Hospital Wastewater Treatment Plant Research Articles

Miscanthus x giganteus biochar: Effective adsorption of pharmaceuticals from model solution and hospital wastewater

This study investigated the adsorption of pharmaceuticals, including atenolol (AT), 17-α-ethinylestradiol (EE2), and sulfamethoxazole (SMX), in model solutions and in the effluent from a hospital wastewater treatment plant. The pharmaceuticals were adsorbed on biochar prepared from Miscanthus x giganteus biomass obtained from the phytoremediation of contaminated or marginal soil. The feedstock was pyrolyzed at 360 °C (M-3) and 500 °C (M-5). The representation of functional groups, specific surface area, porosity, and pore volume were lower for M-5. Pore diameters were comparable, but their depth decreased for M-5. The specific surface area and porosity surface area of M-5 were 30 times higher after 4 h of shaking compared to properties without shaking. The biochar leachate pH was 9.8 ± 1.0 (M-3), and 11.1 ± 1.1 (M-5). No desorption of potentially risk organic compounds was detected. M-3 was generally a better adsorption material. The removal of EE2, AT and SMX was greater than 90%, 70% and 30 % respectively after 4 h in model waters. There was no evidence of a linear relationship between the sorption efficiency of pharmaceuticals and the biochar dose. Sorption experiments with real wastewater from a hospital wastewater treatment plant demonstrated high removal rates of monitored pharmaceuticals, including e.g. SMX (80%), trimethoprim (91%), venlafaxine (100%), clarithromycin (96%), tramadol (93%), diclofenac (86%). It was proven that the efficiency of the adsorption process is influenced not only by the dose or physico-chemical properties of the biochar, but also by the initial concentration of the pharmaceutical and its properties. The presence of other components of real wastewater, which can cause competitive sorption and overlapping of active centers on the surface of the biochar, also decreased the efficiency. The results demonstrate that both biochars are suitable for tertiary or quaternary water treatment for pharmaceutical removal. Due to the lower energetic, and therefore economic, costs of pyrolysis, a lower pyrolysis temperature can be preferred.

Enhancing pollutants removal in hospital wastewater: Comparative analysis of PAC coagulation vs. bio-contact oxidation, highlighting the impact of outdated treatment plants

While the effectiveness of Poly-Aluminum Chloride (PAC) coagulation for pollutant removal has been documented across various wastewater scenarios, its specific application in hospital wastewater (HWW) treatment to remove conventional pollutants and hazardous genetic pollutants has not been studied. The research compared three hospital wastewater treatment plants (HWTPs) to address a knowledge gap, including the PAC coagulation-sodium hypochlorite disinfection process (PAC-HWTP), the biological contact oxidation-precipitation-sodium hypochlorite process (BCO-HWTP), and a system using outdated equipment with PAC coagulation (ODE-PAC-HWTP). Effluent compliance with national discharge standards is assessed, with BCO-HWTP meeting standards for direct or indirect discharge into natural aquatic environments. ODE-PAC-HWTP exceeds pretreatment standards for COD and BOD5 concentrations. PAC-HWTP effluent largely adheres to national pretreatment standards, enabling release into municipal sewers for further treatment. Metagenomic analysis reveals that PAC-HWTP exhibits higher removal efficiencies for antibiotic resistance genes, metal resistance genes, mobile genetic elements, and pathogens compared to BCO-HWTP and ODE-PAC-HWTP, achieving average removal rates of 45.13%, 57.54%, 80.61%, and 72.17%, respectively. These results suggests that when discharging treated HWW into municipal sewers for further processing, the use of PAC coagulation process is more feasible and cost-effective compared to BCO technologies. The analysis emphasizes the urgent need to upgrade outdated equipment HWTPs.

