High concentration and high dose of disinfectants and antibiotics used during the COVID-19 pandemic threaten human health

A new parameter for quantitatively characterizing antibiotic hormesis: QSAR construction and joint toxic action judgment

Antibiotics usually induce the hormetic effects on bacteria, featured by low-dose stimulation and high-dose inhibition, which challenges the central belief in toxicity assessment and environmental risk assessment of antibiotics. However, there are currently no ideal parameters to quantitatively characterize hormesis. In this study, an effective area in hormesis (AH) was developed to quantify the biphasic dose-responses of single antibiotics (sulfonamides (SAs), sulfonamides potentiators (SAPs), and tetracyclines (TCs)) and binary mixtures (SAs-SAPs, SAs-TCs, and SAs-SAs) to the bioluminescence of Aliivibrio fischeri. Using Ebind (the lowest interaction energy between antibiotic and target protein) and Kow (octanol-water partition coefficient) as the structural descriptors, the reliable quantitative structure-activity relationship (QSAR) models were constructed for the AH values of test antibiotics and mixtures. Furthermore, a novel method based on AH was established to judge the joint toxic actions of binary antibiotics, which mainly exhibited synergism. The results also indicated that SAPs (or TCs) contributed more than SAs in the hormetic effects of antibiotic mixtures. This study proposes a new quantitative parameter for characterizing and predicting antibiotic hormesis, and considers hormesis as an integrated whole to reveal the combined effects of antibiotics, which will promote the development of risk evaluation for antibiotics and their mixtures.

Cyclization of acyl thiosemicarbazides led to new Helicobacter pylori α-carbonic anhydrase inhibitors

The eradication of Helicobacter pylori, the etiologic agent of gastric ulcer and adenocarcinoma, is a big concern in clinics due to the increasing drug resistance phenomena and the limited number of efficacious treatment options. The exploitation of the H. pylori carbonic anhydrases (HpCAs) as promising pharmacological targets has been validated by the antibacterial activity of previously reported CA inhibitors due to the role of these enzymes in the bacterium survival in the gastric mucosa. The development of new HpCA inhibitors seems to be on the way to filling the existing antibiotics gap. Due to the recent evidence on the ability of the coumarin scaffold to inhibit microbial α-CAs, a large library of derivatives has been developed by means of a pH-regulated cyclization reaction of coumarin-bearing acyl thiosemicarbazide intermediates. The obtained 1,3,4-thiadiazoles (10-18a,b) and 1,2,4-triazole-3-thiones (19-26a,b) were found to strongly and selectively inhibit HpαCA and computational studies were fundamental to gaining an understanding of the interaction networks governing the enzyme-inhibitor complex. Antibacterial evaluations on H. pylori ATCC 43504 highlighted some compounds that maintained potency on a resistant clinical isolate. Also, their combinations with metronidazole decreased both the minimal inhibitory concentration and minimal bactericidal concentration values of the antibiotic, with no synergistic effect.

Mechanisms linking triclocarban biotransformation to functional response and antimicrobial resistome evolution in wastewater treatment systems

Evaluating the role of antimicrobials biotransformation in the regulation of metabolic functions and antimicrobial resistance evolution in wastewater biotreatment systems is crucial to ensuring water security. However, the associated mechanisms remain poorly understood. Here, we investigate triclocarban (TCC, one of the typical antimicrobials) biotransformation mechanisms and the dynamic evolution of systemic function disturbance and antimicrobial resistance risk in a complex anaerobic hydrolytic acidification (HA)-anoxic (ANO)/oxic (O) process. We mined key functional genes involved in the TCC upstream (reductive dechlorination and amide bonds hydrolysis) and downstream (chloroanilines catabolism) biotransformation pathways by metagenomic sequencing. Acute and chronic stress of TCC inhibit the production of volatile fatty acids (VFAs), NH4+ assimilation, and nitrification. The biotransformation of TCC via a single pathway cannot effectively relieve the inhibition of metabolic functions (e.g., carbon and nitrogen transformation and cycling) and enrichment of antimicrobial resistance genes (ARGs). Importantly, the coexistence of TCC reductive dechlorination and hydrolysis pathways and subsequent ring-opening catabolism play a critical role for stabilization of systemic metabolic functions and partial control of antimicrobial resistance risk. This study provides new insights into the mechanisms linking TCC biotransformation to the dynamic evolution of systemic functions and risks, and highlights critical regulatory information for enhanced control of TCC risks in complex biotreatment systems.

