Hospital Wastewater Research Articles

Clays-based geopolymers: a sustainable application as adsorbent of cytostatic drugs for water purification

The administration of cytostatic drugs in chemotherapy is steadily increasing, triggering thus a risk to the environment. Identifying powerful ways to effectively remove these hazardous pollutants from hospital and effluent wastewater before they discharge into the aquatic environment remains a critical and challenging task. Adsorption is among the most effective ways to treat contaminated water due to the wide availability and selectivity of the adsorbents besides the simplicity and the low start-up costs of the technique. In this work, a geopolymer, elaborated from an illito-kaolinitic clay (Douiret region of Tunisia) and industrial waste (silica fume and phosphogypsum), has been tested as promising decontamination of the cytostatic drugs paclitaxel (PCX) and irinotecan (IRI) from water samples. The foamed geopolymer was characterized using X-ray diffraction, Fourier transform infrared, scanning electron microscopy and thermogravimetric analysis before and after adsorption. Adsorption batch assays were performed using different concentrations of PCX and IRI, contact times and environmental conditions. The geopolymer had an excellent removal efficiency (almost 100% for PCX and 89% for IRI) using 20 mg of adsorbent and 2.5 mg/L of each drug concentration. The characterization results showed that cytostatic drugs were adsorbed to the geopolymer through physical interactions, pore filling, electrostatic attraction and hydrogen bonding. The specific surface area and pore volume of the geopolymer were 82.23 m2/g and 0.19 cm3/g, respectively. In addition to its cost-effective properties, the geopolymer demonstrated excellent efficiency in contaminated natural samples (including influent, effluent wastewater and surface water) denoting a great application for water purification.

Evidence for high-risk pollutants and emerging microbial contaminants at two major bathing ghats of the river Ganga using high-resolution mass spectrometry and metagenomics

An efficient wastewater treatment plant is imperative to limit the entry of emerging pollutants (EPs) and emerging microbial contaminants (EMCs) in the river ecosystem. The detection of emerging EPs in aquatic environments is challenging due to complex sample preparation methods, and the need for sophisticated accurate analytical tools. In Varanasi (India), the river Ganga holds immense significance as a holy river but is consistently polluted with municipal (MWW) and hospital wastewater (HWW). We developed an efficient method for untargeted detection of EPs in the water samples using High-resolution mass spectrometry (HRMS), and identified 577 and 670 chemicals (or chemical components) in the water samples from two major bathing ghats, Assi Ghat (AG) and Dashashwamedh Ghat (DG), respectively. The presence of EPs of different categories viz chemicals from research labs, diagnostic labs, lifestyle and industrial chemicals, toxins, flavor and food additives indicated the unsafe disposal of MWW and HWW or inefficient wastewater treatment plants (WWTPs). Besides, shotgun metagenomic analysis depicted the presence of bacteria associated with MWW viz Cloacibacterium normanse, Sphaerotilus natans (sewage fungi), E. coli, and Prevotella. Also, the presence of human pathogens Arcobacter, Polynucleobacter, Pseudomonas, Klebsiella, Aeromonas, Acinetobacter, Vibrio, and Campylobacter suggests the discharge of HWW. EPs are linked to the development, and transmission of antimicrobial resistance (AMR). Occurrence of antibiotic resistance genes (ARGs), plasmid-borne β-lactamases, aminoglycoside transferases, and ARGs associated with integrons, transposons and plasmids viz mcr-3 gene that confer resistance to colistin, the last resort of antibiotics confirmed the presence of emerging microbial contaminants. Subsequent genome reconstruction studies showed the presence of uncultivable ARB and transmission of ARGs through horizontal gene transfer. This study can be used to monitor the health of aquatic bodies as well as the efficiency of WWTPs and raise an urgent need for efficient WWTPs to safeguard the river, Ganga.