Environmental risk assessment of selected pharmaceuticals in hospital wastewater in nothern Vietnam

Pharmaceuticals are progressively employed in both human and veterinary medicine and increasingly recognized as environmental contaminants. This study investigated the occurrence of selected pharmaceuticals in influent and effluent of wastewater treatment plants of 12 hospitals in Hanoi and 3 northern cities of Vietnam during dry and rainy seasons. In addition, environmental risk of pharmaceuticals in both hospital influents and effluents were evaluated based on risk quotients (RQs). Nine selected pharmaceutical compounds including sulfamethoxazole (SMX), naproxen (NPX), diclofenac (DCF), ibuprofen (IBU), acetaminophen (ACT), carbamazepine (CBM), iopromide (IOP), atenolol (ATN), and caffeine (CAF) were frequently detected in most influent and effluent wastewaters of 12 investigated hospitals. Detected compound levels exhibited a wide range, from as low as 1 ng/L for DCF to as high as 61,772 ng/L for ACT. Among these compounds, ACT, CAF, SMX, and IOP were consistently detected at substantial concentrations in both influents and effluents. This investigation also highlighted potential risks posed by SMX, ACT, and CAF residues present in influents and effluents of hospital wastewater treatment plants (WWTPs) to aquatic ecosystem. These finding are expected to provide scientific-based evidence for the development of hospital waste management and environmental management programs in Vietnam.

Evaluation of Eichhornia crassipes, Pistia stratiotes and Vetiver zizanoides in Phytoremediation of a Hospital Wastewater Effluent

The study assessed the physicochemical parameters from a hospital wastewater treatment plant in Zaria, using a standard method for water and wastewater examination and its phytoremediation by hydroponic treatment method using Eichhornia crassipes (water hyacinth), Pistia stratiotes (Water lettuce) and Vetiveria zizanoides (Vetiver grass). Results recorded were analyzed by one-way Analysis Of Variance at 95% confidence, multiple comparison tests, and quantitative linear relationship. The study showed higher concentrations of Electrical Conductivity (EC) (951.83 µs/cm), Phosphate (PO4) (64.46 mg/l), Biological Oxygen Demand (BOD) (244.90 mg/l), Chemical Oxygen Demand (COD) (625.50 mg/l), Total Suspended Solid (TSS) (27.30 mg/l), Potassium (K) (40.67mg/l) above the permissible limit standard by WHO and FAO, Phytoremediation showed there was significant difference at P ≤ 0.05 in reduction capacity across treatment between water hyacinth, water lettuce and vetiver grass for EC (49.8, 41.6 and 51.4%), TDS (51.3, 47.0 and 63.0%), PO4 (49.0, 45.3 and 53.0%), COD (47.3, 48.4 and 57.1%), NO3 (51.6, 43.1 and 64.6%), TSS (49.5, 42.7 and 60.3%), NH3 (44.7, 40.8 and 53.2%), SO4 (53.9, 47.2 and 62.8%). Plant analysis results showed higher concentrations of contaminant in the roots of water hyacinth than in the shoot, higher in the shoot of vetiver grass than its roots, and an even distribution in roots and shoots of water lettuce. Therefore, the three plants can be used effectively in the phytoremediation of wastewater contaminants due to cost-effectiveness, eco-friendliness, and the emerging cheaper technology for a lasting solution to the problems of water contamination to both humans and the environment.

Potential Environmental Impacts of a Hospital Wastewater Treatment Plant in a Developing Country

