Ciprofloxacin residue and antibiotic-resistant biofilm bacteria in hospital effluent. (July 2016)

• Record Type: Journal Article
• Authors: Ory, Jérôme; Bricheux, Geneviève; Togola, Anne; Bonnet, Jean Louis; Donnadieu-Bernard, Florence; Nakusi, Laurence; Forestier, Christiane; Traore, Ousmane
• Is Part Of: Environmental pollution. Volume 214(2016)
• Page Start: 635
• Page End: 645
• Publication Date: 2016-07
• Subjects: Antibioresistance -- Biofilm -- Effluent hospital -- POCIS -- fluoroquinolones; BOD5 Biochemical Oxygen Demand five days -- CFU Colony Forming Unit -- CIP ciprofloxacin -- COD Chemical Oxygen Demand -- DAPI 4′, 6′-diamidino-2-phenylindole -- DOC Dissolved Organic Carbon -- ESBLs Extended-Spectrum-Beta-Lactamases -- FQs Fluoroquinolones -- HGT Horizontal Gene Transfer -- HQ Hazard Quotient -- IC Inorganic Carbon -- MEC Measured Environmental Concentration -- MIC Minimum Inhibitory Concentration -- NOEC No Observed Effect Concentration -- NT Total Nitrogen -- PEC Predicted Environmental Concentration -- PFGE Pulsed Field Gel Electrophoresis -- PhACs Pharmaceutically Active Compounds -- PI Propidium Iodide -- PMQR Plasmid Mediated Quinolone Resistance -- PNEC Predicted No Effect Concentration -- POCIS Polar Organic Chemical Integrative Samplers -- SEM Scanning Electron Microscopy -- TSS Total Suspended Solid -- TOC Total Organic Carbon -- WWTP Waste Water Treatment Plant; Pollution -- Periodicals; Pollution -- Environmental aspects -- Periodicals; Environmental Pollution -- Periodicals; Pollution -- Périodiques; Pollution -- Aspect de l'environnement -- Périodiques; Pollution -- Effets physiologiques -- Périodiques; Pollution; Pollution -- Environmental aspects; Periodicals; Electronic journals; 363.73
• DOI: 10.1016/j.envpol.2016.04.033
• Languages: English
• ISSNs: 0269-7491

Abstract

Abstract: Discharge of antimicrobial residues and resistant bacteria in hospital effluents is supposed to have strong impacts on the spread of antibiotic resistant bacteria in the environment. This study aimed to characterize the effluents of the Gabriel Montpied teaching hospital, Clermont-Ferrand, France, by simultaneously measuring the concentration of ciprofloxacin and of biological indicators resistant to this molecule in biofilms formed in the hospital effluent and by comparing these data to ciprofloxacin consumption and resistant bacterial isolates of the hospital. Determination of the measured environmental concentration of ciprofloxacin by spot sampling and polar organic chemical integrative (POCIS) sampling over 2 weeks, and comparison with predicted environmental concentrations produced a hazard quotient >1, indicating a potential ecotoxicological risk. A negative impact was also observed with whole hospital effluent samples using the Tetrahymena pyriformis biological model. During the same period, biofilms were formed within the hospital effluent, and analysis of ciprofloxacin-resistant isolates indicated that Gamma-Proteobacteria were numerous, predominantly Aeromonadaceae (69.56%) and Enterobacteriaceae (22.61%). Among the 115 isolates collected, plasmid-mediated fluoroquinolone-resistant genes were detected, with mostly aac(6′)-lb-cr and qnrS . In addition, 60% of the isolates were resistant to up to six antibiotics, including molecules mostly used in the hospital (aminosides and third-generation cephalosporins). In parallel, 1247 bacteria isolated from hospitalized patients and resistant to at least one of the fluoroquinolones were collected. Only 5 of the 14 species identified in the effluent biofilm were also found in the clinical isolates, but PFGE typing of the Gram-negative isolates found in both compartments showed there was no clonality among the strains. Altogether, these data confirm the role of hospital loads as sources of pollution for wastewater and question the role of environmental biofilms communities as efficient shelters for hospital-released resistance genes. Graphical abstract: Highlights: Potential ecotoxicological risk was associated with ciprofloxacin in hospital wastewater. Analysis of biofilms formed within the hospital effluent indicated 41% of damaged cells. Biofilm ciprofloxacin-resistant isolates belonged mostly to Gamma-Proteobacteriae . PMQR were distributed as follows: aac(6′)-lb-cr ( 68.70%), qnrS (40.9%), qnrB (32.17%). There was no clonality between ciprofloxacin-resistant effluent bacteria and clinical isolates. Abstract : Ciprofloxacin and biofilms in hospital effluent.