Wastewater Treatment Plants Could Contribute to a ‘Post-Antibiotic World,’ Study Warns
Antibiotic-resistance is a growing concern, and now a new study from the University of Southern California (USC) has pinpointed another way it can spread: through wastewater treatment plants.
The study, published in Environmental Science and Technology last week, found that if bacteria in wastewater treatment plants are exposed to just one type of antibiotic, they can actually develop resistance to several drugs.
"We're quickly getting to a scary place that's called a 'post-antibiotic world,' where we can no longer fight infections with antibiotics anymore because microbes have adapted to be resilient against those antibiotics," lead researcher and USC assistant professor of Civil and Environmental Engineering Adam Smith said in a USC press release published by Phys.org Wednesday. "Unfortunately, engineered water treatment systems end up being sort of a hot-bed for antibiotic resistance."
Antibiotic #resistance is spreading from wastewater #treatment plants @USC @EnvSciTech https://t.co/Y6bVb0NaRv— Phys.org (@Phys.org)1551903239.0
USC explained how antibiotic-resistant bacteria can spread through the wastewater treatment process:
- Trace amounts of antibiotic end up in wastewater treatment plants via human waste.
- Wastewater is treated with a membrane bioreactor, a process by which water is both filtered and treated by microscopic bacteria that consume waste.
- The bacteria build up resistance to the antibiotics in the waste.
- The resistant bacteria enter the wider world in one of two ways. As biomass, the buildup of bacteria that is disposed of in landfills or used as fertilizer or livestock feed, or as effluent, the water that leaves the treatment plant.
The research team wanted to develop a process that would reduce the amount of resistant bacteria produced by wastewater treatment. They tested a system that used oxygen-free treatment processes and a membrane filter and then compared the drug-resistance of the bacteria in both the effluent and biomass produced by their system.
The most startling finding was that the antibiotics they introduced to the system were not the only drugs the bacteria would emerge able to resist. Instead, they developed the ability to resist multiple drugs.
"The multi-drug resistance does seem to be the most alarming impact of this," Smith said. "Regardless of the influent antibiotics, whether it's just one or really low concentrations, there's likely a lot of multi-drug resistance that's spreading."
The research team plans next to work with the U.S. Department of Agriculture on applying what they have learned to animal waste.
The widespread use of antibiotics in factory farming, and the resultant spreading of those antibiotics into the environment through waste disposal, is a major concern for those worried about growing drug resistance. As of 2018, around 70 percent of antibiotics in the U.S. are consumed by animals, The Bureau of Investigative Journalism reported.
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By Kristen Fischer
It's going to be back-to-school time soon, but will children go into the classrooms?
The American Academy of Pediatrics (AAP) thinks so, but only as long as safety measures are in place.
Keeping Schools Safe<p>What will safer schools look like?</p><p>In a <a href="https://jamanetwork.com/journals/jama/fullarticle/2766822" target="_blank">JAMA article</a> published last month, <a href="https://www.jhsph.edu/faculty/directory/profile/1781/joshua-m-sharfstein" target="_blank">Dr. Joshua Sharfstein</a>, a pediatrician and professor at the Johns Hopkins Bloomberg School of Public Health, outlined suggestions — many of which are similar to AAP's.</p><p>Remote learning protocols must stay in place, especially as some schools stagger home and in-building learning. If another shutdown needs to occur, children will rely on distance learning completely, so it must be easy to switch to, he said.</p><p>He suggested giving parents a daily checklist to document their child's health. Kids should be screened quickly on arrival and be given hygiene supplies. Maintenance staff should use appropriate PPE and have regular cleaning schedules. A notification system should be in place if a case is identified, Sharfstein recommended.</p><p><a href="https://www.albany.edu/rockefeller/faculty/erika-martin" target="_blank">Erika Martin</a>, PhD, an associate professor of public administration and policy at University at Albany, said nutrition assistance and health services should be included. She called for tutoring programs with virtual options as well as technology access.</p>