Assessing the quality of a hospital wastewater treatment process and plant is essential, especially if the presence of chemical and biological toxic compounds is considered. There is less literature on hospital wastewater treatment in developing countries because of a lack of managerial awareness and stakeholder cooperation, accompanied by the limited capacity of investment meant to upgrade the existing infrastructures. Limited access to data further hampers the reliable analysis of hospital wastewater treatment plants (WWTPs) in developing countries. Thus, based on the possibility of collecting a sufficient amount of primary (i.e., field) data, this study performed an assessment of the potential impacts generated by the WWTP of Quaid-Azam International Hospital in Islamabad (Pakistan) considering its construction and operational phases. The major identified impacts were attributed to the energy mix used to operate the plant. Marine ecotoxicity was the most impactful category (34% of the total potential impacts accounted for), followed by human carcinogenic toxicity (31%), freshwater toxicity (18%), terrestrial ecotoxicity (7%), and human non-carcinogenic toxicity (4%). An analysis of potential impacts was combined with an assessment of potential damage according to an endpoint approach. In particular, the endpoint analysis results indicated that human health damage (quantified as DALY) was mainly dependent on the “fine PM (particulate matter) formation” category (51%), followed by “global warming and human health” (43%). Other categories related to human health impacts were human carcinogenic toxicity (3%), water consumption (2%), and human non-carcinogenic toxicity (1%). The other impact categories recorded a percentage contribution lower than 1%. With respect to ecosystem damage, “global warming and terrestrial ecosystems” played a major role (61%), followed by terrestrial acidification (24%), ozone formation (10%), water consumption (5%), and freshwater eutrophication (1%). This study’s findings support an increase in awareness in the hospital management board while pointing out the need to further implement similar studies to improve the quality of decision-making processes and to mitigate environmental impacts in more vulnerable regions. Finally, this research evidenced the need to overcome the existing general constraints on data availability. Consequently, further field work, supported by hospital managers in developing countries, would help in enhancing managerial procedures; optimizing treatment plant efficiency; and facilitating the implementation of circular options, such as sludge management, that often remain unexplored.

Characteristics of Microplastics in a Hospital Wastewater Treatment Plant Effluent and Hazard Risk Assessment

Characteristics of Microplastics in a Hospital Wastewater Treatment Plant Effluent and Hazard Risk Assessment

Airborne ARGs/MGEs from two sewage types during the COVID-21: Population, microbe interactions, cytotoxicity, formation mechanism, and dispersion

During the COVID-2021 epidemic, a large number of antibiotics were used for clinical treatment in hospitals or daily prevention. Sewage from hospital sewage treatment centers (HSTC) and wastewater treatment plants (WWTP) produced a lot of antibiotic-resistance genes/mobile genetic elements (ARGs/MGEs). In this study, the sewage and bioaerosol in the biochemical tank (BT) of an HSTC and a WWTP were sampled throughout the year. The results showed that the average absolute abundance of sewage in BT of WWTP (BTW-W) was higher than sewage in BT of HSTC (BTW-H). Sewage was an important source of microorganisms and ARGs/MGEs in the air of BT. Microorganisms and MGEs were the factors affecting the differences in ARGs/MGEs. Cytotoxicity experiment proved that the cytotoxicity changed from Grade III to Grade IV with the increase in drug-resistant Escherichia coli concentration. According to the formation mechanism formula, the average generation rate of ARGs/MGEs in BT of HSTC was lower than that in WWTP. The diffusion range of ARGs/MGEs of HSTC was larger than that of WWTP. According to the above results, this study found that when people were far away from BT, the health risk of HSTC caused by the diffusion of bioaerosol was higher than WWTP; When people were close to BT, the health risk of WWTP was higher than HSTC due to the aeration of BT. This study provided a basis for public protection of ARGs. In the future, the elimination of airborne ARGs and crowd protection can be further studied in detail.

Effectiveness of wastewater treatment plant at the removal of nutrients, pathogenic bacteria, and antibiotic-resistant bacteria in wastewater from hospital source.