COVIDHealth: A novel labeled dataset and machine learning-based web application for classifying COVID-19 discourses on Twitter

The COVID-19 pandemic has sparked widespread health-related discussions on social media platforms like Twitter (now named 'X'). However, the lack of labeled Twitter data poses significant challenges for theme-based classification and tweet aggregation. To address this gap, we developed a machine learning-based web application that automatically classifies COVID-19 discourses into five categories: health risks, prevention, symptoms, transmission, and treatment. We collected and labeled 6,667 COVID-19-related tweets using the Twitter API, and applied various feature extraction methods to extract relevant features. We then compared the performance of seven classical machine learning algorithms (Decision Tree, Random Forest, Stochastic Gradient Descent, Adaboost, K-Nearest Neighbor, Logistic Regression, and Linear SVC) and four deep learning techniques (LSTM, CNN, RNN, and BERT) for classification. Our results show that the CNN achieved the highest precision (90.41%), recall (90.4%), F1 score (90.4%), and accuracy (90.4%). The Linear SVC algorithm exhibited the highest precision (85.71%), recall (86.94%), and F1 score (86.13%) among classical machine learning approaches. Our study advances the field of health-related data analysis and classification, and offers a publicly accessible web-based tool for public health researchers and practitioners. This tool has the potential to support addressing public health challenges and enhancing awareness during pandemics. The dataset and application are accessible at https://github.com/Bishal16/COVID19-Health-Related-Data-Classification-Website.

Penicillin Allergy in China: Consequences of Inappropriate Skin Testing Practices and Policies

Penicillins are the most frequently prescribed class of medications worldwide and first-line antibiotic of choice for most bacterial infections. They are also commonly labelled as the culprit of drug 'allergy'; leading to obligatory use of second-line antibiotics, suboptimal antibiotic therapy and increased antimicrobial resistance. However, the majority of reported penicillin 'allergy' labels are found to be incorrect after allergy testing, emphasising the importance of proper drug allergy testing and evaluation. Penicillin skin testing (PST) remains an important component of drug allergy diagnosis; however, its practice and policies significantly differ across the world. Inappropriate and non-evidence-based PST practices can lead to consequences associated with allergy mislabelling. Even within different regions of China, with a population exceeding 1.4 billion, there are marked differences in the implementation, execution and interpretation of PST. This review aims to examine the differences in PST between Mainland China, Hong Kong and the rest of the world. We critically analyse the current practice of 'pre-emptive' PST in Mainland China, which has a significant false-positive rate leading to high levels of penicillin allergy mislabelling. Non-evidence-based practices further compound the high false-positive rates of indiscriminatory PST. We postulate that inappropriate PST policies and practices may exacerbate the mislabelling of penicillin allergy, leading to unnecessary overuse of inappropriate second-line antibiotics, increasing antimicrobial resistance and healthcare costs. We advocate for the importance of more collaborative research to improve the contemporary workflow of penicillin allergy diagnosis, reduce mislabelling and promote the dissemination of evidence-based methods for allergy diagnosis.

Disinfectant-induced ammonia oxidation disruption in microbial N-cycling process in aquatic ecosystem after the COVID-19 outbreak

Anthropogenic activities significantly impact the elemental cycles in aquatic ecosystems, with the N-cycling playing a critical role in potential nutrient turnover and substance cycling. We hypothesized that measures to prevent COVID-19 transmission profoundly altered the nitrogen cycle in riverine ecosystems. To investigate this, we re-analyzed metagenomic data and identified 60 N-cycling genes and 21 host metagenomes from four urban reaches (one upstream city, Wuhan, and two downstream cities) along the Yangtze River. Our analyses revealed a marked decrease in the abundance of bacterial ammonia monooxygenase genes, as well as in the host, ammonia-oxidizing autotrophic Nitrosomonas, followed by a substantial recovery post-pandemic. We posited that discharge of sodium hypochlorite (NaOCl) disinfectant may be a primary factor in the reduction of N-cycling process. To test this hypothesis, we exposed pure cultures of Nitrosomonas europaea to NaOCl to explore the microbial stress response. Results indicated that NaOCl exposure rapidly compromised the cell structure and inhibited ammonia oxidation of N. europaea, likely due to oxidative stress damage and reduced expression of nitrogen metabolism-related ammonia monooxygenase. Using the functional tagging technique, we determined that NaOCl directly destroyed the ammonia monooxygenase protein and DNA structure. This study highlights the negative impacts of chlorine disinfectants on the function of aquatic ecosystems and elucidates potential mechanisms of action.

