Impact of easing COVID-19 restrictions on antibiotic usage in Eastern China using wastewater-based epidemiology

Abstract Coronavirus Disease 2019 (COVID-19) emerged in December 2019, prompting the implementation of a “zero-COVID” policy in Mainland China. The easing of this policy in December 2022 led to a surge in COVID cases, which was believed to significantly increase antibiotic usage, potentially due to...

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Main Authors: Jinxin Zang, Lufang Jiang, Yingying Wang, Yue Chen, Chaowei Fu, Barbara Kasprzyk-Hordern, Na Wang, Qingwu Jiang, Helen Lambert
Format: Article
Language:English
Published: Nature Portfolio 2024-11-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-024-54498-2
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author Jinxin Zang
Lufang Jiang
Yingying Wang
Yue Chen
Chaowei Fu
Barbara Kasprzyk-Hordern
Na Wang
Qingwu Jiang
Helen Lambert
author_facet Jinxin Zang
Lufang Jiang
Yingying Wang
Yue Chen
Chaowei Fu
Barbara Kasprzyk-Hordern
Na Wang
Qingwu Jiang
Helen Lambert
author_sort Jinxin Zang
collection DOAJ
description Abstract Coronavirus Disease 2019 (COVID-19) emerged in December 2019, prompting the implementation of a “zero-COVID” policy in Mainland China. The easing of this policy in December 2022 led to a surge in COVID cases, which was believed to significantly increase antibiotic usage, potentially due to antibiotic misuse or increased coinfections. Our study aimed to compare antibiotic consumption and patterns before and after this policy adjustment. We utilised wastewater-based epidemiology (WBE) to analyse antibiotic levels in samples collected from five wastewater treatment plants in Eastern China during January and February of 2021 and 2023. 27 antibiotics were quantified using ultra-high performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry (UPLC-MS/MS) and analysed via WBE, with the resulting estimates compared with catchment-specific prescription data. 23 antibiotics were detected in wastewater samples, with a substantial increase in usage in 2023 (ranging from 531% to 3734%), consistent with prescription data. Here, we show a significant rise in antibiotic consumption during the COVID-19 surge and this underscores the need for further investigation into the impacts of inappropriate antibiotic use in China.
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institution OA Journals
issn 2041-1723
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publishDate 2024-11-01
publisher Nature Portfolio
record_format Article
series Nature Communications
spelling doaj-art-647c2eb7ef9c4dfca99f9160536c50c62025-08-20T02:22:16ZengNature PortfolioNature Communications2041-17232024-11-0115111210.1038/s41467-024-54498-2Impact of easing COVID-19 restrictions on antibiotic usage in Eastern China using wastewater-based epidemiologyJinxin Zang0Lufang Jiang1Yingying Wang2Yue Chen3Chaowei Fu4Barbara Kasprzyk-Hordern5Na Wang6Qingwu Jiang7Helen Lambert8Key Laboratory of Public Health Safety, School of Public Health, Fudan UniversityKey Laboratory of Public Health Safety, School of Public Health, Fudan UniversityKey Laboratory of Public Health Safety, School of Public Health, Fudan UniversitySchool of Epidemiology and Public Health, Faculty of Medicine, University of OttawaKey Laboratory of Public Health Safety, School of Public Health, Fudan UniversityDepartment of Chemistry, Faculty of Science, University of BathKey Laboratory of Public Health Safety, School of Public Health, Fudan UniversityKey Laboratory of Public Health Safety, School of Public Health, Fudan UniversityPopulation Health Sciences, Bristol Medical School, University of BristolAbstract Coronavirus Disease 2019 (COVID-19) emerged in December 2019, prompting the implementation of a “zero-COVID” policy in Mainland China. The easing of this policy in December 2022 led to a surge in COVID cases, which was believed to significantly increase antibiotic usage, potentially due to antibiotic misuse or increased coinfections. Our study aimed to compare antibiotic consumption and patterns before and after this policy adjustment. We utilised wastewater-based epidemiology (WBE) to analyse antibiotic levels in samples collected from five wastewater treatment plants in Eastern China during January and February of 2021 and 2023. 27 antibiotics were quantified using ultra-high performance liquid chromatography coupled with triple quadrupole tandem mass spectrometry (UPLC-MS/MS) and analysed via WBE, with the resulting estimates compared with catchment-specific prescription data. 23 antibiotics were detected in wastewater samples, with a substantial increase in usage in 2023 (ranging from 531% to 3734%), consistent with prescription data. Here, we show a significant rise in antibiotic consumption during the COVID-19 surge and this underscores the need for further investigation into the impacts of inappropriate antibiotic use in China.https://doi.org/10.1038/s41467-024-54498-2
spellingShingle Jinxin Zang
Lufang Jiang
Yingying Wang
Yue Chen
Chaowei Fu
Barbara Kasprzyk-Hordern
Na Wang
Qingwu Jiang
Helen Lambert
Impact of easing COVID-19 restrictions on antibiotic usage in Eastern China using wastewater-based epidemiology
Nature Communications
title Impact of easing COVID-19 restrictions on antibiotic usage in Eastern China using wastewater-based epidemiology
title_full Impact of easing COVID-19 restrictions on antibiotic usage in Eastern China using wastewater-based epidemiology
title_fullStr Impact of easing COVID-19 restrictions on antibiotic usage in Eastern China using wastewater-based epidemiology
title_full_unstemmed Impact of easing COVID-19 restrictions on antibiotic usage in Eastern China using wastewater-based epidemiology
title_short Impact of easing COVID-19 restrictions on antibiotic usage in Eastern China using wastewater-based epidemiology
title_sort impact of easing covid 19 restrictions on antibiotic usage in eastern china using wastewater based epidemiology
url https://doi.org/10.1038/s41467-024-54498-2
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