In the study, Municipal Wastewater Treatment: A Novel Opportunity to Slow the Proliferation of
Antibiotic-Resistant Bacteria? Timothy M. LaPara (May, 2006,) an associate professor at the University of
Minnesota published critical research on mulit-drug resistant disease organisms released in the effluent (cleaned water
and sludge) from public owned wastewater treatment plants. The common belief was that most disinfection processes
used by treatment plants adequately inactivated multi-drug resistant disease organisms in the cleaned water before it
was released into the rivers or used to irrigate public access areas, food crops or used in building cooling systems. You
will notice the key word was inactivate, which indicates the disease organism may still be viable but nonculturable by
standard laboratory methods.
What LaPara and his associates found was that current treatment processes to protect water quality, do not prevent
these multi-drug resistant disease organisms from entering the environment either through the the liquid effluent or
digested solids, which the general wastewater industry playfully refers to as biosolids. . Much of the drugs we take is not
used by our body and ends up in the wastewater treatment plant. Exposure to low levels of these drugs are creating
drug resistant bacteria. LaPara quotes Nobel winner, Alexander Fleming who warned against under perscribing
penicillion dosage, because laboratory research showed that exposing bacteria to antibiotics, which didn't kill them,
create drug resistant disease organisms.
LaPara also discusses research by Stuart Levy in the 70s. His work demonstrated tetracycline-resistant bacteria was in
chicken shit within one week after tetracycline was introduced into the feed. Within two weeks the chickens had
developed multi-drug resistant strains of bacteria. What was extremely alarming was that within five months, farmers who
worked with the chickens were passing multi-drug resistants strains of bacteria in their stools (shit)-- even though they
had taken no drugs.
Tetracycline was the wonder drug of the 70s. Many young middle aged adults that didn't have all their front teeth
crowned still carry its childhood mark -- discolored or yellow teeth.
Then in the 80's all hell broke loose when a multiple-drug-resistant form of tuberculosis showed up. Other multi-drug
resistant disease organisms started hitting hard in the hospital setting and new strains of deadly disease organism (such
as E. Coli 0157:H7) appeared. Then they jumped into the community at large. Multiple pathogenic foodborne illnesses
exploded, the pathogens also cause pneumonia and as one study noted, "Klebsiella meningitis and Staphylococcal
meningitis were more frequently noted after 1987"
As LaPara points out, "Today, 40% to 60% of nosocomial [hospital aquired] Staphylococcus aureus infections are
methicillin resistant" However, community-acquired methicillin-resistant Staphylococcus aureus has in fact become an
epidemic. Staphylococcus aureus has also become one of the leading pathogens associated with Necrotizing fasciitis
(flesh eating bacteria). Necrotizing fasciitis is an invasive disease that showed up in the 80s, first associated with
Streptococcus and now some 70 other disease organisms. The only way to stop this infection is to surgically remove the
infected tissue.
What the Lapara study reveiled was that the future looks very bleak for the sick , and especially the poor. New
antibiotics are not being developed. Pharmaceutical companies are focusing on drugs like Botox,and Viagra. The reality
is these are for profit corporations and the longer we stay sick the greater the profit for the pharmaceutical companies.
The truth is they are making a killing on antibiotics such as Levaquin which is used to treat pneumonia, etc. If you don't
have a drug resistant bacteria, and you are on social security without insurance, the seven little pill pneumonia
treatment will cost you at least $143.00. Canadian drug companies advertise 10 Levaquin pills for less than $40.00. Are
U.S. Doctors under proscribing Levaquin dosage because of the cost?
