Available online at www.sciencedirect.com
Antibiotics and antibiotic resistanceinwater environments
, Jose´ -Luis Martı´ nez
and Rafael Canto´ n
Antibiotic-resistant organisms enter into water environmentsfrom human and animal sources. These bacteria are able tospread their genes into water-indigenous microbes, which alsocontain resistance genes. On the contrary, many antibioticsfrom industrial origin circulate in water environments,potentially altering microbial ecosystems. Risk assessmentprotocols for antibiotics and resistant bacteria in water, basedon better systems for antibiotics detection and antibiotic-resistance microbial source tracking, are starting to bediscussed. Methods to reduce resistant bacterial load inwastewaters, and the amount of antimicrobial agents, in mostcases originated in hospitals and farms, include optimization of disinfection procedures and management of wastewater andmanure. A policy for preventing mixing human-originated andanimal-originated bacteria with environmental organismsseems advisable.
Department of Microbiology, Ramo´ n y Cajal University Hospital,CIBER-ESP, Spain
National Center for Biotechnology, CSIC, Spain
Joint Unit for Antimicrobial Resistance and Virulence, 28034 Madrid,SpainCorresponding author: Baquero, Fernando ( firstname.lastname@example.org )
Current Opinion in Biotechnology
:260–265This review comes from a themed issue onEnvironmental BiotechnologyEdited by Carla Pruzzo and Pietro Canepari Available online 4th June 20080958-1669/$ – see front matter
2008 Elsevier Ltd. All rights reserved.
Human and animal pathogenic and potentially patho-genic bacteria are constantly released with wastewaterinto the water environment. Many of these organismsharbor antibiotic-resistance genes, eventually insertedinto genetic mobile platforms (plasmids, transposons,integrons) able to spread among water and soil bacterialcommunities . Water constitutes not only a way of dissemination of antibiotic-resistant organisms amonghuman and animal populations, as drinking water isproduced from surface water, but also the route by whichresistance genes are introduced in natural bacterial eco-systems. In such systems, nonpathogenic bacteria couldserve as a reservoir of resistance genes and platforms.Moreover, the introduction (and progressive accumu-lation) in the environment of antimicrobial agents, deter-gents, disinfectants, and residues from industrialpollution, as heavy metals, contributes to the evolutionand spread of such resistant organisms in the waterenvironment. The heavy use of prophylactic antibioticsin aquaculture  can be particularly relevant. On thecontrary, environmental bacteria act as an unlimitedsource of genes that might act as resistance genes whenentering in pathogenic organisms. Note that many of these genes are not primarily resistance genes, but belongto the hidden ‘resistome’ , the set of genes able to beconverted in antibiotic-resistance genes. Human healthrisk assessment protocols for antibiotic and resistant bac-teria in water are starting to be discussed . Certainly itis difﬁcult to believe why public health ofﬁcers and eco-toxicologists have failed for more than a century toseriously propose the absolute need of preventing themix between microorganisms from human–animal andenvironmental compartments.
The four genetic reactors in antibioticresistance
Antibiotic resistance evolves in bacteria because of theeffect of industrially produced antimicrobial agents onbacterial populations and communities. Genetic reactorsare places in which the occasion occurs for genetic evol-ution,particularlybecauseofhighbiologicalconnectivity,generation of variation, and presence of speciﬁc selection.Beyond mutational events, signiﬁcant genetic variationoccurs as a consequence of recombinatorial events, fre-quently resulting from genetic exchanges among organ-isms inside populations and communities. There are fourmain genetic reactors in which antibiotic resistanceevolves (Figure 1). The primary reactor is constitutedby the human and animal microbiota, with more than 500bacterial species involved, in which therapeutic or pre-ventive antibiotics exert their actions. The secondaryreactor involves the hospitals, long-term care facilities,farms, or any other place in which susceptible individualsare crowded and exposed to bacterial exchange. Thetertiary reactor corresponds to the wastewater and anytype of biological residues originated in the secondaryreactor, including for instance lagoons, sewage treatmentplants, or compost toilets, in which bacterial organismsfrom many different individuals have the opportunity tomix and genetically react. The fourth reactor is the soiland the surface or ground water environments, where thebacterial organisms originated in the previous reactorsmix and counteract with environmental organisms. Wateris involved as a crucial agent in all four genetic reactors,but particularly in the last ones. The possibility of redu-cing the evolvability of antibiotic resistance depends on
Current Opinion in Biotechnology