Occurrence, fate and antibiotic resistance of fluoroquinolone antibacterials in hospital wastewaters in Hanoi, Vietnam.

Occurrence and behavior of fluoroquinolone antibacterial agents (FQs) were investigated in hospital wastewaters in Hanoi, Vietnam. Hospital wastewater in Hanoi is usually not treated and this untreated wastewater is directly discharged into one of the wastewater channels of the city and eventually reaches the ambient aquatic environment. The concentrations of the FQs, ciprofloxacin (CIP) and norfloxacin (NOR) in six hospital wastewaters ranged from 1.1 to 44 and from 0.9 to 17 micrgl(-1), respectively. Total FQ loads to the city sewage system varied from 0.3 to 14 g d(-1). Additionally, the mass flows of CIP and NOR were investigated in the aqueous compartment in a small wastewater treatment facility of one hospital. The results showed that the FQ removal from the wastewater stream was between 80 and 85%, probably due to sorption on sewage sludge. Simultaneously, the numbers of Escherichia coli (E. coli) were measured and their resistance against CIP and NOR was evaluated by determining the minimum inhibitory concentration. Biological treatment lead to a 100-fold reduction in the number of E. coli but still more than a thousand E. coli colonies per 100ml of wastewater effluent reached the receiving water. The highest resistance was found in E. coli strains of raw wastewater and the lowest in isolates of treated wastewater effluent. Thus, wastewater treatment is an efficient barrier to decrease the residual FQ levels and the number of resistant bacteria entering ambient waters. Due to the lack of municipal wastewater treatment plants, the onsite treatment of hospital wastewater before discharging into municipal sewers should be considered as a viable option and consequently implemented.

[1]  G. Feierl,et al.  Antibiotic resistance of E. coli in sewage and sludge. , 2003, Water research.

[2]  E. Michael Thurman,et al.  Response to Comment on “Pharmaceuticals, Hormones, and Other Organic Wastewater Contaminants in U.S. Streams, 1999−2000: A National Reconnaissance” , 2002 .

[3]  A. Alder,et al.  Primary DNA Damage But Not Mutagenicity Correlates with Ciprofloxacin Concentrations in German Hospital Wastewaters , 1999, Archives of environmental contamination and toxicology.

[4]  Ramanan Laxminarayan,et al.  Antimicrobial resistance in developing countries. Part I: recent trends and current status. , 2005, The Lancet. Infectious diseases.

[5]  Mats Tysklind,et al.  Screening of human antibiotic substances and determination of weekly mass flows in five sewage treatment plants in Sweden. , 2005, Environmental science & technology.

[6]  M. Fuerhacker,et al.  Development of an analytical method for the determination of anthracyclines in hospital effluents. , 2006, Chemosphere.

[7]  D. Aga,et al.  Comparison of the occurrence of antibiotics in four full-scale wastewater treatment plants with varying designs and operations. , 2007, Chemosphere.

[8]  G Keck,et al.  Ecotoxicological risk assessment of hospital wastewater: a proposed framework for raw effluents discharging into urban sewer network. , 2005, Journal of hazardous materials.

[9]  Christa S. McArdell,et al.  Occurrence and fate of macrolide antibiotics in wastewater treatment plants and in the Glatt Valley watershed, Switzerland. , 2003, Environmental science & technology.

[10]  K Kümmerer,et al.  Drugs in the environment: emission of drugs, diagnostic aids and disinfectants into wastewater by hospitals in relation to other sources--a review. , 2001, Chemosphere.

[11]  K. Karthikeyan,et al.  Occurrence of antibiotics in wastewater treatment facilities in Wisconsin, USA. , 2006, The Science of the total environment.

[12]  W. Giger,et al.  Environmental exposure assessment of fluoroquinolone antibacterial agents from sewage to soil. , 2003, Environmental science & technology.

[13]  R Hirsch,et al.  Occurrence of antibiotics in the aquatic environment. , 1999, The Science of the total environment.

[14]  Luca Guardabassi,et al.  Antibiotic Resistance in Acinetobacterspp. Isolated from Sewers Receiving Waste Effluent from a Hospital and a Pharmaceutical Plant , 1998, Applied and Environmental Microbiology.

[15]  Christa S. McArdell,et al.  Extraction and determination of sulfonamides, macrolides, and trimethoprim in sewage sludge. , 2005, Journal of chromatography. A.

[16]  Ursula Obst,et al.  Detection of antibiotic-resistant bacteria and their resistance genes in wastewater, surface water, and drinking water biofilms. , 2003, FEMS microbiology ecology.

[17]  Xiu-Sheng Miao,et al.  Occurrence of antimicrobials in the final effluents of wastewater treatment plants in Canada. , 2004, Environmental science & technology.

[18]  Ettore Zuccato,et al.  Strategic Survey of Therapeutic Drugs in the Rivers Po and Lambro in Northern Italy , 2003 .

