Bacterial resistance to antibiotics threatens modern healthcare on a global scale. Several actors in society, including the general public, must become more involved if this development is to be countered. The conveyance of relevant information provided through education and media reports is therefore of high concern. Antibiotic resistance evolves through the mechanisms of natural selection; in this way, a sound understanding of these mechanisms underlies explanations of causes and the development of effective risk-reduction measures. In addition to natural selection functioning as an explanatory framework to antibiotic resistance, bacterial resistance as a context seems to possess a number of qualities that make it suitable for teaching natural selection – a subject that has been proven notoriously hard to teach and learn. A recently suggested approach for learning natural selection involves so-called threshold concepts, which encompass abstract and integrative ideas. The threshold concepts associated with natural selection include, among others, the notions of randomness as well as vast spatial and temporal scales. Illustrating complex relationships between concepts on different levels of organization is one, of several, areas where visualizations are efficient. Given the often-imperceptible nature of threshold concepts as well as the fact that natural selection processes occur on different organizational levels, visual accounts of natural selection have many potential benefits for learning. Against this background, the present dissertation explores information conveyed to the public regarding antibiotic resistance and natural selection, as well as investigates how these topics are presented together, by scrutinizing media including news reports, websites, educational textbooks and online videos. The principal method employed in the media studies was content analysis, which was complemented with various other analytical procedures. Moreover, a classroom study was performed, in which novice pupils worked with a series of animations explaining the evolution of antibiotic resistance. Data from individual written assignments, group questions and video-recorded discussions were collected and analyzed to empirically explore the potential of antibiotic resistance as a context for learning about evolution through natural selection. Among the findings are that certain information, that is crucial for the public to know, about antibiotic resistance was conveyed to a low extent through wide-reaching news reporting. Moreover, explanations based on natural selection were rarely included in accounts of antibiotic resistance in any of the examined media. Thus, it is highly likely that a large proportion of the population is never exposed to explanations for resistance development during education or through newspapers. Furthermore, the few examples that were encountered in newspapers or textbooks were hardly ever visualized, but presented only in textual form. With regard to videos purporting to explain natural selection, it was found that a majority lacked accounts of central key concepts. Additionally, explanations of how variation originates on the DNA-level were especially scarce. These and other findings coming from the content analyses are discussed through the lens of scientific literacy and could be used to inform and strengthen teaching and scientific curricula with regards to both antibiotic resistance and evolution. Furthermore, several factors of interest for using antibiotic resistance in the teaching of evolution were identified from the classroom study. These involve, among others, how learners’ perception of threshold concepts such as randomness and levels of organization in space and time are affected by the bacterial context

The widespread use of β-lactams has undermined their effectiveness as chemotherapeutic agents by fueling the evolution and dissemination of multiple resistance mechanisms, including: (1) production of hydrolytic β-lactamase enzymes that inactivate β-­lactams, (2) expression of PBPs with low-affinity for β-­lactams and (3) overexpression of multidrug efflux pumps which actively expunge β-­lactams and other toxic substances. The overall goal of this thesis is the structural characterization of bacterial proteins involved in regulating β-lactam resistance. The notorious resistance of Staphylococcus aureus primarily stems from the production of β-lactamases and PBP2a, a low-affinity PBP which confers broad-spectrum β-­lactam resistance in methicillin-resistant S. aureus (MRSA) strains. Expression of these resistance determinants is controlled by a β-­lactam-inducible transmembrane receptor (BlaR1/MecR1) and repressor (BlaI/MecI). This dissertation presents the crystal structure of the BlaR1 sensor domain (BlaRs) from S. aureus, determined in its apo form and acylated with penicillin G. These structures reveal that acylation by β-lactams is not accompanied by a BlaRs conformational change. It is also shown that mutation of the BlaR1 L2 loop prevents induction of β-­lactamase expression in vivo, supporting that the L2 loop plays an important role in signal transduction. The intrinsic resistance of Pseudomonas aeruginosa to a variety of antibiotics (including β-lactams) is exacerbated in mutant strains that overexpress multidrug efflux pumps such as MexAB-OprM. Production of MexAB-OprM is controlled by the MarR family repressor, MexR, and several hyper-resistant strains of P. aeruginosa appear to involve mutations in either MexR or additional regulatory factors upstream of MexR. The allosteric effectors of MarR proteins are typically small lipophenolic compounds. This dissertation confirms that MexR is uniquely modulated by the 53 residue protein, ArmR. Electromobility gel shift assays and isothermal titration calorimetry demonstrate that a direct MexR-ArmR interaction is responsible for neutralizing the affinity of MexR for its DNA operator. The allosteric conformational change induced by ArmR-binding was assessed by determining the crystal structure of MexR double mutant Q106L/A110L (MexRLL) in complex with ArmR residues 29-53 (ArmRC). This structure shows that ArmR induces a dramatic conformational change which repositions the MexR DNA-binding lobes into an orientation that is incompatible with binding DNA. / Medicine, Faculty of / Biochemistry and Molecular Biology, Department of / Graduate

