Occurrence of antibiotics and antibiotic resistance genes in hospital and urban wastewaters and their impact on the receiving river

Rodríguez-Mozaz, Sara; Chamorro, Sara; Marti, Elisabet; Huerta, Belinda; Gros, Meritxell; Sànchez-Melsió, Alexandre; Borrego, Carles M.; Barceló, Damià; Balcázar, José Luís

doi:10.1016/j.watres.2014.11.021

Cited by 1,364 publications

(551 citation statements)

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“…sustaining the hypothesis that, during wastewater treatment, the presence of active antibiotic molecules may impose selective pressure on ARB. Positive correlations between the concentration of antibiotics and rearrangements of the microbial communities, or resistance determinants have been reported (Novo et al 2013Rodriguez-Mozaz et al 2015). These evidences are supported also by the demonstration of the selective potential of subinhibitory concentrations of antibiotics (Andersson and Hughes 2014).…”

Section: Urban Wastewater Treatmentmentioning

confidence: 72%

“…These studies demonstrated that hospital effluents contain higher prevalence of ARGs (e.g., tetW, blaTEM, or sul1), including some genetic determinants which occurrence is mainly related with clinical practices, such as the gene vanA (Varela et al 2013(Varela et al , 2015bNarcisoda-Rocha et al 2014;Rodriguez-Mozaz et al 2015). Hospital effluents can contain higher concentrations of antibiotic residues, metalloids, and metals like arsenic or mercury, and significantly higher abundance of ARB&ARG than municipal effluents (Kümmerer and Henninger 2003;Varela et al 2014;Rodriguez-Mozaz et al 2015). Yet, since hospital effluents can be classified as domes-tic effluents, there is no legal recommendation for pretreatment aiming at reducing the microbial loads before its dis-charge in the municipal collectors.…”

Section: Important Environmental Reservoirs Of Contaminant Antibioticmentioning

confidence: 99%

“…Yet, since hospital effluents can be classified as domes-tic effluents, there is no legal recommendation for pretreatment aiming at reducing the microbial loads before its dis-charge in the municipal collectors. This legal gap can be attributed to the fact that hospital effluent discharges represent less than 5 % of the municipal effluents, leading to the readily dilution of antibiotic residues and ARB in the domestic effluents Rodriguez-Mozaz et al 2015). How-ever, this may be a fallacious argument, since ARB&ARG, unlike other environmental contaminants, can proliferate and spread across different niches and hosts, as it has been demonstrated based on the detection of the closely related ARG&ARB in urban water streams, gulls, or hospitalized patients (Varela et al 2013(Varela et al , 2015bVredenburg et al 2014).…”

Section: Important Environmental Reservoirs Of Contaminant Antibioticmentioning

confidence: 99%

“…In particular, the effluents from hospital and health care units can represent important reservoirs of ARG associated with bacteria of clinical relevance and with antibiotics used mainly in hospitals (ECDC 2012). Therefore, hospital effluents can represent a privileged entry portal in the environment of genes particularly widespread in clinical settings, such as vanA (vancomycin-resistant enterococci, VRE), mecA (methicillin-resistant Staphylococcus aureus, MRSA), and aac(6′)-Ib-cr or blaCTX-M15 (plasmid-encoded resistance to quinolones and beta-lactams in Gram-negative bacteria) (Novais et al 2005;Narciso-da-Rocha et al 2014;Rodriguez-Mozaz et al 2015;Varela et al 2015a).…”

Section: Important Environmental Reservoirs Of Contaminant Antibioticmentioning

confidence: 99%

See 3 more Smart Citations

Antibiotic resistance in urban aquatic environments: can it be controlled?

Manaia

Macedo

Fatta‐Kassinos

et al. 2015

Appl Microbiol Biotechnol

185

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Over the last decade, numerous evidences have contributed to establish a link between the natural and human-impacted environments and the growing public health threat that is the antimicrobial resistance. In the environment, in particular in areas subjected to strong anthropogenic pressures, water plays a major role on the transformation and transport of contaminants including antibiotic residues, antibiotic-resistant bacteria, and antibiotic resistance genes. Therefore, the urban water cycle, comprising water abstraction, disinfection, and distribution for human consumption, and the collection, treatment, and delivery of wastewater to the environment, is a particularly interesting loop to track the fate of antibiotic resistance in the environment and to assess the risks of its trans-mission back to humans. In this article, the relevance of different transepts of the urban water cycle on the potential enrichment and spread of antibiotic resistance is reviewed. According to this analysis, some gaps of knowledge, research needs, and control measures are suggested. The critical rationale behind the measures suggested and the desirable involvement of some key action players is also discussed.

