Antimicrobial resins with quaternary ammonium salts as a supplement to combat the antibiotic resistome in drinking water treatment plants

The increasing finding of pathogens and antibiotic resistance genes (ARGs) in drinking water has become one of the most challenging global health threats worldwide. However, conventional disinfection strategies in drinking water treatment plants (DWTPs) require further optimization in combating the antibiotic resistome. Here, we show that antimicrobial resins with quaternary ammonium salts (AMRs-QAS) exhibit great potentials in diminishing specific potential pathogens that relatively resist chlorine or UV disinfection in DWTPs, and comprehensive analyses using microscopy and fluorescence techniques revealed that the antimicrobial capacity of AMRs-QAS mainly proceed via the bacterial adsorption and cell membrane dissociation. Moreover, a total of 15 among 30 selected ARGs, as well as 4 selected potential pathogens including Pseudomonas aeruginosa, Bacillus subtilis, Escherichia coli and Staphylococcus aureus were all detected in the source water. Coupling the AMRs-QAS with 0.2 mg/L chlorine resulted in higher removal efficiencies than chlorination (2 mg/L) or UV disinfection (400 mJ cm^-2) for all the detected pathogens and ARGs in drinking water and significantly decreased the relative abundances of Pseudomonas aeruginosa, Bacillus subtilis, Escherichia coli, as well as all the detected ARGs (p < 0.05). Co-occurrences of pathogens and ARGs were revealed by a correlation network and possibly accounts for the ARGs removal. This coupled disinfection strategy overcomes the limitations of individual disinfection methods, i.e. the enrichment of specific pathogens and ARGs among bacterial populations, and provides an alternative for minimizing health risks induced by the antibiotic resistome in DWTPs.