Humans are generally having a strong, widespread, and negative impact on nature. Given the many ways we are impacting nature and the many ways nature is responding, it is useful to study responses in an integrative context. My thesis is focused largely (two out of the three data chapters) on butterfly species’ range shifts consistent with modern climate change in Canada. I employed a macroecological approach to my research, drawing on methods and findings from evolutionary biology, phylogenetics, conservation biology, and natural history. I answered three main research questions. First, is there a trade-off between population growth rate (rmax) and carrying capacity (K) at the mutation scale (Chapter 2)? I found rmax and K to not trade off, but in fact to positively co-vary at the mutation scale. This suggests trade-offs between these traits only emerge after selection removes mutants with low resource acquisition rates (i.e., unhealthy genotypes), revealing trade-offs between remaining genotypes with varied resource allocation strategies. Second, did butterfly species shift their northern range boundaries northward over the 1900s, consistent with climate warming (Chapter 3)? Leading a team of collaborators, we found that most butterfly species’ northern range boundaries did indeed shift northward over the 1900s. But range shift rates were slower than those documented in the literature for more recent time periods, likely reflecting the weaker warming experienced in the time period of my study. Third, were species’ rates of range shift related to their phylogeny (Chapter 3) or traits (Chapter 4)? I found no compelling relationships between rates of range shift and phylogeny or traits. If certain traits make some species more successful at northern boundary range expansion than others, their effect was not strong enough to emerge from the background noise inherent in the broad scale data set I used.

Methicillin-resistant Staphylococcus aureus (MRSA) is a growing concern in Canada especially in Aboriginal communities in remote regions. The northern and remote communities possess some or many of the risk factors that are identified in previous research to be associated with Community-Associated Methicillin-resistant Staphylococcus aureus (CA-MRSA) infections such as overcrowding, challenges in maintaining personal hygiene and limited access to healthcare. CA-MRSA spreads rapidly in the communities. It is known to not only affect young and healthy individuals, but it is also associated with high morbidity and mortality rates. Furthermore, antibiotic resistance in CA-MRSA is increasing in Canada. It is known that inappropriate and greater use of antibiotics is associated with increased antibiotic resistance. Resistant CA-MRSA infections are more difficult to treat. To reduce and to control the antibiotic resistance, monitoring the prevalence of CA-MRSA and the changing antibiotic susceptibility profiles at the population level, especially in highly affected communities, is crucial. By monitoring this trend, it will enable healthcare practitioners to provide more adequate and appropriate treatment. To our knowledge, there was no community-based study that examined the epidemiology of CA-MRSA skin and soft-tissue infections (SSTIs) in First Nations communities in Canada at large scale, and the knowledge on the risk factors, outcomes and antibiotic susceptibility profiles is still very limited. This study aimed to describe the local epidemiology of SSTIs at the community level in selected First Nations communities as well as to describe the antibiotic use to treat SSTIs and the antibiotic susceptibility patterns of CA-MRSA. A retrospective chart review was conducted in 12 nursing stations in the First Nations communities across 5 provinces in Canada. The charts of individuals over 18 years of age who had received service at the nursing station in the previous 12 months, starting retrospectively from the date of collection, were reviewed in this study. Each antibiotic prescription that was noted in the chart in this period prior to chart review was recorded in the antibiotic tracking case report form. Data collected included demographics, indication for antibiotic use, antibiotic prescription parameters and patient outcomes. In total, of 372 patient charts reviewed, 224 patient charts contained at least one case (an encounter that resulted in an antibiotic prescription during the study period). Of those 224 charts, 459 cases were recorded and, of those, 137 cases had a diagnosis of an SSTI. In the 65 patients accounting for all cases of SSTI patients, more than 80% of the study population were under the age of 50. The prevalence of impaired renal function was low, diabetes was present in 20% of cases, cardiac disease was present in 15% of cases, and reported alcohol misuse was present in 30% of