Factors influencing antibiotic resistance burden in municipal wastewater treatment plants.

Municipal wastewater treatment plants are recognized reservoirs of antibiotic-resistant bacteria. Three municipal wastewater treatment plants differing on the dimensions and bio-treatment processes were compared for the loads of amoxicillin-, tetracycline-, and ciprofloxacin-resistant heterotrophic bacteria, enterobacteria, and enterococci in the raw inflow and in the treated effluents. The sewage received by each plant, in average, corresponded to 85,000 inhabitant equivalents (IE), including pretreated industrial effluents (<or=30%) in plant activated sludge, 105,000 IE, including pretreated hospital effluents (<or=15%) in plant trickling filter, and 2,000 IE, exclusively of domestic sewage, in plant submerged aerated filter. The presence of pretreated industrial effluents or of pretreated hospital sewage in the raw inflow did not imply significantly higher densities (per milliliter or per IE) of antibiotic-resistant bacteria in the raw wastewater. Longer hydraulic residence periods (24 h) corresponded to higher bacterial removal rates than shorter periods (12 and 9 h), although such efficiency did not imply significant average decreases in the antibiotic resistance prevalence of the treated effluent. The bacterial loads in the treated effluent could be ranked according to the treatment efficiency, suggesting that the characteristics of the raw inflow may have less relevance on the quality of the treated wastewater than other aspects, such as the inflow volume, the type of biological treatment, or the hydraulic residence time.