Occurrence and distribution of azithromycin in wastewater treatment plants, seawater, and sediments of the northern part of the Persian Gulf around Bushehr port: A comparison with Pre-COVID 19 pandemic

Antibiotics in surface waters of the south caspian sea: Occurrence, spatial distribution and ecological risks

Marine environments play a crucial role in absorbing land-based pollutants. While the presence of pharmaceuticals in various marine settings worldwide is well-documented, there is a lack of data regarding pharmaceutical occurrence in the south Caspian Sea. This study examined the presence and spatial distribution of 14 antibiotics in the surface waters of the south Caspian Sea during summer of 2020. Our findings revealed that antibiotics were widespread in this region, with total concentrations reaching up to 3499.9 ng/L. The detection frequencies of the studied antibiotics ranging from 22.0% to 67.0%. Trimethoprim, ofloxacin, and sulfamethoxazole were commonly detected, with detection frequencies exceeding 56.0%. Ofloxacin (235.8 ng/L) and Erythromycin-H2O (2.3 ng/L) had the highest and lowest detected concentrations among the studied antibiotics. Furthermore, fluoroquinolones exhibited notably higher concentrations compared to other antibiotic groups. The highest concentrations of most antibiotics were found in surface waters collected from Ramsar and Chalus stations, located in the middle section of the coastline. Across all transects, the distribution of antibiotics exhibited a decreasing trend towards the sea, indicating that coastal and inland aquaculture, as well as municipal wastewaters, were probably the primary sources of antibiotics in this area. Multivariate analysis revealed that antibiotics, phosphate, nitrate, and COD were all positively correlated with stations Ram-1, Ram-20, Cha-1, Cha-20, and Tor-1, where the highest antibiotic levels were recorded. Risk assessment indicated that clarithromycin, ofloxacin and enrofloxacin posed medium to high risks to aquatic organisms. These findings offer essential baseline information and valuable insights for the comparative assessment of future antibiotic data in the south Caspian Sea.

Long term study on the fate and environmental risks of favipiravir in wastewater treatment plants and comparison with COVID-19 cases

In recent years especially during COVID-19, the increased usage of antiviral drugs has led to increased interest in monitoring their presence in wastewater worldwide. In this study, it was examined the occurrence, fate and environmental risks of favipiravir which is used for COVID-19 treatment in two wastewater treatment plants (WWTPs) with different treatment processes in Istanbul, Turkey. Favipiravir was measured in WWTPs influent samples, effluent samples and sludge samples with maximum concentrations of 97 μg/L, 64.11 μg/L and 182.47 μg/g, respectively. Favipiravir had removal efficiency below 55 % for both WWTPs. Mass balance analysis showed that favipiravir removal in WWTPs mainly attributed to biodegradation/biotransformation. Statistical analysis revealed a significant correlation between favipiravir concentration and COVID-19 incidence in Istanbul. The microbial distribution analysis indicated that comparison of collected COVID-19 pandemic sludge and post-pandemic period sludge samples, a noteworthy reduction in the Chloroflexi and Actinobacteriota phyla at the phylum level was observed. Environmental risk assessment using risk quotients ranged from 168 to 704, indicating that the presence of this antiviral drug posed significant ecological risks to aquatic organisms. The study concluded that WWTPs were releasing antiviral drugs into the environment, thereby posing risks to both the aquatic ecosystem and public health. The results of this study demonstrate the persistence of favipiravir in WWTPs and offer crucial supporting data for further research into the advancement of wastewater treatment technology. Also, this study shows wastewater based monitoring is supplementary and early warning system for determining the occurrence of antiviral drugs.

