Fate, risk and removal of triclocarban: A critical review

Antibiotic resistance is a severe global threat for public health, causing around 700,000 deaths per year. Horizontal gene transfer (HGT) is one of the most significant pathways to disseminate antibiotic resistance. It is commonly acknowledged that sub-minimum inhibition concentrations of antibiotics are major contributors in promoting antibiotic resistance through HGT. Pharmaceuticals are occurring in our environments at increased levels, yet little is known whether non-antibiotic pharmaceuticals cause or accelerate the dissemination of antibiotic resistance. Here, we report for the first time that the antiepileptic drug, carbamazepine, promotes conjugative transfer of antibiotic resistance genes. It was seen that environmentally relevant concentrations of carbamazepine (e.g., 0.05 mg/L) significantly enhanced the conjugative transfer of multiresistance genes carried by plasmid within and across bacterial genera. The underlying mechanisms of the enhanced HGT were revealed by detecting oxidative stress and cell membrane permeability, in combination with MinION DNA sequencing, genome-wide RNA sequencing, and proteomic analysis. Carbamazepine induced a series of acute responses, including increased levels of reactive oxygen species, the SOS response; increased cell membrane permeability, and pilus generation. Expressional levels of genes related to these processes were significantly upregulated during carbamazepine exposure. Given that HGT occurs widely among different species in various environments, these findings are an early warning for a wide assessment of the roles of non-antibiotic pharmaceuticals in the spread of antibiotic resistance.

Triclocarban (TCC) and triclosan (TCS) are antimicrobial additives in personal care products. Whereas TCS has been studied extensively, the environmental fate of TCC remains largely unknown. To address this data gap, we performed quantitative structure-activity relationship (QSAR) analyses that suggested a propensity of TCC to persist in various environmental compartments with predicted half-lives ranging from 0.75 days in air to 540 days in sediment. Moreover, concentrations of both antimicrobials were measured in 42 environmental samples from the Greater Baltimore region using a combination of solid-phase extraction, liquid chromatography/mass spectrometry, and isotope dilution. The co-occurrence of TCC and TCS was observed, owing to similar properties, usage, disposal, and environmental half-lives. A linear empirical correlation (R2 = 0.9882) fit the log-log-transformed data from diverse aquatic media and spanned 5 orders of magnitude in concentration. Occurrences of TCC predicted for 85 U.S. streams were statistically indistinguishable from experimental regional data (alpha < or = 0.05). Annual loading of antimicrobials to water resources probably is dominated by activated sludge treatment plants (39-67%), followed by trickling filters (31-54%) and combined and sanitary sewer overflows (2-7% and <0.2%, respectively). Study results suggest that TCC is a previously unrecognized contaminant of U.S. water resources nationwide, likely ranking in the top 10 in occurrence rate and in the top 20 in maximum concentration among 96 organic pollutants considered. The magnitude and frequency of TCC contamination (regional, 6750 ng/L, 68%; predicted nationwide for 1999--2000, 1150 ng/L, 60%) were markedly higher than non-peer-reviewed numbers (240 ng/L, 30%, U.S.) currently used by the U.S. Environmental Protection Agency for evaluating TCC's ecological and human health risks.