This study is aimed at assessing the effectiveness of hospital's wastewater treatment plant (WWTP) in removing nutrients, pathogenic bacteria, and addressing antibiotic resistance using a case study of a tertiary hospital in Ibadan, Nigeria. During the dry and wet seasons in the month of July and December, respectively, samples were collected, and analyzed using standard guidelines to examine significant physicochemical parameters of the WTTP; to evaluate the removal efficiency of biological oxygen demand (BOD) and chemical oxygen demand (COD), and to examine the prevalence of pathogenic and antibiotic-resistant bacteria. The results of this study showed that during the dry season, certain parameters exceeded acceptable limits, including temperature, total suspended solids (TSS), total dissolved solids (TDS), phosphate, and nitrate. Although there were reductions in BOD (1555mg/L to 482mg/L) and COD levels (3160mg/L to 972mg/L), they remained above acceptable limits by World Health Organization. In the wet season, the level of COD (20mg/L) in the effluent was within acceptable limit, while the BOD (160mg/L) was above the acceptable limit. The WWTP effectively removed nutrients and reduced the microbial load, as evident from the absence of fecal coliforms in the effluent in both seasons. In respect to BOD removal efficiency, the level of purification of wastewater by the WWTP was 69% during the dry season, while the removal efficiency of COD was 83.54% which showed the efficiency of the WWTP at the removal of COD. However, antibiotic resistance was still present. The study concludes that while the WWTP effectively addressed nutrients and microbial load, additional measures such as tertiary treatment methods like chlorination and UV radiation are necessary to tackle antibiotic resistance. This is crucial to prevent the release of antibiotic-resistant bacteria into the environment, safeguarding human health, animals, plants, and overall environmental well-being.

Investigation of Coronavirus RNA in Hospital Wastewater and Municipal Wastewater Treatment Plants in Ardabil Province

Investigation of Coronavirus RNA in Hospital Wastewater and Municipal Wastewater Treatment Plants in Ardabil Province

Ozone micron bubble pretreatment for antibiotic resistance genes reduction in hospital wastewater treatment

Ozone micron bubble (OMB) treatment offers a promising approach to effectively eliminate Antibiotic Resistance Genes (ARGs) from infectious medical wastewater and mitigate the threat of drug resistance transmission. This study evaluated the effectiveness of OMB treatment for reducing ARGs from infectious medical wastewater in laboratory and on-site pilot treatment setups. In part, the presence of antibiotic residues in a hospital wastewater treatment plant (WWTP) and the impact of hospital wastewater on the distribution of ARGs in a wastewater collection system were also investigated. The results of wastewater collection system survey revealed a high prevalence of ARGs in the system, particularly mcr-1, largely originating from medical wastewater discharges. Furthermore, analysis of antibiotic residues in the hospital wastewater treatment system showed significant accumulation, particularly of quinolone antibiotics, in the biomass of the biological oxidation tank, suggesting a potential risk of ARG proliferation within the system. Comparison of wastewater samples from domestic and hospital WWTPs revealed a relatively higher abundance of ARGs in the latter, with differences ranging from 2.2 to sixfold between corresponding locations in the treatment plants. Notably, the biological oxidation unit of both WWTPs exhibited a greater proportion of ARGs among all sampled points, indicating the potential proliferation of ARGs within the biomass of the treatment units. ARG degradation experiments showed that OMB treatment resulted in a significantly lower CT value (9.3 mg O3 L−1 min) compared to ozone coarse bubble treatment (102 mg O3 L−1 min) under identical test conditions. Moreover, the use of OMB on site significantly reduced the accumulation of ARGs in hospital wastewater, underscoring its potential as an effective solution for mitigating ARG spread.

Interphylum dissemination of NDM-5-positive plasmids in hospital wastewater from Fuzhou, China: a single-centre, culture-independent, plasmid transmission study

