Occurrence of Pharmaceuticals and Endocrine Disrupting Compounds in Brazilian Water and the Risks They May Represent to Human Health
Abstract
:1. Introduction
2. Materials and Methods
2.1. Assessment of P&EDC of Concern in Brazilian Water
- Data from the pharmaceutical market: pharmaceuticals listed in the Brazilian sales ranking were selected for the P&EDC list. The 20 top-selling pharmaceutical active ingredients and associations of active ingredients in Brazil have been used. These data were obtained from the “2017 Pharmaceutical Market Statistical Yearbook”, made available by the Brazilian Health Regulatory Agency (ANVISA) [52]. For the specific case of antibiotics, which have controlled sales, another data compilation reported by ANVISA was considered [53]. Thus, the six antibiotics most used in Brazil were also selected for the P&EDC list.
- Occurrence in surface, ground, and/or drinking water: by means of an exhaustive literature review, a P&EDC list was built up from compounds quantified in natural and/or drinking water of Brazil. Figure 1 depicts the sampling sites where such studies have been carried out. Furthermore, many foreign data were also collected to enable a comparison of values found in Brazilian studies.
2.2. Estimation of GV for P&EDC in Drinking Water
- (a)
- a factor of 10 to account for response changes within humans (intraspecies variation);
- (b)
- a factor of 10 for the protection of sensitive subgroups as children and infants;
- (c)
- a factor of 10 to account for the fact the LDTD is not a no-effect level, i.e., the approach is similar to applying LOAEL instead of NOAEL.
- (d)
- a factor of 10 to account for interspecies variations, considering the uncertainty of extrapolating data from studies on experimental animals to humans;
- (e)
- a factor of 10 to account for intraspecies variations;
- (f)
- a factor of 10 when using data from a subchronic study (in absence of a chronic study);
- (g)
- a factor of 10 when using LOAEL instead of NOAEL.
- (a)
- an allocation factor of 1.0 was adopted for pharmaceuticals prescribed only to humans, based on the premise that such CEC are not widespread in the environment and, therefore, are unlikely to be found in food;
- (b)
- an allocation factor of 10% of the acceptable daily intake to drinking water (AF = 0.1) was considered for the case of pharmaceuticals used for agricultural or veterinary purposes (some of these may also be prescribed to humans) [33];
- (c)
- an allocation factor of 20% was used (AF = 0.2) for natural estrogen hormones and compounds that mimic them (nonylphenol and octylphenol). This is the same value applied by USEPA [35], which considers that this value may safely ensure ingestion from other sources (e.g., for the case of estrogens, from milk and derivates, meat, etc.).
- (d)
- For bisphenol A, an allocation factor of 60% of the acceptable daily intake (AF = 0.6) was adopted based on a study completed by the European Food Safety Authority (EFSA). From extremely conservative estimates, EFSA [62] indicated that exposure to bisphenol A from diet and other sources (inhalation of dust, dermal contact through cosmetics, etc.) corresponds to approximately 1.35 µg/kg/d, or 34% of the acceptable daily intake of 4.0 µg/kg/d. Thus, it would be possible to admit an allocation factor to drinking water of up to 0.66 for this acceptable daily intake.
2.3. Exposure via Drinking Water Consumption
- ME ≤ 1: CEC found in drinking water at concentrations greater than or equal to the GV and which, therefore, may represent a high risk to human health;
- 1 < ME ≤ 10: compounds found in drinking water at concentrations slightly lower than the GV, which indicates an alert situation since the occurrence is at the same order of magnitude of the concentration that would represent health risks.
- 10 < ME ≤ 100: compounds that are found in drinking water at concentrations below GV up to 2 orders of magnitude, which might be classified as a moderate risk to human health;
- 100 < ME ≤ 1000: compounds that are found in drinking water at concentrations below GV up to 3 orders of magnitude, which might be classified as a low risk to human health;
- ME > 1000: compounds that are found in drinking water at concentrations well below GV (higher than 3 orders of magnitude), which might be classified as a negligible risk to human health.
