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
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Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2024.1525873/full
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author Yaovi Mahuton Gildas Hounmanou
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
author_facet Yaovi Mahuton Gildas Hounmanou
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
author_sort Yaovi Mahuton Gildas Hounmanou
collection DOAJ
description 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.
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spelling doaj-art-41d26dbdcb164f45a24adf44495b35ea2025-01-29T14:46:24ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011210.3389/fpubh.2024.15258731525873Mitigating antimicrobial resistance through effective hospital wastewater management in low- and middle-income countriesYaovi Mahuton Gildas Hounmanou0Yaovi Mahuton Gildas Hounmanou1Adonias Houefonde2I-CRECT ConsortiumTram Thuy Nguyen3Anders Dalsgaard4Linh Viet NguyenTung Xuan NguyenTroung Nhat MyLan Thi LeHuyen Thi VuNgoc Thi Bich HoangDien M. TranThi Anh Mai PhamPhuc D. PhamDennis NurjadiFlavie GoutardThirumalaisamy P. VelavanVan Anh Thi DinhBent JörgensenLe Huu SongNhung T.T. NguyenEtienne LoireÅse ÖstholmLennart E. NilssonTuyet Hanh T. TranPhuc H. PhanMattias LarssonLinus OlsonHåkan HanbergerDepartment of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, DenmarkPolytechnic School of Abomey-Calavi, University of Abomey-Calavi, Abomey-Calavi, BeninPolytechnic School of Abomey-Calavi, University of Abomey-Calavi, Abomey-Calavi, BeninThe National Institute of Hygiene and Epidemiology (NIHE), Hanoi, VietnamDepartment of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, DenmarkHospital 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.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1525873/fullhospital wastewaterantimicrobial resistanceantibiotic-resistant genesantibioticresistant bacteriahospital wastewater management
spellingShingle Yaovi Mahuton Gildas Hounmanou
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
Mitigating antimicrobial resistance through effective hospital wastewater management in low- and middle-income countries
Frontiers in Public Health
hospital wastewater
antimicrobial resistance
antibiotic-resistant genes
antibioticresistant bacteria
hospital wastewater management
title Mitigating antimicrobial resistance through effective hospital wastewater management in low- and middle-income countries
title_full Mitigating antimicrobial resistance through effective hospital wastewater management in low- and middle-income countries
title_fullStr Mitigating antimicrobial resistance through effective hospital wastewater management in low- and middle-income countries
title_full_unstemmed Mitigating antimicrobial resistance through effective hospital wastewater management in low- and middle-income countries
title_short Mitigating antimicrobial resistance through effective hospital wastewater management in low- and middle-income countries
title_sort mitigating antimicrobial resistance through effective hospital wastewater management in low and middle income countries
topic hospital wastewater
antimicrobial resistance
antibiotic-resistant genes
antibioticresistant bacteria
hospital wastewater management
url https://www.frontiersin.org/articles/10.3389/fpubh.2024.1525873/full
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