Lien La Thi Quynh, Hoa Nguyen Quynh, Chuc Nguyen Thi Kim, Thoa Nguyen Thi Minh, Phuc Ho Dang, Diwan Vishal, Dat Nguyen Thanh, Tamhankar Ashok J, Lundborg Cecilia Stålsby
Global Health-Health Systems and Policy (HSP), Medicines, Focusing Antibiotics, Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18 A, Stockholm 17177, Sweden.
Department of Pharmaceutical Management and Pharmaco-Economics, Hanoi University of Pharmacy, 13-15 Le Thanh Tong, Hoan Kiem District, Hanoi, Vietnam.
Int J Environ Res Public Health. 2016 Jun 14;13(6):588. doi: 10.3390/ijerph13060588.
Hospital effluents represent an important source for the release of antibiotics and antibiotic resistant bacteria into the environment. This study aims to determine concentrations of various antibiotics in wastewater before and after wastewater treatment in a rural hospital (60 km from the center of Hanoi) and in an urban hospital (in the center of Hanoi) in Vietnam, and it aims to explore the relationship between antibiotic concentrations in wastewater before wastewater treatment and quantities of antibiotics used in the rural hospital, over a period of one year in 2013. Water samples were collected using continuous sampling for 24 h in the last week of every month. The data on quantities of antibiotics delivered to all inpatient wards were collected from the Pharmacy department in the rural hospital. Solid-phase extraction and high performance liquid chromatography-tandem mass spectrometry were used for chemical analysis. Significant concentrations of antibiotics were present in the wastewater both before and after wastewater treatment of both the rural and the urban hospital. Ciprofloxacin was detected at the highest concentrations in the rural hospital's wastewater (before treatment: mean = 42.8 µg/L; after treatment: mean = 21.5 µg/L). Metronidazole was detected at the highest concentrations in the urban hospital's wastewater (before treatment: mean = 36.5 µg/L; after treatment: mean = 14.8 µg/L). A significant correlation between antibiotic concentrations in wastewater before treatment and quantities of antibiotics used in the rural hospital was found for ciprofloxacin (r = 0.78; p = 0.01) and metronidazole (r = 0.99; p < 0.001).
医院污水是抗生素和抗生素耐药菌释放到环境中的一个重要来源。本研究旨在测定越南一家农村医院（距离河内市中心60公里）和一家城市医院（位于河内市中心）污水处理前后废水中各种抗生素的浓度，并探讨2013年为期一年的时间里，农村医院污水处理前废水中抗生素浓度与抗生素使用量之间的关系。每月最后一周采用连续24小时采样的方式采集水样。农村医院药房提供了所有住院病房抗生素使用量的数据。采用固相萃取和高效液相色谱 - 串联质谱法进行化学分析。农村医院和城市医院污水处理前后的废水中均存在显著浓度的抗生素。农村医院废水中检测到环丙沙星的浓度最高（处理前：平均值 = 42.8微克/升；处理后：平均值 = 21.5微克/升）。城市医院废水中检测到甲硝唑的浓度最高（处理前：平均值 = 36.5微克/升；处理后：平均值 = 14.8微克/升）。在农村医院，处理前废水中的抗生素浓度与抗生素使用量之间，环丙沙星（r = 0.78；p = 0.01）和甲硝唑（r = 0.99；p < 0.001）存在显著相关性。
