Toxicological impacts of antibiotics on aquatic micro-organisms: A mini-review

Quinolone antibiotics stimulate bacterial mercury methylation by Geobacter metallireducens GS-15

Bacterial mercury (Hg) methylation is critical for bioremediating Hg pollution, but the impact of emerging antibiotics on this process has rarely been reported. This study innovatively investigated the interactions between Hg-methylating bacteria of Geobacter metallireducens GS-15 and two quinolone antibiotics: lomefloxacin (LOM) and ciprofloxacin (CIP) at 5 μg/L. Short-term LOM exposure increased methylmercury (MeHg) yield by 36 % compared to antibiotic-free conditions, caused by hormesis to alter bioactivities of single GS-15 cells. Long-term CIP exposure led to more antibiotic resistance and mercury tolerance in GS-15 cells, doubling MeHg productivity and significantly increasing expression of Hg methylation (hgcA by 95 folds) and antibiotic resistance (gyrA by 54 folds) genes, while mercury resistance gene merA only increased by 2.5 folds than without selective pressure. These results suggest quinolone antibiotics at environmentally contaminated concentrations stimulate bacterial Hg methylation to form highly toxic MeHg, raising considerable concern for the Hg-antibiotic complex in contaminated environments.

Cyanobacteria mediate the dissemination of bacterial antibiotic resistance through conjugal transfer

Cyanobacterial blooms are expanding world-wide in freshwater and marine environments, and can cause serious ecological and environmental issues, which also contribute to the spread of antibiotic resistance genes (ARGs). However, the mechanistic understanding of cyanobacteria-mediated resistance dynamics is not fully elucidated yet. We selected Microcystis aeruginosa as a model cyanobacteria to illustrate how cyanobacteria mediate the evolution and transfer processes of bacterial antibiotic resistance. The results show that the presence of cyanobacteria significantly decreased the abundance of antibiotic resistant bacteria (ARB) and antibiotic resistant genes (ARGs) by 3%-99% and 2%-18%, respectively. In addition, it clearly altered bacterial community structure, with the dominant genera evolving from Acinetobacter (27%) and Enterobacter (42%) to Porphyrobacter (59%). The abundance of ARGs positively correlated with Proteobacteria and Firmicutes, rather than Cyanobacteria, and Bacteroidetes. In the presence of cyanobacteria, the transfer events of bacterial resistance genes via conjugation were found to decrease by 10%-89% (p < 0.05). Surprisingly, we found an extradentary high transfer frequency (about 0.1) for the ARGs via plasmid conjugation from the bacteria into M. aeruginosa population. It confirmed the role of cyanobacterial population as the competent hosts to facilitate ARGs spreading. Our findings provide valuable information on the risk evaluation of ARGs caused by cyanobacterial blooms in aquatic environments, key for the protection and assessment of aquatic environmental quality.

Drugs in the environment - Impact on plants: A review

Medicines, like food, are necessities. Many of the commonly used pharmaceuticals, especially antibiotics and NSAIDs end up in the environment and are detected in it (especially in water) at concentrations in the ng·L-1- μg·L-1 range. Although the concentrations of individual drugs in the environment are low, their high biological activity can cause them to be toxic to the environment. This review analyzes and summarizes the effects of drugs, primarily antibiotics and NSAIDs on photosynthesizing organisms, i.e., algae, aquatic and terrestrial plants. Acute drug toxicity to algae and plants occurs most often at high, often non-existent environmental concentrations, while sublethal effects occur at low drug concentrations. The review also points out the problems associated with ecotoxicological studies and the lack of systemic solutions to better assess the risks associated with the presence of drugs in the environment.

Microbial degradation of contaminants of emerging concern: metabolic, genetic and omics insights for enhanced bioremediation

The perpetual release of natural/synthetic pollutants into the environment poses major risks to ecological balance and human health. Amongst these, contaminants of emerging concern (CECs) are characterized by their recent introduction/detection in various niches, thereby causing significant hazards and necessitating their removal. Pharmaceuticals, plasticizers, cyanotoxins and emerging pesticides are major groups of CECs that are highly toxic and found to occur in various compartments of the biosphere. The sources of these compounds can be multipartite including industrial discharge, improper disposal, excretion of unmetabolized residues, eutrophication etc., while their fate and persistence are determined by factors such as physico-chemical properties, environmental conditions, biodegradability and hydrological factors. The resultant exposure of these compounds to microbiota has imposed a selection pressure and resulted in evolution of metabolic pathways for their biotransformation and/or utilization as sole source of carbon and energy. Such microbial degradation phenotype can be exploited to clean-up CECs from the environment, offering a cost-effective and eco-friendly alternative to abiotic methods of removal, thereby mitigating their toxicity. However, efficient bioprocess development for bioremediation strategies requires extensive understanding of individual components such as pathway gene clusters, proteins/enzymes, metabolites and associated regulatory mechanisms. "Omics" and "Meta-omics" techniques aid in providing crucial insights into the complex interactions and functions of these components as well as microbial community, enabling more effective and targeted bioremediation. Aside from natural isolates, metabolic engineering approaches employ the application of genetic engineering to enhance metabolic diversity and degradation rates. The integration of omics data will further aid in developing systemic-level bioremediation and metabolic engineering strategies, thereby optimising the clean-up process. This review describes bacterial catabolic pathways, genetics, and application of omics and metabolic engineering for bioremediation of four major groups of CECs: pharmaceuticals, plasticizers, cyanotoxins, and emerging pesticides.

Toxicity of Moxifloxacin on the Growth, Photosynthesis, Antioxidant System, and Metabolism of Microcystis aeruginosa at Different Phosphorus Levels

Moxifloxacin (MOX), a widely used novel antibiotic, may pose ecological risks at its actual environmental concentrations, as has been detected in aquatic systems. However, its ecotoxicity to aquatic organisms and regulatory mechanisms of phosphorus in eutrophic aqueous environments are still limited. This study aimed to analyze its physiological and biochemical parameters, including cellular growth, chlorophyll fluorescence, photosynthetic pigments, oxidative stress biomarkers, and metabolomics to elucidate the toxicity induced by environmental concentrations of MOX in Microcystis aeruginosa at different phosphorus levels. The results revealed that the EC50 values of MOX on M. aeruginosa at different phosphorus concentrations were 8.03, 7.84, and 6.91 μg/L, respectively, indicating MOX toxicity was exacerbated with increasing phosphorus levels. High phosphorus intensified the suppression of chlorophyll fluorescence and photosynthetic pigments, while activating the antioxidant enzyme, indicating severe peroxidation damage. Metabolomic analysis showed MOX induced different discriminating metabolites under different phosphorus levels, and perturbed more biological pathways at higher phosphorus concentrations, such as starch and sucrose metabolism, pyrimidine metabolism, and glycerolipid metabolism. This indicates that phosphorus plays an important role in regulating metabolism in M. aeruginosa exposed to MOX. The findings provide valuable information on the mechanisms involved in cyanobacteria responses to antibiotic stress, and offer a theoretical basis for accurately assessing antibiotic toxicity in eutrophic aqueous environments.

Occurrence and dissemination of antibiotics and antibiotic resistance in aquatic environment and its ecological implications: a review

The occurrence of antibiotics and antibiotic-resistant bacteria (ARBs), genes (ARGs), and mobile genetic elements (MGEs) in aquatic systems is growing global public health concern. These emerging micropollutants, stemming from improper wastewater treatment and disposal, highlight the complex and evolving nature of environmental pollution. Current literature reveals potential biases, such as a geographical focus on specific regions, leading to an insufficient understanding of the global distribution and dynamics of antibiotic resistance in aquatic systems. There is methodological inconsistency across studies, making it challenging to compare findings. Potential biases include sample collection inconsistencies, detection sensitivity variances, and data interpretation variability. Gaps in understanding include the need for comprehensive, standardized long-term monitoring programs, elucidating the environmental fate and transformation of antibiotics and resistance genes. This review summarizes current knowledge on the occurrence and dissemination of emerging micropollutants, their ecological impacts, and the global health implications of antimicrobial resistance. It highlights the need for interdisciplinary collaborations among researchers, policymakers, and stakeholders to address the challenges posed by antibiotic resistance in aquatic resistance in aquatic systems effectively. This review highlights widespread antibiotic and antibiotic resistance in aquatic environment, driven by human and agricultural activities. It underscores the ecological consequences, including disrupted microbial communities and altered ecosystem functions. The findings call for urgent measures to mitigate antibiotics pollution and manage antibiotic resistance spread in water bodies.

Exploring the ecotoxicological impact of meropenem on Lemna minor: Growth, photosynthetic activity, and oxidative stress

Meropenem is a potent carbapenem antibiotic frequently used in medical settings. Several studies have confirmed the pervasive presence of these antibiotics in wastewater treatment plants and aquatic environments. However, the effects of these substances on non-target organisms, such as plants, have not been adequately monitored. Thus, this study aimed to assess the short-term impact of meropenem on the growth, photosynthesis, chlorophyll content, and enzyme activity of the macrophyte plant Lemna minor. The methods involved exposing the plant to meropenem under controlled conditions and assessing physiological and biochemical parameters to determine the impact on photosynthetic activity and oxidative stress. These analyses included growth rate, antioxidant enzyme activity, and photosynthetic capacity. The findings suggest that the growth rate of Lemna minor remained unaffected by meropenem at concentrations <200000 μgL-1. However, plants exposed to concentrations >20 μgL-1showed physiological alterations, such as decreased net photosynthesis rate (17%) and chlorophyll concentration (57%), compared to the control group. For acute toxicity assays, the calculated EC50 7-day and EC20 7-day were 1135 μgL-1and 33 μgL-1, respectively. In addition, in most treatments tested, meropenem caused an increase in the superoxide dismutase (SOD), catalase (CAT) and ascorbate peroxidase (APX) activity as a defense mechanism against oxidative stress. Our results suggest that meropenem affects photosynthetic processes and induces oxidative stress in the macrophyte plant Lemna minor. Further studies are needed to assess the physiological and metabolic interactions between antibiotics and primary producers at different long-term trophic levels.

