Abstract
The presence of antibiotics in the environment and their subsequent impact on resistance development has raised concerns globally. Hospitals are a major source of antibiotics released into the environment. To reduce these residues, research to improve knowledge of the dynamics of antibiotic release from hospitals is essential. Therefore, we undertook a study to estimate seasonal and temporal variation in antibiotic release from two hospitals in India over a period of two years. For this, 6 sampling sessions of 24 hours each were conducted in the three prominent seasons of India, at all wastewater outlets of the two hospitals, using continuous and grab sampling methods. An in-house wastewater sampler was designed for continuous sampling. Eight antibiotics from four major antibiotic groups were selected for the study. To understand the temporal pattern of antibiotic release, each of the 24-hour sessions were divided in three sub-sampling sessions of 8 hours each. Solid phase extraction followed by liquid chromatography/tandem mass spectrometry (LC-MS/MS) was used to determine the antibiotic residues. Six of the eight antibiotics studied were detected in the wastewater samples. Both continuous and grab sampling methods indicated that the highest quantities of fluoroquinolones were released in winter followed by the rainy season and the summer. No temporal pattern in antibiotic release was detected. In general, in a common timeframe, continuous sampling showed less concentration of antibiotics in wastewater as compared to grab sampling. It is suggested that continuous sampling should be the method of choice as grab sampling gives erroneous results, it being indicative of the quantities of antibiotics present in wastewater only at the time of sampling. Based on our studies, calculations indicate that from hospitals in India, an estimated 89, 1 and 25 ng/L/day of fluroquinolones, metronidazole and sulfamethoxazole respectively, might be getting released into the environment per 100 hospital beds.
Highlights
One of the contributory factors implicated for the development of antibiotic resistance, is the exposure of bacteria to antibiotics in the environment, the aquatic environment [1]
The seasonal and temporal variation in antibiotic residues in the wastewater of the two hospitals obtained by continuous and grab sampling methods, is presented respectively in figures 2 and 3 In general, 6 of the 8 antibiotics studied were detected in the wastewater samples
These antibiotics belonged to three groups fluoroquinolones, imidazoles and sulphonamides
Summary
One of the contributory factors implicated for the development of antibiotic resistance, is the exposure of bacteria to antibiotics in the environment, the aquatic environment [1]. Due to high analytical costs, occurrence of antibiotic residues in the environment is mostly reported from high-income countries, with relatively few reports from low- and middle-income countries [2,3,6,7,8,9,10,11,12]. Knowledge generation in this aspect is more important in low- and middle-income countries, as wastewater in these countries undergoes little or no treatment before entering fresh water sources and contingent risks need to be evaluated. The long-term aim is to introduce interventions to reduce/remove antibiotic residues from hospital wastewater
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