摘要
背景与目的：抗生素耐药性（ABR）是公众健康关注的首要问题。正如欧洲对抗微生物耐药性的一个健康行动计划所报告的那样，有必要监测环境中，特别是废水中抗生素、抗生素耐药性细菌（ARB）和抗生素耐药性基因（ARGs）的存在。此外，关于抗微生物耐药性的全球行动计划强调，需要获得与废水和环境作为ABR发展和传播因素的作用相关的有力证据。本研究的目的是评估ABR在污水处理厂不同处理步骤中的扩散，同时考虑到污水在农业中的可能再利用。方法：调查在污水处理厂不同步骤收集的样品中是否存在抗生素（氨苄青霉素、四环素、磺胺甲恶唑）、重金属、ARB（氨苄西林、四环素和磺胺甲恶灵耐药细菌）和ARGs（blaTEM、tetA、sulII）的抗生素耐药率。结果：所获得的结果突出了污水处理厂测试的抗生素中ARB和ARGs的存在，在废水处理过程中呈下降趋势，一些抗生素和重金属也呈下降趋势。尽管ABR速率通常没有显著差异，但在废水生产过程中观察到该速率的较高平均值，这表明通过一些处理步骤可能存在ARB的正选择压力。还观察到一些重金属的存在与ABR速率之间的相关性。结论：所获得的结果表明，需要仔细监测WWTP在抗生素耐药性传播中的作用，同时考虑“一个健康”方法。此外，所获得的结果可以建议采取干预措施，以降低与农业废水再利用相关的人类健康风险。
ABSTRACT
Background and Objective: Antibiotic resistance (ABR) is of primary concern for Public Health. As reported by the European One Health Action Plan against Antimicrobial Resistance, there is the need to monitor the presence of antibiotics, antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in the environment, especially in wastewater. Moreover, the global action plan on antimicrobial resistance underlines the need to obtain strong evidence associated to the role of wastewater and environment as contributors to the development and spread of ABR. The aim of this study is to evaluate the ABR spreading in different treatment steps of wastewater treatment plant (WWTP) also considering the possible reuse of effluent in agriculture. Methods: Samples collected at different steps of a WWTP developed for reuse were investigated for the presence of antibiotics (ampicillin, tetracycline, sulfamethoxazole), heavy metals, the antibiotic resistance rate of ARB (ampicillin, tetracycline, and sulfamethoxazole resistant bacteria) and ARGs (blaTEM, tetA, sulII). Results: The Results obtained highlight the presence of ARB and ARGs for the antibiotics tested in WWTP, with a decreasing trend during the wastewater treatment, as also observed for some antibiotics and heavy metals. Although there is generally no significant difference in the ABR rate, a higher average value of this rate is observed during the wastewater production, suggesting a possible positive selective pressure of ARB by some steps of treatment. A correlation was also observed between the presence of some heavy metals and ABR rate. Conclusions: The results obtained suggest the need to carefully monitor the role of WWTPs in the spreading of antibiotic resistance, also considering the One Health approach. Furthermore, the results obtained could suggest interventions to reduce the human health risk associated with wastewater reuse in agriculture.

http://www.populationmedicine.eu/Wastewater-treatment-plant-a-hotspot-of-antibiotic-resistance-spreading-,165718,0,2.html