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Antibiotics, toxic metals and multiresistant bacteria in hospital and urban sewage and their potential impact on receiving water ecosystems

Grant number: 19/18663-2
Support Opportunities:Regular Research Grants
Duration: June 01, 2020 - November 30, 2022
Field of knowledge:Health Sciences - Nursing - Public Health Nursing
Principal Investigator:Susana Segura Muñoz
Grantee:Susana Segura Muñoz
Host Institution: Escola de Enfermagem de Ribeirão Preto (EERP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil


Hospital and urban sewage are considered matrices that pose risks to human and environmental health due to microbiological composition and chemical substances. Among chemical pollutants, antibiotics and toxic metals stand out as multiresistant bacteria selectors due to their antibacterial characteristics. Therefore, they are considered reservoirs of resistant microorganisms, favoring the exchange of resistance mobile genetic elements, as well as facilitating their environmental dissemination. Some metals such as Ag, As, Cd, Cu, Hg, Te and Zn have antibacterial properties and interest as antimicrobials has been resurfacing with increasing bacterial resistance to antibiotics. However, mechanisms of resistance to these metals are already being described, but their epidemiological distribution is not known. Such pollutants can negatively impact receiving water ecosystems and pose risks to their users. The objectives of the present study are to quantify antibiotics and toxic metals and to verify the occurrence of multidrug resistant bacteria (carriers of resistance genes) in hospital sewage, raw and treated urban sewage and in rivers and to evaluate the possible impacts on recipient water ecosystems and risks to the surrounding population. At the tertiary hospital, sewage samples will be collected from outpatient clinics, wards and the confluence of all hospital effluents. At the treatment plant, samples will be collected in the inbox (raw sewage) and after the secondary decanter (treated sewage). Dosages of amoxicillin, ampicillin, cefotaxime, ceftazidime, imipenem, meropenem, ciprofloxacin, gentamicin, sulfamethoxazole, trimetropim and tetracycline antibiotics will be by HPLC and the toxic metals Ag, As, Cd, Cu, Hg, Te and Zn by ICP-MS. Bacterial identification will be by isolation in selective culture media and biochemical kits. Antibiotic susceptibility testing will be performed by disc diffusion on agar and disc tests combined with clavulanic acid and Blue Carba will be used to identify ²-lactamase producing bacteria. Antibiotic and metal resistance genes will be screened by PCR and sequencing. Then, the transferability of resistance genetic elements through conjugation experiments will be evaluated. (AU)

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Scientific publications (4)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
ZAGUI, GUILHERME SGOBBI; MOREIRA, NATALIA COLUMBARO; SANTOS, DANILO VITORINO; PASCHOALATO, CRISTINA FILOMENA PEREIRA ROSA; SIERRA, JORDI; NADAL, MARTI; DOMINGO, JOSE L.; DARINI, ANA LUCIA COSTA; ANDRADE, LEONARDO NEVES; SEGURA-MUNOZ, SUSANA INES. Multidrug-resistant Enterobacter spp. in wastewater and surface water: Molecular characterization of β-lactam resistance and metal tolerance genes. Environmental Research, v. 233, p. 7-pg., . (19/18663-2, 19/05938-3)
ZAGUI, GUILHERME SGOBBI; MOREIRA, NATALIA COLUMBARO; SANTOS, DANILO VITORINO; DARINI, ANA LUCIA COSTA; DOMINGO, JOSE L.; SEGURA-MUNOZ, SUSANA INES; ANDRADE, LEONARDO NEVES. High occurrence of heavy metal tolerance genes in bacteria isolated from wastewater: A new concern?. Environmental Research, v. 196, . (19/05938-3, 19/18663-2)
ZAGUI, GUILHERME SGOBBI; ALMEIDA, OTAVIO GUIHERME GONCALVES DE; MOREIRA, NATALIA COLUMBARO; ABICHALKI, NATHALIA; MACHADO, GABRIEL PINHEIRO; MARTINIS, ELAINE CRISTINA PEREIRA DE; DARINI, ANA LUCIA COSTA; ANDRADE, LEONARDO NEVES; SEGURA-MUNOZ, SUSANA INES. A set of antibiotic-resistance mechanisms and virulence factors in GES-16-producing Klebsiella quasipneumoniae subsp. similipneumoniae from hospital wastewater revealed by whole-genome sequencing. Environmental Pollution, v. 316, p. 8-pg., . (18/13564-3, 19/18663-2, 19/05938-3)
ZAGUI, GUILHERME SGOBBI; ANDRADE, LEONARDO NEVES; SIERRA, JORDI; ROVIRA, JOAQUIM; DARINI, ANA LUCIA COSTA; SEGURA-MUNOZ, SUSANA. Plastisphere as a pathway for antimicrobial-resistant bacteria spread to the environment: New challenge and open questions. Environmental Research, v. 214, p. 3-pg., . (19/18663-2, 19/05938-3)

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