2.4. Risk of Antibiotics in Inducing Antimicrobial Resistance
Compound | Matrix | Brazil | Other Countries | ||||
---|---|---|---|---|---|---|---|
N | Concentration Range (ng/L) | References | N | Concentration Range (ng/L) | References | ||
Paracetamol/ Acetaminophen 1 | RW | 132 | <0.20–2147.00 | [31,65,66,67,68] | nr | <1.83–43.518 | [1,69,70,71,72,73] |
DW | 121 | <0.20–453.60 | [31,65,66,67,68] | nr | <LD a–7.00 | [69,74] | |
Loratadine 2 | RW | 105 | <1.90–486.00 | [31,65,66,67,68] | nr | <0.03–0.6 | [70,73] |
DW | 104 | <1.90–67.00 | [31,65,66,67,68] | - | - | - | |
Promethazine 2 | RW | 23 | <0.30–77.40 | [31,65,66,67,68] | 1 | <0.2 | [71] |
DW | 20 | <0.30–30.84 | [65,66,67,68] | - | - | - | |
Amoxicillin 3 | RW | 74 | <0.46–8.90 | [31,32] | 31 | <LD | [1] |
DW | 72 | <31.50 | [32] | 21 | <LD | [74] | |
Cefalexin 3 | RW | 2 | <0.64–29.00 | [31] | nr | 283 | [73] |
DW | - | - | - | - | - | - | |
Ciprofloxacin 3 | RW | 2 | <0.41–2.50 | [31] | nr | <LD–1407 | [1,72,73,75,76] |
DW | - | - | - | 25 | <20 | [74,75] | |
Clarithromycin 3 | RW | 72 | <63.50 | [32] | nr | <1.22–9831.5 | [1,69,70,72,73,76] |
DW | 72 | <32.50 | [32] | nr | <LD | [69,74] | |
Enoxacin 3 | RW | 72 | <134.00–386.00 | [32] | nr | < 2250 b | [77] |
DW | 72 | <401.60 | [32] | - | - | - | |
Enrofloxacin 3 | RW | 72 | <11.80–71.00 | [32] | nr | <LD–142.3 | [1,73,76] |
DW | 72 | <5.00–219.00 | [32] | - | - | - | |
Linezolid 3 | RW | 21 | <1.75 | [65,66,67,68] | 19 | <LD–87.6 | [72] |
DW | 20 | <1.75–901.20 | [65,66,67,68] | - | - | - | |
Norfloxacin 3 | RW | 74 | <0.40–285.00 | [31,32] | nr | <6.64–261 | [1,69,70,73,75,76] |
DW | 72 | <39.30–210.00 | [32] | nr | < 20.00 | [69,75] | |
Sulfamethoxazole 3 | RW | 74 | <0.80–1826.30 | [31,65,66,68] | nr | <0.25–1820 | [1,58,69,70,71,72,73,75,76] |
DW | 70 | <1.10–2592.60 | [31,65,66,67,68] | nr | <0.25–1.81 | [58,69,73,74,75] | |
Tetracycline 3 | RW | 2 | <2.50–11.00 | [31] | 21 | < LD | [74] |
DW | - | - | - | - | - | - | |
Trimethoprim 3 | RW | 81 | <0.60–1573.90 | [31,32] | nr | <0.25–176 | [1,58,69,72,75] |
DW | 78 | <0.60–4381.20 | [31,32] | nr | <14 | [58,69,75] | |
Metformin 4 | RW | 138 | <1.39–203.00 | [32,65,66,67,68] | nr | 8.4–3200 | [69,73] |
DW | 138 | <1.39–111.20 | [32,65,66,67,68] | nr | <LD | [69] | |
Fluconazole 5 | RW | 72 | <7.40–1413.00 | [32] | 58 | <0.30–898.8 | [70,72] |
DW | 72 | <8.70–750.00 | [32] | - | - | - | |
Atenolol 6 | RW | 72 | <20.50 | [32] | nr | <0.25–941.1 | [1,58,69,70,71,72,73,78,79] |
DW | 72 | <14.50 | [32] | nr | <0.25–715.00 | [58,73,74,78,79] | |
Diltiazem 6 | RW | 21 | <1.22 | [65,66,67,68] | nr | <LD–6.9 | [73] |
DW | 20 | <1.22 | [65,66,67,68] | - | - | - | |
