da Silva Eloísa Stéphanie, Becker Raquel W, Starling Maria Clara V M, Machado Elayne C, Reis Ana Paula V, Aguilar Ananda Pereira, Mendes Tiago Antônio de Oliveira, Sirtori Carla, Amorim Camila C
Research Group on Environmental Applications of Advanced Oxidation Processes (GruPOA), Department of Sanitary and Environmental Engineering, Federal University of Minas Gerais, Av. Antônio Carlos, 6627, Belo Horizonte, Minas Gerais 31270-901, Brazil.
Laboratory of Pesticides Residues Analysis, Federal University of Santa Maria, Av. Roraima, 1000 - Camobi, Santa Maria, RS 97105-000, Brazil.
Sci Total Environ. 2025 Apr 10;973:179132. doi: 10.1016/j.scitotenv.2025.179132. Epub 2025 Mar 18.
Hospital wastewater (HWW) contains pharmaceutical drugs, antibiotic-resistant bacteria (ARB), antibiotic resistance genes (ARG), and pathogens, posing potential risks to environmental and public health. However, data on the occurrence of these contaminants are scarce, especially in low- and middle-income countries. This study employed LC-QTOF MS for a qualitative suspect screening of 1922 pharmaceutical drugs and metabolites in HWW (n = 8 samples). Results were used in an environmental risk assessment applied with the support of in silico tools, to predict potential risks to aquatic organisms. ARB were analyzed using plate count agar method and ARG by Real-time PCR. 113 drugs were identified in HWW, and antibiotics were the most frequently detected (15 compounds). Environmental risk assessment indicated that 29 compounds have the potential to cause toxic effects to aquatic fauna, among which 4 compounds (ampicillin, escitalopram, iopromide, and topiramate) may pose a very high potential risk (RQ > 2). In addition, ARB resistant to azithromycin and cefazolin (10-10 CFU/mL) were abundant in HWW samples, while low levels of bacteria resistant to meropenem (10 CFU/mL) were detected. The relative number of copies of blaKPC, catA1, sul1, ermB, qnrS, vanB, floR, and aadA were higher in HWW from one of the hospitals. However, there was no significant difference for blaOXA (p value = 0.1271) or mecA genes (p value = 0.6077) in HWW samples. These results call attention to potential risks posed by the discharge of HWW and reveal the need to raise data for improving management practices for environmental protection.
医院废水（HWW）含有药物、抗生素抗性细菌（ARB）、抗生素抗性基因（ARG）和病原体，对环境和公众健康构成潜在风险。然而，关于这些污染物存在情况的数据很少，尤其是在低收入和中等收入国家。本研究采用液相色谱-四极杆飞行时间质谱（LC-QTOF MS）对医院废水中的1922种药物和代谢物进行定性可疑物筛查（n = 8个样本）。研究结果用于在计算机工具支持下进行的环境风险评估，以预测对水生生物的潜在风险。采用平板计数琼脂法分析ARB，通过实时聚合酶链反应分析ARG。在医院废水中鉴定出113种药物，其中抗生素是最常检测到的（15种化合物）。环境风险评估表明，29种化合物有可能对水生动物造成毒性影响，其中4种化合物（氨苄西林、艾司西酞普兰、碘普罗胺和托吡酯）可能构成非常高的潜在风险（风险商数RQ > 2）。此外，医院废水样本中对阿奇霉素和头孢唑林耐药的ARB含量丰富（10-10 CFU/mL），而对美罗培南耐药的细菌水平较低（10 CFU/mL）。其中一家医院的医院废水中blaKPC、catA1、sul1、ermB、qnrS、vanB、floR和aadA的相对拷贝数较高。然而，医院废水样本中blaOXA基因（p值 = 0.1271）或mecA基因（p值 = 0.6077）没有显著差异。这些结果提醒人们注意医院废水排放带来的潜在风险，并揭示了提高数据以改进环境保护管理措施的必要性。
