A peek into hospital wastewater: Uncovering hidden risks of antibiotic resistance

Written By Vaish Sundaresan

Antibiotic resistance is a growing global health threat driven by the overuse and improper disposal of antibiotics, particularly in healthcare settings. Hospitals are critical sites where antibiotic resistance can emerge and spread. Wastewater-based epidemiology (WBE) offers a powerful tool to track the rise and spread of antibiotic resistance in the community.

A recent study supported by Digital Health Hub for Antimicrobial Resistance (AMR) and led by a team at Bangor University, including Dr Reshma Silvester and Professor Davey Jones has uncovered significant levels of antibiotic resistance genes and human pathogens in hospital wastewater across Wales. This research highlights the value of WBE combined with advanced metagenomics for tracking AMR and pathogens in healthcare settings. It also emphasises the critical need for improved wastewater treatment in hospitals to prevent the spread of AMR and safeguard public health.

This national-scale study analysed wastewater from hospitals across Wales to identify the types of antibiotic-resistance genes circulating in hospitals. Employing advanced genetic techniques (metagenomics), the research team found that:

  • The levels of antibiotic-resistance genes varied between hospitals. Genes providing resistance to clinically important antibiotics, like beta-lactams, aminoglycosides, and macrolides, were widespread.

  • Many bacterial and fungal pathogens, including some listed as a priority by the World Health Organization (WHO), were present.

  • Alarmingly, levels of some antibiotic residues in the wastewater were high enough to encourage the development of antibiotic resistance in the environment.

Reshma Silvester, Postdoctoral Researcher at Bangor University said: "This research is a key piece of the puzzle in tackling the environmental spread of AMR. Our findings emphasise the urgent need for advanced on-site wastewater treatment in hospitals, particularly near vulnerable coastal and recreational areas, to protect public health. Looking ahead, evaluating the cost-effectiveness and scalability of these technologies will be crucial in developing sustainable solutions to combat AMR."

Read the full paper here: https://www.sciencedirect.com/science/article/pii/S0163445325000970

Vaish Sundaresan
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