摘要
      医院废水往往是抗生素耐药性在环境中传播的热点，因为最近的研究表明，抗生素残留、耐药细菌和耐药基因发生在水生环境中。本研究报告了斯里兰卡医院废水中的抗生素残留、对抗生素有耐药性的细菌以及与抗生素耐药性相关的基因。在选定的抗生素中，AMX（0.001-0.024µg/ml）和AMP（0.001-0.023µg/ml）的浓度在医院废水中最高。抗生素耐药性病原菌，大肠杆菌（31%），葡萄球菌（23%），不动杆菌（23%）。（19%）、链球菌（10%）、假单胞菌
铜绿假单胞菌（8%）、肺炎克雷伯菌（6%）、莫拉克菌（3%）、嗜水气单胞菌（1%）和链霉菌。（1%）被发现为本土细菌，这表明ARGs的风险增加，直接影响公众健康。这项研究的发现表明，在将医院废水排放到自然环境中之前，在现场开发一个特定的处理厂来去除抗生素具有重要意义。因此，有必要开发和应用创新的治疗技术，作为一项国家政策，以保护人们免受沉默杀手的伤害，这些杀手在未来将不再对抗生素敏感，这已被确定为卫生部门的一项挑战。
Abstract
Hospital wastewater tends to be a hotspot for the environmental spread of antibiotic resistance, as recent studies have
shown that antibiotic residues, resistant bacteria, and resistant genes occur in aquatic environments. The present study
reports antibiotic residues, bacteria that are resistant to antibiotics, and genes associated with antibiotic resistance in
hospital wastewater in Sri Lanka. The highest concentration of AMX (0.001-0.024 µg/ml) and AMP (0.001-0.023 µg/ml)
among the selected antibiotics were detected in hospital wastewater effluent. The antibiotic-resistant pathogenic
bacteria, E. coli (31 %), Staphylococcus sp. (23%), Acinetobactersp. (19%), Streptococcus sp. (10%), Pseudomonas
aerugenosa (8%), Klebsiella pneumonia (6%), Moraxella sp. (3%), Aeromonas hydrophila (1%) and Streptomycessp. (1%)
were found as indigenous bacteria which indicate increase the risk of ARGs which directly effect on public health. The
study's findings made apparent the significance of developing a specific treatment plant at the site to remove antibiotics
before discharging hospital wastewater to the natural environment. Therefore, it is necessary to develop and apply
innovative treatment technologies as a national policy to protect people from silent killers who will no longer be
susceptible to antibiotics in the future, which has been identified as a challenge in the health sector.

https://assets.researchsquare.com/files/rs-2258389/v1/90700ca1-b9b0-490e-875f-e4d7929bc6fd.pdf?c=1676024692