cases. The presence of indwelling devices was very rare. There were 137 cases of SSTIs over 372 charts reviewed in total. The prevalence of SSTI among the selected First Nations communities in 2012-2013 was estimated at almost 37% (137 cases of SSTIs / 372 charts reviewed). In the 137 SSTI cases, 55 cases were identified as MRSA infections either by laboratory test such as wound culture or by history of colonization documented in the chart. The overall prevalence of MRSA in all SSTI cases was estimated at 40.1% (55 confirmed MRSA positive cases / 137 cases of SSTIs). The majority of SSTIs were purulent infections and wounds. We also found that a wound culture and susceptibility test were performed only in 29% of all SSTI cases. An orally administered antibiotic was most frequently used (in 71.5% of treatments). Topical antibiotics were used in 18.3% and IV antibiotics were used in 8.8%. Other than the antibiotic treatment, wound care was performed in 49% of the SSTI cases and incision and drainage (I&D) procedure in 9%. The majority of MRSA isolates in this study were susceptible to clindamycin and co-trimoxazole (90.5% and 95.2%), but only 29% were susceptible to erythromycin. In general, higher rates of SSTIs were seen in communities where overcrowding and poor access to running water are more prevalent. In this study, we found that the diagnostic tests such as wound culture and sensitivity test was not ordered very often and there was also lack of follow-up or lack of documentation of the follow-up. More research is needed to better understand some of the challenges and risk factors associated with CA-MRSA infections in remote communities. Developing a national-level surveillance system that can help with monitoring the epidemiology of SSTIs and the antibiotic susceptibility test results of CA-MRSA at community level would be essential for better prevention, control, and management. Furthermore, adopting other initiatives such as antibiotic stewardship programs at community and healthcare settings as well as addressing the socio-environmental factors such as housing and access to water would be all very important in the steps to curb antibiotic resistance.

Les intégrons sont des supports génétiques bactériens de capture, d’expression et de dissémination de gènes de résistance aux antibiotiques sous forme de cassettes. Ils sont majoritairement décrits chez les bactéries à Gram négatif chez qui ils confèrent généralement un phénotype de multirésistance. Les intégrons de résistance (IR) jouent un rôle majeur dans l’acquisition de la résistance dans le monde bactérien. Il existe 3 principales classes d’IR ; les IR de classe 1, les IR de classe 2 et les IR de classe 3 (IR3). Contrairement aux 2 premières classes, les IR3 représentent la classe d’intégrons de résistance la moins étudiée. Très peu de travaux s’intéressent à leur étude et on dénombre actuellement moins de 10 IR3 entièrement caractérisés. Les objectifs de ce travail de thèse étaient (i) d’effectuer une étude épidémiologique des IR3 en France et au Cameroun et (ii) d’étudier les modalités d’expression de l’intégrase et des cassettes de ces intégrons. Nos travaux ont permis d’isoler puis de décrire 3 nouveaux IR3 présents au sein de bactéries environnementales appartenant aux genres Aeromonas, Acinetobacter et Citrobacter. Les cassettes de ces IR3 codent des résistances aux bétalactamines, aminosides et ammoniums quaternaires. De plus, nous avons caractérisé des IR3 dans 3 souches de Delftia spp. (2 D.acidovorans et 1 D. tsuruhatensis) isolées en Afrique ; les cassettes de ces intégrons ne codent pas de résistance aux antibiotiques. L’axe plus fondamental de ce travail de thèse a permis de montrer que le PintI3(1) est le promoteur impliqué dans l’expression du gène intI3. De plus, nous avons montré que les variants du promoteur Pc, ainsi que les variants du promoteur PintI3(1) sont fonctionnels et de force différente. Il ressort de nos travaux que l’environnement constituerait un réservoir d’intégrons de classe 3 et que ces supports génétiques pourraient jouer un rôle important dans la dissémination de la résistance au sein de cet écosystème. / Integrons are bacterial genetic elements able to capture and express genes embedded within gene cassettes. They are widely described among Gram-negative bacteria and generally confer a multidrug resistance phenotype. Resistance integrons (RI) play an important role in the acquisition of antibiotic resistance. There are 3 main classes of RI. Class 3 RI has been poorly studied class with less than ten fully IR3 characterized. Objectives of this thesis were (i) to conduct an epidemiological study of class 3 RI in France and Cameroon and (ii) to better understand the modes of expression of the integrase and cassettes of IR3. We described 3 new class 3 RI isolated from environmental bacteria belonging to genus Aeromonas, Acinetobacter and Citrobacter. Gene cassettes encoded resistance to betalactams, aminoglycosides and quaternary ammonium compounds. We also described IR3 from three Delftia strains (2 D.acidovorans and 1 D.tsuruhatensis) in Africa containing cassettes that do not encode antibiotic resistance. The fundamental part of the work showed that the PintI3(1) promoter is involved in the expression of the intI3 gene. Furthermore, we demonstrated that variants of the Pc promoter and variants of the PintI3(1) promoter are functional with different strengths. These results showed that the environment may constitute a reservoir of class 3 integrons and that these genetic elements could play an important role in the spread of the resistance in this ecosystem.

