摘要
背景
医院废水（HWW）向污水处理厂（WWTP）注入药物活性化合物（PhAC）和致病菌等污染物的混合物。这种基质被认为对生态系统和生物体具有高度毒性，它可能诱导抗生素耐药性细菌（ARB）的发展和微生物群落中抗生素耐药性基因（ARGs）的转移。传统的污水处理厂无法有效治疗HWW，因为它们的设计并不是为了应对这一挑战。因此，本研究考察了光催化纯化HWW的适用性，包括其生态毒性和对目标物质、选定的致病菌和特定ARGs的去除率。
结果
HWW样品对生物指示剂大型瑞香种群显示出高毒性，同时也含有显著水平的ARB和ARGs。在应用光催化处理后，药物浓度以>80%的速率下降，并且被检测细菌（大肠杆菌、肠球菌、克雷伯菌和葡萄球菌）的去除率>80%。重要的是，光催化后残留的细菌对测试的抗生素敏感。相反，在光催化处理之前和之后，所检测的ARGs以高浓度存在。例如，所选基因，即ampC、sul2、tetA和qnrA，在流出物中的浓度为104至106个基因拷贝 L−1。
结论
光催化可能是一种很有前途的去除HWW中PhAC和致病菌的处理技术。此外，它被证明能够改变治疗后存活的细菌的抗生素耐药性，使其对某些抗生素化合物敏感。然而，关于公共卫生保护的主要担忧仍然存在，因为废水中相当浓度的ARGs可能会在水生环境的细菌群落中引起抗生素耐药性。©2023化学工业协会（SCI）。
Abstract
BACKGROUND
Hospital wastewater (HWW) charges wastewater treatment plants (WWTPs) with a mixture of contaminants such as pharmaceutically active compounds (PhACs) and pathogenic bacteria. This matrix is considered highly toxic to the ecosystem and organisms, and it may induce the development of antibiotic resistant bacteria (ARB) and the transfer of antibiotic resistance genes (ARGs) within microbial communities. Conventional WWTPs cannot treat HWW effectively, because they have not been designed to confront this challenge. Therefore, this study investigated the applicability of photocatalysis to purify HWW, regarding its ecotoxicity and the removal rates of targeted substances, selected pathogenic bacteria and specific ARGs.

RESULTS
The HWW samples showed high toxicity towards the bioindicator Daphnia magna population, while they also contained significant levels of ARB and ARGs. Upon application of the photocatalytic treatment, the pharmaceutical concentrations decreased at a rate of >80% and the removal rates of the examined bacteria (Escherichia coli, Enterococci, Klebsiella sp. and Staphylococcus sp.) were >80%. Importantly, the bacteria remaining after photocatalysis were sensitive to the tested antibiotics. Conversely, the examined ARGs were present in high concentrations before and after photocatalytic treatment. For example, the concentrations of the selected genes, namely ampC, sul2, tetA and qnrA, in the effluents were from 104 to 106 gene copies L−1.

CONCLUSIONS
Photocatalysis may be a promising treatment technique for the elimination of PhACs and pathogenic bacteria from HWW. Moreover, it proved capable of altering the antibiotic resistance profile of the bacteria surviving after treatment, making them sensitive to certain antibiotic compounds. However, the main concern regarding public health protection remains, as the presence of ARGs in effluents in considerable concentrations may induce antibiotic resistance in bacterial communities of aquatic environments. © 2023 Society of Chemical Industry (SCI).

https://onlinelibrary.wiley.com/doi/abs/10.1002/jctb.7329