Mitigating antimicrobial resistance through effective hospital wastewater management in low- and middle-income countries

Mitigating antimicrobial resistance through effective hospital wastewater management in low- and middle-income countries

Hospital wastewater (HWW) is a significant environmental and public health threat, containing high levels of pollutants such as antibiotic-resistant bacteria (ARB), antibiotic-resistant genes (ARGs), antibiotics, disinfectants, and heavy metals. This threat is of particular concern in low- and middl...

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Main Authors: Yaovi Mahuton Gildas Hounmanou, Adonias Houefonde, I-CRECT Consortium, Tram Thuy Nguyen, Anders Dalsgaard, Linh Viet Nguyen, Tung Xuan Nguyen, Troung Nhat My, Lan Thi Le, Huyen Thi Vu, Ngoc Thi Bich Hoang, Dien M. Tran, Thi Anh Mai Pham, Phuc D. Pham, Dennis Nurjadi, Flavie Goutard, Thirumalaisamy P. Velavan, Van Anh Thi Dinh, Bent Jörgensen, Le Huu Song, Nhung T.T. Nguyen, Etienne Loire, Åse Östholm, Lennart E. Nilsson, Tuyet Hanh T. Tran, Phuc H. Phan, Mattias Larsson, Linus Olson, Håkan Hanberger
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Public Health
Subjects:
hospital wastewater
antimicrobial resistance
antibiotic-resistant genes
antibioticresistant bacteria
hospital wastewater management
Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2024.1525873/full
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Summary:Hospital wastewater (HWW) is a significant environmental and public health threat, containing high levels of pollutants such as antibiotic-resistant bacteria (ARB), antibiotic-resistant genes (ARGs), antibiotics, disinfectants, and heavy metals. This threat is of particular concern in low- and middle-income countries (LMICs), where untreated effluents are often used for irrigating vegetables crops, leading to direct and indirect human exposure. Despite being a potential hotspot for the spread of antimicrobial resistance (AMR), existing HWW treatment systems in LMICs primarily target conventional pollutants and lack effective standards for monitoring the removal of ARB and ARGs. Consequently, untreated or inadequately treated HWW continues to disseminate ARB and ARGs, exacerbating the risk of AMR proliferation. Addressing this requires targeted interventions, including cost-effective treatment solutions, robust AMR monitoring protocols, and policy-driven strategies tailored to LMICs. This perspective calls for a paradigm shift in HWW management in LMIC, emphasizing the broader implementation of onsite treatment systems, which are currently rare. Key recommendations include developing affordable and contextually adaptable technologies for eliminating ARB and ARGs and enforcing local regulations for AMR monitoring and control in wastewater. Addressing these challenges is essential for protecting public health, preventing the environmental spread of resistance, and contributing to a global effort to preserve the efficacy of antibiotics. Recommendations include integrating scalable onsite technologies, leveraging local knowledge, and implementing comprehensive AMR-focused regulatory frameworks.
ISSN:2296-2565

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