Entre as ß-lactamases, as enzimas CTX-M têm despertado atenção especial pela alta incidência e grande capacidade de propagação. Eventos como recombinação gênica, transferência plasmideal e multirresistência podem ser a razão da manutenção e da ampla disseminação dos genes blaCTX-M. Este é um trabalho retrospectivo que teve como objetivo caracterizar genes blaCTX-M presentes em Klebsiella spp. Foram estudadas 27 linhagens de Klebsiella pneumoniae e 8 linhagens de Klebsiella oxytoca, produtoras de ?-lactamase de espectro estendido, isoladas de pacientes hospitalizados no período de janeiro a junho de 2000. A detecção e identificação dos genes blaCTX-M, assim como dos elementos relacionados com a mobilização destes genes, foi realizada por PCR e seqüenciamento. A localização genética e a mobilidade dos genes blaCTX-M foram pesquisadas por análise plasmideal e hibridação e por conjugação. Os perfis de sensibilidade das linhagens estudadas e das linhagens transconjugantes foram comparados pela determinação da concentração inibitória mínima de antibióticos das classes das cefalosporinas, cefamicinas, aminoglicosídeos e quinolonas. Foram encontrados genes blaCTX-M em plasmídeos conjugativos em 13 (37%) linhagens estudadas: blaCTX-M-9 em 4 K. oxytoca, e blaCTX-M-2 em 9 K. pneumoniae. Os genes blaCTX-M-9 estavam associados ao elemento de inserção ISEcp1, enquanto os genes blaCTX-M-2 estavam associados a integrons de classe I contendo ISCR1. O genes blaCTX-M-2, carreado por plasmídeo, pode estar relacionado com disseminação horizontal entre vários clones de K. pneumoniae, enquanto o gene blaCTX-M-9 foi encontrado sendo carreado por um único clone de K. oxytoca. Este estudo determinou a incidência e a diversidade de enzimas CTX-M no período estudado, além de fornecer dados epidemiológicos que podem explicar a sua prevalência no mundo e contribuir para o entendimento e controle da disseminação deste tipo de resistência. / CTX-M enzymes, the world\'s most prevalent ß-lactamases disseminate very easily. Genetic recombination, plasmid transference and multiresistance could be responsible for the wide spread of blaCTM-X genes. This retrospective study aims to characterize blaCTX-M genes found in Klebsiella spp. The strains were isolated in hospital patients from January to June 2000 and consisted of 27 ESBL-producing Klebsiella pneumoniae and 8 ESBL-producing Klebsiella oxytoca. PCR and sequencing were used in the detection and identification of blaCTX-M genes and genetic elements associated with their mobilization. Determination of genetic localization and mobility of blaCTX-M genes was by plasmid analyses, hybridization and transfer assays. The minimal inhibitory concentrations (MICs) of cephalosporins, cefamicins, aminoglycosides and quinolone antimicrobials evaluated the antibiotic susceptibility profile of transconjugants and strains in the study. The blaCTX-M genes were found in 13 strains (37%): blaCTX-M-9 in 4 K. oxytoca and blaCTX-M-2 in 9 K. pneumoniae. The insertion sequence ISEcp1 was associated with blaCTX-M-9 and blaCTX-M-2 was found in a class I integron bearing ISCR1. Plasmid blaCTX-M-2 genes dissemination was due to horizontal transfer among many K. pneumoniae clones, while blaCTX-M-9 dissemination was associated with a particular clone of K. oxytoca. The study characterized incidence and diversity of CTX-M enzymes during the period studied. Moreover it showed epidemiological data, which may explain CTX-M prevalence worldwide and contribute for the understanding and control of the resistance spread.