The global spread of plasmid-borne carbapenem resistance is an ongoing public health challenge; however, the nature of such horizontal gene transfer events among complex bacterial communities remains poorly understood. We examined the in-situ transfer of the globally dominant New Delhi metallo-β-lactamase (NDM)-5-positive IncX3 plasmid (denoted pX3_NDM-5) in hospital wastewater to simulate a real-world, One Health antimicrobial resistance context. For this transmission study, we tagged pX3_NDM-5 with the green fluorescent protein gene, gfp, using a CRISPR-based method and transferred the plasmid to a donor Escherichia coli strain. Bacteria were extracted from a hospital wastewater treatment plant (Fujian Provincial Maternity and Children's Hospital, Fuzhou, China) as the bacterial recipient community. We mixed this recipient community with the E coli donor strain carrying the gfp-tagged plasmid, both with and without sodium hypochlorite (NaClO) as an environmental stressor, and conducted several culture-based and culture-independent conjugation assays. The conjugation events were observed microscopically and quantified by fluorescence-activated cell sorting. We analysed the taxonomic composition of the sorted transconjugal pool by 16S rRNA gene amplicon sequencing and assessed the stability of the plasmid in the isolated transconjugants and its ability to transfer back to E coli. We show that the plasmid pX3_NDM-5 has a broad host range and can transfer across various bacterial phyla, including between Gram-negative and Gram-positive bacteria. Although environmental stress with NaClO did not affect the overall plasmid transfer frequency, it reduced the breadth of the transconjugant pool. The taxonomic composition of the transconjugal pool was distinct from that of the recipient communities, and environmental stress modulated the permissiveness of some operational taxonomic units towards the acquisition of pX3_NDM-5. Notably, pX3_NDM-5 transconjugants included the Gram-positive pathogen Enterococcus faecalis, and the plasmid could subsequently be reconjugated back to E coli. These findings suggest that E faecalis could act as a natural shuttle vector for the wide dissemination of pX3_NDM-5 plasmids. Our culture-independent conjugation model simulates natural environmental conditions and challenges the established theory that Gram-negative and Gram-positive bacteria rarely exchange clinically important plasmids. The data show that plasmids disseminate more widely across genera and phyla than previously thought. These findings have substantial implications when considering the spread of antimicrobial resistance across One Health sectors. The Laboratory of Lingnan Modern Agriculture Project, the National Natural Science Foundation of China, the Natural Science Foundation of Fujian Province of China, and the Outstanding Young Research Talents Program of Fujian Agriculture and Forestry University.

Presence of blaCTXM-1, blaCTXM-9, and blaTEM-1 Genes in Extended-spectrum β-lactamase-producing Escherichia coli Isolates from Hospital Wastewater

BACKGROUND: Extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) are selectively proliferated in the human gut, excreted through feces, and deposited through wastewater lines, with hospital wastewater acting as a major reservoir of antibiotic resistance genes and resistant bacteria, thus pose adverse effects to human health. This study aimed to determine the presence of blaCTXM-1, blaCTXM-9, blaTEM-1, and blaSHV-1 genes in ESBL-EC in wastewater from selected hospitals in Manila and Quezon City, the Philippines.METHODS: Influent and effluent in twelve hospital wastewater treatment plants were collected, screened for cefotaxime-resistant E. coli, and examined for the ESBL production through phenotypic characterization using conventional bacterial identification, disk diffusion method, and VITEK® 2 Compact system and genotypic identification of ESBL-EC blaCTXM-1, blaCTXM-9, blaTEM-1, blaSHV-1 genes using multiplex polymerase chain reaction (PCR).RESULTS: Conventional bacterial identification methods and the VITEK® 2 Compact system results showed that both influent and effluent samples were positive for ESBL-EC at 33.3% and 16.7%, respectively. Multiplex PCR results revealed that various E. coli isolates were of ESBL-EC blaCTXM-1, blaCTXM-9, and blaTEM-1 genes. Multi-drug resistance was observed among all ESBL-EC isolates with resistance being highest against ampicillin, cefuroxime, ceftazidime, ceftriaxone, cefepime, piperacillin, and aztreonam.CONCLUSION: As the study revealed the presence of ESBL-producing bacteria, efforts must be made to ensure the prudent antimicrobial use with possible emphasis on antibiotic rotation accompanied by intensified infection prevention and control in hospital settings.KEYWORDS: antimicrobial resistance, beta-lactams, blaCTXM, blaTEM, extended-spectrum beta-lactamase, E. coli, hospital wastewater

Are hospital wastewater treatment plants a source of new resistant bacterial strains?

