Antibiotics in Wastewater of a Rural and an Urban Hospital before and after Wastewater Treatment, and the Relationship with Antibiotic Use—A One Year Study from Vietnam
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Setting
2.3. Selection of Antibiotics
2.4. Collection of Water Samples and Antibiotic Use Data
2.5. Water Sample Analysis
2.6. Data Management and Statistical Analysis
3. Results
3.1. Antibiotic Residue Levels in Hospital Wastewater
3.2. Relationship between Antibiotic Use and Antibiotic Residues in Hospital Wastewater of the Rural Hospital
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
Abbreviations
LMICs | low- and lower middle-income countries |
MET | Metronidazole |
SUL | Sulfamethoxazole |
TRI | Trimethoprim |
CEF | Ceftazidime |
CIP | Ciprofloxacin |
OFL | Ofloxacin |
SPI | Spiramycin |
WBT | Wastewater before treatment |
WAT | Wastewater after treatment |
µg/L | Microgram per liter |
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Month | Rural Hospital | Urban Hospital | |||||
---|---|---|---|---|---|---|---|
Quantity of Studied ABs Used (g) | WBT (µg/L) | WAT (µg/L) | Difference (%) | WBT (µg/L) | WAT (µg/L) | Difference (%) | |
January | 398.2 | 28.8 | 13.8 | 52.0 | 18.0 | 12.4 | 30.9 |
February | 215.3 | 29.2 | 7.8 | 73.2 | 8.7 | 2.4 | 72.3 |
March | 669.8 | 75.2 | 48.2 | 36.0 | 17.9 | 8.7 | 51.7 |
April | 552.5 | 106.9 | 25.9 | 75.8 | 39.9 | 10.8 | 72.9 |
May | 590.5 | 21.8 | 10.3 | 52.8 | 29.1 | 6.0 | 79.4 |
June | 852.4 | 22.0 | 16.5 | 25.1 | N | N | N |
July | 842.3 | 30.0 | 20.1 | 32.9 | N | N | N |
August | 815.7 | 58.5 | 46.0 | 21.4 | N | N | N |
September | 539.7 | 133.5 | 82.2 | 38.4 | 151.1 | 14.2 | 90.6 |
October | 877.5 | 124.2 | 33.1 | 73.3 | 202.3 | 40.3 | 80.1 |
November | 875.5 | 131.8 | 71.7 | 45.6 | 37.4 | 5.6 | 85.0 |
December | 630.0 | 83.5 | 32.3 | 61.3 | 337.3 | 191.3 | 43.3 |
Mean | 654.9 | 70.5 | 34.0 | 49.0 | 93.5 | 32.4 | 67.3 |
Mean per bed | 3.0 | 0.32 | 0.15 | 0.18 | 0.06 |
Month | MET * | SUL | TRI * | CEF | CIP * | OFL * | SPI * | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
WBT | WAT | WBT | WAT | WBT | WAT | WBT | WAT | WBT | WAT | WBT | WAT | WBT | WAT | |
January | 0.1 | 0.1 | 1.9 | 1.9 | 3.7 | 0.7 | - | - | 18.0 | 9.8 | 3.1 | 0.8 | 2.0 | 0.5 |
February | - | - | 0.4 | 0.2 | 1.2 | 0.1 | - | - | 26.0 | 6.4 | 1.2 | 1.1 | 0.4 | - |
March | 0.2 | - | 2.7 | 2.9 | 4.3 | 0.5 | 11.0 | 5.0 | 56.4 | 39.5 | - | - | 0.7 | 0.4 |
April | 0.2 | 0.2 | 12.2 | 3.7 | 15.5 | 0.8 | 2.8 | 2.6 | 66.0 | 16.2 | 9.4 | 2.0 | 0.8 | 0.2 |
May | 0.2 | - | 3.2 | 3.8 | 3.0 | 0.5 | - | - | 7.9 | 5.6 | 7.1 | - | 0.5 | 0.4 |
June | 1.2 | - | 1.2 | 4.5 | 1.4 | 0.7 | - | - | 17.4 | 11.0 | - | - | 0.9 | 0.3 |
July | 2.1 | 0.2 | 3.7 | 3.4 | 1.8 | 0.5 | - | - | 16.1 | 13.9 | 2.0 | - | 4.3 | 2.2 |
August | - | - | 23.5 | 20.3 | 5.7 | 4.3 | - | - | 26.3 | 19.5 | 3.1 | 2.0 | - | - |
September | 19.9 | 16.4 | 17.2 | 11.0 | 2.8 | 0.9 | - | - | 79.9 | 48.1 | 5.3 | 4.6 | 8.4 | 1.2 |
October | - | - | 25.5 | 11.2 | 19.1 | 5.0 | - | - | 71.5 | 16.3 | 5.2 | - | 2.9 | 0.6 |
November | 6.3 | - | 17.5 | 8.3 | 10.9 | 2.7 | - | - | 87.3 | 53.3 | 9.7 | 7.4 | - | - |