Losartan 6 | RW | 66 | <1.00–926.00 | [65,66,67,68] | nr | <14.00–620.00 | [69,70,72,73,78] |
DW | 66 | <1.00–576.40 | [65,66,67,68] | nr | <14.00–150.00 | [69,73,78] | |
Propanolol 6 | RW | 66 | <8.30–271.20 | [65,66,67,68] | 85 | <1.1–537 | [1,78] |
DW | 66 | <8.30–6837.00 | [65,66,67,68] | 26 | <1.1–130 | [78] | |
Atorvastatin 7 | RW | 72 | <80.80–1020.00 | [32] | nr | <0.50–530 | [1,58,69,71,73] |
DW | 72 | <25.30–654.00 | [32] | nr | <0.50 | [58,69,74] | |
Bezafibrate 7 | RW | 75 | <71.70–1365.00 | [31,65,66,67,68] | nr | <1.8–256.7 | [1,69,70,73] |
DW | 71 | <2.90–1659.10 | [31,65,66,67,68] | nr | <LD–0.16 | [69,73,74] | |
Gemfibrozil 7 | RW | 202 | <0.30–2032.00 | [31,32,65,66,67,68] | nr | <0.25–210 | [1,58,69,71,73,75] |
DW | 193 | <0.30–2253.00 | [31,32,65,66,67,68] | nr | <0.25–300 | [69,74,75] | |
Triclosan 8 | RW | 20 | <0.70–66.00 | [30,31] | nr | <1.0–102 | [1,58,73,75] |
DW | 100 | <3.00 | [30] | nr | <1.0–1.93 | [58,73,75] | |
Cimetidine 9 | RW | 74 | 2.60–13.90 | [31,32] | 1 | <1.8 | [71] |
DW | 72 | <29.60 | [32] | - | - | - | |
Omeprazole 9 | RW | 72 | <32.00 | [32] | nr | <2.96 | [70,73] |
DW | 72 | <17.80 | [32] | 21 | <LD a | [74] | |
Ranitidine 9 | RW | 74 | 8.30–15.80 | [32] | nr | <5.0–498 | [1,71,73] |
DW | 72 | <26.70 | [32] | - | - | - | |
Acyclovir 10 | RW | 21 | <0.95–220.40 | [65,66,67,68] | 9 | <10 | [80] |
DW | 20 | <0.95–93.08 | [65,66,67,68] | 5 | <10 | [80] | |
Bisphenol A 11 | RW | 166 | <0.03–64,831.00 | [30,31,65,66,67,68] | nr | <0.99–763 | [1,58,73,75,79] |
DW | 227 | <0.03–2549.10 | [30,31,65,66,67,68] | nr | <0.99–683 | [58,72,73,74,75,79] | |
4-Nonylphenol 11 | RW | 145 | <0.10–1918.00 | [30,31,65,66,67,68] | 56 | <2.05–130.00 | [1,58,79] |
DW | 224 | <0.10–2820.00 | [30,31,65,66,67,68] | 27 | <2.05–16 | [74,79] | |
4-Octylphenol 11 | RW | 134 | <0.10–835.10 | [31,65,66,67,68] | nr | <0.66 | [1,69,79] |
DW | 123 | <0.20–276.60 | [31,65,66,67,68] | nr | <0.66 | [69,74,79] | |
17-beta-Estradiol 12 | RW | 146 | <0.25–6806.00 | [31,65,66,67,68] | nr | <0.81–4.04 | [1,73,79] |
DW | 123 | <0.25–43.50 | [31,65,66,67,68] | nr | <0.81 | [74,79] | |
Estriol 12 | RW | 138 | <0.08–67.40 | [30,31,65,66,67,68] | 36 | <4.70–72.00 | [78] |
DW | 221 | <0.08–97.40 | [30,31,65,66,67,68] | 36 | <4.70 | [78] | |
Estrone 12 | RW | 143 | <0.07–279.50 | [30,31,65,66,67,68] | nr | <0.20–130 | [1,58,69,78,79] |
DW | 223 | <0.07–94.80 | [30,31,65,66,67,68] | nr | <0.92 | [58,69,74,78,79] | |
17-alpha- Ethinylestradiol 12 | RW | 153 | <0.39–4390.00 | [30,31,65,66,67,68] | nr | <0.20–3.40 | [1,73,78,79] |
DW | 223 | <0.39–623.00 | [30,31,65,66,67,68] | nr | <2.66 | [74,78,79] | |
Levonorgestrel 13 | RW | 9 | <1.00–663.00 | [30,31] | 39 | <0.42 | [70] |