Molecular insights into pilot-scale selective removal of emerging contaminants in hospital wastewater

Advanced oxidation processes (AOPs) are a promising technology for removing emerging organic contaminants (EOCs) from wastewater, while the coexisting dissolved organic matter (DOM) significantly hinders effective oxidative removal of EOCs. Understanding the effects of DOM on EOCs removal in real water matrices is crucial for designing more efficient AOPs. Herein, a pilot-scale integrated in-situ ozonation/ultrafiltration process was conducted to remove EOCs from hospital wastewater. Furthermore, the ozonation reactivity of DOM and EOCs was contrastingly analyzed at the molecular level. Our integrated process selectively removed 85 % of EOCs at a relatively low oxidant dosage of 0.44 mg O3 per mg dissolved organic carbon (DOC). Using Fourier-transform ion cyclotron resonance mass spectrometry (FT-ICR MS), we reveal that ozone selectivity for EOCs arose from their overall reductive characteristics of being more aromatic and unsaturated in molecular composition compared to DOM. Additionally, specific DOM compounds potentially facilitate EOCs removal. This work provides pilot-scale experience in EOCs removal from hospital wastewater and in-depth understanding of DOM’s role in the integrated process, guiding the development of effective AOPs for selective removal of emerging contaminants.

Temporal dynamics of extended-spectrum β-lactamase-producing Escherichia coli and carbapenemase-producing Gram-negative bacteria in hospital wastewater

Hospital wastewater is a reservoir for the environmental spread of clinically relevant antimicrobial-resistant bacteria and resistance genes. The aim of this study was to quantify total Escherichia coli, extended-spectrum β-lactamase (ESBL)-producing E. coli, and carbapenemase-producing organisms (CPOs) and perform whole-genome sequencing-based characterization of these bacterial isolates in hospital wastewater samples collected bimonthly in Japan from January to November 2021. Total E. coli counts were 8.1 × 103–8.8 × 104 colony-forming units (CFU)/mL. ESBL-producing E. coli were detected in the sampling months of January, March, May, and July, with the ratio of ESBL-producing E. coli to total E. coli being remarkably highest (95 %) in July. In contrast, DHA-1 Ambler class C β-lactamase (AmpC)-producing E. coli was detected in September and November, accounting for 28 % and 3 % of total E. coli counts, respectively. All 140 ESBL-producing E. coli isolates harbored the blaCTX-M genes, with blaCTX-M-14 being the most common genotype (94.3 %), the vast majority of which were associated with the human virulent B2-O25b: H4-ST131-fimH30R/non-Rx. In September, E. coli clade I-O8:H33-ST3910-fimH1074 was primarily associated with blaDHA-1. Among 26 representative CPO isolates, Aeromonas caviae (34.6 %) and A. hydrophila subsp. hydrophila (30.8 %) were dominant. The most frequently detected carbapenemase gene was blaIMP-1 (57.7 %), followed by blaGES-24 (34.6 %) and blaGES-4 (7.7 %). Estimated bacterial counts of CPOs ranged from 4.0 × 10−1 to 4.7 × 103 CFU/mL over the six sampling months. blaIMP-1-positive A. hydrophila subsp. hydrophila ST860, which was repeatedly detected over the five sampling months, accounted for the highest total number of this bacterial clone (79 %).Overall, this study provides insights into the overwhelming presence and persistence of E. coli B2-O25b:H4-ST131-H30R/non-Rx with blaCTX-M-14 and Aeromonas spp. with blaIMP-1 in hospital wastewater, and the change in the dynamics of resistance gene prevalence from blaCTX-M-positive E. coli to blaDHA-1-positive E. coli.

