Strategic measures for the control of surging antimicrobial resistance in Hong Kong and mainland of China

Cheng, Vincent CC; Wong, Sally CY; Ho, Pak-Leung; Yuen, Kwok-Yung

Wastewater or sewage treatment plants are designed to improve the quality of water before it is discharged from urban, industrial and agricultural facilities into the natural environment. However, treatment processes at wastewater treatment plants do not eradicate MDROs. Water samples were collected and cultured weekly over a 10-week period from 11 sites throughout the wastewater network in a city in France to detect the amount of ESBL-producing E. coli. Although the quantity of ESBL-producing E. coli was lower in the treated water than untreated water (22 vs. 481 colony forming unit (CFU)/mL), the proportion of ESBL-producing E. coli was significantly higher in the effluent than in the influent (0.6% vs. 0.3%, P50.017). 71 Similarly, another study evaluated the risk of dissemination of antibiotic-resistant P. aeruginosa from a hospital to the environment via the wastewater network. With the same study design, water treatment is effective in removing P. aeruginosa from the effluent, but does not decrease the proportion of antibiotic-resistant strains. Therefore, treated water and sewage sludge still pose a risk for environmental contamination. 72 Further studies should be focused on methodologies for eliminating MDROs from the effluent of wastewater treatment plants.