DW | 100 | <1.00 | [30] | 11 | <0.05–0.7 | [81] | |
Acetylsalicylic acid 14 | RW | 12 | <0.041–15,687.90 | [31] | nr | <LD–1130 | [1,69,73] |
DW | 6 | <0.04–5286.90 | [31] | nr | <LD | [69] | |
Diclofenac 14 | RW | 72 | <0.28–723.20 | [31,65,66,67,68] | nr | <0.25–10,200 | [1,58,69,70,72,73,79,82] |
DW | 59 | <0.28–1405.00 | [31,65,66,67,68] | nr | <0.25–2.37 | [58,69,73,74,79] | |
Ibuprofen 14 | RW | 205 | 0.02–4155.50 | [31,32,65,66,67,68] | nr | <1.96–17,600 | [1,69,71,73,75,79] |
DW | 195 | <0.28–490.20 | [31,32,65,66,67,68] | nr | <18.00 | [69,73,74,75,79] | |
Ketoprofen 14 | RW | 72 | <34.70–1020.00 | [32] | nr | <LD–9220 | [1,69,70,73] |
DW | 72 | <64.60–561.00 | [32] | nr | <LD–40 | [69,73,74] | |
Naproxen 14 | RW | 64 | <0.20–22,408.00 | [31,32,65,66,67,68] | nr | <0.50–59,300 | [1,58,69,73] |
DW | 53 | <0.20–372.632.00 | [32,65,66,67,68] | nr | <LD–3.12 | [58,69,73,74] | |
Betamethasone 15 | RW | 72 | <8.00–11,960.00 | [32] | 17 | 0.29–7.2 | [83] |
DW | 72 | <8.00–2620.00 | [32] | 11 | <0.02–1.0 | [81] | |
Dexamethasone 15 | RW | 79 | <2.86–2159.00 | [65,66,67,68] | nr | <LD–9.7 | [69,73,83] |
DW | 78 | <2.86–2271.00 | [65,66,67,68] | nr | <0.02–< 0.05 | [69,81] | |
Prednisone 15 | RW | 72 | <5.10–8105.00 | [32] | nr | <0.02–1.3 | [69,83] |
DW | 72 | <4.8–6323.00 | [32] | nr | <0.03–0.05 | [69,81] |
3. Results
3.1. Assessment of P&EDC of Concern in Brazilian Water
3.2. Estimation of GV for Selected P&EDC in Drinking Water
3.3. P&EDC Exposure via Drinking Water Consumption
3.4. Antibiotic Resistance Induction in Raw Water
4. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
(aac(3′)-IIa, ant(2″)-Ia) | aminoglycosides resistance genes |
ADI | acceptable daily intake |
AF | allocation factor |
AMI | amikacin |
AMP | ampicillin |
AMX | amoxicillin |
APEO | alkylphenol ethoxylates |
AR | antibiotic resistance |
ARB | antibiotic resistant bacteria |
ARG | antibiotic resistance genes |
ATM | aztreonam |
BET | Betamethasone |
blaTEM, blaIMP4, blaGES and blaNDM1 | β-lactams resistance genes |
BMDL10 | lower limit of critical effect of the benchmark dose |
BPA | bisphenol A |
CAZ | ceftazidime |
CCL | contaminant candidate list |
CEC | contaminants of emerging concern |
CET | ceftriaxone |
CFL | cephalothin |
CFO | cefoxitin |
CFT | cefotaxime |
CFU | colony forming unit |
CIP | ciprofloxacin |
CLA | clavulanic acid |
CLI | clindamycin |
CLO | chloramphenicol |
CPM | cefepime |
DEX | dexamethasone |
DOX | doxycycline |
DW | drinking water (water distributed by a WTP) |
E1 | estrone |
E2 | β-Estradiol |
E2 -17-beta-estradiol | |
EE2 | 17-alpha-ethinylestradiol |
EFSA | European Food Safety Authority |