An innovative combination of anodic oxidation using Cu/SnO2–Sb2O5 rotating cylinder anode with TiO2 photocatalytic process for treating hospital wastewater

Treatment of hospital wastewater was achieved successfully using a novel combined process composed of an anodic oxidation with Cu/SnO2–Sb2O5 rotating cylinder anode and a photocatalysis process with titanium oxide nanoparticles. Cu/SnO2–Sb2O5 anode and TiO2 nanoparticles were characterized by x-ray diffractometer (XRD) and scanning electron microscopy (SEM). The feasibility of the combined process was evaluated using response surface methodology (RSM). Three operating factors were studied namely current density (10–20 mA/cm2), pH (4–8), and TiO2 dosage (0.3–0.7 g/L). Results showed that current density has the major effect on the COD removal with a contribution percent of 40 %. The optimal conditions were current density of 20 mA/cm2, pH of 4, and TiO2 dosage of 0.7 g/L in which COD removal of 91.2 % was achieved with claiming a total electrical energy (EECT) of 39.41 kWh/ m3. An interesting synergistic effect with a synergy of 21.26 % was recognized in the combined process due to the high productivity of hydroxyl radicals resulting from the interaction between the individual processes. Results confirmed that coupling anodic oxidation with photoctalysis is a promising method for treating hospital wastewater.

More than just the gene: investigating expression using a non-native plasmid and host and its impact on resistance conferred by β-lactamase OXA-58 isolated from a hospital wastewater microbiome.

With the escalation of hospital-acquired infections by multidrug resistant bacteria, understanding antibiotic resistance is of paramount importance. This study focuses on the β-lactamase gene, blaOXA-58, an important resistance determinant identified in a patient-facing hospital wastewater system. This study aimed to characterize the behaviour of the OXA-58 enzyme when expressed using a non-native plasmid and expression host. blaOXA-58 was cloned using a pET28a(+)/Escherichia coli BL21(DE3) expression system. Nitrocefin hydrolysis and antimicrobial susceptibility of OXA-58-producing cells were assessed against penicillin G, ampicillin, meropenem, and amoxicillin. blaOXA-58 conferred resistance to amoxicillin, penicillin G, and ampicillin, but not to meropenem. This was unexpected given OXA-58's annotation as a carbapenemase. The presence of meropenem also reduced nitrocefin hydrolysis, suggesting it acts as a competitive inhibitor of the OXA-58 enzyme. This study elucidates the phenotypic resistance conferred by an antimicrobial resistance gene (ARG) obtained from a clinically relevant setting and reveals that successful functional expression of ARGs is multifaceted. This study challenges the reliability of predicting antimicrobial resistance based solely on gene sequence alone, and serves as a reminder of the intricate interplay between genetics and structural factors in understanding resistance profiles across different host environments.

Whole genome sequencing reveals antibiotic resistance pattern and virulence factors in Klebsiella quasipneumoniae subsp. similipneumoniae from Hospital wastewater in South-West, Nigeria.

Klebsiella quasipneumoniae is a distinct species from K. pneumoniae, even though it is sometimes mistaken phenotypically for the latter in clinical situations. K. quasipneumoniae is a pathogen and this study aims at understanding the genomic antibiotic resistance and virulence characteristics of Klebsiella quasipneumoniae subsp. similipneumoniae (B105 strain) isolated from tertiary hospital wastewater and the potential risks associated with its environmental spread.The Illumina platform was used for whole-genome sequencing (WGS), the generated raw reads (de novo) was assembled using RAPT NCBI, while other standardized bioinformatics tools were utilized to validate and examine the landscape of the genome’s antibiotic resistance and virulence factors. The K. quasipneumoniae subsp. similipneumoniae (B105 strain), belonged to sequence type 1422 and was resistant to ampicillin, amoxicillin-clavulanic acid, ceftazidime, cefepime, meropenem, tetracycline, but susceptible to gentamicin. The annotated genome acknowledged the presence of blaOKP-B-2, ompK 36, fosA5, oqxAB, virulence genes responsible for capsule formation, lipopolysaccharide, iron uptake aerobactin (iutA), salmochelins (iroE, iroN), enterobactin siderophore, efllux pump (acrA, acrB) adherence, (mrkC, mrkD, and fimD) and two plasmids replicon IncFIB(K) and IncR. The study resonates the inadequacy of conventional microbiological identification methods to distinguish K. pneumoniae and K. quasipneumoniae and at the same time heightens the importance of using a genomic platform to extol the identity of K. quasipneumoniae subsp. similipneumoniae strain. Furthermore, the peculiarities of the acquired antimicrobial resistance and virulence genes, in this strain, are a potential risk to the environment.