The wastewater industry has known about the existence of drug-resistants gene transfer in wastewater treatment plants
for a long time. In a 1982 EPA study, M. C. Meckes' (35) noted, "In 1959, Wantanabe (31) discovered that some
Escherichia coli strains could transfer antibiotic-senstive strains of shigella spp. Subsequent research has demonstrated
that bacteria carrying transmissible R-factors [genetic transfer]are responsible for the spread of multiple antibiotic
resistence among members of the Entero-bacteriaceae (such as E. coli, Samonella typi, and Shigella dysenteriae)
Aeromonas and Yersinis species (4), Pseudomonas, and Vibro cholerae (34),"
For the past twenty-five years (80s) the wastewater industry (through EPA, USDA, CDC and FDA (drugs)) has been
pushing sewage effluent and the sludge solids as an environmental friendly fertilizer and soil amendment. They tell us
this is a sustainable practice, whereas disposal in a landfill is not -- because -- we are running out of landfill space. The
chilling reality is that EPA states in its sludge rule that exposure through the air, water, or food to any of the pollutants (e.
g., organics, inorganics, disease organisms or a combination of them) in sludge solids could cause death, disease,
cancer, etc. The second chilling reality is that the federal Bureau of Land Management (BLM) manages over 260 million
acres and considers sludge solids to be a hazarous waste with potential Superfund liabilities. What does BLM know
about national policy and sludge, that you need to know?
5) The term ``hazardous waste'' means a solid waste [sludge], or combination of solid wastes [sewage and
sewage sludge, etc], which because of its quantity, concentration, or physical, chemical, or infectious
characteristics may--
(A) cause, or significantly contribute to an increase in mortality or an increase in serious irreversible, or
incapacitating reversible, illness; or
(B) pose a substantial present or potential hazard to human health or the environment when improperly
treated, stored, transported, or disposed of, or otherwise managed.
We are told that the Metropolitan Wastewater Treatment Facility in St. Paul, MN., regularly wins state and national
awards for operational excellence. However, the facility still releases treated effluent (clean water) carrying 300,000
tetracycline-resistant bacteria per liter in winter (November to April) and 30,000 tetracycline-resistant bacteria per liter
in the summer. Anyway you look at it, that is some very hazardous water. LaPara said, "about 99.6% and 99.97% of the
resistant bacteria in the aeration tanks are removed in the winter and summer." Using the summer figure of 99.7%,
according to LaPara, there are still "10 trillion tetracycline-resistant bacteria released each day from this treatment
facility into our waterways" Where do you think the 99.7% of bacteria taken out of the final effluent is disposed?
For the first time, a study acknowledges that wastewater is not always treated if it is not expected to affect recreational
water and the best treatment doesn't get rid of the disease organisms.. Furthermore, according to LaPara, "The
majority of municipal wastewater is disinfected using chlorine, which poses a security risk (chlorine gas is very
dangerous) and generates disinfection by-products that are known or suspected carcinogens."
LaPara's team also investigated anaerobic digestion of sludge (thermophilic and conventional) at two other treatment
plants that have earned awards for operational excellence. The wastewater entering the digesters contained about
100,000,000 tetracycline-resistant bacteria per liter. According to LaPara, the team "isolated and identified 173 bacterial
strains that were resistant to tetracycline. All of these bacterial strains were pathogenic (disease-causing—e.g., Shigella
or Klebsiella spp.), possibly pathogenic (e.g., Escherichia coli), or non-pathogenic but related to pathogens (e.g.,
Citrobacter spp.). In more than 50% of these bacteria, we also detected at least one gene encoding for tetracycline
resistance."
Perhaps there was an editorial problem concerning Citrobacter. Citrobacter is listed as non-pathogenic, yet, studies
show:
"Citrobacter infection is commonly reported in neonates and immunocompromised patients."
"Citrobacter koseri (diversus) is an important cause of neonatal meningitis and brain abscess formation."
"Depending on the site of infection, they have been associated with urinary tract infections and blood
poisoning in debilitated persons."
"Occasionally and more usually in developing countries, Citrobacter infection can cause infant meningitis
and diarrhoea."
None of these bacteria were detected in the sludge leaving the digester, apparently because of the research methods
used. The reason appears to be that Viable but nonculturable bacteria are non-detectable by standard research
methods. LaPara warns:
"A substantial fraction of these bacteria (greater than 50%) harbored genes encoding for tetracycline
resistance"
"The frequency of lateral gene transfer of ciprofloxacin resistance, which occurred in more than 40% of the
strains we studied, is particularly worrisome because this trait is typically very rare (less than 1%) among
clinical strains of ciprofloxacin-resistant E. coli. Simply put, the bacteria that we detected in municipal
wastewater are some of the most resistant bacteria ever studied."
