Predicting selection for antimicrobial resistance in UK wastewater and aquatic environments: ciprofloxacin poses a significant risk

Hayes, April; Murray, Laura May; Stanton, Isobel Catherine ORCID:; Zhang, Lihong; Snape, Jason; Gaze, William Hugo; Murray, Aimee Kaye. 2022 Predicting selection for antimicrobial resistance in UK wastewater and aquatic environments: ciprofloxacin poses a significant risk. Environment International, 169, 107488. 10, pp.

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Antimicrobial resistance (AMR) is a threat to human and animal health, with the environment increasingly recognised as playing an important role in AMR evolution, dissemination, and transmission. Antibiotics can select for AMR at very low concentrations, similar to those in the environment, yet their release into the environment, e.g., from wastewater treatment plants, is not currently regulated. Understanding the selection risk antibiotics pose in wastewater and receiving waters is key to understanding if environmental regulation of antibiotics is required. We investigated the risk of selection occurring in UK wastewater and receiving waters by determining where measured environmental concentration data (n = 8187) for four antibiotics (ciprofloxacin, azithromycin, clarithromycin, and erythromycin) collected in England and Wales 2015–2018 (sites n = 67) exceeded selective concentration thresholds derived from complex microbial community evolution experiments undertaken previously. We show that selection for AMR by ciprofloxacin is likely to have occurred routinely in England and Wales wastewater during the 2015–2018 period, with some seasonal and regional trends. Wastewater treatment reduces the selection risk posed by ciprofloxacin significantly, but not completely, and predicted risk in surface waters remains high in several cases. Conversely, the potential risks posed by the macrolides (azithromycin, clarithromycin, and erythromycin) were lower than those posed by ciprofloxacin. Our data demonstrate further action is needed to prevent selection for AMR in wastewater, with environmental quality standards for some antibiotics required in the future, and that selection risk is not solely a concern in low/middle income countries.

Item Type: Publication - Article
Digital Object Identifier (DOI):
UKCEH and CEH Sections/Science Areas: Pollution (Science Area 2017-)
ISSN: 0160-4120
Additional Information. Not used in RCUK Gateway to Research.: Open Access paper - full text available via Official URL link.
Additional Keywords: antibiotics, antimicrobial resistance, environmental risk assessment, wastewater
NORA Subject Terms: Biology and Microbiology
Date made live: 19 Dec 2022 16:26 +0 (UTC)

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