Selective micropollutants removal in wastewaters by non-radical activation of peroxymonosulfate: Multiparameter analysis of electron-donating capacity

Understanding the electron-donating capacity (EDC) of pollutants in selective advanced oxidation systems is crucial for efficient wastewater decontamination. A novel catalyst, composed of a zeolitic imidazolate framework (ZIF)-derived Co3O4 and carbon nanotubes (CNTs), was synthesized for peroxymonosulfate (PMS) activation. This multiphase PMS activation system efficiently degraded organic pollutants (OPs) with high EDC, indicated by their Hammett constant (σρ) and energy of the highest occupied molecular orbital (EHOMO), achieving a mineralization rate of 83.63 % within 15 min. Singlet oxygen and Co(IV) were identified as the primary reactive species in wastewater decontamination. The electron transfer pathway played a pivotal role in converting Co(II) to Co(IV) and oxidizing OPs. Moreover, the multiphase PMS activation system maintained high activity and selectivity in practical hospital wastewater decontamination. This study offers insights into selective decontamination for complex wastewaters, leveraging the EDC of OPs and the advantages of non-radical-dominated advanced oxidation processes.

N-coordinated iron sites dispersed in porous carbon frameworks to activate peroxymonosulfate for efficient sulfisoxazole degradation and real hospital wastewater decontamination

Herein, an N-coordinated Fe site dispersed in porous carbon frameworks (Fe-NC) fabricated from zeolitic imidazolate frameworks encapsulated with iron acetylacetonate (Fe(acac)3 @ZIFs) was employed to activate peroxymonosulfate (PMS) for the attenuation of sulfisoxazole (SIZ) and treating real hospital wastewater. The constructed Fe-NC/PMS system exhibited good catalytic stability for SIZ degradation, maintaining excellent degradation performance over multiple cycles with virtually no leaching. The quenching experiments, electron paramagnetic resonance (EPR) capture analyses, and semi-quantitative measurements showed that singlet oxygen (1O2) and high-valent metal-oxo species were mainly responsible for SIZ degradation by Fe-NC/PMS. Significantly, ultra-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS/MS) was used to trace 134 pharmaceutical contaminants in real hospital wastewater. Effective degradation was achieved for 87 % of the pharmaceutical contaminants by the Fe-NC/PMS process. Seventy-four pharmaceutical contaminants were eliminated. Taken together, this work successfully established the Fe-NC/PMS technology using the developed iron-based materials and explored its application to real hospital wastewater treatment, providing an eco-friendly and effective strategy for treating wastewater.

Towards geospatially-resolved public-health surveillance via wastewater sequencing

Wastewater is a geospatially- and temporally-linked microbial fingerprint of a given population, making it a potentially valuable tool for tracking public health across locales and time. Here, we integrate targeted and bulk RNA sequencing (N = 2238 samples) to track the viral, bacterial, and functional content over geospatially distinct areas within Miami Dade County, USA, from 2020-2022. We used targeted amplicon sequencing to track diverse SARS-CoV-2 variants across space and time, and we found a tight correspondence with positive PCR tests from University students and Miami-Dade hospital patients. Additionally, in bulk metatranscriptomic data, we demonstrate that the bacterial content of different wastewater sampling locations serving small population sizes can be used to detect putative, host-derived microorganisms that themselves have known associations with human health and diet. We also detect multiple enteric pathogens (e.g., Norovirus) and characterize viral diversity across sites. Moreover, we observed an enrichment of antimicrobial resistance genes (ARGs) in hospital wastewater; antibiotic-specific ARGs correlated to total prescriptions of those same antibiotics (e.g Ampicillin, Gentamicin). Overall, this effort lays the groundwork for systematic characterization of wastewater that can potentially influence public health decision-making.