The combination of ciprofloxacin and dialkyldimethyl ammonium compound synergistically proliferated intracellular resistance genes in nitrifying system

Antibiotics and quaternary ammonium compounds (QACs) usually co-exist in wastewater treatment plants. Hence, three sequencing batch reactors were established and named as R1, R2 and R3, to investigate the effects of individual and combined exposure of different concentrations of ciprofloxacin (CIP) (0.2, 1.0 and 2.0 mg/L) and dialkyldimethyl ammonium compound (DADMAC) (0.4, 2.0 and 4.0 mg/L) on the performance, microbial community structures and resistance genes (RGs) in nitrifying system during 150 days. Results showed that CIP had a slight effect on ammonia oxidation activity, while 2.0 and 4.0 mg/L DADAMAC could obviously inhibit it, and the combination of CIP and DADMAC had a synergistic inhibitory effect. Besides, both CIP and DADMAC caused partial nitrification, and the order of nitrite accumulation rate was ranked as R3 > R2 > R1. The combination of CIP and DADMAC had an antagonistic effect on the increase of sludge particle size and α-Helix/(β-Sheet + Random coil) was lowest in R3 (0.40). The combination of CIP and DADMAC synergistically stimulated most intracellular RGs in sludge, and the relative abundances of target RGs (e.g., qacEdelta1-01, qacH-01 and qnrS) at the end of operation in R3 were increased by 4.61-18.19 folds compared with those in CK, which were 1.34-5.57 folds higher than the R1 and R2. Moreover, the combination of CIP and DADMAC also promoted the transfer of RGs from sludge to water and enriched more potential hosts of RGs, further promoting the spread of RGs in nitrifying system. Thus, the combined pollution of CIP and DADMAC in wastewaters should attract more attentions.

Characterization and Performance of Peanut Shells in Caffeine and Triclosan Removal in Batch and Fixed-Bed Column Tests

Peanut shells' adsorption performance in caffeine and triclosan removal was studied. Peanut shells were analyzed for their chemical composition, morphology, and surface functional groups. Batch adsorption and fixed-bed column experiments were carried out with solutions containing 30 mg/L of caffeine and triclosan. The parameters examined included peanut shell particle size (120-150, 300-600, and 800-2000 µm), adsorbent dose (0.02-60 g/L), contact time (up to 180 min), bed height (4-8 cm), and hydraulic loading rate (2.0 and 4.0 m3/m2-day). After determining the optimal adsorption conditions, kinetics, isotherm, and breakthrough curve models were applied to analyze the experimental data. Peanut shells showed an irregular surface and consisted mainly of polysaccharides (around 70% lignin, cellulose, and hemicellulose), with a specific surface area of 1.7 m2/g and a pore volume of 0.005 cm3/g. The highest removal efficiencies for caffeine (85.6 ± 1.4%) and triclosan (89.3 ± 1.5%) were achieved using the smallest particles and 10.0 and 0.1 g/L doses over 180 and 45 min, respectively. Triclosan showed easier removal compared to caffeine due to its higher lipophilic character. The pseudo-second-order kinetics model provided the best fit with the experimental data, suggesting a chemisorption process between caffeine/triclosan and the adsorbent. Equilibrium data were well-described by the Sips model, with maximum adsorption capacities of 3.3 mg/g and 289.3 mg/g for caffeine and triclosan, respectively. In fixed-bed column adsorption tests, particle size significantly influenced efficiency and hydraulic behavior, with 120-150 µm particles exhibiting the highest adsorption capacity for caffeine (0.72 mg/g) and triclosan (143.44 mg/g), albeit with clogging issues. The experimental data also showed good agreement with the Bohart-Adams, Thomas, and Yoon-Nelson models. Therefore, the findings of this study highlight not only the effective capability of peanut shells to remove caffeine and triclosan but also their versatility as a promising option for water treatment and sanitation applications in different contexts.

