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Antibiotic Resistance in Septic Effluent

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... prison inmates, and athletes ... methicillin-resistant staphylococcus aureus (MRSA) alone causes 15 20,000 deaths in the United States each year (4). – PowerPoint PPT presentation

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Title: Antibiotic Resistance in Septic Effluent


1
Antibiotic Resistance in Septic Effluent
  • 2011 National Environmental Health Association
    Meeting
  • Crispin Pierce, Sasha Showsh, and Eli Gottfried
    (faculty)
  • Tola Ekunsanmi, Michael Checkai, Jay Nielsen,
    Jacob Schafer, Michael Servi and Matt Haak
    (students)
  • University of Wisconsin-Eau Claire

2
Outline
  • Background
  • Antibiotic Resistance from Land Spreading?
  • Antibiotic Resistance in Septic Effluent
  • Big box store
  • Chain restaurant
  • Rehabilitation and Convalescent Center
  • Surveillance and Control
  • Summary of Control Measures

3
Background
  • Antibiotic resistance is evident when a drug can
    no longer inhibit the growth of the target
    bacteria.
  • Resistance may be natural or as a result of
    mutation of existing genetic material acquiring
    new genetic material.
  • Feed additives, including antibiotics, are used
    to promote growth of livestock enter the food
    chain.
  • Widespread human use of antibiotics is also
    associated with antibiotic resistance.

4
  • According to the National Nosocomial Infections
    Surveillance (NNIS) System data on intensive care
    units (ICUs) in the U.S, 28.5 of enterococci
    associated with nosocomial infections were
    resistant to vancomycin, 31.9 of Pseudomonas
    aeruginosa were resistant to ceftazidime and 60
    of Staphylococcus aureus isolates were resistant
    to methicillin (i.e. MRSA) (1).
  • More than 80 pharmaceuticals and drug
    metabolites, have been measured in µg/l-levels in
    sewage samples and downstream surface waters. (2)
  • Recent research has shown certain bacteria may
    survive on a diet of the antibiotic Vancomycin.
    (3)

5
  • The improper disposal and overuse of antibiotics
    accelerates the spread of antibiotic-resistant
    bacteria.
  • Nontherapeutic use of antibiotics in animal
    production is estimated to be the cause of about
    70 of antibiotic resistance (4).

6
When food animals are treated with antibiotics to
speed growth or compensate for dirty, crowded and
stressful conditions, bacteria resistant to these
drugs proliferate and enter humans through meat
consumption. Similarly, over-prescription and
improper disposal of antibiotics lead to ground
and surface water contamination, and entry into
humans from drinking water. (Photo agmates.com)
7
Transmission of antibiotic-resistant bacteria is
highest in confined populations such as
hospitalized patients, college students living in
dormitories, prison inmates, and athletes
(football players on artificial turf have 15-fold
higher prevalence rates). Populations most
likely to develop disease and death are children,
elderly, and immune-compromised individuals.
(Photo http//abopposito.blogspot.com/)
8
  • These bacteria in turn cause extensive disease
    and death methicillin-resistant staphylococcus
    aureus (MRSA) alone causes 1520,000 deaths in
    the United States each year (4).

9
Antibiotic Resistance from Land Spreading?
  • Hypothesis Agricultural fields receiving land
    spreading of septic system effluent will have
    higher levels of antibiotic resistant bacteria
    than fields without spreading.

10
Materials and Methods
  • Thirteen soil samples (7 control and 6 treated)
    were collected from a crop field near Eau Claire
    treated with septic system effluent (Figs. 1 and
    2). These samples were mixed with water and
    plated on Colombian Blood Agar and four
    antibiotics (chloramphenicol, tetracycline,
    erythromycin and ampicillin, Fig. 3).

11
Fig. 1 Land spreading of septic tank effluent.
http//www.limemaster.com/Land_Spreading.html
12
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13
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14
Results
  • Although the fraction of antibiotic-resistant
    colonies tended to be higher for control vs.
    treated samples, this apparent difference did not
    reach a significance of plt0.05 (one-tailed
    t-test, equal variance, Fig. 4).

