Environmental Engineering Department and Nireas International Water Research Center, University of Cyprus, P.O. Box 20537, Nicosia, CY-1678, Cyprus

Merlin, C. - UMR 7564 University of Lorraine-CNRS (LCPME), France

Topp, E. - Agriculture and Agri-Food Canada, London Research and Development Centre (ON), Canada; Department of Biology, University of Western Ontario, London, ON, Canada

Jurkevitch, E. - Department of Agroecology and Plant Health, The Robert H. Smith, Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel

Henn, L. - School Applied Sciences, Edinburgh Napier University, EH11 4BN, United Kingdom

Scott, A. - Agriculture and Agri-Food Canada, London Research and Development Centre (ON), Canada

Heß, S. - Institute of Hydrobiology, TU Dresden, Dresden, Germany; Institute of Microbiology, TU Dresden, Dresden, Germany

Slipko, K. - Vienna University of Technology, Institute for Water Quality and Resources Management, Vienna, Austria

Laht, M. - Institute of Technology, University of Tartu, Estonia; Estonian Environmental Research Centre, Estonia

Kisand, V. - Institute of Technology, University of Tartu, Estonia

Di Cesare, A. - CNR-IRSA Molecular Ecology Group, Largo Tonolli 50, Verbania, 28922, Italy

Karaolia, P. - Civil and Environmental Engineering Department and Nireas International Water Research Center, University of Cyprus, P.O. Box 20537, Nicosia, CY-1678, Cyprus

Michael, S.G. - Civil and Environmental Engineering Department and Nireas International Water Research Center, University of Cyprus, P.O. Box 20537, Nicosia, CY-1678, Cyprus

Petre, A.L. - Department of Chemical Engineering, University of Alcalá, Alcalá de Henares, Madrid E-28871, Spain

Rosal, R. - Department of Chemical Engineering, University of Alcalá, Alcalá de Henares, Madrid E-28871, Spain

Pruden, A. - Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, United States

Riquelme, V. - Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, United States

Agüera, A. - Solar Energy Research Centre (CIESOL), Joint Centre University of Almería-CIEMAT, Almería, 04120, Spain

Esteban, B. - Solar Energy Research Centre (CIESOL), Joint Centre University of Almería-CIEMAT, Almería, 04120, Spain

Luczkiewicz, A. - Faculty of Civil and Environmental Engineering, Gdansk University of Technology, G. Narutowicza 11/12 street, Gdańsk, 80-233, Poland

Kalinowska, A. - Faculty of Civil and Environmental Engineering, Gdansk University of Technology, G. Narutowicza 11/12 street, Gdańsk, 80-233, Poland

Leonard, A. - sUniversity of Exeter Medical School, European Centre for Environment and Human Health, Environment and Sustainability Institute, University of Exeter, Penryn campus, TR10 9FE, United Kingdom

Gaze, W.H. - University of Exeter Medical School, European Centre for Environment and Human Health, Environment and Sustainability Institute, University of Exeter, Penryn campus, TR10 9FE, United Kingdom

Adegoke, A.A. - Institute for Water and Wastewater Technology, Durban University of Technology, Durban, South Africa; Department of Microbiology, University of Uyo, Uyo, Nigeria

Stenstrom, T.A. - Institute for Water and Wastewater Technology, Durban University of Technology, Durban, South Africa

Pollice, A. - CNR-IRSA, Viale F. De Blasio 5, Bari, 70132, Italy.
Salerno, C. - CNR-IRSA, Viale F. De Blasio 5, Bari, 70132, Italy


Schwermer, C.U. - Norwegian Institute for Water Research, Gaustadalléen 21, Oslo, N-0349, Norway.
Krzeminski, P. - Norwegian Institute for Water Research, Gaustadalléen 21, Oslo, N-0349, Norway

Guilloteau, H. - UMR 7564 University of Lorraine-CNRS (LCPME), France

Donner, E. - Future Industries Institute, University of South Australia, Adelaide, SA 5001, Australia

Drigo, B. - Future Industries Institute, University of South Australia, Adelaide, SA 5001, Australia

Libralato, G. - Department of Biology, University of Naples Federico II, via Cinthia 21, Naples, 80126, Italy

Guida, M. - Department of Biology, University of Naples Federico II, via Cinthia 21, Naples, 80126, Italy

Bürgmann, H. - Eawag, Swiss Federal Institute of Aquatic Science and Technology, Kastanienbaum, 6047, Switzerland

Beck, K. - Eawag, Swiss Federal Institute of Aquatic Science and Technology, Kastanienbaum, 6047, Switzerland

Garelick, H. - Department of Natural Sciences, Middlesex University, London, NW4 4BT, United Kingdom

Tacão, M. - acCESAM and Department of Biology, University of Aveiro, Campus Universitário de Santiago, 3810-193, Portugal

Henriques, I. - CESAM and Department of Biology, University of Aveiro, Campus Universitário de Santiago, 3810-193, Portugal; University of Coimbra, Department of Life Sciences, Calçada Martim de Freitas, Coimbra, 3000-456, Portugal

Martínez-Alcalá, I. - Department of Civil Engineering, Av. de los Jerónimos, 135, Guadalupe, Murcia 30107, Spain

