Hidden risks: Unrecognized biological toxicity and antibiotic resistance spread in peracetic acid-based advanced...

The escalating concern over antibiotic resistance in wastewater demands urgent attention. While advanced treatment technologies are anticipated to enhance secondary effluent quality and mitigate this issue, the associated biological toxicity and potential for resistance spread have been largely neglected. Herein, we explored the impact of peracetic acid (PAA)-based processes on antibiotic resistance during advanced secondary effluent treatment. Our findings revealed that PAA effectively inactivated most wastewater bacteria. However, it simultaneously induced environmental biotoxicity and genotoxicity, triggering a 1.5-2-fold increase in extracellular ARGs (eARGs) release and doubling horizontal gene transfer frequency. In contrast, PAA-based advanced oxidation process (PAA-AOP) demonstrated strong efficacy in detoxifying antibiotics and minimizing harm to aquatic organisms. It reduced both intracellular and extracellular ARGs by 2-4 orders of magnitude in real wastewater and significantly inhibited the conjugative transfer and transformation frequency of ARGs (by approximately 10 times), impairing their spread. Moreover, PAA-AOP reduced the abundance of pathogenic bacteria in wastewater transconjugants, thus minimizing direct harm to humans. Additionally, a membrane flow-through system designed with PAA-AOP exhibited excellent catalytic performance and stability in removing antibiotics and ARGs. These findings provide key insights into PAA-based advanced wastewater treatment, making a significant contribution to mitigating biotoxicity and antibiotic resistance in aquatic ecosystems.