Institute for Hygiene and Public Health, University Hospital Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany.
Institute for Hygiene and Public Health, University Hospital Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany.
Int J Hyg Environ Health. 2019 Apr;222(3):455-467. doi: 10.1016/j.ijheh.2018.12.013. Epub 2019 Jan 6.
Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference. To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02 μg·L to a maximum of 79 mg·L. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.
抗生素是人类和动物细菌感染治疗中最重要的药物类别之一。由于抗生素耐药性问题日益严重，确保这些物质的抗菌效果已成为公共卫生关注的焦点。减少废水中和环境中的抗生素残留可能对不断增加的抗生素耐药率的发展起到决定性作用。本研究检测了德国 31 间病房的废水，以及五户私人住宅的废水，以寻找可能存在的抗生素残留。据我们所知，这项研究首次表明，在抗生素使用量高的医院，这些药物的残留可以在马桶、水槽虹吸管和淋浴排水道中以 0.02μg·L 至最高 79mg·L 的浓度定期检测到。完全冲洗废水虹吸管后，不再检测到抗生素，但在暂时停滞后，相应虹吸管水相中的活性物质浓度再次增加，表明抗生素通过生物膜中的洗涤过程得以持续存在。本研究表明，临床废水系统为优化抗生素耐药性监测提供了更多的可能性。
