Antibiotic Resistance Characteristics of Environmental Bacteria from an Oxytetracycline Production Wastewater Treatment Plant and the Receiving River

We characterized the bacterial populations in surface water receiving effluent from an oxytetracycline (OTC) production plant. Additional sampling sites included the receiving river water 5 km upstream and 20 km downstream from the discharge point. High levels of OTC were found in the wastewater (WW), and the antibiotic was still detectable in river water downstream (RWD), with undetectable levels in river water upstream (RWU). A total of 341 bacterial strains were isolated using nonselective media, with the majority being identified as Gammaproteobacteria. The MICs were determined for 10 antibiotics representing seven different classes of antibiotics, and the corresponding values were significantly higher for the WW and RWD isolates than for the RWU isolates. Almost all bacteria (97%) from the WW and RWD samples demonstrated multidrug-resistant (MDR) phenotypes, while in RWU samples, these were less frequent (28%). The WW and RWD isolates were analyzed for the presence of 23 tetracycline (tet) resistance genes. The majority of isolates (94.2% and 95.4% in WW and RWD, respectively) harbored the corresponding genes, with tet(A) being the most common (67.0%), followed by tet(W), tet(C), tet(J), tet(L), tet(D), tet(Y), and tet(K) (in the range between 21.0% and 40.6%). Class I integrons were detected in the majority of WW and RWD isolates (97.4% and 86.2%, respectively) but were not associated with the tet genes. We hypothesize that the strong selective pressure imposed by a high concentration of OTC contributes to the wide dissemination of tetracycline resistance genes and other antibiotic resistance genes, possibly through mobile genetic elements.The widespread emergence of antibiotic resistance, particularly multidrug resistance (MDR), among bacterial pathogens has become one of the most serious challenges in clinical therapy (22, 46). Some pathogens, such as MDR Klebsiella pneumoniae and Acinetobacter baumannii, are now virtually untreatable with current antibiotics (14, 30). Acquisition of resistance genes through horizontal transfer has been found to be ubiquitous in clinical pathogens (22). Environmental bacteria have been shown to be a reservoir of antibiotic resistance genes and a potential source of novel resistance genes in clinical pathogens (10, 12). Horizontal transfer of genes between bacterial strains could be facilitated by mobile genetic elements, such as plasmids, transposons, bacteriophages, integrons, insertion elements (IS), and genomic islands (13). Some elements, including class I integrons, conjugative plasmids, and transposons, are frequently linked to antibiotic resistance as they harbor rather diverse resistance genes and possibly promote the distribution of these genes in phylogenetically diverse bacteria (29). In light of the potential health risk, many studies have focused on antibiotic-resistant bacteria recovered from various ecosystems (1, 18, 45). Environments that contain antibiotic residues are particularly worrisome because antibiotics could exert selective pressure and might contribute to the appearance of resistant bacteria. Hospital sewage was once considered the major source of antibiotics in aquatic environments, followed by municipal, agricultural, and aquacultural wastewater (WW), which have also been shown to be important sources of these compounds and resistant bacteria (40). It has also been reported that treated antibiotic production wastewater contains much higher concentrations of antibiotic residues than other aquatic environments (20, 26, 27) and can serve as an important reservoir of resistant bacteria and genes (25).In the current study, we investigated resistance profiles of bacterial isolates from a unique wastewater treatment plant (WWTP) that is used solely for treating oxytetracycline (OTC), avermectin, and ivermectin production wastewater from the facility of the North China Pharmaceutical Group Corporation in Hebei Province, China. Avermectin and ivermectin are both broad-spectrum antiparasitic agents without any antibacterial or antifungal activities. The effluent of the WWTP is discharged directly into the receiving river without disinfection, and residual levels of OTC in wastewater and downstream sampling points nearly approach those in human blood after drug administration (15, 26). Thus, the characteristics of bacterial strains in heavily OTC-contaminated wastewater and surface water could be unique. In a 1-year (2002-2003) survey of antibiotic resistance in 140 clinical enterococcal isolates from a hospital in this region, the prevalence of tetracycline resistance ranged from 14.9% to 25.0% (47). This rate increased to 47.9 to 75.9% for 302 clinical enterococcal isolates from the same hospital over the following 3 years (2004-2006) (28), indicating that tetracycline resistance among human pathogens in this region is becoming more prevalent. Elucidation of the resistance characteristics of bacterial isolates from OTC wastewater and surface water might help explain the prevalence of increased resistance among human pathogens. To gain a comprehensive understanding of this relationship, we isolated bacterial strains from wastewater (WW) and river water downstream (RWD) and river water upstream (RWU) samples using nonselective culture media. Previously, it was shown that long-term administration of a single antibiotic can lead to MDR, a phenomenon that has been observed in bacteria obtained from the urinary tract, intestine, and other niches in both clinical therapy and livestock raising (11, 23, 34). Thus, the combination of long-term treatment and discharge of antibiotic production wastewater might contribute to MDR in environmental bacteria in this specific ecosystem. To test this hypothesis, we determined the resistance profiles of bacterial isolates for 10 antibiotics representing seven classes.OTC belongs to the tetracycline class of antibiotics, which includes tetracycline, chlortetracycline, doxycycline, minocycline, and glycylcyclines (6). This class of antibiotics represents broad-spectrum agents that act against a range of Gram-positive and Gram-negative bacteria by inhibiting protein synthesis. The tetracyclines have played an important role in human and veterinary medicine, and some have been used as growth promoters for livestock and aquaculture. However, resistance to tetracyclines in many commensal and pathogenic bacteria emerged soon after the widespread application of this class of antibiotic. More than 40 types of tetracycline resistance determinants have been described to date and grouped into three main classes: energy-dependent membrane-associated efflux proteins, which export tetracycline out of the cell; ribosomal protection proteins, which interact with the ribosome and disrupt the tetracycline binding site; and tetracycline inactivation enzymes (6, 37). Many studies of tetracycline resistance (tet) genes in various environmental niches have been reported. Resistance genes encoding efflux proteins and ribosomal protection proteins have been identified in phylogenetically diverse bacterial genera. Extensive reviews with detailed information about tet genes and their distribution are available (4, 6, 24, 37). Notably lacking, however, is information about tet genes in aquatic environments with high levels of antibiotic residue. Studies have shown that several tet genes are associated with mobile genetic elements (6, 37) and that the SOS response induced by antibiotics and other factors can promote horizontal dissemination of mobile genetic elements like genomic islands, as well as integron recombination, among bacterial populations (5, 17, 41). In the current study, the presence and distribution of 23 tet genes in bacterial isolates from wastewater and river water were determined by PCR. Class I integrons were also examined in the bacterial isolates to evaluate the possibility of horizontal transfer of these resistance genes and/or the promoted dissemination of mobile genetic elements in such heavily antibiotic-polluted environments. We also compared the characteristics of the recovered bacteria with those of isolates from samples from water upstream of the discharge site in the river. Our results reveal the potential environmental influence of wastewater discharge on acquired antibiotic resistance.