A Surveillance Study of Culturable and Antimicrobial-Resistant Bacteria in Two Urban WWTPs in Northern Spain

Wastewater treatment plants (WWTPs) are hotspots for the spread of antimicrobial resistance into the environment. This study aimed to estimate the proportion of clinically relevant antimicrobial-resistant bacteria in two Spanish urban WWTPs, located in the region of La Rioja (Spain); Methods: Ninety-four samples (48 water/46 sludge) were collected and streaked on ten different selective media, in order to recover the culturable bacterial diversity with relevant resistance phenotypes: Extended-Spectrum β-Lactamase-producing <i>Escherichia coli</i>/<i>Klebsiella pneumoniae</i> (ESBL-Ec/Kp), Carbapenem-resistant <i>Enterobacteriaceae</i> (CR-E), Methicillin-resistant <i>Staphylococcus aureus</i> (MRSA), and Vancomycin-resistant <i>Enterococcus faecium</i>/<i>faecalis</i> (VR-<i>E. faecium</i>/<i>faecalis</i>). Isolates were identified by MALDI-TOF and were tested for antimicrobial susceptibility using the disk diffusion method. The confirmation of ESBL production was performed by the double-disk test; Results: A total of 914 isolates were recovered (31 genera and 90 species). Isolates with clinically relevant resistance phenotypes such as ESBL-Ec/Kp and CR-E were recovered in the effluent (0.4 × 10⁰-4.8 × 10¹ CFU/mL) and organic amendment samples (1.0-10¹-6.0 × 10² CFU/mL), which are discharged to surface waters/agricultural fields. We reported the presence of VR-<i>E. faecium</i> in non-treated sludge and in the digested sludge samples (1.3 × 10¹-1 × 10³ CFU/mL). MRSA was also recovered, but only in low abundance in the effluent (0.2 × 10¹ CFU/mL); Conclusions: This study highlights the need for improved wastewater technologies and stricter regulations on the use of amendment sludge in agriculture. In addition, regular monitoring and surveillance of WWTPs are critical for early detection and the mitigation of risks associated with the spread of antimicrobial resistance.