To understand which type of hospital waste may contain the highest amount of antibiotic resistant microorganisms that could be released into the environment, the bacterial strains entering and leaving a hospital wastewater treatment plant (HWTP) were identified and tested for their antibiotic susceptibility. To achieve this goal, samples were collected from three separate sites, inlet and outlet wastewater positions, and sludge generated in a septic tank. After microbiological characterization according to APHA, AWWA, and WEF protocols, the relative susceptibility of the bacterial strains to various antibiotic agents was assessed according to the Clinical and Laboratory Standards Institute guidelines, to determine whether there were higher numbers of resistant bacterial strains in the inlet wastewater sample than in the outlet wastewater and sludge samples. The results showed more antibiotic resistant bacteria in the sludge than in the inlet wastewater, and that the Enterobacteriaceae family was the predominant species in the collected samples. The most antibiotic-resistant families were found to be Streptococcacea and non-Enterobacteriaceae. Some bacterial strains were resistant to all the tested antibiotics. We conclude that the studied HWTP can be considered a source of resistant bacterial strains. It is suggested that outlet water and sludge generated in HWTPs should be monitored, and that efficient treatment to eliminate all bacteria from the different types of hospital waste released into the environment is adopted.

Inhibitory impact of the anticancer drug doxorubicin on anaerobic microbial community

The inhibitory effect of the anticancer drug doxorubicin (DOX) on biogas production was evaluated in short-term and long-term exposure assays. The short-term assays reached the DOX IC50 value on 648 ± 50 µg·L−1. In addition, it was found that inhibition caused by the exposure of 10×103 µg·L−1 was reversible after removing DOX from the feeding synthetic medium. Furthermore, DOX can be rapidly sorbed by the biomass (despite the low Kow), which might contribute to the inhibitory effect. The results of long-term exposure assays, when the DOX volumetric loading rate was increased from 100 µgDOX·L−1·day−1 to 200 µgDOX·L−1·day−1, showed that biogas production and COD removal decreased rapidly. However, the methanogenic Archaeas could recover from this exposure, corroborating the results on short-term exposure assays. In conclusion, DOX can play a key role in inhibiting biological wastewater treatment processes if its concentration in hospital wastewater treatment plants increases abruptly.

Assessment of Wastewater Characteristics of Treatment Units in some Hospitals in the City of Basra

This paper presents the results of the flowing water characteristics from the sanitation system studied in targeted hospitals in the city of Basra, Iraq, in four sites from the 1st of December 2021 to the 1 st of March 2022, including two major sites for government hospitals and two main sites for private hospitals. Statistical analysis of a set of physicochemical water quality parameters of flowing water collected directly from hospitals and water flowing before mixing with public sewage was conducted to investigate the efficiency of a hospital wastewater treatment plant in Basra, Iraq. The study concluded that the operational capacity in the selected treatment stations is commensurate with the hospital’s absorptive capacity and that all stations from different global origins operate as efficiently. The efficiency of removing Al–Saadi Hospital is 44.7% higher than other hospitals (Al–sader teaching, Al Mawanee, and Al–Mawadda) the efficiency of removing was (43.06%, 41.35%, 37.73%) respectively that have been studied. It is necessary to provide government and private hospitals with biological treatment stations to achieve the water environment in a city that suffers from severe pollution of water resources.

Occurrence of Klebsiella pneumoniae ST244 and ST11 extensively drug-resistant producing KPC, NDM, OXA-370 in wastewater, Brazil.