15
Fig. 4 Colony growth and fraction of antibiotic
resistance in control and treated (septic
effluent-applied) samples for five antibiotics.
16
Conclusion
  • In this small study, treatment of an
    agricultural field with septic system effluent
    did not significantly change the fraction of
    bacteria that were resistant to five antibiotics
    (Kanamycin, Tetracycline, Eosine Methylene Blue,
    Erythromycin and Ampicillin).

17
Antibiotic Resistance in the Effluents from a Big
Box Store, Chain Restaurant and Convalescent Home
  • Bacterial antibiotic resistance generated from a
    large retail store, small chain restaurant and
    convalescent home was measured.  Several samples
    of effluent from the respective septic systems
    were analyzed for bacterial resistance to
    ampicillin, kanamycin, tetracycline, and
    erythromycin. 

18
Results
  • The restaurant contained higher levels of
    resistance to ampicillin, kanamycin, and
    tetracycline than the store or convalescent home,
    with an average of 51.79, 27.54, and 30.78 of
    microbial growth resistant to the respective
    antibiotics. 

19
  • Erythromycin resistance was highest in effluent
    discharged from the convalescent home at 22
    compared to the store at 7.00 and restaurant at
    2.87.

20
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21
Conclusion
  • Our research analyzed wastewater effluent from a
    rehabilitation and convalescent facility, a
    big-box store, a local chain restaurant, and
    septic sewage spread agricultural and untreated
    soils. We found that wastewater and soil samples
    contained fractions of antibiotic resistant
    bacteria from 0.552.

22
Surveillance and Control
  • Wisconsin State Division of Health
  • Information for Health Care Providers
  • Antibiotic Resistance Report

23
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24
Summary of Control Measures
  • Surveillance of hospital and non-hospital
    incidence and prevalence.
  • Appropriate use of antibiotics
  • Use only when needed
  • Proper disposal
  • Legislation to limit non-therapeutic use in
    animals.
  • Sanitation

25
References
  • 1. Wisconsin Division of Public Health Bureau of
    Communicable Diseases and Preparedness Guidelines
    for Prevention and Control of Antibiotic
    Resistant Organisms in Health Care Settings,
    September, 2005.
  • 2. Herberer, Thomas. "Toxicology Letters
    Occurrence, Fate, and Removal of Pharmaceutical
    Residues in the Aquatic Environment a Review of
    Recent Research Data." ScienceDirect. 15 Mar.
    2002. Toxicology Letters. 7 Apr. 2008
  • 3. "Antibiotic-eating germ alarms doctors -
    Enterococcus faecium bacterium survives on diet
    of the antibiotic vancomycin - Biomedicine -
    Brief Article". Science News. Dec 21, 1996.
  • 4. Pew Charitable Trusts. Human Health and
    Antibiotic use in Industrial Farming 2010.
  • Additional References
  • Paterson, David . "Update on Antibiotic
    Resistance in Hospitals." The Prevalence of
    Antibiotic Resistance in the Hospital Setting.
    2006. 20 Apr 2007 lthttp//www.medscape.com/editori
    al/cmetogo/5541gt.
  • Fridkin, Scott K. et al. "Temporal Changes in
    Prevalence of Antimicrobial Resistance in 23 U.S.
    Hospitals." Emerging Infectious Diseases Vol. 8,
    No. 7,(2002) 697-701.
  • Lipsitch, Marc. "The epidemiology of antibiotic
    resistance in hospitalsParadoxes and
    prescriptions." PNAS vol.97(2000) 1938-1943.

26
Thanks for Your Attention
27
Contact Information
  • Crispin H. Pierce, Ph.D.
  • Associate Professor / Program Director
  • Department of Public Health Professions
  • 244 Nursing
  • University of Wisconsin - Eau Claire
  • Eau Claire, WI 54702-4004
  • (715) 836-5589
  • http//www.uwec.edu/piercech
  • http//www.uwec.edu/ph/enph/
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