Estimating the use of antibiotics for humans across China

Bu, Qingwei; Wang, Bin; Huang, Jun; Liu, Kai; Deng, Shubo; Wang, Yujue; Yu, Gang

doi:10.1016/j.chemosphere.2015.10.010

Cited by 55 publications

(28 citation statements)

References 27 publications

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“…It is worthy to note that the most popular drink in China is tea, which could have lower and more variable content of caffeine than coffee (Barone and Roberts, 1996). Previous studies have indicated that the economic status could influence the consumption behavior of PPCPs in different places (Bu et al, 2016;Hodges et al, 2012;Whelan et al, 2012). It was observed that caffeine and acesulfame consumption in China have good agreement with this hypothesis.…”

Section: Consumption Of Acesulfame and Caffeinesupporting

confidence: 73%

“…Those PPCPs are commonly used substances that could be easily measured in wastewater and could also be associated with population life style, behavior and health status. Previous studies have observed geographical PPCP consumption differences (Bu et al, 2016;Cox et al, 2003;Wangia and Shireman, 2013). These differences were observed for some compounds in this study such as acesulfame and caffeine.…”

Section: Consumption Of Selected Ppcps In Chinacontrasting

confidence: 47%

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Measuring selected PPCPs in wastewater to estimate the population in different cities in China

Gao

O’Brien

et al. 2016

Science of The Total Environment

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Sampling and analysis of wastewater from municipal wastewater treatment plants (WWTPs) has become a useful tool for understanding exposure to chemicals. Both wastewater based studies and management and planning of the catchment require information on catchment population in the time of monitoring. Recently, a model has been developed and calibrated using selected pharmaceutical and personal care products (PPCPs) measured in influent wastewater for estimating population in different catchments in Australia. The present study aimed at evaluating the feasibility of utilizing this population estimation approach in China. Twenty-four hour composite influent samples were collected from 31 WWTPs in 17 cities with catchment sizes from 200,000-3,450,000 people representing all seven regions of China. The samples were analyzed for 19 PPCPs using liquid chromatography coupled to tandem mass spectrometry in direct injection mode. Eight chemicals were detected in more than 50% of the samples. Significant positive correlations were found between individual PPCP mass loads and population estimates provided by WWTP operators. Using the PPCP mass load modeling approach calibrated with WWTP operator data, we estimated the population size of each catchment with good agreement with WWTP operator values (between 50-200% for all sites and 75-125% for 23 of the 31 sites). Overall, despite much lower detection and relatively high heterogeneity in PPCP consumption across China the model provided a good estimate of the population contributing to a given wastewater sample. Wastewater analysis could also provide objective PPCP consumption status in China.

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Section: Consumption Of Acesulfame and Caffeinesupporting

confidence: 73%

Section: Consumption Of Selected Ppcps In Chinacontrasting

confidence: 47%

Measuring selected PPCPs in wastewater to estimate the population in different cities in China

Gao

O’Brien

et al. 2016

Science of The Total Environment

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“…The gene and protein expression of the resistant bacteria will change, the protective defense and immunity of the body will gradually weaken, and the risk of MDRI elevates [37]. China is a large country with massive use of antibiotics, and the frequency of antibiotics use is very high [38,39]. It's been reported [40,41] that almost 80% hospitalized patients in China have been prescribed antibacterial drugs, and the use of broad-spectrum antibiotics is 28% higher than the average antibiotics use globally.…”

Section: Discussionmentioning

confidence: 99%

What we can do? The risk factors for multi-drug resistant infection in pediatric intensive care unit (PICU): a case-control study

Wang

Xia

2020

Ital J Pediatr

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Background: The risk factors for multi-drug resistant infection (MDRI) in the pediatric intensive care unit (PICU) remain unclear. It's necessary to evaluate the epidemiological characteristics and risk factors for MDRI in PICU, to provide insights into the prophylaxis of MDRI clinically.Methods: Clinical data of 79 PICU children with MDRI were identified, and 80 children in PICU without MDRI in the same period were selected as control group. The related children's characteristics, clinical care, microbiologic data, treatments provided, and outcomes of the patients with were reviewed and collected. Univariate and multivariate logistic regression analyses were performed to identify the potential risks of MDRI in PICU. Results: Of the diagnosed 79 cases of MDRI, there were28 cases of CR-AB, 24 cases of MRSA, 22 cases of PDR-PA,3 cases of VRE and 2 cases of CRE respectively. Univariate analyses indicated that the length of PICU stay, the duration of mechanical ventilation > 5 days, parenteral nutrition, coma, urinary catheter indwelling, invasive operation, 2 or more antibiotics use were associated with MDRIs (all p < 0.05); The logistic multiple regression analyses indicated that coma, parenteral nutrition, 2 or more antibiotics use and the duration of mechanical ventilation > 5 days were independent risk factors associated with MDRI (all p < 0.05).Conclusions: This present study has identified several potentially modifiable risk factors for MDRI in PICU, it's conducive to take appropriate measures targeting risk factors of MDRI for health care providers to reduce MDRI.