ERI | erythromycin |
ermB | macrolides resistance gene |
GEN | gentamicin |
GV | guideline values |
IARC | International Agency for Research on Cancer |
intI1, intI2 | integron genes |
IPM | imipenem |
KAN | kanamycin |
LD | limit of detection |
LQ | limit of quantification |
LDTD | lowest daily therapeutic dose |
LEV | levofloxacin |
LOAEL | lowest observable adverse effect level |
MAV | maximum acceptable values |
ME | margin of exposure |
MEC | maximum environmental concentration |
MER | meropenem |
NAL | nalidixic acid |
NIT | nitrofurantoin |
NOAEL | no observed adverse effect level |
NOR | norfloxacin |
NP | nonylphenol |
NPX | naproxen |
OC | occurrence concentration |
PCR | polymerase chain reaction |
P&EDC | pharmaceuticals and endocrine disrupting compounds |
PEN | penicillin |
PIP | piperacillin |
PNEC | predicted no effect concentrations |
PRE | prednisone |
QCRA | Quantitative Chemical Risk Assessment |
qnrS, qepA, gyrA | quinolone resistance genes |
rRNA | ribossomal RNA |
RQ | risk quotient |
RW | raw water (water source that feeds a WTP) |
SMX | sulfamethoxazole |
SPM | spectinomycin |
STM | streptomycin |
SUL | sulfonamides |
sulI | sulfonamide resistance gene |
SUT | sulphazothrin |
TBM | tobramycin |
TET | tetracyclines |
tetA, tetB, tetC, tetM, tetW | tetracycline resistance genes |
TRI | trimethoprim |
TZB | tazobactam |
UF | uncertainty factor |
USEPA | United States Environmental Protection Agency |
VAN | vancomycin |
WHO | World Health Organization |
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Compound | Reason for Selection | Compound | Reason for Selection | ||
---|---|---|---|---|---|
Occurrence in Brazilian Water | Top-Selling in Brazil | Occurrence in Brazilian Water | Top-Selling in Brazil | ||
Acyclovir | x | Gemfibrozil | x | ||
Acetylsalicylic acid | x | Hydrochlorothiazide | x | ||
Albendazole | x | Ibuprofen | x | x | |
Amoxicillin | x | Ketoprofen | x | ||
Atenolol | x | Levonorgestrel | x | x | |
Atorvastatin | x | Levothyroxine | x | ||
Azithromycin | x | Linezolid | x | ||
Amlodipine besilate | x | Loratadine | x | ||
Betamethasone | x | Losartan | x | x | |
Bezafibrate | x | Metformin | x | x | |
Bisphenol A | x | Naproxen | x | ||
Cefalexin | x | x | Nimesulide | x | |
Cimetidine | x | Nonylphenol | x | ||
Ciprofloxacin | x | Norfloxacin | x | ||
Clarithromycin | x | Octylphenol | x | ||
Clonazepam | x | Omeprazole | x | ||
Dexamethasone | x | Paracetamol | x | x | |
Diclofenac | x | x | Prednisone | x | |
Diltiazem | x | Promethazine | x | ||
Dipyrone | x | Propanolol | x | ||
Enalapril | x | Ranitidine | x | ||
Enoxacin | x | Sildenafil | x | ||
Enrofloxacin | x | Simvastatin | x | ||