Supporting Staff<p>Teachers and staff will be affected by safeguarding measures, noted <a href="https://directory.sph.umn.edu/bio/sph-a-z/rachel-widome" target="_blank">Rachel Widome</a>, PhD, an associate professor of epidemiology and community health at University of Minnesota.</p><p>"In order for all of the in-school precautions to work well, we'll be asking a lot of teachers and staff," Widome told Healthline. In addition to their usual workload, they'll now be asked to monitor mask-wearing, ensure children are keeping distance, and be aware of any symptoms.</p><p>Along with Sharfstein, Widome called for an increase in financial support. More employees will likely be required so teachers and staff members can keep up with the added demands.</p>
Should Kids Go Back?<p>While these guidelines may help get some schools to reopen, many people don't think children should go back to school over fears they could contract the disease and spread it to other vulnerable family members like grandparents, infant siblings, or their parents.</p><p>In a <a href="https://pediatrics.aappublications.org/content/early/2020/07/08/peds.2020-004879" target="_blank">Pediatrics</a> commentary, <a href="https://www.md.com/doctor/william-raszka-md" target="_blank">Dr. William V. Raszka, Jr.</a>, an infectious disease specialist at The University of Vermont Medical Center, argued that schools should open because school-aged children are far less important drivers of COVID-19 than adults.</p><p>But he says the risk and benefit is not equal among all students ages 5 to 18.</p><p>"Elementary schools are arguably higher priority for face-to-face schooling, since younger children are at lower risk for infection and transmission, and since parental supervision of younger children's distance learning may be particularly challenging," added Sorensen, who penned a <a href="https://jamanetwork.com/channels/health-forum/fullarticle/2767411" target="_blank">June article in JAMA</a> with reopening tips. "That means middle and high schools are more likely to emphasize distance learning."</p><p>Specific student populations, such as special education students and students with disabilities, would also benefit greatly from more time spent in face-to-face environments, Sorensen said.</p>
What Parents Can Do<p>Parents should ask for and receive frequent updates from schools about plans for the fall. They should also be informed about plans if and when COVID infections are identified, Sharfstein said.</p><p>"I'd like to see parents investing now, during the summer, in doing things that can slow and stop the spread of the virus in their communities," Widome said.</p><p>"Now is a good time for kids to practice wearing masks and get used to them as they may be wearing them for longer stretches if school starts up in person," Widome suggested.</p><p>She recommends parents try different mask designs and materials to see what children are more comfortable wearing.</p><p>"If you are using cloth face coverings, it's good to have extras on hand," Widome added.</p><p>Parents should model healthy behavior at home and while out in public — another thing that could affect how well children adapt to reopening practices, Sorensen said.</p><p>"Children may want to know more about face coverings," added <a href="https://www.linkedin.com/in/leescott/" target="_blank">Lee Scott</a>, chairwoman of the Educational Advisory Board at <a href="https://www.goddardschool.com/" target="_blank">The Goddard School</a>. "Dramatic play, such as creating or wearing a face covering, may help some children adjust to this concept." Schools can also show children photos of what faculty members look like in their masks so the students are familiar with that appearance.</p><p>Johns Hopkins University recently released its eSchool+ Initiative, a slew of resources surrounding education during the pandemic. These include a <a href="https://equityschoolplus.jhu.edu/reopening-checklist/" target="_blank">checklist for administrators</a>, report on <a href="https://equityschoolplus.jhu.edu/ethics-of-reopening/" target="_blank">ethical considerations</a>, and a tracker of <a href="https://equityschoolplus.jhu.edu/reopening-policy-tracker/" target="_blank">state and local reopening plans</a>.</p>
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By Eoin Higgins
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<div id="fea63" class="rm-shortcode" data-rm-shortcode-id="9a6f211c2bc5aedd34837944cb8eeedf"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1281000111481294849" data-partner="rebelmouse"><div style="margin:1em 0">Water in Illinois is overwhelmingly public. Why is Tammy Duckworth sponsoring a bill that aims to change that? https://t.co/1V36Kkd99s</div> — The American Prospect (@The American Prospect)<a href="https://twitter.com/TheProspect/statuses/1281000111481294849">1594249201.0</a></blockquote></div>
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