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Article

On-Site Pilot Testing of Hospital Wastewater Ozonation to Reduce Pharmaceutical Residues and Antibiotic-Resistant Bacteria

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Uppsala University Hospital, Uppsala County Council, 75185 Uppsala, Sweden
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Zoonosis Science Center, Department of Medical Sciences, Uppsala University, 75185 Uppsala, Sweden
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Department of Chemistry, Umeå University, 90187 Umeå, Sweden
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Uppsala Clinical Research Center, Uppsala University, 75185 Uppsala, Sweden
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Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden
*
Author to whom correspondence should be addressed.
Academic Editor: Jie Fu
Antibiotics 2021, 10(6), 684; https://doi.org/10.3390/antibiotics10060684
Received: 6 May 2021 / Revised: 1 June 2021 / Accepted: 4 June 2021 / Published: 8 June 2021
Hospital sewage constitutes an important point source for antibiotics and antibiotic-resistant bacteria due to the high antibiotic use. Antibiotic resistance can develop and cause problems in sewage systems within hospitals and municipal wastewater treatment plants, thus, interventions to treat hospital sewage on-site are important. Ozonation has proven effective in treating relatively clean wastewater, but the effect on untreated wastewater is unclear. Therefore, we piloted implementation of ozonation to treat wastewater in a tertiary hospital in Uppsala, Sweden. We measured active pharmaceutical ingredients (APIs) using liquid chromatography-mass spectrometry and antibiotic-resistant Enterobacteriaceae using selective culturing pre- and post-ozonation. Comparing low (1 m3/h) and high (2 m3/h) flow, we obtained a ‘dose-dependent’ effect of API reduction (significant reduction of 12/29 APIs using low and 2/29 APIs using high flow, and a mean reduction of antibiotics of 41% using low vs. 6% using high flow, 25% vs. 6% for all APIs). There was no significant difference in the amount of antibiotic-resistant Enterobacteiaceae pre- and post-ozonation. Our results demonstrate that ozonation of untreated wastewater can reduce API content. However, due to the moderate API decrease and numerous practical challenges in the on-site setting, this specific ozonation system is not suitable to implement at full scale in our hospital. View Full-Text
Keywords: antibiotic resistance; API; sewage treatment; drug residues; environment; ozone treatment; pharmaceuticals antibiotic resistance; API; sewage treatment; drug residues; environment; ozone treatment; pharmaceuticals
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MDPI and ACS Style

Svebrant, S.; Spörndly, R.; Lindberg, R.H.; Olsen Sköldstam, T.; Larsson, J.; Öhagen, P.; Söderström Lindström, H.; Järhult, J.D. On-Site Pilot Testing of Hospital Wastewater Ozonation to Reduce Pharmaceutical Residues and Antibiotic-Resistant Bacteria. Antibiotics 2021, 10, 684. https://doi.org/10.3390/antibiotics10060684

AMA Style

Svebrant S, Spörndly R, Lindberg RH, Olsen Sköldstam T, Larsson J, Öhagen P, Söderström Lindström H, Järhult JD. On-Site Pilot Testing of Hospital Wastewater Ozonation to Reduce Pharmaceutical Residues and Antibiotic-Resistant Bacteria. Antibiotics. 2021; 10(6):684. https://doi.org/10.3390/antibiotics10060684

Chicago/Turabian Style

Svebrant, Sofia, Robert Spörndly, Richard H. Lindberg, Therese Olsen Sköldstam, Jim Larsson, Patrik Öhagen, Hanna Söderström Lindström, and Josef D. Järhult. 2021. "On-Site Pilot Testing of Hospital Wastewater Ozonation to Reduce Pharmaceutical Residues and Antibiotic-Resistant Bacteria" Antibiotics 10, no. 6: 684. https://doi.org/10.3390/antibiotics10060684

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