VIM-1-producing Enterobacter asburiae with mobile colistin resistance genes from wastewaters

BackgroundWastewaters are considered as important players in the spread of antimicrobial resistance, thus affecting the health of humans and animals. Here, we focused on wastewaters as a possible source of carbapenemase-producing Enterobacterales for the environment.MethodsA total of 180 presumptive coliforms from hospital and municipal wastewaters, and a river in the Czech Republic were obtained by selective cultivation on meropenem-supplemented media and tested for presence of carbapenemase-encoding genes by PCR. Strains carrying genes of interest were characterized by testing antimicrobial susceptibility, carbapenemase production and combination of short- and long- read whole-genome sequencing. The phylogenetic tree including publicly available genomes of Enterobacter asburiae was conducted using Prokka, Roary and RAxML.ResultsThree VIM-producing Enterobacter asburiae isolates, members of the Enterobacter cloacae complex, were detected from hospital and municipal wastewaters, and the river. The blaVIM−1 gene was located within a class 1 integron that was carried by different F-type plasmids and one non-typeable plasmid. Furthermore, one of the isolates carried plasmid-borne colistin-resistance gene mcr-10, while in another isolate chromosomally located mcr-9 without colistin resistance phenotype was detected. In addition, the analysis of 685 publicly available E. asburiae genomes showed they frequently carry carbapenemase genes, highlighting the importance of this species in the emergence of resistance to last-line antibiotics.ConclusionOur findings pointed out the important contribution of hospital and community wastewaters in transmission of multi-drug resistant pathogens.

First detection of VEB-1 extended-spectrum β-lactamase-producing Escherichia coli clinical isolate in Japan.

ESBLs are plasmid-mediated enzymes that confer resistance to clinically significant antimicrobial agents, such as broad-spectrum cephalosporins. Recently, the rapid spread of CTX-M-type ESBL-producing E. coli has become a global issue, including in Japan, where ESBL production in human pathogenic E. coli, such as the ExPEC and UPEC lineages, which typically harbor several virulence genes, is a severe public health concern. To date, VEB (Vietnamese extended-spectrum β-lactamase) producers have been found only in hospital wastewater and rivers in Japan. Thus, we describe the first detection of a very rare human-derived blaVEB-1 gene in the E. coli B2-ST95 pandemic clonal lineage that is highly associated with ExPEC and UPEC in a Japanese clinical setting. Furthermore, we characterized the genomic features of plasmids harboring the class 1 integron-borne blaVEB-1. Our findings highlight the significance of closely monitoring ESBL-producing E. coli isolates to prevent the potential dissemination of this resistance determinant in Japan.

Reviewing the Phenomenon of Antimicrobial Resistance in Hospital and Municipal Wastewaters: The Crisis, the Challenges and Mitigation Methods

Antibiotic resistance is a major crisis that the modern world is confronting. This review highlights the abundance of different types of antibiotic resistance genes (ARGs) in two major reservoirs in the environment, namely hospital and municipal wastewater, which is an unforeseen threat to human lives across the globe. The review helps understand the current state of affairs and the whereabouts on the dissemination of ARGs in both these environments. The various traditional wastewater treatment methods, such as chlorination and UV treatment, and modern methods, such as electrochemical oxidation, are discussed, and the gaps in these technologies are highlighted. The need for the development of newer techniques for wastewater treatment with enhanced efficiency is urgently underscored. Nanomaterial applications for ARG removal were observed to be less explored. This has been discussed, and prospective nanomaterials and nanocomposites for these applications are proposed.

To Analysis the Necessity of Advance Sewage Treatment Plant (STP) Waste Management In Primary Health Care Centers (A Review)