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“…It is worthy to note that the most popular drink in China is tea, which could have lower and more variable content of caffeine than coffee (Barone and Roberts 1996). Previous studies have indicated that the economic status could influence the consumption behavior of PPCPS in different places (Bu et al 2016, Hodges et al 2012, Whelan et al 2012. It was observed that caffeine and acesulfame consumption in China have good agreement with this hypothesis.…”

Section: App 534 Consumption Of Acesulfame and Caffeinementioning

confidence: 99%

“…Until now, WWA studies in China have focused only on estimating the consumption of recreational illicit drugs (Du et al 2015, Khan et al 2014, Li et al 2014. Although many studies have monitored the occurrence of a wide variety of PPCPs in wastewater and other environmental compartments (Bu et al 2016, Chen et al 2012b, Peng et al 2008, Sim et al 2010, Wang et al 2015, Yu et al 2011, few studies in China have attempted to link the load measured in the influent with consumption in the population (Sui et al 2015).…”

Section: App 5 Introductionmentioning

confidence: 99%

Refining the uncertainties and expansion of wastewater-based epidemiology for assessing population exposure to chemicals

O’Brien¹

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Systematic sampling and analysis of wastewater is an increasingly used tool to complement more traditional techniques for assessing consumption of licit and illicit chemical substances in the population. The use of wastewater sampling and analysis contributes to a broader field that is referred to as wastewater-based epidemiology (WBE). Both spatial and temporal analysis can be conducted quantitatively, quickly and cost effectively using the WBE approach.In brief, per capita exposure to a given chemical within a population is estimated by measuring the concentration of that chemical or a metabolite in a representative wastewater sample multiplied by the volume of wastewater represented by the sample, divided by the population size from which the sample originates and correcting by factors such as the excretion factor of the metabolite or chemical, molecular weight change and potential stability of the chemical within the sewer. It has previously been determined that the population size is the largest uncertainty for WBE estimates.The aim of this thesis it to therefore identify useful markers that allow population estimation for a given wastewater sample and apply this technique including to assess per capita exposure/release of a group of chemicals that have not been examined in previous WBE studies.The approach for this thesis was to systematically collect samples on a day when the population is well defined. For this we collected samples on the 2011 Census Day in Australia from 10 wastewater catchments ranging in size from approximately 1,500 to 500,000 people. By providing catchment maps to the Australian Bureau of Statistics, the accurate population size for each catchment was determined.The most obvious choice of a potentially useful population markers are endogenous chemicals such as creatinine. Therefore, in Chapter 2, creatinine was assessed as a population marker. It was found that there was no correlation between the mass load of creatinine in wastewater and the population. Using laboratory-scale sewer reactors with conditions representative of both gravity sewers and rising mains, it was found that creatinine, while stable in collected samples, is unstable under sewer conditions. We therefore conclude that creatinine is not suitable for predicting differences in population size particularly when different sewer systems are compared. 2In Chapter 3, a method was developed to quantify 96 chemicals in wastewater influent and applied to the census wastewater samples to identify potential population size markers. Thirteen chemicals including acesulfame, caffeine, and pharmaceuticals and personal care products were detected in all samples and found to have a good correlation (R 2 > 0.8) between mass load and population size. A Bayesian inference model was developed which incorporated these potential population size markers to provide a population size estimate. The model was validated using a leave-one-out approach for all sites and comparing the population size estimate from the model with the accur...

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Estimating the use of antibiotics for humans across China

Cited by 55 publications

References 27 publications

Measuring selected PPCPs in wastewater to estimate the population in different cities in China

Measuring selected PPCPs in wastewater to estimate the population in different cities in China

What we can do? The risk factors for multi-drug resistant infection in pediatric intensive care unit (PICU): a case-control study

Refining the uncertainties and expansion of wastewater-based epidemiology for assessing population exposure to chemicals

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