摘要
      本研究旨在探讨以下问题：（1）废水处理厂抗生素耐药性的发生和扩散；（2） 污水处理厂中抗生素耐药性细菌和基因的影响因素；（3） 评估污水处理厂抗生素耐药性的工具；（4） 污水处理厂抗生素耐药性细菌（ARB）和抗生素耐药性基因（ARGs）的环境污染；（5） 污水处理厂的ARB和ARGs对人类健康的影响；以及（6）治疗策略。一般来说，包括肠杆菌科、铜绿假单胞菌和大肠杆菌在内的耐药和多重耐药细菌存在于污水处理厂的各种过程中。ARB和ARGs的存在是由废水中高浓度的抗生素引起的，这会对污水处理厂中的局部细菌产生选择性压力。因此，改进废水处理技术和避免滥用抗生素对于克服ARBs和ARGs扩散的威胁至关重要。许多因素会影响污水处理厂中ARB和ARG的发展。非生物因素会影响细菌群落动力学，从而影响ARB在废水处理过程中的适用性。此外，有机负荷和其他营养物质会影响细菌的存活和生长。具体而言，用于快速表征和检测ARBs或其基因的分子方法包括DNA测序、实时PCR、简单和多重PCR以及基于杂交的技术，包括微阵列和宏阵列。污水处理厂污水回用于灌溉是解决缺水问题的有效方法。然而，这种做法也有一些潜在的环境风险，例如土壤微生物组中抗生素耐药性的增加。人类死亡率可能会显著增加，因为ARB会导致几种抗生素的耐药性或更长的治疗时间。一些处理技术，如厌氧和好氧处理、混凝、膜生物反应器和消毒工艺，被认为是限制环境中抗生素耐药性的潜在技术。
Abstract
This study aims to discuss the following: (1) occurrence and proliferation of antibiotic resistance in wastewater treatment plants (WWTPs); (2) factors influencing antibiotic resistance bacteria and genes in WWTPs; (3) tools to assess antibiotic resistance in WWTPs; (4) environmental contamination of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) from WWTPs; (5) effects of ARB and ARGs from WWTPs on human health; and (6) treatment strategies. In general, resistant and multi-resistant bacteria, including Enterobacteriaceae, Pseudomonas aeruginosa, and Escherichia coli, exist in various processes of WWTPs. The existence of ARB and ARGs results from the high concentration of antibiotics in wastewater, which promote selective pressures on the local bacteria present in WWTPs. Thus, improving wastewater treatment technology and avoiding the misuse of antibiotics is critical to overcoming the threat of proliferation of ARBs and ARGs. Numerous factors can affect the development of ARB and ARGs in WWTPs. Abiotic factors can affect the bacterial community dynamics, thereby, affecting the applicability of ARB during the wastewater treatment process. Furthermore, the organic loads and other nutrients influence bacterial survival and growth. Specifically, molecular methods for the rapid characterization and detection of ARBs or their genes comprise DNA sequencing, real-time PCR, simple and multiplex PCR, and hybridization-based technologies, including micro- and macro-arrays. The reuse of effluent from WWTPs for irrigation is an efficient method to overcome water scarcity. However, there are also some potential environmental risks associated with this practice, such as increase in the levels of antibiotic resistance in the soil microbiome. Human mortality rates may significantly increase, as ARB can lead to resistance among several types of antibiotics or longer treatment times. Some treatment technologies, such as anaerobic and aerobic treatment, coagulation, membrane bioreactors, and disinfection processes, are considered potential techniques to restrict antibiotic resistance in the environment.

https://www.sciencedirect.com/science/article/abs/pii/S0048969722036415