摘要

       抗菌素耐药性代表着日益严重的公共卫生威胁，需要全球应对以制定有效的策略并减轻这种现象在临床和环境中的出现和传播。因此，我们调查了几种抗生素和抗生素抗性基因 (ARG) 的出现和丰度，以及位于罗马尼亚克鲁日县不同医院的废水中的细菌群落组成。抗生素浓度介于 3.67 和 53.05 μg L-1 之间，最丰富的抗生素类别是 β-内酰胺类、糖肽类和甲氧苄啶。在检测到的 ARG 中，有 14 个基因对 β-内酰胺类、氨基糖苷类、氯霉素、大环内酯-林可酰胺-链球菌素 B (MLSB) 抗生素、磺胺类和四环素类产生抗性。还检测到编码季铵盐抗性和转座子相关元件的基因。 sulI 和 qacEΔ1 基因赋予对磺胺类和季铵盐的抗性，相对丰度最高，其值范围为 5.33 × 10-2 至 1.94 × 10-1 和 1.94 × 10-2 至 4.89 × 10-2 拷贝/16 rRNA 基因拷贝，分别。在医院废水样本中检测到的优势门是变形菌门、拟杆菌门、厚壁菌门和放线菌门。在选定的医院中，其中一家在将污水排放到市政收集器之前应用了活性污泥和氯消毒过程。这种传统的废水处理显示出对所研究污染物的中等去除效率，抗生素浓度降低了 55-81%，ARGs 的相对丰度降低了 1-3 个数量级，但一些潜在的致病细菌略有增加。鉴于此，医院废水（未经处理的或经过处理的）可能会导致这些新出现的污染物在接收环境中扩散。据我们所知，这项研究首次量化了罗马尼亚不同医院废水中抗生素和 ARG 的含量。

       Antimicrobial resistance represents a growing and significant public health threat, which requires a global response to develop effective strategies and mitigate the emergence and spread of this phenomenon in clinical and environmental settings. We investigated, therefore, the occurrence and abundance of several antibiotics and antibiotic resistance genes (ARGs), as well as bacterial community composition in wastewater effluents from different hospitals located in the Cluj County, Romania. Antibiotic concentrations ranged between 3.67 and 53.05 μg L−1, and the most abundant antibiotic classes were β-lactams, glycopeptides, and trimethoprim. Among the ARGs detected, 14 genes confer resistance to β-lactams, aminoglycosides, chloramphenicol, macrolide-lincosamide-streptogramin B (MLSB) antibiotics, sulfonamides, and tetracyclines. Genes encoding quaternary ammonium resistance and a transposon-related element were also detected. The sulI and qacEΔ1 genes, which confer resistance to sulfonamides and quaternary ammonium, had the highest relative abundance with values ranging from 5.33 × 10−2 to 1.94 × 10−1 and 1.94 × 10−2 to 4.89 × 10−2 copies/16 rRNA gene copies, respectively. The dominant phyla detected in the hospital wastewater samples were Proteobacteria, Bacteroidetes, Firmicutes, and Actinobacteria. Among selected hospitals, one of them applied an activated sludge and chlorine disinfection process before releasing the effluent to the municipal collector. This conventional wastewater treatment showed moderate removal efficiency of the studied pollutants, with a 55–81% decrease in antibiotic concentrations, 1–3 order of magnitude lower relative abundance of ARGs, but with a slight increase of some potentially pathogenic bacteria. Given this, hospital wastewaters (raw or treated) may contribute to the spread of these emerging pollutants in the receiving environments. To the best of our knowledge, this study quantified for the first time the abundance of antibiotics and ARGs in wastewater effluents from different Romanian hospitals.

https://www.sciencedirect.com/science/article/abs/pii/S0269749116324447