To investigate the occurrence of carbapenem-resistant Klebsiella pneumoniae (CRKP) and their clonal relationships from hospital and municipal wastewater treatment plants (WWTPs). Eighteen K. pneumoniae strains recovered from three WWTPs were identified by MALDI-TOF. The antimicrobial susceptibility were evaluated by disk-diffusion and the carbapenemases production by Carbapenembac®. The carbapenemases genes were investigated by real-time PCR and the clonal relationship through multi-locus sequence typing (MLST). Thirty nine percent (7/18) of isolates were classified as multidrug-resistant (MDR), 61.1% (11/18) extensively drug-resistant (XDR) and 83.3% (15/18) showed carbapenemase activity. Three carbapenemase-encoding genes were found, blaKPC (55%), blaNDM (27.8%) and blaOXA-370 (11.1%) as well five sequencing types ST11, ST37, ST147, ST244 and ST281. ST11 and ST244, sharing four alleles were grouped into clonal complex 11 (CC11). Our results show the importance of monitoring antimicrobial resistance in WWTPs effluents to minimize the risk of spreading bacterial load and ARGs in aquatic ecosystems, using advanced treatment technologies to reduce these emerging pollutants at WWTPs.

Oxidative stress as regulator of neuronal impairment after exposure to hospital effluents in Danio rerio

The variety of activities carried out within hospitals results in their final discharges being considered hotspots for the emission of emerging pollutants. Hospital effluents contain different substances capable of altering the health of ecosystems and biota, furthermore, little research has been done to elucidate the adverse effects of these anthropogenic matrices. Taking this into account, herein we aimed to establish whether exposure to different proportions (2 %, 2.5 %, 3 %, and 3.5 %) of hospital effluent treated by hospital wastewater treatment plant (HWWTP) can induce oxidative stress, behavioral alterations, neurotoxicity, and disruption of gene expression in Danio rerio brain. Our results demonstrate that the hospital effluent under-study induces an anxiety-like state and alters swimming behavior, as fish exhibited increased freezing episodes, erratic movements and traveled less distance than the control group. In addition, after exposure we observed a meaningful rise in biomarkers related to oxidative damage, such as protein carbonyl content (PCC), lipoperoxidation level (LPX), hydroperoxide content (HPC), as well as an increase in enzyme antioxidant activities of catalase (CAT), and superoxide dismutase (SOD) upon short-term exposure. Moreover, we discovered an inhibition of acetylcholinesterase (AChE) activity in a hospital effluent proportion-dependent manner. Regarding gene expression, a significant disruption of genes related to antioxidant response (cat, sod, nrf2), apoptosis (casp6, bax, casp9), and detoxification (cyp1a1) was observed. In conclusion, our outcomes suggest that hospital effluents enhance the emergence of oxidative molecules, and promote a highly oxidative environment at the neuronal level that favors the inhibition of AChE activity, which consequently explains the anxiety-like behavior observed in D. rerio adults. Lastly, our research sheds light on possible toxicodynamic mechanism by which these anthropogenic matrices may trigger damage in D. rerio brain.

A comprehensive approach to how hospital effluents lead to oxidative stress and shift the gene expression in target organs of Danio rerio

Hospital effluents represent a threat to the environment owing to the content of toxic substances capable of altering the structure and function of ecosystems. Despite the available information about the impact of hospital effluents on aquatic organisms, the molecular mechanism underlying this process has received little or no attention. The present study aimed to evaluate the oxidative stress and gene expression induced by different proportions (2 %, 2.5 %, 3 % and 3.5 %) of hospital effluent treated by hospital wastewater treatment plant (HWWTP) in liver, gut, and gills of Danio rerio at different exposure times. Significant increases in the levels of protein carbonylation content (PCC), hydroperoxides content (HPC), lipoperoxidation level (LPX) and superoxide dismutase (SOD) and catalase (CAT) activity were observed in most of the organs evaluated at the four proportions tested with respect to the control group (p < 0.05). It was found that at longer exposure times there is a lower response in SOD activity, suggesting catalytic depletion due to the oxidative environment at the intracellular level. The lack of complementarity between SOD and mRNA activity patterns indicates that the activity itself is subordinated to post-transcriptional processes. Upregulation of transcripts related to antioxidant processes (sod, cat, nrf2), detoxification (cyp1a1) and apoptosis (bax, casp6, and casp9) was observed in response to oxidative imbalance. On the other hand, the metataxonomic approach allowed the characterization of pathogenic bacterial genera such as Legionella, Pseudomonas, Clostridium XI, Parachlamydia and Mycobacterium present in the hospital effluent. Our findings indicate that although hospital effluent was treated by HWWTP, it caused oxidative stress damage and disrupted gene expression by decreasing the antioxidant response in Danio rerio.

