“…For example, discharges of hospital wastewater, which may contain antibiotic concentrations at the high μg/L level (Brown, Kulis, Thomson, Chapman, & Mawhinney, ), may periodically cause antibiotic spikes in the raw wastewater entering a municipal water resource recovery facility. These higher influent antibiotic concentrations may lead to increased prevalence of antibiotic resistance (Neyestani, Dickenson, McLain, Obergh et al., ), but as long as the concentrations remain subclinical, they may not have a significant impact on microbial community function (Li & Zhang, ; Neyestani, Dickenson, McLain, Obergh et al., ). The potential impacts on overall microbial community structure are less clear, although there is evidence to suggest that exposure to hospital wastewater can select for unique microbial taxa (Ahn & Choi, ).…”