摘要
      在没有事先消除病原体和有害污染物的情况下处理医疗废物会对环境和公众健康产生负面影响。这项研究旨在描述完整的微生物群落，并将其与从马来西亚半岛三家不同的废物运营商收集的微波预处理医疗废物中鉴定的抗生素化合物相关联。细菌和真菌成分通过扩增子测序确定，分别靶向全长16S rRNA基因和具有全长ITS1–ITS2区域的部分18S。使用高通量光谱法对抗生素化合物进行了表征。三组样品的细菌和真菌组成存在显著差异，α-（p值=0.04）和β-多样性（p值<0.006和<0.002）分别为。发现FC样品比FA和FV样品获得更多的致病微生物。三组样本中共有Paenibacillus属和未分类的Bacilli属，同时发现了少量的抗生素耐药性细菌奇异变形杆菌、粪肠球菌和粪肠球菌。共发现了19种抗生素化合物，并与医疗废物样本中检测到的微生物丰度有关。主成分分析表明，假单胞菌属、气球菌属、Comamonas属和阴道球菌属的抗生素与细菌呈正相关，而其他细菌与抗生素呈负相关。然而，深入的生物信息学分析证实了blaTEM-1和penP的存在，它们与A类β-内酰胺酶和β-内内酰胺耐药途径的产生有关。微生物和污染物是医疗废物处理评估中的假定指标，它们揭示了使用微波灭菌方法灭活微生物的无效性。我们的研究结果表明，当通过ARGs传播释放到垃圾填埋场时，临床相关微生物、抗生素污染物和相关抗生素耐药性基因（ARGs）的出现代表了环境和人类健康危害。
Abstract
The disposal of healthcare waste without prior elimination of pathogens and hazardous contaminants has negative effects on the environment and public health. This study aimed to profile the complete microbial community and correlate it with the antibiotic compounds identified in microwave pre-treated healthcare wastes collected from three different waste operators in Peninsular Malaysia. The bacterial and fungal compositions were determined via amplicon sequencing by targeting the full-length 16S rRNA gene and partial 18S with full-length ITS1–ITS2 regions, respectively. The antibiotic compounds were characterized using high-throughput spectrometry. There was significant variation in bacterial and fungal composition in three groups of samples, with alpha- (p-value = 0.04) and beta-diversity (p-values <0.006 and < 0.002), respectively. FC samples were found to acquire more pathogenic microorganisms than FA and FV samples. Paenibacillus and unclassified Bacilli genera were shared among three groups of samples, meanwhile, antibiotic-resistant bacteria Proteus mirabilis, Enterococcus faecium, and Enterococcus faecalis were found in modest quantities. A total of 19 antibiotic compounds were discovered and linked with the microbial abundance detected in the healthcare waste samples. The principal component analysis demonstrated a positive antibiotic-bacteria correlation for genera Pseudomonas, Aerococcus, Comamonas, and Vagococcus, while the other bacteria were negatively linked with antibiotics. Nevertheless, deep bioinformatic analysis confirmed the presence of blaTEM-1 and penP which are associated with the production of class A beta-lactamase and beta-lactam resistance pathways. Microorganisms and contaminants, which serve as putative indicators in healthcare waste treatment evaluation revealed the ineffectiveness of microbial inactivation using the microwave sterilization method. Our findings suggested that the occurrence of clinically relevant microorganisms, antibiotic contaminants, and associated antibiotic resistance genes (ARGs) represent environmental and human health hazards when released into landfills via ARGs transmission.

https://www.sciencedirect.com/science/article/pii/S0013935122024665