A Review on Fluoroquinolones' Toxicity to Freshwater Organisms and a Risk Assessment

Fluoroquinolones (FQs) have achieved significant success in both human and veterinary medicine. However, regulatory authorities have recommended limiting their use, firstly because they can have disabling side effects; secondly, because of the need to limit the spread of antibiotic resistance. This review addresses another concerning consequence of the excessive use of FQs: the freshwater environments contamination and the impact on non-target organisms. Here, an overview of the highest concentrations found in Europe, Asia, and the USA is provided, the sensitivity of various taxa is presented through a comparison of the lowest EC50s from about a hundred acute toxicity tests, and primary mechanisms of FQ toxicity are described. A risk assessment is conducted based on the estimation of the Predicted No Effect Concentration (PNEC). This is calculated traditionally and, in a more contemporary manner, by constructing a normalized Species Sensitivity Distribution curve. The lowest individual HC5 (6.52 µg L-1) was obtained for levofloxacin, followed by ciprofloxacin (7.51 µg L-1), sarafloxacin and clinafloxacin (12.23 µg L-1), and ofloxacin (17.12 µg L-1). By comparing the calculated PNEC with detected concentrations, it is evident that the risk cannot be denied: the potential impact of FQs on freshwater ecosystems is a further reason to minimize their use.

Synergistic adsorption and photocatalytic degradation of tetracycline using a Z-scheme kaolin/g-C3N4/MoO3 nanocomposite: A sustainable approach for water treatment

This research focuses on the synthesis and application of a novel kaolin-supported g-C3N4/MoO3 nanocomposite for the degradation of tetracycline, an important antibiotic contaminant in water systems. The nanocomposite was prepared through a facile and environmentally friendly approach, leveraging the adsorption and photocatalytic properties of kaolin, g-C3N4 and MoO3 nanoparticles, respectively. Comprehensive characterization of the nanocomposite was conducted using techniques such as X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR) and optical spectra. The surface parameters were studied using N2 adsorption-desorption isotherm. The elemental composition was studied using X-ray photoelectron spectroscopy. The efficiency of the developed nanocomposite in tetracycline degradation was evaluated and the results revealed an efficient tetracycline degradation exhibiting the synergistic effects of adsorption and photocatalytic degradation in the removal process. The tetracycline degradation was achieved in 60 min. Kinetic studies and thermodynamic analyses provided insights into the degradation mechanism, suggesting potential applications for the nanocomposite in wastewater treatment. Additionally, the recyclability and stability of the nanocomposite were investigated, demonstrating its potential for sustainable and long-term application in water treatment.

Determination of antibiotics during treatment of hospital wastewater using automated solid-phase extraction followed by UHPLC-MS: occurrence, removal and environmental risks

The extent of removal of pharmaceuticals by African-based wastewater treatment plants (WWTPs) is relatively unknown with various studies observing high concentrations in effluents. This is mainly due to WWTPs still utilising the traditional treatment methods which are known to be less effective. In this study, 15 selected antibiotics (amoxicillin, ampicillin, azithromycin, ciprofloxacin, doxycycline, erythromycin, gentamicin, metronidazole, norfloxacin, ofloxacin, penicillin, sulfamethoxazole, sulfapyridine, tetracycline and trimethoprim) were monitored in wastewater as it goes through sedimentation (primary and secondary), aeration and chlorination stages of a WWTP. Analytical method involved solid-phase extraction followed by liquid chromatographic determination. Removal efficiencies during sedimentation were generally positive with doxycycline achieving 80-95.8%, while negative removal efficiencies were observed for penicillin V (-46.4 to -17.1%) and trimethoprim (-26.2 to -18.9%). The aeration and agitation stage resulted in concentration enhancement for several antibiotics with seven of them ranging between -273 and -15.5%. This stage was responsible for the relatively low overall removal efficiencies in which only 4 antibiotics (doxycycline, tetracycline, ciprofloxacin, and erythromycin) experienced overall removal efficiencies above 50%. The recorded effluent concentrations ranging between 0.0130 and 0.383 ng/mL were translated to low potential for development of antibiotic resistance genes in the receiving environments while ecotoxicity risk was high for only amoxicillin, ampicillin and sulfapyridine. The study has provided an overview of the performance of common wastewater treatment processes in South Africa and hopes that more monitoring and environmental risk data can be made available towards drafting of antibiotic priority lists that cater for Africa.

Towards sorptive eradication of pharmaceutical micro-pollutant ciprofloxacin from aquatic environment: A comprehensive review

Antibiotics are widely prioritized pharmaceuticals frequently adopted in medication for addressing numerous ailments of humans and animals. However, the non-judicious disposal of ciprofloxacin (CIP) with concentration levels exceeding threshold limit in an aqueous environment has been the matter of growing concern nowadays. CIP is found in various waterways with appreciable mobility due to its limited decay in solidified form. Hence, the effective eradication strategy of this non-steroidal anti-inflammatory antibiotic from aqueous media is pivotal for preventing the users and the biosphere from their hazardous impacts. Reportedly several customary techniques like reverse osmosis, precipitation, cross-filtration, nano-filtration, ion exchange, microbial remediation, and adsorption have been employed to eliminate CIP from water. Out of them, adsorption is ascertained to be a potential method because of lesser preliminary investment costs, ease of operation, greater efficiency, less energy usage, reduced chemical and biological slurry production, and ready availability of precursor materials. Towards remediation of ciprofloxacin-laden water, plenty of researchers have used different adsorbents. However, the present-day challenge is opting the promising sorbent and its application towards industrial scale-up which is vital to get reviewed. In this article, adsorbents of diverse origins are reviewed in terms of their performances in CIP removal. The review stresses the impact of various factors on sorptive assimilation of CIP, adsorption kinetics, isotherms, mechanism of ionic interaction, contrivances for CIP detection, cost estimation and reusability assessments of adsorbents also that may endorse the next-generation investigators to decide the efficacious, environmental appealing and cost-competitive adsorbents for effective riddance of CIP from wastewater.

Repeated Exposure Enhanced Toxicity of Clarithromycin on Microcystis aeruginosa Versus Single Exposure through Photosynthesis, Oxidative Stress, and Energy Metabolism Shift

Antibiotics are being increasingly detected in aquatic environments, and their potential ecological risk is of great concern. However, most antibiotic toxicity studies involve single-exposure experiments. Herein, we studied the effects and mechanisms of repeated versus single clarithromycin (CLA) exposure on Microcystis aeruginosa. The 96 h effective concentration of CLA was 13.37 μg/L upon single exposure but it reduced to 6.90 μg/L upon repeated exposure. Single-exposure CLA inhibited algal photosynthesis by disrupting energy absorption, dissipation and trapping, reaction center activation, and electron transport, thereby inducing oxidative stress and ultrastructural damage. In addition, CLA upregulated glycolysis, pyruvate metabolism, and the tricarboxylic acid cycle. Repeated exposure caused stronger inhibition of algal growth via altering photosynthetic pigments, reaction center subunits biosynthesis, and electron transport, thereby inducing more substantial oxidative damage. Furthermore, repeated exposure reduced carbohydrate utilization by blocking the pentose phosphate pathway, consequently altering the characteristics of extracellular polymeric substances and eventually impairing the defense mechanisms of M. aeruginosa. Risk quotients calculated from repeated exposure were higher than 1, indicating significant ecological risks. This study elucidated the strong influence of repeated antibiotic exposure on algae, providing new insight into antibiotic risk assessment.

Environmental Risks of Pharmaceutical Mixtures in Aquatic Ecosystems: Reflections on a Decade of Research

Pharmaceuticals and personal care products (PPCPs) occur as variable mixtures in surface waters receiving discharges of human and animal wastes. A key question identified a decade ago is how to assess the effects of long-term exposures of these PPCP mixtures on nontarget organisms. We review the recent progress made on assessing the aquatic ecotoxicity of PPCP mixtures-with a focus on active pharmaceutical ingredients-and the challenges and research needs that remain. New knowledge has arisen from the use of whole-mixture testing combined with component-based approaches, and these studies show that mixtures often result in responses that meet the concentration addition model. However, such studies have mainly been done on individual species over shorter time periods, and longer-term, multispecies assessments remain limited. The recent use of targeted and nontargeted gene analyses has improved our understanding of the diverse pathways that are impacted, and there are promising new "read-across" methods that use mammalian data to predict toxicity in wildlife. Risk assessments remain challenging given the paucity of ecotoxicological and exposure data on PPCP mixtures. As such, the assessment of PPCP mixtures in aquatic environments should remain a priority given the potential for additive-as well as nontarget-effects in nontarget organisms. In addition, we need to improve our understanding of which species, life stages, and relevant endpoints are most sensitive to which types of PPCP mixtures and to expand our knowledge of environmental PPCP levels in regions of the globe that have been poorly studied to date. We recommend an increased use of new approach methodologies, in particular "omics," to advance our understanding of the molecular mechanics of mixture effects. Finally, we call for systematic research on the role of PPCP mixtures in the development of antimicrobial resistance. Environ Toxicol Chem 2024;43:549-558. © 2023 SETAC.