Dynamics of antimicrobial resistance and susceptibility profile in full-scale hospital wastewater treatment plants

Drug resistance has become a matter of great concern, with many bacteria now resist multiple antibiotics. This study depicts the occurrence of antibiotic-resistant bacteria (ARB) and resistance patterns in five full-scale hospital wastewater treatment plants (WWTPs). Samples of raw influent wastewater, as well as pre- and post-disinfected effluents, were monitored for targeted ARB and resistance genes in September 2022 and February 2023. Shifts in resistance profiles of Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii antimicrobial-resistant indicators in the treated effluent compared to that in the raw wastewater were also worked out. Ceftazidime (6.78 × 105 CFU/mL) and cefotaxime (6.14 × 105 CFU/mL) resistant species showed the highest concentrations followed by ciprofloxacin (6.29 × 104 CFU/mL), and gentamicin (4.88 × 104 CFU/mL), in raw influent respectively. WWTP-D employing a combination of biological treatment and coagulation/clarification for wastewater decontamination showed promising results for reducing ARB emissions from wastewater. Relationships between treated effluent quality parameters and ARB loadings showed that high BOD5 and nitrate levels were possibly contributing to the persistence and/or selection of ARBs in WWTPs. Furthermore, antimicrobial susceptibility tests of targeted species revealed dynamic shifts in resistance profiles through treatment processes, highlighting the potential for ARB and ARGs in hospital wastewater to persist or amplify during treatment.

Global insight into the occurrence, treatment technologies and ecological risk of emerging contaminants in sanitary sewers: Effects of the SARS-CoV-2 coronavirus pandemic

The SARS-CoV-2 pandemic caused changes in the consumption of prescribed/non-prescribed drugs and the population's habits, influencing the detection and concentration of emerging contaminants (ECs) in sanitary sewage and harming environmental and health risks. Therefore, the present work sought to discuss current literature data on the effects of the "COVID-19 pandemic factor" on the quality of raw sewage produced over a five-year period (2018-2019: pre-pandemic; 2020-2022: during the pandemic) and biological, physical, chemical and hybrid treatment technologies, influencing factors in the removal of ECs and potential ecological risks (RQs). Seven hundred thirty-one publications correlating sewage and COVID-19 were identified: 184 pre-pandemic and 547 during the pandemic. Eight classes and 37 ECs were detected in sewage between 2018 and 2022, with the "COVID-19 pandemic factor" promoting an increase in estrogens (+31,775 %), antibiotics (+19,544 %), antiepileptics and antipsychotics (+722 %), pesticides (+200 %), analgesics, anti-inflammatories and anticoagulants (+173 %), and stimulant medications (+157 %) in sanitary sewage. Among the treatment systems, aerated reactors integrated into biomembranes removed >90 % of cephalexin, clarithromycin, ibuprofen, estrone, and 17β-estradiol. The absorption, adsorption, and biodegradation mechanisms of planted wetland systems contributed to better cost-benefit in reducing the polluting load of sewage ECs in the COVID-19 pandemic, individually or integrated into the WWTP. The COVID-19 pandemic factor increased the potential ecological risks (RQs) for aquatic organisms by 40 %, with emphasis on clarithromycin and sulfamethoxazole, which changed from negligible risk and low risk to (very) high risk and caffeine with RQ > 2500. Therefore, it is possible to suggest that the COVID-19 pandemic intensified physiological, metabolic, and physical changes to different organisms in aquatic biota by ECs during 2020 and 2022.

A new approach of simultaneous adsorption and regeneration of activated carbon to address the bottlenecks of pharmaceutical wastewater treatment

This study proposes a sustainable approach for hard-to-treat wastewater using sintered activated carbon (SAC) both as an adsorption filter and as an electrode, allowing its simultaneous electrochemical regeneration. SAC improves the activated carbon (AC) particle contact and thus the conductivity, while maintaining optimal liquid flow. The process removed 87 % of total organic carbon (TOC) from real high-load (initial TOC of 1625 mg/L) pharmaceutical wastewater (PWW), generated during the manufacturing of azithromycin, in 5 h, without external input of chemicals other than catalytic amounts of Fe(II). Kinetic modelling indicated that adsorption was the dominant process, while concomitant electrochemical degradation of complex organics first converted them to short-chain acids, followed by their full mineralization. In-situ electrochemical regeneration of SAC, taking place at the same time as the treatment, is a key feature of our process, enhancing its performance and ensuring its stable operation over time, while eliminating cleaning downtimes altogether. The energy consumption of this innovative process was remarkably low at 8.0×10-3 kWh gTOC-1. This study highlights the potential of SAC for treating hard-to-treat effluents by concurrent adsorption and mineralization of organics.