"There is a substantial need, therefore, to prevent these organisms from reaching the environment."
"This ongoing research is particularly pertinent because of a recent shift in policy that emphasizes the
application of treated wastewater solids to land rather than putting these residues into landfills—that is, the
"environmental friendly" practice of applying wastewater solids to land may have unexpected and
undesirable consequences in terms of the proliferation of antibiotic-resistant bacteria."
In June 2006, the Water Environment Federation released a study by wastewater professionals " Examination of
Reactivation and Regrowth of Fecal Coliforms in Centrifuge Dewatered, Anaerobically Digested Sludges" The main
point was "At four of the seven facilities studied, higher levels of fecal coliforms were detected after dewatering in high
solids centrifuges than before this dewatering treatment. WEF scientists now admit "The issue of viable but non-
culturable (VBNC) bacteria was advanced in the 1980s, and gained significant interest in medicine, the food industry,
and many other fields."
According to EPA scientist, David Lewis (1998), standard test methods underestimate the number of water repellant
contaminates. In looking at the aids virus found on medical and dental tools, Lewis discovered that the HIV virus, when it
was covered with a water repellant lubricant such as silicone, was still infectious after several days. The water repellant
lubricants such as silicon and petroleum products cover the pathogens and prevent them from being found by standard
test methods. It was only when he dissolved the lubricants with acetone or other solvents, that the pathogens showed up
in tests. "Body fluids also break down the lubricants surrounding the contaminates," he said. Lewis has brought these
facts to the attention of the Food and Drug Administration who is supposed to be setting up a committee to study the
problem.
"The problem of pathogen detection in sludge, according to Lewis, "is that the sewage treatment process changes the
outside crust of the aggregates in sludge and only the pathogens on the outside of the aggregates are measured by
standard tests." He says that most of the microbes are trapped inside the aggregates. When ultrasound was used to
break open the aggregates of sludge the trapped microbes were revealed. In effect, it appears that the treatment
processes hide most of the pathogens rather than destroying them.
In the study, "Survival of pathogenic micro-organisms and parasite in extreta, manure and sewage sludge", D. Strauch
(1991), Institute of Animal Medicine and Hygiene, University of Hohenhiem, found that" most pathogenic agents can
survive the treatment process" and the sewage treatment process causes some of the pathogenic disease organisms to
be absorbed or enclosed in faecal particles during the treatment process. "Therefore," according to Strauch, "sewage
sludge is rightly described as a concentration of pathogens."
Strauch also reported that two groups of researchers had found that pathogenic disease organisms will be taken up
inside the food crops. In other words, it will do little good to wash the outside of fresh vegetables and fruit when the
pathogenic bacteria, viruses and worms from the sludge can be inside the plant. Strauch concluded in the study that, "In
any case, the agricultural utilization of hygienically dubious sewage sludge poses a risk for the whole national economy."
Municipal Wastewater Treatment Studies:
Releases of Multi-drug Resistant Bacteria to the Environment
Reclaimed Effluent and Sludge
By Jim Bynum
In May 2006, University of Minnesota researchers published data showing that extremely high numbers of
multi-drug resistant bacteria (173) in effluent (treated water) at high levels are being released into the
environment from highly efficent, award winning, sewage wastewater treatment plants. Researchers were
very concerned when they found extremely fast transfer of the drug resistant gene between bacteria in
the treatment plant which confirmed EPA studies fron the 80s. They appeared to be somewhat confused
because the bacteria taken out of the treated water were not detectable in sludge.
In June 2006, the Water Environment Federation (WEF) water quality professionals published data showing
that the disappearing bacteria, reappeared in sludge when dewatered in centrifuges. The research is a
little behind the times as EPA and German scientist explained this phenomenon of bacteria being
absorbed or encrusted in solids in the 90s. The WEF data also mentions the viable but nonculturalable
bacteria phenomenon, which everyone else seems to have known about since the 80s.
These are bio-level level 2 pathogens iin the laboratory -- yet the wastewater industy has claimed they are
safe for public contact in sewage effluent and sludge used on food crops and lawns.