Management of hospital wastewaters: the case of the effluent of a large hospital situated in a small town

Verlicchi, Paola; Galletti, Alessio; Masotti, L.

doi:10.2166/wst.2010.138

Cited by 78 publications

(48 citation statements)

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“…Antibiotics may be impregnated in food given to farm animals and fish and uneaten food contaminates the surrounding environment. Antibiotics from human therapeutic use, especially from hospital effluents, are a continual source of pollution and are considered part of the “emerging contaminants” in municipal waste with concentrations of tetracycline varying from ng/L to μg/L (Verlicchi et al, 2010). At these levels antibiotics may select for antibiotic resistant environmental bacteria which may persist for extended time periods and become reservoirs of antibiotic resistance genes.…”

Section: The Environmentmentioning

confidence: 99%

Environmental Macrolide–Lincosamide–Streptogramin and Tetracycline Resistant Bacteria

Roberts¹

2011

Front. Microbio.

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Bacteria can become resistant to antibiotics by mutation, transformation, and/or acquisition of new genes which are normally associated with mobile elements (plasmids, transposons, and integrons). Mobile elements are the main driving force in horizontal gene transfer between strains, species, and genera and are responsible for the rapid spread of particular elements throughout a bacterial community and between ecosystems. Today, antibiotic resistant bacteria are widely distributed throughout the world and have even been isolated from environments that are relatively untouched by human civilization. In this review macrolides, lincosamides, streptogramins, and tetracycline resistance genes and bacteria will be discussed with an emphasis on the resistance genes which are unique to environmental bacteria which are defined for this review as species and genera that are primarily found outside of humans and animals.

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Section: The Environmentmentioning

confidence: 99%

Environmental Macrolide–Lincosamide–Streptogramin and Tetracycline Resistant Bacteria

Roberts¹

2011

Front. Microbio.

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“…Usually hospital effluents are directly discharged into public sewer network, being co-treated with domestic wastewaters in municipal WWTPs. This practice has been questioned by some authors (Pauwels and Verstraete, 2006;Verlicchi et al, 2012a), who suggested the adoption of a more dedicated treatment for hospital effluents before being discharged into public wastewaters and then both urban and hospital wastewaters would be subsequently treated in WWTPs (Pauwels and Verstraete, 2006;Verlicchi et al, 2010a). This approach has benefits like avoiding the dilution of hospital wastewaters with urban wastewaters, which may result in the inhibition of biomass and reduction of removal efficiency in WWTPs, as well as to avoid losses into the environment due to sewer leakage and combined sewer overflows (Kovalova et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Contribution of hospital effluents to the load of pharmaceuticals in urban wastewaters: Identification of ecologically relevant pharmaceuticals

Santos

Gros²,

Rodríguez-Mozaz³

et al. 2013

Science of The Total Environment

524

216

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The impact of effluent wastewaters from four different hospitals: a university (1456 beds), a general (350 beds), a pediatric (110 beds) and a maternity hospital (96 beds), which are conveyed to the same wastewater treatment plant (WWTP), was evaluated in the receiving urban wastewaters. The occurrence of 78 pharma-ceuticals belonging to several therapeutic classes was assessed in hospital effluents and WWTP wastewaters (influent and effluent) as well as the contribution of each hospital in WWTP influent in terms of pharmaceu-tical load. Results indicate that pharmaceuticals are widespread pollutants in both hospital and urban waste-waters. The contribution of hospitals to the input of pharmaceuticals in urban wastewaters widely varies, according to their dimension. The estimated total mass loadings were 306 g d − 1 for the university hospital, 155 g d − 1 for the general one, 14 g d −1 for the pediatric hospital and 1.5 g d − 1 for the maternity hospital, showing that the biggest hospitals have a greater contribution to the total mass load of pharmaceuticals. Fur-thermore, analysis of individual contributions of each therapeutic group showed that NSAIDs, analgesics and antibiotics are among the groups with the highest inputs. Removal efficiency can go from over 90% for pharmaceuticals like acetaminophen and ibuprofen to not removal for β-blockers and salbutamol. Total mass load of pharmaceuticals into receiving surface waters was estimated between 5 and 14 g/d/1000 inhabitants. Finally, the environmental risk posed by pharmaceuticals detected in hospital and WWTP effluents was assessed by means of hazard quotients toward different trophic levels (algae, daphnids and fish). Several pharmaceuticals present in the different matrices were identified as potentially hazardous to aquatic organ-isms, showing that especial attention should be paid to antibiotics such as ciprofloxacin, ofloxacin, sulfameth-oxazole, azithromycin and clarithromycin, since their hazard quotients in WWTP effluent revealed that they could pose an ecotoxicological risk to algae.

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“…They are composed of wastewater related to domestic and urban activities, and those specific to hospital practices [1]. Hospital wastewaters contain a variety of toxic and persistent substances such as drug residues, chemical reagents, and disinfectants for medical purposes in a wide range of concentrations, detergents, solvents, revealing and radiographic fixing and radionuclides.…”

Section: Introductionmentioning

confidence: 99%

Study on Cadmium Resistant-Bacteria Isolated from Hospital Wastewaters

Benmalek¹,

Benayad²,

Lila³

et al. 2014

ABB

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In hospital, a variety of substances are in use for medical purposes as diagnostics and researches. Among them, heavy metals which are not biodegradable by chemical reactions have bioaccumulation properties. Cadmium is a toxic pollutant that enters hospital wastewaters by different ways. However, isolated bacteria from hospital effluents have high resistance to antimicrobial agents and therefore the ability to uptake cadmium and other metals. So, their use is recommended for wastewater bioremediation. In this study, twelve cadmium-resistant bacteria were isolated from hospital wastewaters and identified. The cadmium-resistant isolates characterized include both Gram-negative [75%] and Gram-positive [25%]. The Minimum Inhibitory Concentration of hospital wastewaters isolates was determined in solid media and was ranged from 250 to 950 micrograms/milliliters. All the isolates showed co-resistance to zinc and mercury. They were also antibiotic resistant and tolerated up a significant concentration of NaCl. The cadmium-resistant species Klebsiella pneumoniae and Pseudomonas aeruginosa were the most resistant to cadmium. The species Klebsiella pneumonia also resists to the highest concentrations of zinc and mercury. The results of toxicity tests on Vibrio fischeri, showed that the DI50 [15 min] as low as 0.07 carried away 50% luminescence inhibition.

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Management of hospital wastewaters: the case of the effluent of a large hospital situated in a small town

Cited by 78 publications

References 0 publications

Environmental Macrolide–Lincosamide–Streptogramin and Tetracycline Resistant Bacteria

Environmental Macrolide–Lincosamide–Streptogramin and Tetracycline Resistant Bacteria

Contribution of hospital effluents to the load of pharmaceuticals in urban wastewaters: Identification of ecologically relevant pharmaceuticals

Study on Cadmium Resistant-Bacteria Isolated from Hospital Wastewaters

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