No description available.

In a world where the human population is increasing, new innovations to produce enough food are required. Aquaculture’s part of the global animal protein production has increased in recent years and could be a possible solution. However, if aquaculture is poorly managed, it can result in negative consequences and one such consequence is the development of antibiotic resistance. In this review, I examine how aquaculture affect antibiotic resistance by studying what the literature says on accumulation of antibiotics in different organisms and sediment, if antibiotics can be transferred to humans through consumption of antibiotic treated products, and if human pathogens in aquaculture farms may acquire antibiotic resistance. Furthermore, I examine what factors are contributing to irresponsible antibiotic use and how such use is managed. The result of this review indicate that antibiotics are able to accumulate in organisms and sediment. It is not clear however how consumption of these affect human microbiomes. In contrast, it is clear that antibiotic resistance can be transferred from antibiotic-resistant bacteria to human pathogens. Regarding antibiotic use, irresponsible use foremost exists in low-income countries and the main drivers behind such use are socioeconomic ones, such as lack of knowledge, poverty and food security. Finally, I propose possible solutions that might improve future management. / I en värld där den mänskliga befolkningen ökar krävs nya innovationer för att producera tillräckligt med mat. Vattenbrukets andel av den globala animaliska proteinproduktionen har ökat de senaste åren och kan ses som en potentiell lösning. Om vattenbruk dock hanteras ansvarslöst kan det uppstå negativa konsekvenser. En sådan konsekvens är utveckling av antibiotikaresistens hos skadliga bakterier. I denna litteraturstudie undersöker jag vattenbrukets påverkan på antibiotikaresistens genom att studera vad litteraturen säger om ackumulation av antibiotika i olika organismer och sediment, om antibiotika kan överföras till människor genom konsumtion av antibiotikabehandlade produkter, och om mänskliga patogener i vattenbruksodlingar kan förvärva antibiotikaresistens. Jag undersöker också vilka faktorer som bidrar till ansvarslös antibiotikaanvändning och hur den hanteras ur ett hållbarhetsperspektiv. Resultaten i denna studie tyder på att antibiotika kan ackumuleras i organismer och sediment men att det råder oklarheter huruvida konsumtion av antibiotikabehandlad mat påverkar mänskliga bakteriekulturer. Antibiotikaresistens kan dock överföras från antibiotikaresistenta bakterier till mänskliga patogener. Ansvarslös antibiotikaanvändning sker huvudsakligen i fattigare länder och det är förmodligen i stor utsträckning till följd av socioekonomiska faktorer som okunskap, fattigdom och livsmedelstrygghet. Slutligen föreslår jag lösningar som möjligen kan bidra till bättre hantering av framtida antibiotikaanvändning.

Global threats to treatment of bacterial infections due to antibiotic resistance (AR) have been on the rise in recent years. Current diagnostic tests identify bacteria by using blood culture, which takes more than 24 hours. This study focuses on the fluorescent labeling of DNA derived from bacterial AR genes (KPC & VIM) and other model DNAs using oligreen dye (OG) and molecular beacons (MB). A NanoDrop 3300 fluorospectrometer was used to take fluorescence measurements. Linear dynamic range and labeling efficiency were dependent on the following optimized conditions: dilution factor of OG (200 fold), buffer (20 mM Tris HCl, pH 8), and heat treatment of 95 °C for 15 min.Fluorescence analysis of a target DNA with a designed MB showed signal-to-background of 10 with our buffer only and 20 with our buffer and 25% ethanol. I also demonstrated a simple microfluidic device capable of detecting AR genes using model DNAs, magnetic beads, and designed MBs for assays of µ50 L volume. This study provides a first step towards detecting MB-DNA complexes by a simple, low cost, and fast non-amplified method, which may be used to detect AR genes in clinical samples in the future.