Understanding the photo-sensitive essence of organic-inorganic hybrids for the targeted detection of azithromycin

Being a macrolide antibiotic, the antiviral and anti-inflammatory properties of azithromycin (AZM) were taken advantage of during the COVID-19 pandemic which led to the overuse of AZM resulting in excessive release and accumulation in the waterways and ecosystem causing unpleasant threats to humankind. This demands the necessity for a highly sensitive material being capable of recognizing AZM in wastewater. Mindful of the optical attributes of organic ligand structures, we have constructed a hybrid material by chelating Zn2+ with pyridyl benzimidazole (PBI). The prepared sensor material ZnPBI was characterized using various microscopic and spectroscopic techniques including XRD, FT-IR, HR-SEM, HR-TEM, etc. The proposed sensor material exhibited proficient detection performance selectively towards AZM with a very low detection limit of 72 nM. Two linear ranges between 0 - 70 μM and 70-100 μM were observed corresponding to two different mechanistic pathways. To the best of our knowledge, the utilization of a metal-organic complex (MOC) for the fluorometric detection of AZM has not been explored so far. It is creditworthy to cite that the long-term structural stability of the sensor material was maintained for 100 days in water and it can be reused three times without any depreciation in the sensing activity. A combination of energy transfer routes, adsorption and electrostatic interactions for AZM detection are described experimentally and theoretically which provides insights into the role of MOC as sensing probes.

Exploring patterns of antibiotics during and after COVID-19 pandemic in wastewaters of northern Greece: Potential adverse effects on aquatic environment

Antibiotics, recognized as Emerging Contaminants (ECs), have raised concerns due to their pervasive presence in wastewater treatment plants (WWTPs) and subsequent release into aquatic environments, posing potential ecological risks and contributing to the development of antibiotic-resistant genes. The COVID-19 pandemic prompted an unprecedented surge in antibiotic consumption, necessitating a comprehensive assessment of its impact on antibiotic levels in wastewater. In this light, a four-year monitoring study (2020-2023) was conducted in a WWTP located in the Northern Greece (Thessaloniki), employing High-Resolution Mass Spectrometry (HRMS) technology to monitor twenty antibiotics, during distinct phases pre-, during, and post-COVID-19. Our findings revealed that macrolides and fluoroquinolones were among the most often detected categories during the sampling period. Among the compounds detected, azithromycin and clarithromycin showed the most significant increases during the pandemic, doubling their average concentrations. This establishes a clear correlation between the rise in their concentrations and the incidence of COVID-19 cases. A general downward trend after 2021 was attributed to the new restrictions posed in Greece during this year, regarding the liberal prescription of antibiotics. Seasonal variation revealed a minute augmentation of antibiotics' use during the months that infections are increased. Additionally, the study highlights the ecological risks associated with elevated antibiotic presence and emphasizes the need for continued monitoring and regulatory measures to mitigate potential ecological repercussions. These findings contribute to our understanding of the complex interplay between antibiotic consumption, environmental presence, and the COVID-19 pandemic's impact on antibiotic pollution in WWTPs.

