Disinfectant residuals in drinking water systems select for mycobacterial populations with intrinsic antimicrobial resistance.

Antimicrobial resistance (AMR) in drinking water has received less attention than counterparts in the urban water cycle. While culture-based techniques or gene-centric PCR have been used to probe the impact of treatment approaches (e.g., disinfection) on AMR in drinking water, to our knowledge there is no systematic comparison of AMR traits between disinfected and disinfectant residual-free drinking water systems. We use metagenomics to assess the associations between disinfectant residuals and AMR prevalence and its host association in full-scale drinking water distribution systems (DWDSs). The differences in AMR profiles between DWDSs are associated with the presence or absence of disinfectant. Further, AMR genes and mechanisms enriched in disinfected systems are associated with drug classes primarily linked to nontuberculous mycobacteria (NTM). Finally, evaluation of metagenome assembled genomes (MAGs) of NTM indicates that they possess AMR genes conferring intrinsic resistance to key antibiotics, whereas such NTM genomes were not detected in disinfectant residual free DWDSs. Thus, disinfection may not only influence the AMR profiles of the drinking water microbiome but also select for NTM with intrinsic AMR.