<div>Antibiotics have been widely used to treat bacterial diseases since the 1940s. However, the benefits offered by antibiotics have gradually faded due to the increased occurrence and frequency of antibiotic resistance. The widespread use of antibiotics has driven selection for resistance in bacteria and is becoming a global problem for human health and the environment. Antibiotic resistance is exacerbated by the ability of bacteria to share their antibiotic resistance genes (ARGs) with other bacteria via horizontal gene transfer (HGT). Many existing studies on HGT of ARGs focused on antibiotic concentrations at or above the minimal inhibitory concentration (MIC), which is the lowest concentration of an antibiotic that prevents visible growth of a bacteria culture. However, knowledge on the development of antibiotic resistance under different stressors at sub-MIC levels is still limited. In addition, carbon nanotubes (CNTs) have been widely studied in environmental, agricultural and biomedical areas due to their unique physical and chemical characteristics, but limited studies have been done to evaluate the effects of CNTs on the spread of ARGs. Electrochemical filtration has been shown to be a cost-effective technique to remove recalcitrant compounds and reduce antibiotic resistance, but limited studies have been done to evaluate the effectiveness of removal of ARGs with electrochemical filtration. Therefore, there is a critical need to evaluate the effects of trace levels of antibiotics and CNTs on the development of antibiotic resistance and electrochemical removal of ARGs. </div><div><br></div><div>The specific research objectives of this study were to evaluate: (1) selective pressure of sub-inhibitory concentrations of antibiotics on the development of antibiotic resistance and HGT, (2) development of antibiotic resistance and HGT under exposure to CNTs and antibiotics, and (3) effectiveness of using an electrochemical MWCNT filter to remove ARGs. </div><div><br></div><div>To evaluate the development of antibiotic resistance exposed to sub-MIC of erythromycin, HGT between environmental donor (<i>E. coli)</i> and pathogenic bacterial recipient (<i>B. cereus</i>) was quantified. The results indicated that extremely low concentration (0.4 ng/L to 4 µg/L) of erythromycin promoted HGT of <i>erm</i>80 gene, which is an erythromycin resistance gene. In addition to traditional culture-based method and quantitative real-time PCR (qPCR), a fluorescence <i>in situ</i> hybridization (FISH) approach was used to detect the occurrence and development of ARGs even the bacteria were in the viable but nonculturable (VBNC) state after treatment of sub-lethal level of erythromycin. Multi-walled carbon nanotubes (MWCNT) was selected as a representative stressor to evaluate the effects on HGT. The results showed that MWCNT enhanced HGT above 1 × MIC, which is the lethal level of erythromycin to recipients, and transfer frequencies of erm80 genes increased up to 101-fold under exposure to 1 × MIC erythromycin and MWCNT as compared to no MWCNT control. However, transfer efficiency of <i>erm</i>80 gene under exposure to sub-MIC of erythromycin was inhibited by MWCNTs. Moreover, transfer of antibiotic resistance plasmids was affected by antibiotics and MWCNTs. Although the concentration of individual stressor was not enough to confer antibiotic selection, effects of both antibiotics above 1 × MIC and MWCNTs could add up and select for antibiotic resistance. The results suggested that CNTs might create additional selective pressure for the spread of ARGs and their effects on HGT should be further investigated. Finally, an electrochemical MWCNT filtration was evaluated to remove genomic DNA and ARGs under the effects of operating conditions, such as pH, phosphate, and NOM. The results showed that the electrochemical MWCNT filtration reactor achieved 79% removal efficiency for genomic DNA and 91% removal efficiency for <i>erm</i>80 genes. The study suggested that electrochemical MWCNT filtration could be a promising technology for the removal of DNA and ARGs.</div><div><br></div><div>Overall, the results improved our understanding of the development of antibiotic resistance and ARGs under various selective pressures. Trace levels of antibiotics promoted the development and spread of ARGs. Conjugative transfer of resistance genes exposed to sub-MIC levels of erythromycin and MWCNTs also contributed to the spread and propagation of ARGs. As antibiotic concentrations detected in natural environment are often in trace levels, the results of this study may improve the understanding of health risks of trace levels of antibiotics and help develop effective mitigation strategies to control the spread of antibiotic resistance. Effective removal of ARGs with electrochemical MWCNT filtration may help the development of cost-effective treatment systems to remove ARGs to protect human health and the environment.</div><div><br></div>