17- beta-Estradiol | x | Sulfamethoxazole | x | x | |
Estriol | x | Tetracycline | x | x | |
Estrone | x | Triclosan | x | ||
17-alpha-Ethinylestradiol | x | x | Trimethoprim | x | x |
Fluconazole | x |
Compound | ADI (µg/kg bw/d) | GV (µg/L) | Compound | ADI (µg/kg bw/d) | GV (µg/L) | ||
---|---|---|---|---|---|---|---|
1° | 17-alpha-Ethinylestradiol | 0.0001–0.005 | 0.003 a–0.15 | 29° | Trimethoprim | 1.7–191 | 5.0–575 |
2° | Levothyroxine | 0.0002 | 0.006 | 30° | Diltiazem | 2.0 | 60 |
3° | 17- beta-Estradiol | 0.0003 b–0.05 | 0.008–0.30 | 31° | Azithromycin | 3.0–8.3 | 9.0–25 |
4° | Levonorgestrel | 0.0005 | 0.015 | 32° | Cimetidine | 3.3 | 100 |
5° | Dexamethasone | 0.008 | 0.025–0.045 | 33° | Nimesulide | 3.3 | 100 |
6° | Betamethasone | 0.008 | 0.25 | 34° | Bisphenol A | 4.0–50 | 72–900 |
7° | Clonazepam | 0.008 | 0.25 | 35° | Paracetamol | 5.4–50 | 160–1500 |
8° | Estrone | 0.013–0.05 | 0.078 a–0.30 | 36° | Enrofloxacin | 6.2 | 20 |
9° | Enalapril | 0.04–0.23 | 1.3–7.0 | 37° | Enoxacin | 6.7 | 200 |
10° | Prednisone | 0.042 | 0.13 | 38° | Albendazole | 6.7 | 20 |
11° | Estriol | 0.05 | 0.01–0.30 | 39° | Acetylsalicylic acid | 7.2 | 22 |
12° | Amlodipine besilate | 0.08 | 2.5 | 40° | Naproxen | 7.3 | 220 |
13° | Simvastatin | 0.08–0.7 | 2.5–20 | 41° | Metformin | 8.3 | 250 |
14° | Loratadine | 0.17 | 5.0 | 42° | Clarithromycin | 8.3 | 250 |
15° | Atorvastatin | 0.17–6.7 | 5.0–200 | 43° | Dipyrone | 8.3–150 | 25–450 |
16° | Omeprazole | 0.17 | 5.0 | 44° | Sulfamethoxazole | 10–512 | 30–1535 |
17° | Hydrochlorothiazide | 0.21 | 0.6 | 45° | Bezafibrate | 10 | 300 |
18° | Sildenafil | 0.21 | 6.3 | 46° | Cefalexin | 10 | 30 |
19° | Promethazine | 0.33 | 10 | 47° | Acyclovir | 13.3 | 400 |
20° | Losartan | 0.42 | 13 | 48° | Ibuprofen | 13.3 | 400 |
21° | Diclofenac | 0.5–67 | 1.5–200 | 49° | Linezolid | 13.3 | 400 |
22° | Propanolol | 0.5 | 15 | 50° | Norfloxacin | 13.3 | 40 |
23° | Amoxicillin | 0.5 | 1.5 | 51° | Octylphenol | 15 | 90 |
24° | Fluconazole | 0.8 | 25 | 52° | Nonylphenol | 15–50 | 90–300 |
25° | Atenolol | 0.8–2,7 | 25–80 | 53° | Gemfibrozil | 20–31 | 600–930 |
26° | Ketoprofen | 1.0–1.7 | 3.0–5.0 | 54° | Tetracycline | 30 | 90 |
27° | Ranitidine | 1.3 | 38 | 55° | Triclosan | 50–75 | 150–225 |
28° | Ciprofloxacin | 1.6–83 | 4.8–25 |
Target Organism 1 | Location | Phenotypic Antibiotic Resistance (AR) | Genetic Elements | Reference |
---|---|---|---|---|
Escherichia coli | Surface water in agricultural area, Rio de Janeiro (RJ) | 57.7% of isolates were resistant at least to one of the 11 antimicrobials tested: AMI, AMP, CFL, CPM, CFO, CIP, GEN, NIT, NOR, SUT, TRI. | nd | [96] |