Proposal for priority emerging pollutants in the Nakdong river, Korea: Application of EU watch list mechanisms

The Nakdong River, the longest in Korea, has received numerous pollutants from heavily industrialized and densely populated areas while being used as a drinking water source. A number of research have reported occurrences of emerging pollutants (EPs) in the river. The results requested efficient monitoring and systematic management strategies such as EU watch list under Water Framework Directive. The aim of this study is to propose a watch list through preliminary monitoring of the river and risk-based prioritization approach. As candidates for monitoring target, 632 substances were selected based on literature and database searches. Among them, 175 substances were subjected to target screening method whereas 457 were evaluated via suspect screening. A risk-based prioritization was applied to substances quantified through target screening based on concentrations, and a scoring-based prioritization was applied to substances tentatively identified through suspect screening. Sampling campaigns (n = 12) were conducted from October 2020 to September 2021, at 8 sampling sites along the river. As a result, 130 target substances were quantified above the LOQ. Among the 21 substances whose priority score was assigned through risk-based prioritization, telmisartan and iprobenfos were identified with very high environmental risk while candesartan, TBEP, imidacloprid, azithromycin and clotrimazole were classified with high or intermediate risk. As result of the scoring system for 39 tentatively identified substances, 6 substances (benzophenone, caprolactam, metolachlor oxanilic acid, heptaethylene glycol, octaethylene glycol and pentaethylene glycol), which were then confirmed with reference standards, showed a potential environmental risk. Those substances prioritized through target and suspect screening followed by scoring systems can be a subset for the watch list and potential targets for nationwide water quality monitoring program in the future.

Effects of azithromycin exposure during pregnancy at different stages, doses and courses on testicular development in fetal mice

Azithromycin is a commonly used antibiotic during pregnancy, but some studies have suggested its potential developmental toxicity. Currently, the effects and mechanisms of prenatal azithromycin exposure (PAzE) on fetal testicular development are still unclear. The effects of prenatal exposure to the same drug on fetal testicular development could vary depending on different stages, doses, and courses. Hence, in this study, based on clinical medication characteristics, Kunming mice was administered intragastrically with azithromycin at different stages (mid-/late-pregnancy), doses (50, 100, 200 mg/kg·d), and courses (single-/multi-course). Fetal blood and testicular samples were collected on GD18 for relevant assessments. The results indicated that PAzE led to changes in fetal testicular morphology, reduced cell proliferation, increased apoptosis, and decreased expression of markers related to Leydig cells (Star), Sertoli cells (Wt1), and spermatogonia (Plzf). Further investigation revealed that the effects of PAzE on fetal testicular development were characterized by mid-pregnancy, high dose (clinical dose), and single course having more pronounced effects. Additionally, the TGFβ/Smad and Nrf2 signaling pathways may be involved in the changes in fetal testicular development induced by PAzE. In summary, this study confirmed that PAzE influences fetal testicular morphological development and multicellular function. It provided theoretical and experimental evidence for guiding the rational use of azithromycin during pregnancy and further exploring the mechanisms underlying its developmental toxicity on fetal testicles.

Wastewater surveillance of pharmaceuticals during the COVID-19 pandemic in Mexico City and the Mezquital Valley: A comprehensive environmental risk assessment