Distribution and quantification of antibiotic resistance genes in a large subalpine lake (Lugano Lake) and tributary rivers

Antibiotic resistance genes (ARGs) are causing increasing problems, especially in clinical settings. Nowadays, they are considered important environmental contaminants, but little is known about their fate in the environment or how they affect natural microbial populations. In the environment, especially in water affected by anthropic activities such as discharge of hospital, urban, and industrial wastewater treatment plant (WWTP) and agricultural runoff, antibiotic determinants may become part of the environmental gene pool, spread horizontally, and be ingested by humans and animals via contaminated food and drinking water. The aim of this work was to monitor long-term the presence of antibiotic resistance determinants in water samples collected from a subalpine lake and some tributary rivers located in the southern part of Switzerland, and to assess if anthropic activities could influence the distribution of antibiotic resistance genes present in water environments. We analysed water samples by qPCR to quantify five antibiotic resistance genes that confer resistance to the major classes of antibiotics used in clinical and veterinary settings (β-lactams, macrolides, tetracycline, quinolones, and sulphonamides). Water samples were collected from January 2016 to December 2021, from three rivers located in south Switzerland and from five different sites of Lugano Lake. The most abundant genes were sulII, followed by ermB, qnrS, and tetA; they were found especially in the river influenced by wastewater treatment plants and in the lake near the potable water uptake plant. We observed an overall decrease in the number of resistance genes during the three years. Our results indicate that the aquatic ecosystems monitored in this study are a reservoir of ARGs and could potentially be a setting for the transmission of resistance from the environment to humans.

Antibiotic-resistant bacteria in hospital wastewater treatment plant effluent and the possible consequences of its reuse in agricultural irrigation.

Wastewater from hospitals should be monitored precisely and treated properly before discharge and reuse to avoid epidemic and pandemic complications, as it contains hazardous pollutants for the ecosystem. Antibiotic residues in treated hospital wastewater effluents constitute a major environmental concern since they resist various wastewater treatment processes. The emergence and spread of multi-drug-resistant bacteria, that cause public health problems, are therefore always a major concern. The aims and objectives of this study were mainly to characterize the chemical and microbial properties of the hospital effluent of wastewater treatment plant (WWTP) before discharge to the environment. Special attention was paid to the presence of multiple resistant bacteria and the effects of hospital effluent reuse in irrigation on zucchini as an economically important plant. The risk of cell-free DNA carrying antibiotic resistance genes contained in the hospital effluent as a long-lasting hazard had been discussed. In this study, 21 bacterial strains were isolated from the effluent of a hospital WWTP. Isolated bacteria were evaluated for multi-drug resistance ability against 5 antibiotics (Tetracycline, Ampicillin, Amoxicillin, Chloramphenicol, and Erythromycin) at a concentration of 25 ppm. Out of them, three isolates (AH-03, AH-07, and AH-13) were selected because they recorded the highest growth in presence of tested antibiotics. Selected isolates were identified using 16S rRNA gene sequence homology as Staphylococcus haemolyticus (AH-03), Enterococcus faecalis (AH-07), and Escherichia coli (AH-13). Their susceptibility to ascending concentrations of tested antibiotics indicated that they were all susceptible at a concentration above 50 ppm. Results of the greenhouse experiment regarding the effect of hospital WWTP effluent reuse on zucchini plant fresh weights compared to that irrigated with fresh water indicated that the former recorded a limited increase in total fresh weights (6.2 g and 5.3 g/plant, respectively). Our results demonstrated the low impact of the reuse of Hospital WWTP effluent in agriculture irrigation compared to its greater risk in transferring multiple antibiotic bacteria and antibiotic resistance genes to soil bacteria through natural transformation.