Surface water in recreational area, Rio de Janeiro (RJ) | 56.4% of isolates were resistant at least to one of the 11 antimicrobials tested: AMI, AMP, CFL, CPM, CFO, CIP, GEN, NIT, NOR, SUT, TRI. | nd | [96] | |
Patos Lagoon (RS) | 35% of isolates were resistant at least to one of the 17 antimicrobials tested: AMP, CFO, CPM, AMI, GEN, NOR, AMX/CLA, PIP/TZB, ATM, IPM, CAZ, CFT, CLO, TET, TRI/SMX, SUL, STM, SPM. | qacEΔ1, dfrA1, dfrA12, dfrA17, aadA1, aadA5, aadA22. | [97] | |
Belém and Barigui Rivers, Curitiba (PR) | 33% of isolates were resistant to AMX, 28% to SMX, 10% to NOR, 13% to CIP, 3% to DOX. | nd | [98] | |
Fecal coliforms | Drinking and surface water in Morrinhos (GO) | 14.6% of the isolates were resistant to AMP, 7.9% to TET, 3.4% to CIP. | Stable plasmids | [99] |
Staphylococci | Dilúvio River, Porto Alegre (RS) | 37.50% of the isolates were resistant to ERI, 27.27% to PEN, 12.50% to CLI, 6.81% to TRI/SMX, 5.68% to CLO, 2.27% to NOR. | nd | [100] |
Enterococcus spp. | Belém and Barigui Rivers, Curitiba (PR) | 4% of isolates were resistant to CIP, 2% to NOR, 1.7% to VAN, none were resistant to AMX. | nd | [98] |
Rivers from Apucarana City, (PR) | One isolate was resistant to TET; any isolate was resistant to AMP, CIP, ERT, GEN, NOR, TET, VAN. | nd | [101] | |
Pseudomonas | Belém and Barigui Rivers, Curitiba (PR) | No resistance was observed among isolates. | nd | [98] |
Rivers, streams, and lakes from São Paulo | 87% of the isolates were resistant to TET, 78% to CET, 78% to CFT, 74% to CLO, 62% to PIP/TZB, 61% to CAZ, 52% to ATM, 30% to CIP, 30% to LEV, 30% to NOR, 26% to CPM, 13% to IPM, 13% to MER, 9% to GEN and 9% to TBM. | blaGES, qnrS, qepA, tetB, aac(3′)-IIa, and ant(2″)-Ia, no plasmids were found. | [102] | |
Aeromonas | Mineral water, tap water, artesian water | 91% of the isolates were resistant to AMP, 87% to CFL, 52% to CLO, 30% to CFT, 30% to ATM, 26% to GEN, 26% to TET, 26% to TMP/SMX, 17% to NAL and 4% to MER. | nd | [103] |
Cefotazime resistant bacteria (Acinetobacter, Pseudomonas, Klebsiella, and Enterobacter | Bolonha reservoir, Pará | 94.9% of isolates were resistant to three or more classes of antibiotics: 96.2% to ATM, 94.3% to CFT, 90.5% to AMX, 88.6% to AMP, 86.7% to NAL, 75.4% to CFL, 75.4% to CA and 71.6% to AMX/CLA. | blaCTX (28.3%), blaSHV (22.6%), blaTEM (18.8%), blaIMP (15.0%), blaVIM (3.7%). | [104] |
Imipenen resistant bacteria (Acinetobacter, Pseudomonas, Klebsiella, and Enterobacter) | Bolonha reservoir, Pará | 85.7% of isolates were resistant to three or more classes of antibiotics: 88.5% to AMX, 80.3% to ATM, 73.7% to AMP, 63.9% to IPM, 62.3% to CFL, 48% to KAN, 47.6% to NAL and 45.9% to CAZ. | blaVIM (28.8%), blaIMP (22.2%), blaCTX (8.8%), blaKPC (6.6%). | [104] |