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Section: Urban Wastewater Treatmentmentioning

confidence: 72%

Section: Important Environmental Reservoirs Of Contaminant Antibioticmentioning

confidence: 99%

Section: Important Environmental Reservoirs Of Contaminant Antibioticmentioning

confidence: 99%

Section: Important Environmental Reservoirs Of Contaminant Antibioticmentioning

confidence: 99%

See 2 more Smart Citations

Antibiotic resistance in urban aquatic environments: can it be controlled?

Manaia

Macedo

Fatta‐Kassinos

et al. 2015

Appl Microbiol Biotechnol

185

View full text Add to dashboard Cite

show abstract

“…As such, riverine pollution is a serious and growing public health challenge with antibiotic resistance genes (ARGs) regarded as a critical emerging contaminant (Pruden et al 2006;Xu et al 2016;Coutinho et al 2014). Aquatic ecosystems are ideal environments for diverse ARGs (Amos et al 2014;Nakayama et al 2017) with high levels of ARGs detected in urban rivers Xu et al 2016;Rodriguez-Mozaz et al 2015). Recently, Di Cesare et al (2017) found the load of ARGs from rivers was correlated to rainfall, and thus runoff from surrounding lands.…”

Section: Introductionmentioning

confidence: 99%

Antibiotic resistance genes in an urban river as impacted by bacterial community and physicochemical parameters

Zhou

Zheng

Wei

et al. 2017

Environ Sci Pollut Res

144

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Antibiotic resistance genes (ARGs) in urban rivers are a serious public health concern in regions with poorly planned, rapid development. To gain insights into the predominant factors affecting the fate of ARGs in a highly polluted urban river in eastern China, a total of 285 ARGs, microbial communities, and 20 physicochemical parameters were analyzed for 17 sites. A total of 258 unique ARGs were detected using high-throughput qPCR, and the absolute abundance of total ARGs was positively correlated with total organic carbon and total dissolved nitrogen concentrations (P < 0.01). ARG abundance and diversity were greatly altered by microbial community structure. Variation partitioning analysis showed that the combined effects of multiple factors contributed to the profile and dissemination of ARGs, and variation of microbial communities was the major factor affecting the distribution of ARGs. The disparate distribution of some bacteria, including Bacteroides from mammalian gastrointestinal flora, Burkholderia from zoonotic infectious diseases, and Zoogloea from wastewater treatment, indicates that the urban river was strongly influenced by point-source pollution. Results imply that microbial community shifts caused by changes in water quality may lead to the spread of ARGs, and point-source pollution in urban rivers requires greater attention to control the transfer of ARGs between environmental bacteria and pathogens.

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Should Physicians Consider the Environmental Effects of Prescribing Antibiotics?

Balch¹,

Schoen²,

Patel

2017

AMA Journal of Ethics

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Pharmaceuticals are beginning to receive attention as a source of pollution in aquatic environments. Yet the impact of physician prescription patterns on water resources is not often discussed in clinical decision making. Here, we comment on a case in which empiric antibiotic treatment might benefit a patient while simultaneously being detrimental to the aquatic environment. We first highlight the potential harm caused by this prescription from its production to its disposal. We then suggest that Van Rensselaer Potter's original conceptualization of bioethics can be used to balance clinicians' obligations to protect individual, public, and environmental health. CaseDr. Turner, a hospitalist, is called to assess Mr. Johnson, an elderly patient with a history of urinary tract infections (UTIs), who presented to the ER with altered mental status. Urine cultures are pending but previous cultures have grown Escherichia coli (E. coli) with an extended-spectrum beta-lactamase (ESBL) gene. Although Mr. Johnson improves with intravenous fluids, Dr. Turner plans to treat Mr. Johnson with ciprofloxacin, a broadspectrum fluoroquinolone-class antibiotic, to cover the E. coli that he has grown in the past. Dr. Turner recently read that this drug can persist, unaltered, in the hospital's wastewater collection system and in the municipal wastewater water treatment plant (WWTP). While much will be filtered, a quantifiable amount will end up in Mr. Johnson's local watershed. How should Dr. Turner, other physicians, and their institutions weigh the benefits that individual patients derive from pharmaceutical treatment with the contamination risk this treatment poses to freshwater resources used by entire communities and ecosystems?

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Occurrence of antibiotics and antibiotic resistance genes in hospital and urban wastewaters and their impact on the receiving river

Cited by 1,364 publications

References 50 publications

Antibiotic resistance in urban aquatic environments: can it be controlled?

Antibiotic resistance in urban aquatic environments: can it be controlled?

Antibiotic resistance genes in an urban river as impacted by bacterial community and physicochemical parameters

Should Physicians Consider the Environmental Effects of Prescribing Antibiotics?

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