Sampling Considerations for Wastewater Surveillance of Antibiotic Resistance in Fecal Bacteria

Patricia M. C. Huijbers, Julián Bobis Camacho, Marion Hutinel, D. G. Joakim Larsson and Carl-Fredrik Flach ()
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Patricia M. C. Huijbers: Centre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, 40530 Gothenburg, Sweden
Julián Bobis Camacho: Centre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, 40530 Gothenburg, Sweden
Marion Hutinel: Centre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, 40530 Gothenburg, Sweden
D. G. Joakim Larsson: Centre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, 40530 Gothenburg, Sweden
Carl-Fredrik Flach: Centre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, 40530 Gothenburg, Sweden

IJERPH, 2023, vol. 20, issue 5, 1-10

Abstract: Wastewaters can be analyzed to generate population-level data for public health surveillance, such as antibiotic resistance monitoring. To provide representative data for the contributing population, bacterial isolates collected from wastewater should originate from different individuals and not be distorted by a selection pressure in the wastewater. Here we use Escherichia coli diversity as a proxy for representativeness when comparing grab and composite sampling at a major municipal wastewater treatment plant influent and an untreated hospital effluent in Gothenburg, Sweden. All municipal samples showed high E. coli diversity irrespective of the sampling method. In contrast, a marked increase in diversity was seen for composite compared to grab samples from the hospital effluent. Virtual resampling also showed the value of collecting fewer isolates on multiple occasions rather than many isolates from a single sample. Time-kill tests where individual E. coli strains were exposed to sterile-filtered hospital wastewater showed rapid killing of antibiotic-susceptible strains and significant selection of multi-resistant strains when incubated at 20 °C, an effect which could be avoided at 4 °C. In conclusion, depending on the wastewater collection site, both sampling method and collection/storage temperature could significantly impact the representativeness of the wastewater sample.

Keywords: sewage; Escherichia coli; hospital effluent; wastewater treatment plant influent; wastewater-based epidemiology; grab sample; composite sample; PhenePlate TM; time-kill test; temperature (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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