Antibiotics in Wastewater of a Rural and an Urban Hospital before and after Wastewater Treatment, and the Relationship with Antibiotic Use—A One Year Study from Vietnam

Abstract

Hospital effluents represent an important source for the release of antibiotics and antibiotic resistant bacteria into the environment. This study aims to determine concentrations of various antibiotics in wastewater before and after wastewater treatment in a rural hospital (60 km from the center of Hanoi) and in an urban hospital (in the center of Hanoi) in Vietnam, and it aims to explore the relationship between antibiotic concentrations in wastewater before wastewater treatment and quantities of antibiotics used in the rural hospital, over a period of one year in 2013. Water samples were collected using continuous sampling for 24 h in the last week of every month. The data on quantities of antibiotics delivered to all inpatient wards were collected from the Pharmacy department in the rural hospital. Solid-phase extraction and high performance liquid chromatography-tandem mass spectrometry were used for chemical analysis. Significant concentrations of antibiotics were present in the wastewater both before and after wastewater treatment of both the rural and the urban hospital. Ciprofloxacin was detected at the highest concentrations in the rural hospital’s wastewater (before treatment: mean = 42.8 µg/L; after treatment: mean = 21.5 µg/L). Metronidazole was detected at the highest concentrations in the urban hospital’s wastewater (before treatment: mean = 36.5 µg/L; after treatment: mean = 14.8 µg/L). A significant correlation between antibiotic concentrations in wastewater before treatment and quantities of antibiotics used in the rural hospital was found for ciprofloxacin (r = 0.78; p = 0.01) and metronidazole (r = 0.99; p < 0.001).

Detection of Multidrug-Resistance Gram-Negative Bacteria from Hospital Sewage in North East, Nigeria

“…al. [40] confirmed the presence of bacteria resistant from hospital wastewater pre-treatment and posttreated wastewater, thus rise concern about the efficacy of wastewater treatment in eliminating antibiotic resistant bacteria. This has serious threat to public health and could play role in further spread of antibiotic resistance.…”

“…Attempts have been made to measure the concentration of antibiotics in hospitals sewage since they are continuously release into wastewater chamber [40,[56][57]. The authors reported presence of most commonly prescribed antibiotics and this encourages selective pressure in bacterial community to become resistant.…”

Field hospital wastewater treatment scenario

“…The characteristics of HWW effluents are dependent on topog-raphy and some physical, chemical, biological and microbiological parameters. Maximum values of these parameters, detected in different studies (Carraro et al, 2016;al., 2016;El-Ogri et al, 2016), are mentioned in Table 1. HWW physicochemical characteristics are comparable with the domestic wastewater. Nowadays the presence of micropollutants in HWW is mainly focused on due to their low biodegradability, antibiotic-resistant genes and associated factors like cancer, mutagen ones, etc.…”

EVALUACIÓN DE RÍOS DEL VALLE DE CULIACÁN, MÉXICO, COMO RESERVORIOS DE SEROTIPOS DE Salmonella RESISTENTES A ANTIBIÓTICOS

“…Cabe señalar que estos antibióticos se han señalado como los de mayor consumo para el tratamiento médico en México (Benavides-Plascencia et al 2005). Por ello, grandes cantidades de estos fármacos son liberados en aguas residuales municipales por excreción o eliminación (Lien et al 2016), y se han detectado en diferentes ambientes acuáticos como ríos (Zhang et al 2015), agua para acuacultura (Pham et al 2015), influentes y efluentes de plantas de tratamiento de aguas residuales (Rodríguez-Mozaz et al 2015) y principalmente en los efluentes de hospitales (CastroPastrana et al 2015). Por otro lado, se encontró una alta incidencia de cepas de Salmonella resistentes a tetraciclina, lo que podría estar relacionado con el amplio uso de este antibiótico para tratamiento humano, así como en actividades agrícolas y pecuarias (Borghi y Palma 2014).…”