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The performance of ozonation for the removal of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) using  Escherichia coli  and  Pseudomonas aeruginosa  carrying ARGs from hospital wastewaters was evaluated in this study. Bacterial inactivation was determined using plate count methods and real time PCR for ARG damage ( Sul1, bla   tem   ,   bla   ctx   ,   bla   vim    and qnrS ). The reduction rate of bacterial cells and ARGs was increased by different amounts of transferred ozone dose from 11 to 45 mg/L. The concentration of 10 8  cfu/ml bacteria was reduced  to an acceptable level by ozone treatment after a 5 min contact time,  Although the removal rate was much higher for concentrations of 10 6  cfu/ml and 10 4  cfu/ml bacteria. Overall, the tendency of gene reduction by ozonation from more to less was  16S rRNA  &gt;  sul1  &gt;  bla   tem   &gt;  bla   ctx   &gt;  qnrS  &gt;  bla   vim  . Given that plasmid-borne ARGs can potentially be transferred to other bacteria even after the disinfection process, our results can provide important insights into the fate of ARGs during hospital wastewater ozonation.

Performance evaluation of ozonation for removal of antibiotic-resistant Escherichia coli and Pseudomonas aeruginosa and genes from hospital wastewater