Antimicrobial resistance of fecal indicators in disinfected wastewater.

The main objective of the study was to assess the potential of three systems (UV irradiation, ozonation, and micro/ultrafiltration) operated in a pilot scale in removal of antimicrobial-resistant fecal bacteria from secondary effluent of the local wastewater treatment plant (700,000 population equivalent). The effectiveness of the processes was analysed using the removal ratio of fecal indicators (Escherichia coli and Enterococcus spp.). The susceptibility of fecal indicators to antimicrobial agents important in human therapy was examined. Resistance to nitrofurantoin and erythromycin was common among enterococci and followed by resistance to fluoroquinolones and tetracycline. Resistance to high-level aminoglycosides and glycopeptides was also observed. E. coli isolates were most frequently resistant to penicillins and tetracycline. The extended-spectrum beta-lactamase-producing E. coli was detected once, after ozonation. Substantial attention should be paid to the E. coli and enterococci resistant to three or more chemical classes of antimicrobials (MAR), which in general constituted up to 15 and 49% of the tested isolates, respectively. Although the applied methods were effective in elimination of fecal indicators (removal efficiency up to 99.99%), special attention has to be paid to the application of sufficient disinfection and operation conditions to avoid selection of antimicrobial resistant bacteria.