Impact of health index and hospitals on dissemination of antibiotic resistance in two sewersheds of the third largest metropolitan region of Brazil

Antimicrobial resistance (AMR) stands as a critical threat to global public health. Wastewater-based epidemiology (WBE) provides health data within communities via sewage analysis. This study delved into antibiotic resistance prevalence across two sewersheds in Belo Horizonte, each with distinct hea...

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Main Authors: Henrique Alves Santos, Ana Paula Assad de Carvalho, Juliana Calábria de Araújo
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Cleaner Water
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Online Access:http://www.sciencedirect.com/science/article/pii/S295026322400019X
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author Henrique Alves Santos
Ana Paula Assad de Carvalho
Juliana Calábria de Araújo
author_facet Henrique Alves Santos
Ana Paula Assad de Carvalho
Juliana Calábria de Araújo
author_sort Henrique Alves Santos
collection DOAJ
description Antimicrobial resistance (AMR) stands as a critical threat to global public health. Wastewater-based epidemiology (WBE) provides health data within communities via sewage analysis. This study delved into antibiotic resistance prevalence across two sewersheds in Belo Horizonte, each with distinct health vulnerability indexes (HVI) and number of hospitals. Bacteria resistant (ARB) to amoxicillin, azithromycin, cephalexin, sulfamethoxazole + trimethoprim, meropenem and ARGs (Intl1, sul1, blaTEM, blaKPC) were quantified in sewage from the two sewersheds over the years from 2020 to 2023. Statistical analysis revealed no significant differences in median concentrations of ARBs between sewersheds, except for bacteria resistant to meropenem. ARGs Investigated exhibited similar patterns, with blaKPC showing statistical significant difference. This suggests that hospital density within a sewershed exerts a more pronounced influence on AMR dissemination than HVI. The difference found in meropenem-resistant bacteria, a hospital-prescribed carbapenem, and blaKPC concentrations underscores the impact of hospital antibiotic usage. Thus, the presence and number of hospitals emerges as a pivotal factor in AMR spread, emphasizing the need for specific treatment and management of hospital wastewater to curb antimicrobial resistance.
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spelling doaj-art-aaa392254fff4d339b162418d4dd4a412025-08-20T01:57:55ZengElsevierCleaner Water2950-26322024-12-01210002110.1016/j.clwat.2024.100021Impact of health index and hospitals on dissemination of antibiotic resistance in two sewersheds of the third largest metropolitan region of BrazilHenrique Alves Santos0Ana Paula Assad de Carvalho1Juliana Calábria de Araújo2Federal University of Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, BrazilFederal University of Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, BrazilCorresponding author.; Federal University of Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, BrazilAntimicrobial resistance (AMR) stands as a critical threat to global public health. Wastewater-based epidemiology (WBE) provides health data within communities via sewage analysis. This study delved into antibiotic resistance prevalence across two sewersheds in Belo Horizonte, each with distinct health vulnerability indexes (HVI) and number of hospitals. Bacteria resistant (ARB) to amoxicillin, azithromycin, cephalexin, sulfamethoxazole + trimethoprim, meropenem and ARGs (Intl1, sul1, blaTEM, blaKPC) were quantified in sewage from the two sewersheds over the years from 2020 to 2023. Statistical analysis revealed no significant differences in median concentrations of ARBs between sewersheds, except for bacteria resistant to meropenem. ARGs Investigated exhibited similar patterns, with blaKPC showing statistical significant difference. This suggests that hospital density within a sewershed exerts a more pronounced influence on AMR dissemination than HVI. The difference found in meropenem-resistant bacteria, a hospital-prescribed carbapenem, and blaKPC concentrations underscores the impact of hospital antibiotic usage. Thus, the presence and number of hospitals emerges as a pivotal factor in AMR spread, emphasizing the need for specific treatment and management of hospital wastewater to curb antimicrobial resistance.http://www.sciencedirect.com/science/article/pii/S295026322400019XAntibiotic resistanceWastewater-based epidemiologyAntibiotic resistant bacteriaAntibiotic resistance genesAMR propagationDomestic and hospital sewage
spellingShingle Henrique Alves Santos
Ana Paula Assad de Carvalho
Juliana Calábria de Araújo
Impact of health index and hospitals on dissemination of antibiotic resistance in two sewersheds of the third largest metropolitan region of Brazil
Cleaner Water
Antibiotic resistance
Wastewater-based epidemiology
Antibiotic resistant bacteria
Antibiotic resistance genes
AMR propagation
Domestic and hospital sewage
title Impact of health index and hospitals on dissemination of antibiotic resistance in two sewersheds of the third largest metropolitan region of Brazil
title_full Impact of health index and hospitals on dissemination of antibiotic resistance in two sewersheds of the third largest metropolitan region of Brazil
title_fullStr Impact of health index and hospitals on dissemination of antibiotic resistance in two sewersheds of the third largest metropolitan region of Brazil
title_full_unstemmed Impact of health index and hospitals on dissemination of antibiotic resistance in two sewersheds of the third largest metropolitan region of Brazil
title_short Impact of health index and hospitals on dissemination of antibiotic resistance in two sewersheds of the third largest metropolitan region of Brazil
title_sort impact of health index and hospitals on dissemination of antibiotic resistance in two sewersheds of the third largest metropolitan region of brazil
topic Antibiotic resistance
Wastewater-based epidemiology
Antibiotic resistant bacteria
Antibiotic resistance genes
AMR propagation
Domestic and hospital sewage
url http://www.sciencedirect.com/science/article/pii/S295026322400019X
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