Abstract
Controlling antibiotic resistance genes (ARGs) is a worldwide intervention to ensure global health. Hospital wastewater is the main pollution source of antibiotic-resistant bacteria and ARGs in the environment. Expanding our knowledge on the bacterial composition of hospital wastewater could help us to control infections in hospitals and decrease pathogen release into the environment. In this study, a high-throughput sequencing-based metagenomic approach was applied to investigate the community composition of bacteria and ARGs in untreated wastewater from three different types of hospitals [the general hospital, traditional Chinese medicine (TCM) hospital, and stomatology hospital]. In total, 130 phyla and 2,554 genera were identified from the microbiota of the wastewaters, with significantly different bacterial community compositions among the three hospitals. Total ARG analysis using the Antibiotic Resistance Genes Database (ARDB) and Comprehensive Antibiotic Resistance Database (CARD) revealed that the microbiota in the wastewaters from the three hospitals harbored different types and percentage of ARGs, and their composition was specific to the hospital type based on the correlation analysis between species and ARG abundance, some ARGs contributed to different bacterial genera with various relationships in different hospitals. In summary, our findings demonstrated a widespread occurrence of ARGs and ARG-harboring microbiota in untreated wastewaters of different hospitals, suggesting that protection measures should be applied to prevent human infections. Concurrently, hospital wastewater should be treated more specifically for the removal of pathogens before its discharge into the urban sewage system.
Highlights
Antibiotic resistance poses a serious challenge to the treatment of pathogenic infections
Hospital wastewater contains high concentrations of antibiotics and several types of pathogenic bacteria, which are the main source of antibiotic-resistant bacteria and antibiotic resistance genes (ARGs) (HassounKheir et al, 2020)
By comparing the corresponding species and taxonomic annotation information with the National Center for Biotechnology Information (NCBI) NR database, our results showed that the community composition of bacteria in the wastewaters was different between hospitals at both the phyla and genera levels with significantly different communities of bacteria in each of them (Figures 1, 2)
Summary
Antibiotic resistance poses a serious challenge to the treatment of pathogenic infections. Two-thirds of antibiotics are consumed by animal husbandry (Done et al, 2015), and some were used in crops (Taylor and Reeder, 2020), which increase the ARGs in the environment This may be relevant to human health interventions on food, water, and sewage. Hospital effluents are a mixture of different compounds, including pharmaceuticals, diagnostic agents, disinfectants, and metabolites of these compounds They are highly hazardous because of their infection rate and toxicity. These wastewaters should be treated to reduce transmission of antibiotic resistance bacteria (ARB) to the ecosystem, which is one type of intervention to control resistance (Petrovich et al, 2020). Traditional Chinese medicines (TCMs) were used in the treatment of infectious diseases to avoid antibiotic resistance (Cai et al, 2017; Su et al, 2020)
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