Antibiotic Resistance in Recreational Waters: State of the Science

Sharon P. Nappier, Krista Liguori, Audrey M. Ichida, Jill R. Stewart and Kaedra R. Jones
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Sharon P. Nappier: U.S. Environmental Protection Agency, Office of Water, Office of Science and Technology, 1200 Pennsylvania Avenue, NW, Washington, DC 20460, USA
Krista Liguori: U.S. Environmental Protection Agency, Office of Water, Office of Science and Technology, 1200 Pennsylvania Avenue, NW, Washington, DC 20460, USA
Audrey M. Ichida: ICF, LLC, 9300 Lee Highway, Fairfax, VA 22031, USA
Jill R. Stewart: 1301 Michael Hooker Research Center, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
Kaedra R. Jones: ICF, LLC, 9300 Lee Highway, Fairfax, VA 22031, USA

IJERPH, 2020, vol. 17, issue 21, 1-28

Abstract: Ambient recreational waters can act as both recipients and natural reservoirs for antimicrobial resistant (AMR) bacteria and antimicrobial resistant genes (ARGs), where they may persist and replicate. Contact with AMR bacteria and ARGs potentially puts recreators at risk, which can thus decrease their ability to fight infections. A variety of point and nonpoint sources, including contaminated wastewater effluents, runoff from animal feeding operations, and sewer overflow events, can contribute to environmental loading of AMR bacteria and ARGs. The overall goal of this article is to provide the state of the science related to recreational exposure and AMR, which has been an area of increasing interest. Specific objectives of the review include (1) a description of potential sources of antibiotics, AMR bacteria, and ARGs in recreational waters, as documented in the available literature; (2) a discussion of what is known about human recreational exposures to AMR bacteria and ARGs, using findings from health studies and exposure assessments; and (3) identification of knowledge gaps and future research needs. To better understand the dynamics related to AMR and associated recreational water risks, future research should focus on source contribution, fate and transport—across treatment and in the environment; human health risk assessment; and standardized methods.

Keywords: antibiotic resistance; antimicrobial resistant bacteria; antimicrobial resistant genes; recreational exposures; aquatic microbial community; aquatic microbiome; wastewater; human health risk; ambient water; surface water (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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