Providing safe water through water reuse is becoming a global necessity. One concern with water reuse is the introduction of unregulated contaminants to the environment that cannot be easily removed by conventional wastewater treatment plants (WWTP). The occurrence of ampicillin, sulfamethoxazole, ciprofloxacin, and tetracycline-resistant Escherichia coli through the treatment stages of a WWTP (raw sewage, post-secondary, post-UV and post-chlorination) was investigated from January to May 2016. The highest concentrations of antibiotic resistant E. coli in the effluent were detected in April after rainfall. Ampicillin-resistant E. coli was the most common at the post UV and chlorination stages comprising 63% of the total E. coli population. The minimum inhibitory concentration (MIC) analysis showed that one in five isolates was resistant to three or more antibiotics, and the majority of these E. coli were resistant to ampicillin, followed by sulfamethoxazole and ciprofloxacin. The highest MIC was detected at the finished water after application of multiple disinfection methods. Tetracycline resistance was the least observed among others, indicating that certain drug families may respond to wastewater treatment differently. Currently, there are no policies to enforce the monitoring of antibiotic-resistant pathogen removal in WWTP. Better guidelines are needed to better regulate reuse water and prevent health risk upon exposure to antibiotic-resistant bacteria.
Background: Many studies have been done concerning the prevalence of sickle cell trait, its incidence and screening techniques. It is most commonly observed in the Black and Hispanic population in the United States. This study used retrospective data from the Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR-December 12, 2014) to model, analyze, and substantiate the geographic distribution of sickle cell trait, its incidence, prevalence and screening in 44 states divided into 4 regions in the United States. Methods: We conducted data modelling of geographic regions in the United States. The four regions were West, Midwest, South and Northeast. The research question was: How is screening rate related to sickle cell trait in the regions of the United States? The data were pooled in an Excel file and analyzed using linear regression and generalized linear modelling in SAS 9.4. Results: The results showed that (1) there is a significant relationship between incidence and the number of infants screened for region 2 (Midwest), p=0.0020; (2) a significant relationship between incidence and sickle cell trait for region 2 (Midwest), p=0.000; (3) incidence with screening and trait for region 1 (West), region 2 (Midwest) and region 3 (South), p<0.05. (4) Generalized linear modelling was also significant with interactions for the region 1, region 2, and region 3, with p<0.05. Conclusions: Findings indicate that more screening is needed to diagnose sickle cell trait, particularly among Black and Hispanic infants from the region 2 (Midwest) states. There should be more intervention programs implemented to promote early screening among newborns to reduce disparities and the burden of prevalence.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.