Guillén-Navarro, J.M. - Department of Civil Engineering, Av. de los Jerónimos, 135, Guadalupe, Murcia 30107, Spain

Popowska, M. - aeInstitute of Microbiology, Department of Applied Microbiology, Faculty of Biology, University of Warsaw, Poland

Piotrowska, M. - aeInstitute of Microbiology, Department of Applied Microbiology, Faculty of Biology, University of Warsaw, Poland

Quintela-Baluja, M. - School of Engineering, Newcastle University, Newcastle Upon Tyne, United Kingdom

Bunce, J.T. - School of Engineering, Newcastle University, Newcastle Upon Tyne, United Kingdom.
Polo-López, M.I. - Solar Energy Research Centre (CIESOL), Joint Centre University of Almería-CIEMAT, Almería, 04120, Spain; Plataforma Solar de Almería – CIEMAT, P.O. Box 22, Tabernas, Almería, 04200, Spain

Nahim–Granados, S. - Solar Energy Research Centre (CIESOL), Joint Centre University of Almería-CIEMAT, Almería, 04120, Spain; Plataforma Solar de Almería – CIEMAT, P.O. Box 22, Tabernas, Almería, 04200, Spain

Pons, M.-N. - Université de Lorraine, CNRS, LRGP, Nancy, F-54000, France

Milakovic, M. - Rudjer Boskovic Institute, Bijenicka 54, Zagreb, Croatia

Udikovic-Kolic, N. - Rudjer Boskovic Institute, Bijenicka 54, Zagreb, Croatia

Ory, J. - Laboratoire “Microorganisme: Génome et Environnement”, Université Clermont Auvergne, BP 10448, Clermont-Ferrand, F-63000, France; CNRS, UMR 6023, LMGE, F-63170 Campus Universitaire des Cézeaux, Clermont-Ferrand, France; Service d'hygiène hospitalière, CHU Clermont-Ferrand, Clermont-Ferrand, France.
Ousmane, T. - Laboratoire “Microorganisme: Génome et Environnement”, Université Clermont Auvergne, BP 10448, Clermont-Ferrand, F-63000, France; CNRS, UMR 6023, LMGE, F-63170 Campus Universitaire des Cézeaux, Clermont-Ferrand, France; Service d'hygiène hospitalière, CHU Clermont-Ferrand, Clermont-Ferrand, Franceaj,ak,al,
Caballero, P. - Laboratori EMATSA, Ctra Valls Km 3, Tarragona, 43130, Spain

Oliver, A. - Laboratori EMATSA, Ctra Valls Km 3, Tarragona, 43130, Spain

Rodriguez-Mozaz, S. - Catalan Institute for Water Research (ICRA), Girona, 17003, Spain

Balcazar, J.L. - Catalan Institute for Water Research (ICRA), Girona, 17003, Spain

Jäger, T. - Institute of Functional Interfaces (IFG), Karlsruhe Institute of Technology (KIT), Eggenstein-Leopoldshafen, Germany

Schwartz, T. - Institute of Functional Interfaces (IFG), Karlsruhe Institute of Technology (KIT), Eggenstein-Leopoldshafen, Germany

Yang, Y. - School of Marine Sciences, Sun Yat-sen University, Guangzhou, China

Zou, S. - School of Marine Sciences, Sun Yat-sen University, Guangzhou, China

Lee, Y. - School of Earth Sciences and Environmental Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, 61005, South Korea

Yoon, Y. - School of Earth Sciences and Environmental Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, 61005, South Korea

Herzog, B. - Chair of Urban Water Systems Engineering, Technical University of Munich (TUM), Germany

Mayrhofer, H. - Chair of Urban Water Systems Engineering, Technical University of Munich (TUM), Germany

Prakash, O. - National Centre for Microbial Resource (NCMR), National Centre for Cell Science, Pune, 411007, India

Nimonkar,  Y. -  National Centre for Microbial Resource (NCMR), National Centre for Cell Science, Pune, 411007, India

Heath, E. - Jozef Stefan Institute, Jamova 39, Ljubljana, 1000, Slovenia

Baraniak, A. - National Medicines Institute, Department of Molecular Microbiology, Chelmska 30/34, Warsaw, 00-725, Poland

Abreu-Silva, J. - Universidade Católica Portuguesa, CBQF – Centro de Biotecnologia e Química Fina – Laboratório Associado, Escola Superior de Biotecnologia, Rua Arquiteto Lobão Vital, 172, Porto, 4200-374, Portugal.
Choudhury, M. - abDepartment of Natural Sciences, Middlesex University, London, NW4 4BT, United Kingdom

Munoz, L.P. - Department of Natural Sciences, Middlesex University, London, NW4 4BT, United Kingdom

Krizanovic, S. - Rudjer Boskovic Institute, Bijenicka 54, Zagreb, Croatia

Brunetti, G. - Future Industries Institute, University of South Australia, Adelaide, SA 5001, Australia

Maile-Moskowitz, A. - p, Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, United States
Brown, C. - Department of Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, United States

 

A global multinational survey of cefotaxime-resistant coliforms in urban wastewater treatment plants

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 103 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.

Scientific Publication
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