Ampicillin resistant bacteria (heterotrophs) | Parnaioca river, Rio de Janeiro | No ampicillin resistant bacteria were isolated from this site. | nd | [105] |
Antibiotic resistance genes | Dilúvio River, Porto Alegre (RS) | nd | SulI: 101–104 gene copies/mL; blaTEM: 101–106 gene copies/mL; ermB: 100–103 gene copies/mL; qnrS: 101–103 gene copies/mL. | [106] |
Prevotella spp., Enterobacter spp., Aeromonas hydrophila, Staphylococcus epidermidis, Serratia marcescens, Erysipelothrix spp., Acinetobacter lwoffii, and Bacteroides fragilis. | Uberabinha River, Uberlândia (MG) | nd | sul2, tetW, ermF blaIMP4, blaNDM1, intI2; tetB, tetC, tetM, and gyrA were dominant with an average level of 1.0 × 102/16S rRNA copies. | [46] |
PNEC (μg/L) 1 | PNEC (ng/L) | Occurrence in Raw (Surface) Water (ng/L) 2 | MEC (ng/L) | RQ 3 | Risk Classification | |
---|---|---|---|---|---|---|
Amoxicillin | 0.25 | 250 | <0.46–8.9 | 8.9 | 0.03 | Low |
Cefaloxin | 4 | 4000 | <0.64–29 | 29 | 0.007 | Low |
Ciprofloxacin | 0.064 | 64 | <0.4–2.5 | 2.5 | 0.04 | Low |
Clarithromycin | 0.25 | 250 | <63.5 | 63.5 | 0.25 | Moderate |
Enoxacin | NA | NA | <134–386 | 386 | NA | NA |
Enrofloxacin | 0.064 | 64 | <11.8–71 | 71 | 1.11 | High |
Linezolide | 8 | 8000 | <1.75 | 1.75 | 0.0002 | Low |
Norfloxacin | 0.5 | 500 | <0.40–285 | 285 | 0.57 | Moderate |
Sulfamethoxazole | 16 | <0.8–1826.3 | 1826.3 | 0.11 | Moderate | |
Tetracycline | 1 | 1000 | <2.5–11 | 11 | 0.01 | Low |
Trimethoprim | 0.5 | 500 | <0.6–1573.9 | 1573.9 | 3.15 | High |
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de Aquino, S.F.; Brandt, E.M.F.; Bottrel, S.E.C.; Gomes, F.B.R.; Silva, S.d.Q. Occurrence of Pharmaceuticals and Endocrine Disrupting Compounds in Brazilian Water and the Risks They May Represent to Human Health. Int. J. Environ. Res. Public Health 2021, 18, 11765. https://doi.org/10.3390/ijerph182211765
de Aquino SF, Brandt EMF, Bottrel SEC, Gomes FBR, Silva SdQ. Occurrence of Pharmaceuticals and Endocrine Disrupting Compounds in Brazilian Water and the Risks They May Represent to Human Health. International Journal of Environmental Research and Public Health. 2021; 18(22):11765. https://doi.org/10.3390/ijerph182211765
Chicago/Turabian Stylede Aquino, Sérgio Francisco, Emanuel Manfred Freire Brandt, Sue Ellen Costa Bottrel, Fernanda Bento Rosa Gomes, and Silvana de Queiroz Silva. 2021. "Occurrence of Pharmaceuticals and Endocrine Disrupting Compounds in Brazilian Water and the Risks They May Represent to Human Health" International Journal of Environmental Research and Public Health 18, no. 22: 11765. https://doi.org/10.3390/ijerph182211765