A review on the antibiotic florfenicol: Occurrence, environmental fate, effects, and health risks

Florfenicol, as a replacement for chloramphenicol, can tightly bind to the A site of the 23S rRNA in the 50S subunit of the 70S ribosome, thereby inhibiting protein synthesis and bacterial proliferation. Due to the widespread use in aquaculture and veterinary medicine, florfenicol has been detected in the aquatic environment worldwide. Concerns over the effects and health risks of florfenicol on target and non-target organisms have been raised in recent years. Although the ecotoxicity of florfenicol has been widely reported in different species, no attempt has been made to review the current research progress of florfenicol toxicity, hormesis, and its health risks posed to biota. In this study, a comprehensive literature review was conducted to summarize the effects of florfenicol on various organisms including bacteria, algae, invertebrates, fishes, birds, and mammals. The generation of antibiotic resistant bacteria and spread antibiotic resistant genes, closely associated with hormesis, are pressing environmental health issues stemming from overuse or misuse of antibiotics including florfenicol. Exposure to florfenicol at μg/L-mg/L induced hormetic effects in several algal species, and chromoplasts might serve as a target for florfenicol-induced effects; however, the underlying molecular mechanisms are completely lacking. Exposure to high levels (mg/L) of florfenicol modified the xenobiotic metabolism, antioxidant systems, and energy metabolism, resulting in hepatotoxicity, renal toxicity, immunotoxicity, developmental toxicity, reproductive toxicity, obesogenic effects, and hormesis in different animal species. Mitochondria and the associated energy metabolism are suggested to be the primary targets for florfenicol toxicity in animals, albeit further in-depth investigations are warranted for revealing the long-term effects (e.g., whole-life-cycle impacts, multigenerational effects) of florfenicol, especially at environmental levels, and the underlying mechanisms. This will facilitate the evaluation of potential hormetic effects and construction of adverse outcome pathways for environmental risk assessment and regulation of florfenicol.

Advanced oxidation and biological integrated processes for pharmaceutical wastewater treatment: A review

The stress of pharmaceutical and personal care products (PPCPs) discharging to water bodies and the environment due to increased industrialization has reduced the availability of clean water. This poses a potential health hazard to animals and human life because water contamination is a great issue to the climate, plants, humans, and aquatic habitats. Pharmaceutical compounds are quantified in concentrations ranging from ng/Lto μg/L in aquatic environments worldwide. According to (Alsubih et al., 2022), the concentrations of carbamazepine, sulfamethoxazole, Lutvastatin, ciprofloxacin, and lorazepam were 616-906 ng/L, 16,532-21635 ng/L, 694-2068 ng/L, 734-1178 ng/L, and 2742-3775 ng/L respectively. Protecting and preserving our environment must be well-driven by all sectors to sustain development. Various methods have been utilized to eliminate the emerging pollutants, such as adsorption and biological and advanced oxidation processes. These methods have their benefits and drawbacks in the removal of pharmaceuticals. Successful wastewater treatment can save the water bodies; integrating green initiatives into the main purposes of actor firms, combined with continually periodic awareness of the current and potential implications of environmental/water pollution, will play a major role in water conservation. This article reviews key publications on the adsorption, biological, and advanced oxidation processes used to remove pharmaceutical products from the aquatic environment. It also sheds light on the pharmaceutical adsorption capability of adsorption, biological and advanced oxidation methods, and their efficacy in pharmaceutical concentration removal. A research gap has been identified for researchers to explore in order to eliminate the problem associated with pharmaceutical wastes. Therefore, future study should focus on combining advanced oxidation and adsorption processes for an excellent way to eliminate pharmaceutical products, even at low concentrations. Biological processes should focus on ideal circumstances and microbial processes that enable the simultaneous removal of pharmaceutical compounds and the effects of diverse environments on removal efficiency.

Metabolomic Response of Thalassiosira weissflogii to Erythromycin Stress: Detoxification Systems, Steroidal Metabolites, and Energy Metabolism

Erythromycin, a macrolide antibiotic, is a prioritized pollutant that poses a high risk to environmental health. It has been detected in different environmental matrices and can cause undesired effects in aquatic organisms, particularly freshwater algae, which are primary producers. However, the impact of erythromycin on marine algae remains largely unexplored. Erythromycin has been reported to induce hormetic effects in the marine diatom Thalassiosira weissflogii (T. weissflogii). These effects are associated with the molecular pathways and biological processes of ribosome assembly, protein translation, photosynthesis, and oxidative stress. However, the alterations in the global gene expression have yet to be validated at the metabolic level. The present study used non-targeted metabolomic analysis to reveal the altered metabolic profiles of T. weissflogii under erythromycin stress. The results showed that the increased cell density was possibly attributed to the accumulation of steroidal compounds with potential hormonic action at the metabolic level. Additionally, slight increases in the mitochondrial membrane potential (MMP) and viable cells were observed in the treatment of 0.001 mg/L of erythromycin (an environmentally realistic level). Contrarily, the 0.75 and 2.5 mg/L erythromycin treatments (corresponding to EC20 and EC50, respectively) showed decreases in the MMP, cell density, and viable algal cells, which were associated with modified metabolic pathways involving ATP-binding cassette (ABC) transporters, the metabolism of hydrocarbons and lipids, thiamine metabolism, and the metabolism of porphyrin and chlorophyll. These findings suggest that metabolomic analysis, as a complement to the measurement of apical endpoints, could provide novel insights into the molecular mechanisms of hormesis induced by antibiotic agents in algae.

Effects of water environmental factors and antibiotics on bacterial community in urban landscape lakes

The presence of antibiotics can affect the natural microbial community and exert selective pressure on the environment's microorganisms. This study focused on three types of urban landscape lakes in Xi'an that were closely related to human activities. By combining basic water quality indicators, antibiotic occurrence status, bacterial communities and their potential metabolic functions, Spearman correlation coefficient and redundancy analysis were used to explore the relationship between them, and further explore the impact mechanism of environmental factors and antibiotics on bacterial community structure. The results showed that ofloxacin, erythromycin, and roxithromycin were the main types of antibiotics in the three landscape lakes, with low ecological risks, and there was a clear clustering of antibiotic occurrence. Proteobacteria was the most abundant bacterial phylum, and each lake had its own unique dominant bacteria, which indicates that they are influenced by varying water sources, pollution, and other nearby environments. Statistical analysis showed that pH and nitrogen nutrients were the most critical environmental factors affecting bacterial communities (P<0.01), while tetracyclines and lincomycins were the antibiotics that had a significant impact on bacterial communities (P<0.05). Antibiotics mainly promote defense- and signal transduction-related functions, and inhibit the metabolic activity of bacterial communities. However, the impact of antibiotics on bacterial diversity, community structure, and potential metabolic function in the three urban lakes was less than that of environmental factors. These results help to clarify the mechanism and degree of impact of different interference factors (environmental factors, conventional pollutants, and antibiotics) on bacterial communities in the water environment and are important for the management of urban landscape lake water environments.

Degradation of enrofloxacin by a novel Fe-N-C@ZnO material in freshwater and seawater: Performance and mechanism

In this study, we investigated the doping of Fe-N-C with ZnO (Fe-N-C@ZnO) to enhance its performance in the reduction of biological toxicity and degradation of enrofloxacin (ENR) in seawater. The steady-state/transient fluorescence analysis and free radical quenching test indicated an extremely low electron-hole recombination rate and the generation of reactive oxygen species in Fe-N-C@ZnO, leading to an improvement in the energy efficiency. We compared the ENR degradation efficiencies of Fe-N-C@ZnO and ZnO using both freshwater and seawater. In freshwater, Fe-N-C@ZnO exhibited a slightly higher degradation efficiency (95.00%) than ZnO (90.30%). However, the performance of Fe-N-C@ZnO was significantly improved in seawater compared to that of ZnO. The ENR degradation efficiency of Fe-N-C@ZnO (58.87%) in seawater was 68.39% higher than that of ZnO (34.96%). Furthermore, the reaction rate constant for ENR degradation by Fe-N-C@ZnO in seawater (7.31 × 10-3 min-1) was more than twice that of ZnO (3.58 × 10-3 min-1). Response surface analysis showed that the optimal reaction conditions were a pH of 7.42, a photocatalyst amount of 1.26 g L-1, and an initial ENR concentration of 6.56 mg L-1. Fe-N-C@ZnO prepared at a hydrothermal temperature of 128 °C and heating temperature of 300 °C exhibited the optimal performance for the photocatalytic degradation of ENR. Based on liquid chromatography-mass spectrometry analysis, the degradation processes of ENR were proposed as three pathways: two piperazine routes and one quinolone route.