The effluent from medical facilities poses a serious risk to human health because of how vulnerable people are to certain diseases. Additionally, the COVID-19 pandemic has called for a global awareness of the need to monitor infections and other resistant organisms in hospital wastewater and remove them. Apart from that, the presence of various resistant organics, pharmaceutically active compounds (PhACs), etc., creates a complicated pollution stack that affects biological systems and water resources. This survey has provided information on the occurrence, persistence, and removal of drug-resistant microbes, infectious diseases, and other micropollutants. The implementation of several pilot/full-scale measures has been evaluated with respect to the removal of pathogens, PhACs, biochemical oxygen demand (BOD), chemical oxygen demand (COD), total suspended solids (TSS), etc. Many organic forms, including constructed wetlands, actuated slime handles, and film bioreactors, were discovered to provide more than 80% evacuation of BOD, COD, TSS, etc. Nevertheless, some stubborn natural toxins are not as amenable to such treatments and necessitate the use of tertiary drugs such adsorption, UV treatment, ozone treatment, and so forth. Following the treatment of clinic wastewater, antibiotic-resistant bacteria and illnesses were discovered to be very persistent, necessitating high dosages of chlorination or UV therapy to render them inactive. This project involves the Govthospital exectting STP supplanted by modern innovation STP.

Risk Assessment of Hospital Waste Water Treatment Plant Operation – A Case Study of a Class B Hospital in Indonesia

Risk Assessment of Hospital Waste Water Treatment Plant Operation – A Case Study of a Class B Hospital in Indonesia

SUITABILITY OF THE HOSPITAL WASTEWATER TREATMENT SYSTEM IN BINH DUONG PROVINCE TO THE ENVIRONMENTAL CARRYING CAPACITY

As the number of healthcare facilities increases, stringent management of wastewater treatment systems becomes imperative. This study investigates a wastewater treatment system designed for a general clinic in Bình Dương Province, Vietnam, which complies with Vietnamese environmental standards. The clinic, located in Bến Cát City, serves approximately 200 patients per day and generates an average wastewater volume of 1.7m³/day. The treatment system, with a capacity of 10m³/day, employs a combination of biological and chemical methods, including anoxic and aerobic processes, to efficiently reduce pollutants. Results indicate that the treated wastewater meets the QCVN 28:2010/BTNMT, column A standards, ensuring minimal environmental impact when discharged into the Thi Tinh River. The study demonstrates the system's effectiveness in managing hospital wastewater, contributing to environmental protection and public health.

Shotgun metagenomic analysis reveals the emergence of plasmid-encoded mcr-5.1 gene in hospital wastewater in Bangladesh

Colistin is considered the last line therapy for treating multidrug-resistant (MDR) bacterial infections in humans. Therefore, the spread of colistin resistance poses a serious threat to human, and environmental health. Though Bangladesh is known as a hotspot of AMR, limited studies have been carried out regarding the status of colistin resistance. Information on the emerging bacterial resistance is inevitable for protecting public health. Nowadays, wastewater analysis has been prioritized for metagenomics-enabled AMR surveillance. Our study on the metagenomic analysis of untreated hospital effluents first detected the colistin resistance-conferring mcr-5.1 gene in the hospital environment of Bangladesh. Phylogenetic tree and in silico AMR analysis confirmed the detection of this mcr-5 variant, which is located in a plasmid contig. The plasmid was untypeable and belonged to the bacteria from the Enterobacteriaceae family. The mcr-5.1 operon was embedded in a Tn3 transposon, suggesting the mobility of the gene. Tnshfr1 transposon, chromate resistance protein ChrB, DNA invertase hin, and two MFS-type proteins were present in the genetic environment of mcr-5.1. Our findings provide evidence of the occurrence of mcr-5.1 in a hospital environment in Bangladesh, which calls for immediate attention and effective measures to contain the dissemination of colistin resistance in the environment.

Antibiotic resistance genes and crAssphage in hospital wastewater and a canal receiving the treatment effluent

