title: Seasonality of antibiotic prescriptions for outpatients and resistance genes in sewers and wastewater treatment plant outflow.
abstract: To test the hypothesis of a seasonal relationship of antibiotic prescriptions for outpatients and the abundance of antibiotic resistance genes (ARGs) in the wastewater, we investigated the distribution of prescriptions and different ARGs in the Dresden sewer system and wastewater treatment plant during a two-year sampling campaign. Based on quantitative PCR (qPCR), our results show a clear seasonal pattern for relative ARGs abundances. The higher ARGs levels in autumn and winter coincide with the higher rates of overall antibiotic prescriptions. While no significant differences of relative abundances were observed before and after the wastewater treatment for most of the relative ARGs, the treatment clearly influenced the microbial community composition and abundance. This indicates that the ARGs are probably not part of the dominant bacterial taxa, which are mainly influenced by the wastewater treatment processes, or that plasmid carrying bacteria remain constant, while plasmid free bacteria decrease. An exception was vancomycin (vanA), showing higher relative abundance in treated wastewater. It is likely that a positive selection or community changes during wastewater treatment lead to an enrichment of vanA. Our results demonstrate that in a medium-term study the combination of qPCR and next generation sequencing corroborated by drug-related health data is a suitable approach to characterize seasonal changes of ARGs in wastewater and treated wastewater.
authors.affiliation: Institute for Hydrobiology, Technische Universität Dresden, 01217 Dresden, Germany.
authors.forename: Serena
authors.initials: S
authors.lastname: Caucci
authors.affiliation: Department of Food and Environmental Sciences, University of Helsinki, 00014 Helsinki, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Karkman
authors.affiliation: Institute for Hydrobiology, Technische Universität Dresden, 01217 Dresden, Germany.
authors.forename: Damiano
authors.initials: D
authors.lastname: Cacace
authors.affiliation: Institute for Hydrobiology, Technische Universität Dresden, 01217 Dresden, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Rybicki
authors.affiliation: Forschungsverbund Public Health Sachsen und Sachsen-Anhalt, Technische Universität Dresden, 01307 Dresden, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Timpel
authors.affiliation: Institute for Hydrobiology, Technische Universität Dresden, 01217 Dresden, Germany.
authors.forename: Veiko
authors.initials: V
authors.lastname: Voolaid
authors.affiliation: Institute of Clinical Pharmacology, Technische Universität Dresden, 01307 Dresden, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Gurke
authors.affiliation: Department of Food and Environmental Sciences, University of Helsinki, 00014 Helsinki, Finland.
authors.forename: Marko
authors.initials: M
authors.lastname: Virta
authors.affiliation: Institute for Hydrobiology, Technische Universität Dresden, 01217 Dresden, Germany thomas.berendonk@tu-dresden.de.
authors.forename: Thomas U
authors.initials: TU
authors.lastname: Berendonk
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000187:drug effects* / Q000235:genetics; D024881:Drug Resistance, Bacterial; D005798:Genes, Bacterial; D005858:Germany; D059014:High-Throughput Nucleotide Sequencing; D055553:Prescription Drugs / Q000627:therapeutic use; D060888:Real-Time Polymerase Chain Reaction; D012621:Seasons; D017422:Sequence Analysis, DNA; D062065:Wastewater / Q000382:microbiology*; D018508:Water Purification
chemical_list: D000900:Anti-Bacterial Agents; D055553:Prescription Drugs; D062065:Wastewater
keywords: WWTP; antibiotic prescriptions; antibiotic resistance genes; aquatic environment; seasonal; wastewater