Unraveling the Role of Microalgae in Mitigating Antibiotics and Antibiotic Resistance Genes in Photogranules Treating Antibiotic Wastewater

Harnessing the potential of specific antibiotic-degrading microalgal strains to optimize microalgal-bacterial granular sludge (MBGS) technology for sustainable antibiotic wastewater treatment and antibiotic resistance genes (ARGs) mitigation is currently limited. This article examined the performance of bacterial granular sludge (BGS) and MBGS (of Haematococcus pluvialis, an antibiotic-degrading microalga) systems in terms of stability, nutrient and antibiotic removal, and fate of ARGs and mobile genetic elements (MGEs) under multiclass antibiotic loads. The systems exhibited excellent performance under none and 50 μg/L mixed antibiotics and a decrease in performance at a higher concentration. The MBGS showed superior potential, higher nutrient removal, 53.9 mg/L/day higher chemical oxygen demand (COD) removal, and 5.2-8.2% improved antibiotic removal, notably for refractory antibiotics, and the system removal capacity was predicted. Metagenomic analysis revealed lower levels of ARGs and MGEs in effluent and biomass of MBGS compared to the BGS bioreactor. Particle association niche and projection pursuit regression models indicated that microalgae in MBGS may limit gene transfers among biomass and effluent, impeding ARG dissemination. Moreover, a discrepancy was found in the bacterial antibiotic-degrading biomarkers of BGS and MBGS systems due to the microalgal effect on the microcommunity. Altogether, these findings deepened our understanding of the microalgae's value in the MBGS system for antibiotic remediation and ARG propagation control.

Insights in Pharmaceutical Pollution: The Prospective Role of eDNA Metabarcoding

Environmental pollution is a growing threat to natural ecosystems and one of the world's most pressing concerns. The increasing worldwide use of pharmaceuticals has elevated their status as significant emerging contaminants. Pharmaceuticals enter aquatic environments through multiple pathways related to anthropogenic activity. Their high consumption, insufficient waste treatment, and the incapacity of organisms to completely metabolize them contribute to their accumulation in aquatic environments, posing a threat to all life forms. Various analytical methods have been used to quantify pharmaceuticals. Biotechnology advancements based on next-generation sequencing (NGS) techniques, like eDNA metabarcoding, have enabled the development of new methods for assessing and monitoring the ecotoxicological effects of pharmaceuticals. eDNA metabarcoding is a valuable biomonitoring tool for pharmaceutical pollution because it (a) provides an efficient method to assess and predict pollution status, (b) identifies pollution sources, (c) tracks changes in pharmaceutical pollution levels over time, (d) assesses the ecological impact of pharmaceutical pollution, (e) helps prioritize cleanup and mitigation efforts, and (f) offers insights into the diversity and composition of microbial and other bioindicator communities. This review highlights the issue of aquatic pharmaceutical pollution while emphasizing the importance of using modern NGS-based biomonitoring actions to assess its environmental effects more consistently and effectively.

A Smartphone-Integrated Molecularly Imprinted Fluorescence Sensor for Visual Detection of Chlortetracycline Based on N,P-Codoped Carbon Dots Decorated Iron-Based Metal-Organic Frameworks

The residue of chlortetracycline is potentially hazardous to human health; it is meaningful to exploit a portable, rapid, sensitive, and selective method for detection of chlortetracycline (CTC). In this study, a novel fluorescence bionic sensing probe (NH2-MIL-53&N,P-CDs@MIP) was successfully prepared based on the nitrogen and phosphorus codoped carbon dots decorated iron-based metal-organic frameworks combining with molecular imprinted polymer for the detection of CTC. A fluorescence intensity-responsive "on-off" detection of CTC on account of the inner-filter effect (IFE) was achieved by NH2-MIL-53&N,P-CDs@MIP. Under the optimal conditions, the fluorescence quenching degree of NH2-MIL-53&N,P-CDs@MIP presented a good linear relationship with the CTC concentration in the range 0.06-30 μg mL-1 and the limit of detection (LOD) was 0.019 μg mL-1. The fluorescent probe was applied to detect CTC in milk samples, and experimental results showed a good recovery rate (88.73%-96.28%). Additionally, a smartphone-integrated fluorescence sensing device based on NH2-MIL-53&N,P-CDs@MIP was exploited to replace the expensive and bulky fluorescence spectrophotometer for quantitative determination of CTC with the LOD of 0.033 μg mL-1. The sensing system showed high selectivity, strong stability, high specificity, and portability, which provide a great strategy for the quantitative detection of antibiotic residue.

Subcellular tissues-specific responses of Mytilus galloprovincialis to fluoroquinolone antibiotics

The study aimed to investigate the in vitro effects of the fluoroquinolone antibiotics (FQs) Ciprofloxacin (CIP), Enrofloxacin (ENR) and Danofloxacin (DAN) on the mussel Mytilus galloprovincialis exposed to environmentally relevant concentrations. In vitro exposure was performed on subcellular fractions of the digestive gland and gills through a multi-biomarker approach, which included the assessment of cellular damage, antioxidant and biotransformation enzyme activities, neurotoxicity, and DNA single-strand breaks (DNAssb). Results showed a decrease in protein carbonyl content in the gills when exposed to all concentrations of ENR. A significant overall decrease in the enzymatic activity of antioxidant defences was observed in the digestive gland exposed to the highest concentration of DAN and CIP, with a similar trend observed in the gills. Neurotoxicity was observed in the digestive gland at all tested concentrations of all FQs, but no effects were detected in the gills. DNAssb was evident in both tissues at all higher FQ concentrations.

Pharmaceutically active compounds in aqueous environment: recent developments in their fate, occurrence and elimination for efficient water purification

The existence of pharmaceutically active compounds (PhACs) in the water is a major concern for environmentalists due to their deleterious effects on living organisms even at minuscule concentrations. This review focuses on PhACs such as analgesics and anti-inflammatory compounds, which are massively excreted in urine and account for the majority of pharmaceutical pollution. Furthermore, other PhACs such as anti-epileptics, beta-blockers and antibiotics are discussed because they also contribute significantly to pharmaceutical pollution in the aquatic environment. This review is divided into two parts. In the first part, different classes of PhACs and their fate in the wastewater environment are presented. In the second part, recent advances in the removal of PhACs by conventional wastewater treatment plants, including membrane bioreactors (MBRs), activated carbon adsorption and bench-scale studies concerning a broad range of advanced oxidation processes (AOPs) that render practical and appropriate strategies for the complete mineralization and degradation of pharmaceutical drugs, are reviewed. This review indicates that drugs like diclofenac, naproxen, paracetamol and aspirin are removed efficiently by conventional systems. Activated carbon adsorption is suitable for the removal of diclofenac and carbamazepine, whereas AOPs are leading water treatment strategies for the effective removal of reviewed PhACs.

Optimization of process parameters for trimethoprim and sulfamethoxazole removal by magnetite-chitosan nanoparticles using Box-Behnken design

The contamination of the aquatic environment with antibiotics is among the major and developing problems worldwide. The present study investigates the potential of adsorbent magnetite-chitosan nanoparticles (Fe3O4/CS NPs) for removing trimethoprim (TMP) and sulfamethoxazole (SMX). For this purpose, Fe3O4/CS NPs were synthesized by the co-precipitation method, and the adsorbent characteristics were investigated using XRD, SEM, TEM, pHzpc, FTIR, and VSM. The effect of independent variables (pH, sonication time, adsorbent amount, and analyte concentration) on removal performance was modeled and evaluated by Box-Behnken design (BBD). The SEM image of the Fe3O4/CS adsorbent showed that the adsorbent had a rough and irregular surface. The size of Fe3O4/CS crystals was about 70 nm. XRD analysis confirmed the purity and absence of impurities in the adsorbent. TEM image analysis showed that the adsorbent had a porous structure, and the particle size was in the range of nanometers. In VSM, the saturation magnetization of Fe3O4/CS adsorbent was 25 emu g-1 and the magnet could easily separate the adsorbent from the solution. The results revealed that the optimum condition was achieved at a concentration of 22 mg L-1, a sonication time of 15 min, an adsorbent amount of 0.13 g/100 mL, and a pH of 6. Among different solvents (i.e., ethanol, acetone, nitric acid, and acetonitrile), significant desorption of TMP and SMX was achieved using ethanol. Also, results confirmed that Fe3O4/CS NPs can be used for up to six adsorption/desorption cycles. In addition, applying the Fe3O4/CS NPs on real water samples revealed that Fe3O4/CS NPs could remove TMP and SMX in the 91.23-95.95% range with RSD (n = 3) < 4. Overall, the Fe3O4/CS NPs exhibit great potential for removing TMP and SMX antibiotics from real water samples.

More movement with manure: increased mobility of erythromycin through agricultural soil in the presence of manure

Antibiotic residues in the environment threaten soil and aquatic organisms and human and livestock health through the building of antimicrobial resistance. Manure spreading associated with animal agriculture is one source of environmental antibiotic residues. To better understand the risk of contamination, we studied the adsorption of erythromycin, a model macrolide antibiotic used across human and animal medicine. We conducted a series of equilibrium batch experiments to determine the kinetics and extent of adsorption and a continuous-flow column adsorption experiment to observe non-equilibrium adsorption patterns. We determined that the adsorption equilibration time to soil was approximately 72 h in our batch experiments. Erythromycin adsorbed to soil relatively strongly (K = 8.01 × 10-2 L/mg; qmax = 1.53 × 10-3 mg/mg), adsorbed to the soil in the presence of manure with less affinity (K = 1.99 × 10-4 L/mg) at a soil: manure ratio of 10:1 by mass, and did not adsorb to manure across the solid ratios tested. We observed multi-phased adsorption of erythromycin to the soil during the non-equilibrium column experiment, which was largely absent from the treatments with both soil and manure present. These results suggest that erythromycin is more mobile in the environment when introduced with manure, which is likely the largest source of agriculturally sourced environmental antibiotics.

