Scientific studies show that urban wastewater treatment plants (UWWTP) are among the main sources of release of antibiotics, antibiotic resistance genes (ARG) and antibiotic-resistant bacteria (ARB) into the environment, representing a risk to human health. This review summarizes selected publications from 1 January 2010 to 31 December 2019, with particular attention to the presence and treatment of ARG and ARB in UWWTPs in Italy. Following a brief introduction, the review is divided into three sections: (i) phenotypic assessment (ARB) and (ii) genotypic assessment (ARG) of resistant microorganisms, and (iii) wastewater treatment processes. Each article was read entirely to extract the year of publication, the geographical area of the UWWTP, the ARB and ARG found, and the type of disinfection treatment used. Among the ARB, we focused on the antibiotic resistance of Escherichia coli, Klebsiella pneumoniae, and Enterococci in UWWTP. The results show that the information presented in the literature to date is not exhaustive; therefore, future scientific studies at the national level are needed to better understand the spread of ARB and ARG, and also to develop new treatment methods to reduce this spread.

中文翻译：

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城市废水在抗菌素耐药性环境传播中的作用：意大利现状（2010-2019）


科学研究表明，城市污水处理厂（UWWTP）是抗生素、抗生素抗性基因（ARG）和抗生素抗性细菌（ARB）释放到环境中的主要来源之一，对人类健康构成风险。本综述总结了 2010 年 1 月 1 日至 2019 年 12 月 31 日期间选定的出版物，特别关注意大利 UWWTP 中 ARG 和 ARB 的存在和处理。简要介绍后，综述分为三个部分：（i）耐药微生物的表型评估（ARB）和（ii）基因型评估（ARG），以及（iii）废水处理工艺。每篇文章均经过完整阅读，以提取出版年份、UWWTP 的地理区域、发现的 ARB 和 ARG 以及所使用的消毒处理类型。在ARB中，我们重点研究了UWWTP中大肠杆菌、肺炎克雷伯菌和肠球菌的抗生素耐药性。结果表明，迄今为止文献中提供的信息并不详尽；因此，未来需要在国家层面进行科学研究，以更好地了解 ARB 和 ARG 的传播，并开发新的治疗方法来减少这种传播。