摘要

       本研究定量分析了荷兰两个城市医院和公共废水中的抗生素和抗生素耐药基因（ARG）浓度，以及接收城市污水处理厂（UWWTP）的进水和出水。只有一个城市采用膜生物反应器（MBR）、臭氧氧化、颗粒活性炭（GAC）和紫外处理等先进技术对医院废水进行了现场处理。现场医院废水（HWW）处理降低了接收城市污水处理厂中医院相关抗生素耐药基因的存在和抗生素浓度。这些发现支持了对抗生素耐药基因高危点源进行现场治疗的必要性。采用多重定量实时PCR（qPCR）技术对13个耐药基因、整合酶1级和16srrna进行定量分析，并对711种抗生素的存在和/或浓度进行分析。医院废水中抗生素和基因浓度比公共废水（CWW）高出约25%，约0.4-1.8倍。blaKPC和vanA可被鉴定为医院相关基因，在现场治疗过程中可降至检测限（LOD）以下。与传统的城市污水生物处理（活性污泥）相比，先进的现场处理去除了0.5到3.6倍的基因。先进的现场处理能够消除19种检测到的抗生素中的12种，而城市污水处理则消除了多达1种（在21种检测到的抗生素中）。不同的深度处理技术能够不同程度地针对不同的污染物，使序列比对更加有效。MBR处理对抗生素耐药基因的减少和臭氧氧化对抗生素的减少最为有效。只有在城市污水处理厂接收未经处理的医院废水的进水中才能检测到blaKPC。类似地，在这个处理厂中也只能持续检测到vanA。这些结果表明，医院污水的现场处理对公共污水系统具有积极的作用。

        This study quantified antibiotic and antibiotic resistance gene (ARG) concentrations in hospital and communal wastewaters as well as the influents and effluents of the receiving urban wastewater treatment plants (UWWTP) in two Dutch cities. In only one city, hospital wastewater was treated on-site using advanced technologies, including membrane bioreactor treatment (MBR), ozonation, granulated activated carbon (GAC) and UV-treatment. On-site hospital wastewater (HWW) treatment reduced gene presence of hospital-related antibiotic resistance genes and antibiotic concentrations in the receiving urban wastewater treatment plant. These findings support the need for on-site treatment of high-risk point sources of antibiotic resistance genes. 13 antibiotic resistance genes, Integrase Class 1 and 16S rRNA concentrations were quantified using multiplex quantitative real-time PCR (qPCR) assays and the presence and/or concentration of 711 antibiotics were analyzed. Hospital wastewater contained approximately 25% more antibiotics and gene concentrations between 0.4 log to 1.8-fold higher than communal wastewater (CWW). bla_KPC and vanA could be identified as hospital-related genes and were reduced to under the limit of detection (LOD) during on-site treatment. Advanced on-site treatment removed between 0.5 and 3.6-fold more genes than conventional biological urban wastewater treatment (activated sludge). Advanced on-site treatment was able to eliminate 12 out of 19 detected antibiotics, while urban waste water treatment eliminated up to 1 (out of 21 detected). Different advanced treatment technologies were able to target different pollutants to varying extents, making sequential alignment more effective. MBR treatment was most efficient in antibiotic resistance gene reduction and ozonation in antibiotic reduction. bla_KPC could only be detected in the influent of the urban wastewater treatment plant receiving untreated hospital wastewater. Similarly, vanA was only consistently detected in this treatment plant. These results indicate a positive effect of on-site treatment of hospital wastewater on the communal sewage system.

        https://www.sciencedirect.com/science/article/pii/S1438463918308289?via%3Dihub