An investigation on removal of ciprofloxacin and norfloxacin by phycoremediation with an emphasis on acute toxicity and biochemical composition

Ciprofloxacin (CIP) and norfloxacin (NOR) belong to the class of emerging contaminants that are frequently detected in the aquatic environment as a binary mixture, responsible for the development of antibiotic-resistant genes and antibiotic-resistant bacteria. This study aims to investigate five different algal species Chlorella vulgaris (Cv), Chlorella pyrenoidosa (Cp), Scenedesmus obliquus (So), Tetradesmus sp (T) and Monoraphidium sp (M) for their tolerance and removal of binary mixture. The effects on biochemical composition in the algal species concerning the binary mixture and its removal efficiency are first reported in this study. The acute toxicity (96 h EC50) values are in the order of So > Cp > T > M > Cv, Chlorella vulgaris is the most sensitive algal species with 17.73 ± 0.24 mg/L and Scenedesmus obliquus is the least sensitive algal species with 39.19 ± 0.79 mg/L. The removal efficiency of the binary mixture was found to be in the order of So > Cp > T > M > Cv, Scenedesmus obliquus removed CIP (52.4%) and NOR (87.5%) with biodegradation as the major contributing removal mechanism. Furthermore, less toxic biotransformed products were detected in Scenedesmus obliquus and the biochemical characterization revealed that the growth-stimulating effect is higher with lipid (35%), carbohydrate (18%), and protein (33%) providing an advantage in the production of valuable biomass.

Occurrence, environmental impact and fate of pharmaceuticals in groundwater and surface water: a critical review

In many nations and locations, groundwater serves as the population's primary drinking water supply. However, pharmaceuticals found in groundwater and surface waters may affect aquatic ecosystems and public health. As a result, their existence in natural raw waters are now more widely acknowledged as a concern. This review summarises the evidence of research on pharmaceuticals' occurrence, impact and fate, considering results from different water bodies. Also, various analytical techniques were reviewed to compare different pharmaceuticals' detection frequencies in water bodies. These include liquid chromatography-mass spectrometry (LC-MS), high-performance liquid chromatography (HPLC), ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), and gas chromatography-mass spectrometry (GC-MS). However, owing to LC-MS's high sensitivity and specification, it is the most reported instrument used for analysis. The PRISMA reviewing methodology was adopted based on relevant literature in order to focus on aim of the review. Among other pharmaceuticals reviewed, sulfamethoxazole was found to be the most frequently detected drug in wastewater (up to 100% detection frequency). The most reported pharmaceutical group in this review is antibiotics, with sulfamethoxazole having the highest concentration among the analysed pharmaceuticals in groundwater and freshwater (up to 5600 ng/L). Despite extensive study and analysis on the occurrence and fate of pharmaceuticals in the environment, appropriate wastewater management and disposal of pharmaceuticals in the water environment are not still monitored regularly. Therefore, there is a need for mainstream studies tailored to the surveillance of pharmaceuticals in water bodies to limit environmental risks to human and aquatic habitats in both mid and low-income nations.

Experimental and numerical elucidation of the fate and transport of antibiotics in aquatic environment: A review

This review highlights various experimental and mathematical modeling strategies to investigate the fate and transport of antibiotics that elucidate antimicrobial selective pressure in aquatic environments. Globally, the residual antibiotic concentrations in effluents from bulk drug manufacturing industries were 30- and 1500-fold greater than values reported in municipal and hospital effluents, respectively. The antibiotic concentration from different effluents enters the waterbodies that usually get diluted as they go downstream and undergo various abiotic and biotic reactive processes. In aquatic systems, photolysis is the predominant process for antibiotic reduction in the water matrix, while hydrolysis and sorption are frequently reported in the sediment compartment. The rate of antibiotic reduction varies widely with influencing factors such as the chemical properties of the antibiotics and hydrodynamic conditions of river streams. Among all, tetracycline was found to more unstable (log Kow =  - 0.62 to - 1.12) that can readily undergo photolysis and hydrolysis; whereas macrolides were more stable (log Kow = 3.06 to 4.02) that are prone to biodegradation. The processes like photolysis, hydrolysis, and biodegradation followed first-order reaction kinetics while the sorption followed a second-order kinetics for most antibiotic classes with reaction rates occurring in the decreasing order of Fluoroquinolones and Sulphonamides. The reports from various experiments on abiotic and biotic processes serve as input parameters for an integrated mathematical modeling to predict the fate of the antibiotics in the aquatic environment. Various mathematical models viz. Fugacity level IV, RSEMM, OTIS, GREAT-ER, SWAT, QWASI, and STREAM-EU are discussed for their potential capabilities. However, these models do not account for microscale interactions of the antibiotics and microbial community under real-field conditions. Also, the seasonal variations for contaminant concentrations that exert selective pressure for antimicrobial resistance has not been accounted. Addressing these aspects collectively is the key to exploring the emergence of antimicrobial resistance. Therefore, a comprehensive model involving antimicrobial resistance parameters like fitness cost, bacterial population dynamics, conjugation transfer efficiency, etc. is required to predict the fate of antibiotics.

Microalgae systems - environmental agents for wastewater treatment and further potential biomass valorisation

Water is the most valuable resource on the planet. However, massive anthropogenic activities generate threatening levels of biological, organic, and inorganic pollutants that are not efficiently removed in conventional wastewater treatment systems. High levels of conventional pollutants (carbon, nitrogen, and phosphorus), emerging chemical contaminants such as antibiotics, and pathogens (namely antibiotic-resistant ones and related genes) jeopardize ecosystems and human health. Conventional wastewater treatment systems entail several environmental issues: (i) high energy consumption; (ii) high CO₂ emissions; and (iii) the use of chemicals or the generation of harmful by-products. Hence, the use of microalgal systems (entailing one or several microalgae species, and in consortium with bacteria) as environmental agents towards wastewater treatment has been seen as an environmentally friendly solution to remove conventional pollutants, antibiotics, coliforms and antibiotic resistance genes. In recent years, several authors have evaluated the use of microalgal systems for the treatment of different types of wastewater, such as agricultural, municipal, and industrial. Generally, microalgal systems can provide high removal efficiencies of: (i) conventional pollutants, up to 99%, 99%, and 90% of total nitrogen, total phosphorus, and/or organic carbon, respectively, through uptake mechanisms, and (ii) antibiotics frequently found in wastewaters, such as sulfamethoxazole, ciprofloxacin, trimethoprim and azithromycin at 86%, 65%, 42% and 93%, respectively, through the most desirable microalgal mechanism, biodegradation. Although pathogens removal by microalgal species is complex and very strain-specific, it is also possible to attain total coliform and Escherichia coli removal of 99.4% and 98.6%, respectively. However, microalgal systems' effectiveness strongly relies on biotic and abiotic conditions, thus the selection of operational conditions is critical. While the combination of selected species (microalgae and bacteria), ratios and inoculum concentration allow the efficient removal of conventional pollutants and generation of high amounts of biomass (that can be further converted into valuable products such as biofuels and biofertilisers), abiotic factors such as pH, hydraulic retention time, light intensity and CO₂/O₂ supply also have a crucial role in conventional pollutants and antibiotics removal, and wastewater disinfection. However, some rationale must be considered according to the purpose. While alkaline pH induces the hydrolysis of some antibiotics and the removal of faecal coliforms, it also decreases phosphates solubility and induces the formation of ammonium from ammonia. Also, while CO₂ supply increases the removal of E. coli and Pseudomonas aeruginosa, as well as the microalgal growth (and thus the conventional pollutants uptake), it decreases Enterococcus faecalis removal. Therefore, this review aims to provide a critical review of recent studies towards the application of microalgal systems for the efficient removal of conventional pollutants, antibiotics, and pathogens; discussing the feasibility, highlighting the advantages and challenges of the implementation of such process, and presenting current case-studies of different applications of microalgal systems.

Direct and gut microbiota-mediated toxicities of environmental antibiotics to fish and aquatic invertebrates

The accumulation of antibiotics in the environment has ecological impacts that have received less attention than the human health risks of antibiotics, although the effects could be far-reaching. This review discusses the effects of antibiotics on the health of fish and zooplankton, manifesting in direct or dysbiosis-mediated physiological impairment. Acute effects of antibiotics in these organism groups are usually induced at high concentrations (LC₅₀ at ∼100-1000 mg/L) that are not commonly present in aquatic environments. However, when exposed to sub-lethal, environmentally relevant levels of antibiotics (ng/L-μg/L) disruption of physiological homeostasis, development, and fecundity can occur. Antibiotics at similar or lower concentrations can induce dysbiosis of gut microbiota which can affect the health of fish and invertebrates. We show that the data about molecular-level effects of antibiotics at low exposure concentrations are limited, hindering environmental risk assessment and species sensitivity analysis. Fish and crustaceans (Daphnia sp.) were the two groups of aquatic organisms used most often for antibiotic toxicity testing, including microbiota analysis. While low levels of antibiotics impact the composition and function of gut microbiota in aquatic organisms, the correlation and causality of these changes to host physiology are not straightforward. In some cases, negative or lack of correlation have occurred, and, unexpectedly, gut microbial diversity has been unaffected or increased upon exposure to environmental levels of antibiotics. Efforts to incorporate functional analyses of gut microbiota are beginning to provide valuable mechanistic information, but more data is needed for ecological risk assessment of antibiotics.

