Understanding human health risks caused by antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARG) in water environments: Current knowledge and questions to be answered

• Published in: Critical reviews in environmental science and technology Vol. 50; no. 19; pp. 2016 - 2059
• Main Authors: Amarasiri, Mohan, Sano, Daisuke, Suzuki, Satoru
• Format: Journal Article
• Language: English
• Published: Boca Raton Taylor & Francis 01.10.2020; Taylor & Francis Ltd
• Subjects: Antibiotic resistance; antibiotic resistance genes; Antibiotic resistant bacteria; Antibiotics; Aquatic environment; Bacteria; cephalosporins; Disease hot spots; Disinfection; DNA; dose response; Drug resistance; Evaluation; Exposure; gene transfer; Genes; Health risk assessment; Health risks; human health; humans; Insertion; microbiological risk assessment; Microorganisms; polymers; Propagation; quantitative microbial risk assessment; Questions; risk; Risk assessment; solid wastes; technology; Wastewater treatment; Wastewater treatment plants
• ISSN: 1064-3389; 1547-6537; 1547-6537
• DOI: 10.1080/10643389.2019.1692611

Aquatic environments are identified as an ideal setting for acquisition and dissemination of antibiotic resistance, and human exposure to antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) in aquatic environments may pose an additional health risk. Quantitative microbial risk assessment (QMRA) has been suggested as a suitable method to evaluate and quantify this health risk. However, information about the exposure to ARB and ARGs in aquatic environments is lacking for many scenarios and dose-response models regarding the ARB infections are not developed yet. This review summarizes the current knowledge regarding the ARB and ARGs in aquatic environments and highlights the challenging questions remaining to be answered to better forecast the health risks caused by ARB and ARGs in water environments. The questions include what are the missing information needed to quantify the human health risks caused by exposing to ARB and ARGs in aquatic environments? what are the suitable markers to evaluate the ARB/ARGs contamination in aquatic environments? how frequently do the ARG selection and propagation occur in aquatic environments? and are there any unknown hot spots? Studies on the above topics will contribute to better management of antibiotic resistance dissemination in water environments and its risks on human health. Abbreviations 3GC 3 rd generation cephalosporins ARB Antibiotic resistant bacteria ARG Antibiotic resistance gene CFU Colony forming unit DBP Disinfection by-products eDNA Extracellular DNA EPS Extracellular polymeric substances HGT Horizontal gene transfer ISCR Insertion sequence common region MAR Multiple antibiotic resistant MIC Minimum inhibitory concentration MGE Mobile genetic elements MSW Municipal solid waste QMRA Quantitative microbial risk assessment VBNC Viable but non-culturable WWTP Wastewater treatment plant