This study tracked five pharmaceutically active compounds (PhACs) in Mexico City's sewage, namely, famotidine, indomethacin, dexamethasone, azithromycin, and ivermectin, which were used to treat COVID-19. The monitoring campaign was carried out over 30 months (May 2020 to November 2022), covering the five COVID-19 waves in Mexico. In the Central Emitter, the main sewage outflow, famotidine displayed levels of 132.57 ± 28.16 ng L-1 (range from < LOQ to 189.1 ng L-1), followed by indomethacin (average 672.46 ± 116.4 ng L-1, range from 516.7 to 945.2 ng L-1), dexamethasone (average 610.4 ± 225.7 ng L-1, range from 233.4 to 1044.5 ng L-1), azithromycin (average 4436.2 ± 903.6 ng L-1, range from 2873.7 to 5819.6 ng L-1), and ivermectin (average 3413.3 ± 1244.6 ng L-1, range from 1219.8 to 4622.4 ng L-1). The concentrations of dexamethasone, azithromycin and ivermectin were higher in sewage from a temporary COVID-19 care unit, by a factor of 3.48, 3.52 and 2.55, respectively, compared with those found in municipal wastewater. In the effluent of the Atotonilco Wastewater Treatment Plant (AWWTP), which treats near 60 % of the Mexico City's sewage, famotidine was absent, while concentrations of indomethacin, dexamethasone, azithromycin and ivermectin were 78.2 %, 76.7 %, 74.4 %, and 88.1 % lower than those in the influent, respectively. The occurrence of PhACs in treated and untreated wastewater resulted in medium to high environmental risk since Mexico City's wastewater is reused for irrigation in the Mezquital Valley. There, PhACs were found in irrigation canals at lower levels than those observed in Mexico City throughout the monitoring. On the other hand, famotidine, indomethacin, and dexamethasone were not found in surface water resulting from the infiltration of wastewater through soil in Mezquital Valley, while azithromycin and ivermectin sporadically appeared in surface water samples collected through 2021. Using an optimized risk assessment based on a semi-probabilistic approach, the PhACs were prioritized as ivermectin > azithromycin > dexamethasone > famotidine > indomethacin.

Effective removal of azithromycin by novel g-C3N4/CdS/CuFe2O4 nanocomposite under visible light irradiation

In this study, the visible light active pristine, binary and ternary g-C₃N₄/CdS/CuFe₂O₄ nanocomposite is prepared through a coprecipitation-assisted hydrothermal technique. The characterization of the as-synthesized catalysts was conducted using various analytical techniques. When compared with pristine and binary nanocomposites, the ternary g-C₃N₄/CdS/CuFe₂O₄ nanocomposite exhibits higher photocatalytic degradation of azithromycin (AZ) under a visible light source. Ternary nanocomposite exhibits high AZ removal efficiency of about 85% within 90 min of the photocatalytic degradation experiment. Enhanced the visible light absorption ability and the suppression of photoexcited charge carriers is also achieved by forming heterojunctions between pristine materials. The ternary nanocomposite exhibited ∼2 times higher degradation efficiency than CdS/CuFe₂O₄ nanoparticles and ∼3 times higher degradation efficiency than CuFe₂O₄. The trapping experiments were conducted and it shows superoxide radicals (O₂^•-) are the predominant reactive species involved in the photocatalytic degradation reaction. This study provided a promising approach for the treatment of contaminated water using g-C₃N₄/CdS/CuFe₂O₄ as a photocatalyst.

Biodegradation of COVID19 antibiotic; azithromycin and its impact on soil microbial community in the presence of phenolic waste and with temperature variation

The increase in using antibiotics, especially Azithromycin have increased steadily since the beginning of COVID19 pandemic. This increase has led to its presence in water systems which consequently led to its presence upon using this water for irrigation. The aim of the present work is to study the impact of irrigation using Azithromycin containing water on soil microbial community and its catabolic activity in the presence of phenolic wastes as compost. Wild berry, red grapes, pomegranate, and spent tea waste were added to soil and the degradation was monitored after 5 and 7 days at ambient and high temperatures. The results obtained show that at 30 °C, soil microbial community collectively was able to degrade Azithromycin, while at 40 °C, addition of spent tea as compost was needed to reach higher degradation. To ensure that the degradation was biotic and depended on degradation by indigenous microflora, a 25 kGy irradiation dose was used to kill the microorganisms in the soil and this was used as negative control. The residual antibiotic was assayed using UV spectroscopy and High Performance Liquid Chromatography (HPLC). Indication of Azithromycin presence was studied using Fourier Transform Infrared Spectroscopy (FTIR) peaks and the same pattern was obtained using the 3 used detection methods, the ability to assign the peaks even in the presence of soil and not to have any overlaps, gives the chance to study this result in depth to prepare IR based sensor for quick sensing of antibiotic in environmental samples.