Intra- and inter-habitat variation in sediment heavy metals, antibiotics and ecological risks in Mai Po RAMSAR, China

Distribution of heavy metals (HMs) and antibiotics (ABs) in surface sediments of three habitats: mudflat, mangrove and gei wai (inter-tidal shrimp ponds), at Mai Po RAMSAR were determined with inductively coupled plasma and liquid chromatograph tandem - mass spectrometry, respectively. Eight HMs (Cr, As, Pb, Cd, Mn, Ni, Cu and Zn), and ten ABs (tetracyclines, quinolones, macrolides and sulphonamides) were detected in all habitats, with relatively lower concentration in gei wai. Ecological risk assessment based on PNEC revealed that HMs posed a higher ecological risk to microorganisms than ABs. All metals except Mn were above their respective threshold effect levels according to sediment quality guidelines, indicating their potential toxicity to benthos. The enrichment factor and geo-accumulation index on background values suggested sediments were moderately polluted by Zn, Cu and Cd, possibly from anthropogenic inputs. This study implies that HMs pollution must be prevented through proper regulation of agricultural and industrial discharge.

SiC@FeZnZiF as a Bifunctional Catalyst with Catalytic Activating PMS and Photoreducing Carbon Dioxide

Herein, we encapsulated modified silicon carbide nanoparticles utilizing a metal-organic backbone. E-SiC-FeZnZIF composites were successfully prepared via Fe doping. The catalysis activity of this bifunctional composite material was evaluated by the degradation of tetracycline (THC) and carbamazepine (CBZ) and the reduction of carbon dioxide (CO₂). Nano SiC has received widespread attention in advanced oxidation applications, especially in the catalytic activation of peroxymonosulfate (PMS). However, the inferior activity of SiC has severely restricted its practical use. In this study of dual functional composite materials, nano SiC was firstly etched under aqueous alkali. Then, zeolite imidazolate frame-8 (ZIF-8) was used for immobilization. The filling of the etched nano SiC with FeZnZiF was confirmed by SEM, XRD, FTIR, BET, and XPS analyses. In addition, E-SiC-FeZnZIF exhibited excellent catalytic activation of peroxymonosulfate (PMS) to oxidize water pollutants, which can degrade tetracycline hydrochloride (THC), achieving a removal rate of 72% within 60 min. Moreover, E-SiC-FeZnZIF exhibited a relatively high CO₂ reduction rate with H₂O. The yields of CO and CH₄ were 0.085 and 0.509 μmol g^-1, respectively, after 2 h, which are higher than that of 50 nm of commercial SiC (CO: 0.084 μmol g^-1; CH₄: 0.209 μmol g^-1). This work provides a relatively convenient synthesis path for constructing metal skeleton composites for advanced oxidation and photocatalytic applications. This will have practical significance in protecting water bodies and reducing CO₂, which are vital not only for maintaining the natural ecological balance and negative feedback regulation, but also for creating a new application carrier based on nano silicon carbide.

Cyanobacterial Harmful Algal Bloom Toxin Microcystin and Increased Vibrio Occurrence as Climate-Change-Induced Biological Co-Stressors: Exposure and Disease Outcomes via Their Interaction with Gut-Liver-Brain Axis

The effects of global warming are not limited to rising global temperatures and have set in motion a complex chain of events contributing to climate change. A consequence of global warming and the resultant climate change is the rise in cyanobacterial harmful algal blooms (cyano-HABs) across the world, which pose a threat to public health, aquatic biodiversity, and the livelihood of communities that depend on these water systems, such as farmers and fishers. An increase in cyano-HABs and their intensity is associated with an increase in the leakage of cyanotoxins. Microcystins (MCs) are hepatotoxins produced by some cyanobacterial species, and their organ toxicology has been extensively studied. Recent mouse studies suggest that MCs can induce gut resistome changes. Opportunistic pathogens such as Vibrios are abundantly found in the same habitat as phytoplankton, such as cyanobacteria. Further, MCs can complicate human disorders such as heat stress, cardiovascular diseases, type II diabetes, and non-alcoholic fatty liver disease. Firstly, this review describes how climate change mediates the rise in cyanobacterial harmful algal blooms in freshwater, causing increased levels of MCs. In the later sections, we aim to untangle the ways in which MCs can impact various public health concerns, either solely or in combination with other factors resulting from climate change. In conclusion, this review helps researchers understand the multiple challenges brought forth by a changing climate and the complex relationships between microcystin, Vibrios, and various environmental factors and their effect on human health and disease.

Mechanisms for the increase in lipid production in cyanobacteria during the degradation of antibiotics

This study evaluated the responses of cell density, photosynthesis activity, dry cell weight, lipid productivity, proteome and metabolome in two non-toxic cyanobacterial species (Synechococcus sp. and Chroococcus sp.) exposed to two frequently detected antibiotics (sulfamethoxazole and ofloxacin) at test concentrations of 0.2-20.0 μg L^-1 in a 4-day culture period. Upregulated antioxidant enzymes and oxidoreductases contributed to antibiotic biodegradation in Synechococcus sp.; whereas, upregulated carotenoid protein contributed to antibiotic biodegradation in Chroococcus sp. The 4-day removal efficiencies of sulfamethoxazole and ofloxacin by cyanobacteria were 35.98-66.23% and 33.01-61.92%, respectively. In cyanobacteria, each antibiotic induced hormetic responses, such as increase in cell density, dry cell weight, and photosynthetic activity; upregulation of photosynthesis-related proteins; and elevation of lipid expression by up to 2.05-fold. Under antibiotic stress, the two cyanobacterial species preferred to store energy in the form of lipids rather than ATP, with fructose-bisphosphate aldolase playing an essential role in lipid synthesis. The downregulation of lipid transporters also facilitated lipid accumulation in Synechococcus sp. In general, the two non-toxic cyanobacterial species achieved a good combination of lipid deposition and antibiotic treatment performance, especially in Chroococcus sp. exposed to sulfamethoxazole.

Higher toxicity induced by co-exposure of polystyrene microplastics and chloramphenicol to Microcystis aeruginosa: Experimental study and molecular dynamics simulation

Antibiotics and microplastics (MPs) inevitably coexist in natural waters, but their combined effect on aquatic organisms is still ambiguous. This study investigated the individual and combined toxicity of chloramphenicol (CAP) and micro-polystyrene (mPS) particles to Microcystis aeruginosa by physiological biomarkers, related gene expression, and molecular dynamics simulation. The results indicated that both individual and joint treatments threatened algal growth, while combined toxicity was higher than the former. Photosynthetic pigments and gene expression were inhibited by single CAP and mPS exposure, but CAP dominated and aggravated photosynthetic toxicity in combined exposure. Additionally, mPS damaged cell membranes and induced oxidative stress, which might further facilitate the entry of CAP into cells during co-exposure. The synergistic effect of CAP and mPS might be explained by the common photosynthetic toxicity target of CAP and mPS as well as oxidative stress. Furthermore, the molecular dynamics simulation revealed that CAP altered conformations of photosynthetic assembly protein YCF48 and SOD enzyme, and competed for functional sites of SOD, thus disturbing photosynthesis and antioxidant systems. These findings provide useful insights into the combined toxicity mechanism of antibiotics and MPs as well as highlight the importance of co-pollutant toxicity in the aquatic environment.

Toxicity interactions of azole fungicide mixtures on Chlorella pyrenoidosa

It is acknowledged that azole fungicides may release into the environment and pose potential toxic risks. The combined toxicity interactions of azole fungicide mixtures, however, are still not fully understood. The combined toxicities and its toxic interactions of 225 binary mixtures and 126 multi-component mixtures on Chlorella pyrenoidosa were performed in this study. The results demonstrated that the negative logarithm 50% effect concentration (pEC₅₀ ) of 10 azole fungicides to Chlorella pyrenoidosa at 96 h ranged from 4.23 (triadimefon) to 7.22 (ketoconazole), while the pEC₅₀ values of the 351 mixtures ranged from 3.91 to 7.44. The high toxicities were found for the mixtures containing epoxiconazole. According to the results of the model deviation ratio (MDR) calculated from the concentration addition (MDR_CA ), 243 out of 351 (69.23%) mixtures presented additive effect at the 10% effect, while the 23.08% and 7.69% of mixtures presented synergistic and antagonistic effects, respectively. At the 30% effect, 47.29%, 29.34%, and 23.36% of mixtures presented additive effects, synergism, and antagonism, respectively. At the 50% effect, 44.16%, 34.76%, and 21.08% of mixtures presented additive effects, synergism, and antagonism, respectively. Thus, the toxicity interactions at low concentration (10% effect) were dominated by additive effect (69.23%), whereas 55.84% of mixtures induced synergism and antagonism at high concentration (50% effect). Climbazole and imazalil were the most frequency of components presented in the additive mixtures. Epoxiconazole was the key component induced the synergistic effects, while clotrimazole was the key component in the antagonistic mixtures.

Responses of cyanobacterium Microcystis aeruginosa under single and repeated ofloxacin exposure

Antibiotics are omnipresent and pseudo-persistent in the environment. Yet, their potential ecological risks under repeated exposure, which is more environmentally relevant, are understudied. Therefore, this study used ofloxacin (OFL) as the probe chemical to investigate the toxic effects of different exposure scenarios-single dose of high concentration (4.0 µg/L) and multiple additions of low concentrations-towards the cyanobacterium Microcystis aeruginosa. Flow cytometry was employed to measure a collection of biomarkers, including endpoints related with biomass, single cell properties and physiological status. Results showed that the single dose of the highest OFL level inhibited cellular growth, chl-a content and cell size of M. aeruginosa. In contrast, OFL induced stronger chl-a autofluorescence and higher doses tended to have more remarkable effects. Repeated low OFL doses can more significantly increase the metabolic activity of M. aeruginosa than a single high dose. Viability and cytoplasmic membrane were not affected by OFL exposure. Oxidative stress was observed for the different exposure scenarios, with fluctuating responses. This study demonstrated the different physiological responses of M. aeruginosa under different OFL exposure scenarios, providing novel insights into the toxicity of antibiotics under repeated exposure.

