title: Occurrence of vancomycin-resistant and -susceptible Enterococcus spp. in reclaimed water used for spray irrigation.
abstract: Reclaiming municipal wastewater for agricultural, environmental, and industrial purposes is increasing in the United States to combat dwindling freshwater supplies. However, there is a lack of data regarding the microbial quality of reclaimed water. In particular, no previous studies have evaluated the occurrence of vancomycin-resistant enterococci (VRE) in reclaimed water used at spray irrigation sites in the United States. To address this knowledge gap, we investigated the occurrence, concentration, and antimicrobial resistance patterns of VRE and vancomycin-susceptible enterococci at three U.S. spray irrigation sites that use reclaimed water. We collected 48 reclaimed water samples from one Mid-Atlantic and two Midwest spray irrigation sites, as well as their respective wastewater treatment plants, in 2009 and 2010. Samples were analyzed for total enterococci and VRE using standard membrane filtration. Isolates were purified and then confirmed using biochemical tests and PCR. Antimicrobial susceptibility testing was conducted using the Sensititre® microbroth dilution system. Data were analyzed by two-sample proportion tests and one-way analysis of variance. We detected total enterococci and VRE in 71% (34/48) and 4% (2/48) of reclaimed water samples, respectively. Enterococcus faecalis was the most common species identified. At the Mid-Atlantic spray irrigation site, UV radiation decreased total enterococci to undetectable levels; however, subsequent storage in an open-air pond at this site resulted in increased concentrations of enterococci. E. faecalis isolates recovered from the Mid-Atlantic spray irrigation site expressed intrinsic resistance to quinupristin/dalfopristin; however, non-E. faecalis isolates expressed resistance to quinupristin/dalfopristin (52% of isolates), vancomycin (4%), tetracycline (13%), penicillin (4%) and ciprofloxacin (17%). Our findings show that VRE are present in low numbers in reclaimed water at point-of-use at the sampled spray irrigation sites; however, resistance to other antimicrobial classes is more prevalent, particularly among non-E. faecalis isolates.
authors.affiliation: Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
authors.forename: Stephanie Ann
authors.initials: SA
authors.lastname: Carey
authors.affiliation: Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
authors.forename: Rachel E Rosenberg
authors.initials: RE
authors.lastname: Goldstein
authors.affiliation: Department of Environmental Health, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA.
authors.forename: Shawn G
authors.initials: SG
authors.lastname: Gibbs
authors.affiliation: Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
authors.forename: Emma
authors.initials: E
authors.lastname: Claye
authors.affiliation: Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA.
authors.forename: Xin
authors.initials: X
authors.lastname: He
authors.affiliation: Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA. Electronic address: ars@umd.edu.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Sapkota
mesh_terms: D057914:Agricultural Irrigation; D016983:Enterococcus / Q000302:isolation & purification / Q000502:physiology*; D008826:Microbial Sensitivity Tests; D059027:Recycling; D014481:United States; D020713:Vancomycin Resistance
keywords: Antibiotic-resistant bacteria; Enterococci; Reclaimed water; Spray irrigation; Vancomycin-resistant enterococci; Wastewater