Characteristics of antibiotic resistance gene distribution in rainfall runoff and combined sewer overflow

Antibiotic resistance in urban stormwater: a review of the dissemination of resistance elements, their impact, and management opportunities

“…[48][49][50] Primarily, previous research has sought to describe the resistance elements in stormwater runoff by sampling at stormwater outfalls, where runoff from a larger urban area is piped and discharged into a water body (e.g., lake, river, reservoir) at one central point (Table 1). [48][49][50][51][52][53][54][55][56][57][58][59][60][61] The stormwater disseminated from outfalls is mostly runoff collected via overland flow, but stormwater can include sewage inputs as it travels through a storm sewer system. 56 The presence of sewage in stormwater can significantly alter the ARGs present and their concentration at an outfall.…”

“…64 What has been confirmed across studies is that stormwater contains a diverse resistome, with multidrug resistance (MDR) being the most common classification for the ARGs. 53,57,60 MDR is a major concern for the public health crisis of antibiotic resistance because it indicates that the bacterium is able to confer resistance to more than one antibiotic. MDR can thus limit treatment options for bacterial infections and can ultimately lead to resistance to all antibiotics (i.e., pan-drug resistance).…”

“…Beyond efflux pumps, aminoglycoside and bacitracin resistance genes were the most frequently occurring ARGs in genome datasets. 50,53,55,57,60 Through sequencing techniques, the microbial hosts of these ARGs have been identified. Aminoglycoside ARGs, for example, were found to be correlated with the Limnohabitans, Lefisonia, and Sphingomonas genera, which are associated with freshwater, soil and plant, and wastewater environments, respectively.…”

“…, lake, river, reservoir) at one central point (Table 1). 48–61 The stormwater disseminated from outfalls is mostly runoff collected via overland flow, but stormwater can include sewage inputs as it travels through a storm sewer system. 56 The presence of sewage in stormwater can significantly alter the ARGs present and their concentration at an outfall.…”

Drivers of Antibiotic Resistance Gene Abundance in an Urban River

“…A recent global meta-analysis found sanitation infrastructure to be one of the strongest drivers of elevated antimicrobial resistance, having a much greater effect than antibiotic consumption rates [ 15 ]. Although numerous studies have considered the impact of wastewater on the distribution and diversity of ARGs in urban rivers [ 4 , 16 , 17 , 18 , 19 ], the specific impact of combined sewage systems has received comparatively less attention [ 20 , 21 ]. Combined sewage systems are common in older cities around the world, especially in Europe and the United States.…”