Antibiotics affected the bacterial community structure and diversity in pore water and sediments with cultivated Phragmites australis in a typical Chinese shallow lake

The migration of antibiotics and bacterial communities between sediments and pore water occurring in the lake, which is affected by aquatic vegetation. However, the differences in bacterial community structure and biodiversity between pore water and sediments with plants in lakes under antibiotic stress are still poorly understood. We collected pore water and sediments in both wild and cultivated Phragmites australis regions in the Zaozhadian (ZZD) Lake to explore the characteristics of the bacterial community. Our results showed that the diversity of bacterial community in sediment samples were significantly higher than those in pore water samples in both P. australis regions. Due to higher antibiotic levels in sediments from the cultivated P. australis region, the composition of bacterial communities showed a difference, which reduced the relative abundance of dominant phyla in pore water and increased that in sediments. The higher bacterial variations in pore water could be explained by sediment in the cultivated P. australis region than that in wild P. australis region, therefore plant cultivation might change the source-sink pattern between sediments and pore water. The dominant factors shaping the bacterial communities in the wild P. australis region pore water or sediment were NH4-N, NO3-N, and particle size, while cultivated P. australis region pore water or sediment were oxytetracycline, tetracycline, etc. The findings of this work indicates that the antibiotic pollution caused by planting activities has a greater impact on the bacterial community, which will provide a reference for the use and management of antibiotics in lake ecosystems.

Occurrence and the potential ecological risk of veterinary antimicrobials in swine farm wastewaters in Japan: Seasonal changes, relation to purchased quantity and after termination of oxytetracycline usage

This study provides the first comprehensive investigation of the residual concentrations of eight classes of antimicrobial agents (AMs, 20 compounds) in 13 swine wastewater treatment facilities in Japan. These facilities implemented the aerobic activated sludge (AS) or its alternative methods. The maximum concentrations before treatment were found at the level of 7100, 6900, 6000, 3600, 3400, and 1400 µg/L for tilmicosin, oxytetracycline (OTC), chlortetracycline, lincomycin , sulfamethoxazole, and trimethoprim, respectively. The highest detection rate (96.3%) in influents was noted for the morantel, which was a feed additive. The seasonal difference in residual concentration was much greater for tetracyclines (TCs) and macrolides (MLs) when their residual concentrations were high, especially in the cold season. There was a positive correlation between the purchased quantity of TCs and fluoroquinolones (FQs) and their residue levels detected in the effluents (p < 0.01). The estimated removal rate of AMs was greater than 80%. In contrast, on a few occasions, it was diminished due to failing operating conditions, such as water temperature and AS rate in the aeration tank. The estimated ecological risks of AMs in effluents based on risk quotients (RQs) considered to enhance the selection pressure for drug resistance (RQs-AMR) were high for TCs and FQs, whereas ecotoxicological effects (RQs-ENV) to aquatic organisms were higher for sulfonamides and MLs. When OTC usage ceased, its concentration in wastewater decreased rapidly; however, it remained longer period in the effluents, probably due to OTC desorption from the AS. The concentrations (and respective RQs) of TCs were decreased by >99.8% and >92% in the influents and effluents, respectively. This data suggested that it is essential to reduce the amount used and introduce more efficient methods and operating conditions to constantly remove AMs during the treatment to reduce the risk of AM discharge from swine farms.

Health risk-benefit assessment of the commercial red mangrove crab: Implications for a cultural delicacy

Mangrove forests, provide vital food resources and are an endangered ecosystem worldwide due to pollution and habitat destruction. A risk-benefit assessment (RBA) was performed on the red mangrove crab (Ucides occidentalis) from the threatened Guayas mangroves in Ecuador. It was aimed to assess the combined potential adverse and beneficial health impact associated with crab consumption and define a recommended safe intake (SI) to improve the diet of the Ecuadoran population while ensuring safe food intake. Target hazard quotients (THQs), benefit quotients (Qs), and benefit-risk quotients (BRQs) were calculated based on the concentrations of the analyzed contaminants (121 pesticide residues, 11 metal(loid)s, antimicrobial drugs from 3 classes) and nutrients (fatty acids, amino acids, and essential nutrients). Except for inorganic arsenic (iAs), the THQ was below 100 for all investigated contaminants, suggesting that the average crab consumer is exposed to levels that do not impose negative non-carcinogenic or carcinogenic health effects in the long and/or short term. Concentrations of iAs (average AsIII: 25.64 and AsV: 6.28 μg/kg fw) were of the highest concern because of the potential to cause negative health effects on long-term consumption. Despite the thriving aquaculture in the Guayas estuary, concentrations of residues of the antimicrobial drugs oxytetracycline (OTC), florfenicol, and nitrofurans still were low. Based on the fact that different risk reference values exist, related to different safety levels, four SI values (0.002, 0.04, 4, and 18 crabs/day) were obtained. The strictest intake values indicate a concern for current consumption habits. In conclusion, the red mangrove crab contains various important nutrients and can be part of a balanced diet for the Ecuadorian population when consumed in limited portions. The present study emphasizes the importance of safeguarding the quality of the environment as a prerequisite for procuring nutritious and safe food.

The Use of Antibiotics and Antimicrobial Resistance in Veterinary Medicine, a Complex Phenomenon: A Narrative Review

As warned by Sir Alexander Fleming in his Nobel Prize address: “the use of antimicrobials can, and will, lead to resistance”. Antimicrobial resistance (AMR) has recently increased due to the overuse and misuse of antibiotics, and their use in animals (food-producing and companion) has also resulted in the selection and transmission of resistant bacteria. The epidemiology of resistance is complex, and factors other than the overall quantity of antibiotics consumed may influence it. Nowadays, AMR has a serious impact on society, both economically and in terms of healthcare. This narrative review aimed to provide a scenario of the state of the AMR phenomenon in veterinary medicine related to the use of antibiotics in different animal species; the impact that it can have on animals, as well as humans and the environment, was considered. Providing some particular instances, the authors tried to explain the vastness of the phenomenon of AMR in veterinary medicine due to many and diverse aspects that cannot always be controlled. The veterinarian is the main reference point here and has a high responsibility towards the human–animal–environment triad. Sharing such a burden with human medicine and cooperating together for the same purpose (fighting and containing AMR) represents an effective example of the application of the One Health approach.

Beach-cast Sargassum cymosum macroalgae: biochar production and apply to adsorption of Acetaminophen in batch and fixed-bed adsorption processes

In order to add value to the beach-cast Sargassum cymosum algae, its biomass was converted by pyrolysis process at 800°C into biochar, characterized and applied in the adsorption of Acetaminophen in batch and fixed-bed processes. Characterization by pH, Point of Zero Charge (pHPZC), Fourier-Transform Infrared Spectroscopy (FTIR), Thermogravimetric (TG), Scanning Electron Microscopy (SEM) and Surface area (BET) showed that the biochar presents properties favourable for the Acetaminophen adsorption. High surface area was obtained of 368.1 m². g-1, presenting the formation of pores, observed by SEM. The biochar showed basic characteristics (pH = 8.84 and pHPZC = 9.9), inferring an adsorption involving several different mechanisms such as dispersive interactions by π electrons, electrostatic attractions, and hydrophobic interactions. The adsorption mechanism is limited by chemisorption and governed by the formation of monolayer on the biochar surface, the Pseudo-second order kinetic and Langmuir-Freundlich isotherm model described the best behaviour of batch adsorption, with equilibrium and maximum adsorption capacity q e  = 6.93 ± 0.07 mg. g-1 and q m s  = 12.34 ± 0.45 mg. g-1, respectively. Fixed-bed adsorption were performed varying adsorbent mass (0.3 and 0.6 g) and flow rate (2.5 and 5.0 mL. min-1), the best q y  = 42.33 mg. g-1 found to adsorbent mass of 0.6 g and flow rate of 2.5 mL. min-1. Yan model described the best behaviour of the breakthrough curves data. Thus, the results provide insights into the development of adsorbents from beach-cast of Sargassum cymosum to adsorption of Acetaminophen, enhancing the use of environmental waste to obtain it.

Ecotoxicological effect of enrofloxacin on Spirulina platensis and the corresponding detoxification mechanism

Enrofloxacin is a widely used antibiotic targeting DNA gyrase and has become the commonly detected micropollutant in aquatic environments. Thus, the potential toxicity of enrofloxacin to Spirulina platensis which is a kind of prokaryote similar to Gram-negative bacteria has been hypothesized. However, little is known about the toxicity and degradation mechanism of enrofloxacin during the growth process of Spirulina platensis. Herein, the biomass accumulation of Spirulina platensis was stimulated to 115% of the control group by 0.1 mg L^-1 enrofloxacin (10th day), which could be removed probably through the metabolism. Further increasing the enrofloxacin level to 5.0 mg L^-1 almost inhibited the growth and remediation ability of Spirulina platensis for 35 days. Environmental stress also caused the variations of photosynthetic pigments (chlorophyll a and carotenoids) and primary biocomponents (proteins, lipids, and carbohydrates), reflecting the adaptation of Spirulina platensis for handling the negative effects of enrofloxacin. The detoxification mechanism was studied by identifying the degradation products of enrofloxacin, suggesting the occurrence of dealkylation and oxidation reactions primarily at the piperazine group. The decreased antimicrobial activity was confirmed by the reduced binding affinity of degradation products with enzymes. The obtained results could help us understand the role of enrofloxacin in the growth of Spirulina platensis, thus providing great support for employing Spirulina platensis in risk assessment and hazard reduction.