December | 1.0 | - | 9.1 | 5.4 | 22.4 | 1.1 | - | - | 41.3 | 18.7 | 9.7 | 7.1 | - | - |
Total | 31.3 | 16.9 | 118.0 | 76.5 | 91.8 | 17.9 | 13.8 | 7.6 | 514.0 | 258.2 | 55.7 | 25.1 | 20.9 | 5.8 |
Mean | 2.6 | 1.4 | 9.8 | 6.4 | 7.7 | 1.5 | 1.2 | 0.6 | 42.8 | 21.5 | 4.6 | 2.1 | 1.7 | 0.5 |
Average Difference | 46.0% | 35.2% | 80.5% | 45.0% | 49.8% | 54.9% | 72.3% |
Month | MET * | SUL * | TRI * | CEF | CIP * | OFL * | SPI * | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
WBT | WAT | WBT | WAT | WBT | WAT | WBT | WAT | WBT | WAT | WBT | WAT | WBT | WAT | |
January | 0.3 | 0.1 | 0.8 | 1.2 | 0.6 | 0.7 | - | - | 7.5 | 3.1 | 6.9 | 5.7 | 1.9 | 1.7 |
February | - | - | 0.2 | 0.1 | 0.2 | 0.1 | - | - | 1.7 | 0.6 | 2.9 | 1.6 | 3.6 | - |
March | 0.8 | - | 0.9 | 0.3 | 0.4 | 0.2 | - | - | 15.7 | 8.0 | - | - | 0.2 | 0.2 |
April | 0.6 | 0.2 | 0.8 | 0.1 | 5.4 | 0.4 | - | - | 3.6 | 1.4 | 22.8 | 7.3 | 6.7 | 1.5 |
May | 0.2 | 0.2 | 2.7 | 0.1 | 1.9 | 0.4 | - | - | 7.0 | 0.8 | 17.1 | 4.3 | 0.3 | 0.4 |
June | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
July | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
August | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
September | 64.0 | 2.6 | 31.4 | 4.5 | 2.0 | 0.8 | - | - | 30.2 | 4.1 | 21.8 | 2.3 | 1.7 | - |
October | - | - | 19.1 | 18.9 | 8.0 | 7.1 | - | - | 60.3 | 10.3 | 111.1 | 4.1 | 3.7 | - |
November | 4.0 | - | 16.0 | 1.5 | 3.2 | 1.6 | - | - | 5.3 | 2.6 | 8.9 | - | - | - |
December | 258.3 | 130.4 | 15.3 | - | 2.7 | 0.9 | - | - | 40.4 | 40.2 | 20.7 | 19.8 | - | - |
Total | 328.2 | 133.5 | 87.2 | 26.5 | 24.3 | 11.9 | - | - | 171.8 | 71.1 | 212.2 | 45.1 | 18.1 | 3.7 |
Mean | 36.5 | 14.8 | 9.7 | 3.0 | 2.7 | 1.3 | - | - | 19.1 | 7.9 | 23.6 | 5.0 | 2.0 | 0.4 |
Average Difference | 59.3% | 69.6% | 51.3% | - | 58.6% | 78.7% | 79.6% |
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Share and Cite
Lien, L.T.Q.; Hoa, N.Q.; Chuc, N.T.K.; Thoa, N.T.M.; Phuc, H.D.; Diwan, V.; Dat, N.T.; Tamhankar, A.J.; Lundborg, C.S. Antibiotics in Wastewater of a Rural and an Urban Hospital before and after Wastewater Treatment, and the Relationship with Antibiotic Use—A One Year Study from Vietnam. Int. J. Environ. Res. Public Health 2016, 13, 588. https://doi.org/10.3390/ijerph13060588
Lien LTQ, Hoa NQ, Chuc NTK, Thoa NTM, Phuc HD, Diwan V, Dat NT, Tamhankar AJ, Lundborg CS. Antibiotics in Wastewater of a Rural and an Urban Hospital before and after Wastewater Treatment, and the Relationship with Antibiotic Use—A One Year Study from Vietnam. International Journal of Environmental Research and Public Health. 2016; 13(6):588. https://doi.org/10.3390/ijerph13060588
Chicago/Turabian StyleLien, La Thi Quynh, Nguyen Quynh Hoa, Nguyen Thi Kim Chuc, Nguyen Thi Minh Thoa, Ho Dang Phuc, Vishal Diwan, Nguyen Thanh Dat, Ashok J. Tamhankar, and Cecilia Stålsby Lundborg. 2016. "Antibiotics in Wastewater of a Rural and an Urban Hospital before and after Wastewater Treatment, and the Relationship with Antibiotic Use—A One Year Study from Vietnam" International Journal of Environmental Research and Public Health 13, no. 6: 588. https://doi.org/10.3390/ijerph13060588