Hospital wastewater is a major hotspot for the spread of antimicrobial resistance (AMR) in aquatic ecosystems. This study aimed to investigate the prevalence of antibiotic resistance genes (ARGs) and their correlation with crAssphage in a hospital wastewater treatment plant (HWWTP) and a receiving canal. Water samples were analyzed for 94 ARGs and crAssphage relative to the 16S rRNA using high-throughput quantitative polymerase chain reaction (HT-qPCR). Subsequently, 7 ARGs and crAssphage were selected and quantified using qPCR. The results showed that the detected genes ranged from 79 to 93 out of 95 genes. The raw wastewater (WW) samples had the highest gene diversity compared to the upstream canal, which had less diversity than downstream samples, as determined by HT-qPCR. The blaGES was the most abundant in WW samples, while qacEΔ1, merA, IS6100, tnpA, and IS26 showed high prevalence throughout the treatment processes. The concentrations of intI1, sul1, blaTEM,blaNDM,blaVIM,tetQ, mcr-1, crAssphage, and 16S rRNA, measured using qPCR, were the highest in WW and significantly reduced in treated water samples. Although some water quality parameters, such as total suspended solids and dissolved oxygen, did not significantly differ before and after treatment, removal efficiency ranged from 0.60 to 3.23 log reduction values (LRV). The highest LRV was observed for the tetQ, whereas the mcr-1 had the lowest LRV. Strong positive correlations among the absolute concentrations of ARGs and crAssphage were observed (Spearman's rho = 0.6–1.0), and biochemical oxygen demand correlated with blaTEM and blaVIM (Spearman's rho = 0.6). These results indicate that crAssphage and water quality could reflect the distribution of other ARGs throughout the HWWTP. Further studies are needed to underscore the importance of monitoring ARGs and genetic markers such as crAssphage in HWWTPs and their receiving waters to enhance our understanding of ARG distribution.

Detection of SARS-CoV-2 variants in hospital wastewater in Peru, 2022.

To identify the presence of the SARS-CoV-2 virus in wastewater from hospitals in Peru. Water samples were collected from the effluents of nine hospitals in Peru during March and September 2022. SARS-CoV-2 was identified by using Illumina sequencing. Variant, lineage and clade assignments were carried out using the Illumina and Nextclado tools. We verified whether the SARS-CoV-2 variants obtained from wastewater were similar to those reported by the National Institute of Health of Peru from patients during the same period and region. Eighteen of the 20 hospital wastewater samples (90%) provided sequences of sufficient quality to be classified as the Omicron variant according to the WHO classification. Among them, six (30%) were assigned by Nextclade to clades 21K lineage BA.1.1 (n=1), 21L lineage BA.2 (n=2), and 22B lineages BA.5.1 (n=2) and BA .5.5 (n=1). SARS-CoV-2 variants were found in hospital wastewater samples and were similar to those reported by the surveillance system in patients during the same weeks and geographic areas. Wastewater monitoring could provide information on the environmental and temporal variation of viruses such as SARS-CoV-2.

A review on hazards and treatment methods of released antibiotics in hospitals wastewater during the COVID-19 pandemic.

Drugs and related goods are widely used in order to promote public health and the quality of life. One of the most serious environmental challenges affecting public health is the ongoing presence of antibiotics in the effluents generated by pharmaceutical industries and hospitals. Antibiotics cannot be entirely removed from wastewater using the traditional wastewater treatment methods. Unmetabolized antibiotics generated by humans can be found in urban and livestock effluent. The antibiotic present in effluent contributes to issues with resistance to antibiotics and the creation of superbugs. Over the recent 2years, the coronavirus disease 2019 pandemic has substantially boosted hospital waste volume. In this situation, a detailed literature review was conducted to highlight the harmful effects of untreated hospital waste and outline the best approaches to manage it. Approximately 50 to 70% of the emerging contaminants prevalent in the hospital wastewater can be removed using traditional treatment strategies. This paper emphasizes the numerous treatment approaches for effectively eliminating emerging contaminants and antibiotics from hospital wastewater and provides an overview of global hospital wastewater legislation and guidelines on hospital wastewater administration. Around 90% of ECs might be eliminated by biological or physical treatment techniques when used in conjunction with modern oxidation techniques. According to this research, hybrid methods are the best approach for removing antibiotics and ECs from hospital wastewater. The document outlines the many features of effective hospital waste management and might be helpful during and after the coronavirus disease 2019 outbreak, when waste creation on all hospitals throughout the globe has considerably increased.