The different toxicological effects and removal efficiencies of norfloxacin and sulfadiazine in culturing Arthrospira (Spirulina) platensis

Norfloxacin (NFX) and sulfadiazine (SDZ) are two widely used antibiotics belonging to fluoroquinolone and sulfonamide groups, respectively, and have become the commonly detected micropollutants in aquatic environments. However, only few works have been conducted to investigate the highly probable inhibition of these antibiotic pollutants to Arthrospira platensis, which is an important species of cyanobacteria that is one of primary producers in aquatic ecosystems and should be remarkably sensitive to environmental pollutants due to its prokaryotic characteristics. Hence, the toxicological effects and removal efficiencies of NFX and SDZ in culturing A. platensis were studied by analyzing the biomass growth, photosynthetic pigments, primary biocomponents, and antibiotics concentration. The corresponding variations of these characteristics showed the higher sensitivity of A. platensis to NFX than to SDZ, indicating the specifically targeted effect of NFX on A. platensis, which could be confirmed in silico by the higher binding affinity of NFX with the critical enzyme. The obtained results illustrated the roles of NFX and SDZ on the growth of A. platensis, thus providing the great support in employing A. platensis to reduce hazards from contaminated water and recover biomass resources.

Functionalized magnetic nanostructured composites and hybrids for photocatalytic elimination of pharmaceuticals and personal care products

Due to rapid urbanization and globalization, an enormous use of pharmaceuticals and personal care products (PPCPs) has resulted their excessive release in water bodies leading to several environmental issues. This release into the environment takes place via household sewage, hospital effluents, manufacturing units and landfill sites etc. The pharmaceuticals and personal care products (PPCPs) are recently listed as emerging contaminants having many adverse effects towards aquatic life, human beings, and the whole ecosystem. The alarming threats of PPCPs demand efficient methods to cope up their hazardous impacts. The conventional wastewater remediations are not specifically designed for the removal of PPCPs and hence, they require advanced technologies and materials for their elimination to ensure water safety. Among various methods employed so far, photocatalysis is considered to be one of the most cost effective and eco-friendly method but it requires a suitable candidate as a photocatalyst. Thanks to the magnetic nanocomposites which have improved the limitations (poor stability, agglomeration, and difficult separation, etc.) of classically used nanomaterials. Magnetic nanocomposites contain at least one component having magnetic properties making their separation easy from the aqueous media after the photodegradation phenomenon. These can be further functionalized with other materials to obtain maximum advantage as photocatalyst. Few examples of such functionalized nanocomposites are inorganic material based magnetic nanocomposites, carbon based magnetic nanocomposites, biomaterial based magnetic nanocomposites, metal-organic framework based magnetic nanocomposites and polymer based magnetic nanocomposites etc. This review covers the global environmental issue of water pollution especially with respect to the PPCPs, their occurrence in aqueous environment and toxic effects on living beings. A comprehensive discussion of the recently reported functionalized magnetic nanocomposites for the photocatalytic removal of PPCPs from water is the main aim of this review. The synthetic/morphological approaches of various functionalized magnetic composites and their mechanism of action are also elaborated. The possible research challenges in the field of magnetic nanocomposites and future research directions are discussed to apply magnetic nanocomposites for wastewater treatment in near future.

Degradation of Azithromycin from aqueous solution using Chlorine-ferrous- oxidation: ANN-GA modeling and Daphnia magna biotoxicity test assessment

Azithromycin (AZM), an antibacterial considered one of the most consumed drugs, especially during the period against the Covid 19 pandemic, and it is one of the persistent contaminants that can be released into aquatic ecosystems. The purpose of this study is to determine the efficacy of a Fenton-like process (chlorine/iron) for the degradation of AZM in an aqueous medium by determining the impact of several factors (the initial concentration of (FeSO₄, NaClO, pollutant), and the initial pH) on the degradation rate. The Response Surface Methodology (RSM) based on the Box-Wilson design as well as the Artificial Neural Network (ANN) modeling combined with a genetic algorithm (GA) approaches were used to determine the optimal levels of the selected variables and the optimal rate of degradation. The quadratic model of multi-linear regression developed indicated that the optimal conditions were a concentration of chlorine of 600 μM, the concentration of AZM is 32.8 mg/L, the mass of the catalyst FeSO₄ is 3.5 mg and a pH of 2.5, these optimal values gave a predicted and experimental yield of 64.05% and 70% respectively, the lack of fit test in RSM modeling (F₀ = 3.31 which is inferior to Fcritic (0.05, 10.4) = 5.96) indicates that the true regression function is not linear therefore, the ANN-GA modeling as non-linear regression indicated that the optimal conditions were a concentration of chlorine of 256 μM, the concentration of AZM is 5 mg/L, the mass of the catalyst FeSO₄ is 9.5 mg and a pH of 2.8, these optimal values gave a predicted and experimental yield of 79.69% and close to 80% respectively, Furthermore, biotoxicity tests were conducted to confirm the performance of our process using bio-indicators called daphnia (Daphnia magna), which demonstrated the efficacy of the like-Fenton process after 4 h of degradation.

Occurrence and Distribution of Antibiotics in the Water, Sediment, and Biota of Freshwater and Marine Environments: A Review

Antibiotics, as pollutants of emerging concern, can enter marine environments, rivers, and lakes and endanger ecology and human health. The purpose of this study was to review the studies conducted on the presence of antibiotics in water, sediments, and organisms in aquatic environments (i.e., seas, rivers, and lakes). Most of the reviewed studies were conducted in 2018 (15%) and 2014 (11%). Antibiotics were reported in aqueous media at a concentration of <1 ng/L−100 μg/L. The results showed that the highest number of works were conducted in the Asian continent (seas: 74%, rivers: 78%, lakes: 87%, living organisms: 100%). The highest concentration of antibiotics in water and sea sediments, with a frequency of 49%, was related to fluoroquinolones. According to the results, the highest amounts of antibiotics in water and sediment were reported as 460 ng/L and 406 ng/g, respectively. In rivers, sulfonamides had the highest abundance (30%). Fluoroquinolones (with an abundance of 34%) had the highest concentration in lakes. Moreover, the highest concentration of fluoroquinolones in living organisms was reported at 68,000 ng/g, with a frequency of 39%. According to the obtained results, it can be concluded that sulfonamides and fluoroquinolones are among the most dangerous antibiotics due to their high concentrations in the environment. This review provides timely information regarding the presence of antibiotics in different aquatic environments, which can be helpful for estimating ecological risks, contamination levels, and their management.

Metal-free single heteroatom (N, O, and B)-doped coconut-shell biochar for enhancing the degradation of sulfathiazole antibiotics by peroxymonosulfate and its effects on bacterial community dynamics

Metal-free single heteroatom (N, O, and B)-doped coconut-shell biochar (denoted as N-CSBC, O-CSBC, and B-CSBC, respectively) were fabricated in a one-step pyrolysis process to promote peroxymonosulfate (PMS) activation for the elimination of sulfathiazole (STZ) from aquaculture water. B-CSBC exhibited remarkably high catalytic activity with 92% of STZ degradation in 30 min attributed to the presence of meso-/micro-pores and B-containing functional groups (including B-N, B-C, and B₂O₃ species). Radical quenching tests revealed SO₄^•-, HO•, and ¹O₂ being the major electron acceptors contributing to STZ removal by PMS over B-CSBC catalyst. The B-CSBC catalyst has demonstrated high sustainability in multiple consecutive treatment cycles. High salinity and the presence of inorganic ions such as chloride, enhanced the performance of the sulfate radical-carbon-driven advanced oxidation processes (SR-CAOPs) as pretreatment strategy that significantly facilitated the removal of STZ from aquaculture water. Furthermore, a potential sulfonamide-degrading microorganism, Cylindrospermum_stagnale, belonging to the phylum Cyanobacteria, was the dominant functional bacteria according to the results of high-throughput 16S rRNA gene sequencing conducted after the B-CSBC/PMS treatment. This study provides new insights into the SR-CAOP combined with bioprocesses for removing STZ from aqueous environments.

A tiered probabilistic approach to assess antibiotic ecological and resistance development risks in the fresh surface waters of China

Exposure to antibiotics can result in not only ecotoxicity on aquatic organisms but also the development of antibiotic resistance. In the study, the ecotoxicity data and minimum inhibitory concentrations of the antibiotics were screened to derive predicted no-effect concentrations of ecological (PNEC_eco) and resistance development risks (PNEC_res) for 36 antibiotics in fresh surface waters of China. The derived PNEC_eco and PNEC_res values were ranged from 0.00175 to 2351 μg/L and 0.037-50 μg/L, respectively. Antibiotic ecological and resistance development risks were geographically widespread, especially in the Yongding River, Daqing River, and Ziya River basins of China. Based on the risk quotients, 11 and 14 of 36 target antibiotics were at high ecological risks and high resistance development risks in at least one basin, respectively. The higher tiered assessments provided more detailed risk descriptions by probability values and β-lactams (penicillin and amoxicillin) were present at the highest levels for ecological and resistance development risks. Although there was uncertainty based on the limited data and existing methods, this study can indicate the overall situation of the existing risk levels and provide essential insights and data supporting antibiotic management.