[19]  S. Chitnis,et al.  Bacterial population changes in hospital effluent treatment plant in central India. , 2004, Water research.

[20]  Ching-Hua Huang,et al.  Simultaneous determination of fluoroquinolone, sulfonamide, and trimethoprim antibiotics in wastewater using tandem solid phase extraction and liquid chromatography-electrospray mass spectrometry. , 2004, Journal of chromatography. A.

[21]  K Kümmerer,et al.  Promoting resistance by the emission of antibiotics from hospitals and households into effluent. , 2003, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[22]  Paul D. Jones,et al.  Determination of fluoroquinolone antibiotics in wastewater effluents by liquid chromatography-mass spectrometry and fluorescence detection. , 2005, Chemosphere.

[23]  Sushil K. Khetan,et al.  Human Pharmaceuticals in the Aquatic Environment: A Challenge to Green Chemistry , 2007 .

[24]  Christa S. McArdell,et al.  Environmental Exposure of Antibiotics in Wastewaters, Sewage Sludges and Surface Waters in Switzerland , 2004 .

[25]  D. Mawhinney,et al.  Occurrence of antibiotics in hospital, residential, and dairy effluent, municipal wastewater, and the Rio Grande in New Mexico. , 2006, The Science of the total environment.

[26]  Adriano Joss,et al.  Removal of pharmaceuticals and fragrances in biological wastewater treatment. , 2005, Water research.

[27]  Mats Tysklind,et al.  Behavior of fluoroquinolones and trimethoprim during mechanical, chemical, and active sludge treatment of sewage water and digestion of sludge. , 2006, Environmental science & technology.

[28]  T. Ternes,et al.  Determination of acidic pharmaceuticals, antibiotics and ivermectin in river sediment using liquid chromatography-tandem mass spectrometry. , 2003, Journal of chromatography. A.

[29]  W. Giger,et al.  Trace determination of fluoroquinolone antibacterial agents in urban wastewater by solid-phase extraction and liquid chromatography with fluorescence detection. , 2001, Analytical chemistry.

[30]  Alfredo C. Alder,et al.  Identification of fluoroquinolone antibiotics as the main source of umuC genotoxicity in native hospital wastewater , 1998 .

[31]  Ursula Obst,et al.  Detection of clinically relevant antibiotic-resistance genes in municipal wastewater using real-time PCR (TaqMan). , 2004, Journal of microbiological methods.

[32]  T. Stenström,et al.  Fluoroquinolone Antibiotics in a Hospital Sewage Line; Occurrence, Distribution and Impact on Bacterial Resistance , 2004, Scandinavian journal of infectious diseases.

[33]  Sushil K. Khetan,et al.  Human pharmaceuticals in the aquatic environment: a challenge to Green Chemistry. , 2007, Chemical reviews.

[34]  Mats Tysklind,et al.  Determination of antibiotic substances in hospital sewage water using solid phase extraction and liquid chromatography/mass spectrometry and group analogue internal standards. , 2004, Chemosphere.

[35]  Adriano Joss,et al.  Fate of sulfonamides, macrolides, and trimethoprim in different wastewater treatment technologies. , 2007, The Science of the total environment.

[36]  Klaus Kümmerer,et al.  Pharmaceuticals in the environment : sources, fate, effects and risks , 2008 .

[37]  E. Thurman,et al.  Pharmaceuticals, hormones, and other organic wastewater contaminants in U.S. streams, 1999-2000: a national reconnaissance. , 2002, Environmental science & technology.

[38]  E. Thurman,et al.  Pharmaceuticals, hormones, and other organic wastewater contaminants in U.S. streams, 1999-2000: a national reconnaissance. , 2002 .

[39]  W. Giger,et al.  Trihalomethane formation by chlorination of ammonium- and bromide-containing groundwater in water supplies of Hanoi, Vietnam. , 2003, Water research.

[40]  Christa S. McArdell,et al.  Consumption and occurrence , 2006 .

[41]  Raimund Haberl,et al.  Two-Stage Constructed Wetland for Treating Hospital Wastewater in Nepal , 1999 .

[42]  N Yamashita,et al.  Removal of antibiotics from wastewater by sewage treatment facilities in Hong Kong and Shenzhen, China. , 2008, Water research.

[43]  Walter Giger,et al.  Environmental exposure and risk assessment of fluoroquinolone antibacterial agents in wastewater and river water of the Glatt Valley Watershed, Switzerland. , 2002, Environmental science & technology.

[44]  Walter Giger,et al.  Occurrence and fate of antibiotics as trace contaminants in wastewaters, sewage sludges, and surface waters , 2003 .

[45]  J. Hacker,et al.  Impact of antibiotics on conjugational resistance gene transfer in Staphylococcus aureus in sewage. , 2003, Environmental microbiology.

[46]  W. Craig,et al.  Quinolone Antibacterials , 1998, Handbook of Experimental Pharmacology.