Urban Wastewater-Based Surveillance of SARS-CoV-2 Virus: A Two-Year Study Conducted in City of Patras, Greece

Wastewater-based epidemiology, during the COVID-19 pandemic years, has been applied as a complementary approach, worldwide, for tracking SARS-CoV-2 virus into the community and used as an early warning of the prevalence of COVID-19 infection. The present study presents the results of the 2-year surveillance project, in the city of Patras, Greece. The purpose of the study was to monitor SARS-CoV-2 and implement WBE as an early warning method of monitoring Public Health impact. The presence of SARS-CoV-2 was determined and quantified in 310 samples using RT-qPCR assays. For the years 2022 and 2023, 93.5% and 78.7% of samples were found positive, respectively. Comparison of detection methods have been conducted to select the method with the highest recovery of the viral load. A seasonal variation of the virus was recorded, showing a recession in summer months confirming the country's epidemiological data as indicated by positive correlation of wastewater viral load with registered cases of COVID-19 infections during these years (p < 0.05) and moreover sealed with a significant negative correlation observed with Daily Average (p < 0.01) and Daily Maximum Temperature (p < 0.01). More research was carried out to elucidate a possible association of physicochemical characteristics of wastewater with viral load showing positive correlation with Chlorides (p < 0.01) advocating possible increased use of chlorine-based disinfectants and Electrical Conductivity (p < 0.01) indicates that wastewater during periods of increased infections is more heavily loaded with ions from chemical and biological pollutants. No correlation found with rainfall and physicochemical indicators, such as COD, BOD5, Total Phosphorus, Total Nitrogen, and Total Suspended Solids. According to the findings, WBE represents a useful tool in the management of epidemics based on an environmental approach and it can also shed light on the interacting parameters that capture Public Health since any infections that may lead to epidemics lead to a parallel change in the use of pharmaceuticals, antimicrobials, disinfectants, and microbial load in urban wastewater.

A study on the subchronic toxicity of triclocarban to the early-life development of oryzias melastigma and focused on the analysis of osmoregulatory regulation mechanisms

Triclocarban (TCC), a novel antimicrobial agent found in personal care products, has been extensively detected in marine environments. However, research on the toxic effects of TCC on marine organisms remains inadequate. This study delved into the subchronic toxic effects of TCC on the early life stages of marine medaka (Oryzias melastigma, O. melastigma), revealing that TCC could reduce embryo heart rate and hatching rate while diminishing the survival rate of larvae. Biomarker assays indicated that TCC could inflict damage on the embryos' antioxidant and nervous systems. Transcriptomic analysis suggested that TCC could impact cell growth, reproduction, and various life processes, activating cancer signaling pathways, increasing the likelihood of cancer, and exerting toxic effects on the immune and osmoregulatory systems. To validate and enhance our understanding of TCC's unique toxic impact on the osmoregulatory system of O. melastigma, we conducted homology modeling and molecular docking analyses on the protein involved in osmoregulation. The study intuitively revealed the potential binding affinity of TCC to sodium/potassium-transporting ATPase subunit alph (ATP1A1), indicating its ability to disrupt osmotic balance in marine fish by affecting this target protein. In summary, the results of this study will further enhance our comprehension of the potential toxic effects and mechanisms of TCC on the early stages of marine fish, with a specific focus on its unique toxic effects in osmoregulation.

Manure application amplified the co-selection of quaternary ammonium disinfectant and antibiotic on soil antibiotic resistome

Disinfectants and antibiotics are widely used for the prevention and control of bacterial infectious diseases. Frequent disinfection is thought to exacerbate antibiotic resistance. However, little is known about how disinfectants and antibiotics co-induce changes in the soil antibiotic resistance genes (ARGs). This study determined the ARG profiles and bacterial community dynamics between unamended soil and manure-amended soil exposed to benzalkonium chloride (C12) (BC, 10 mg kg-1) disinfectant and sulfamethazine (SMZ, 1 mg kg-1), using high-throughput quantitative PCR and 16 S rRNA gene sequencing. Manure application enriched the soil in terms of ARGs abundance and diversity, which synergistically amplified the co-selection effect of BC and SMZ on soil antibiotic resistome. Compared with the control treatment, BC and SMZ exposure had a smaller impact on the bacterial infectious diseases and antimicrobial resistance-related functions in manure-amended soil, in which bacterial communities with greater tolerance to antimicrobial substances were constructed. Manure application increased the proportion of rank I ARGs and potential human pathogenic bacteria, while BC and SMZ exposure increased the drug-resistant pathogens transmission risk. This study validated that BC and SMZ aggravated the antimicrobial resistance under manure application, providing a reference for managing the spread risk of antimicrobial resistance in agricultural activities.

Far-UV-C irradiation promotes synergistic bactericidal action against adhered cells of Escherichia coli and Staphylococcus epidermidis

The contamination of indoor areas is a global health problem that can cause the dispersion of infectious diseases. In that sense, it is urgent to find new strategies applying a lower concentration of the traditional chemicals used for cleaning and disinfection. Ultraviolet radiation (UV), in particular far-UV-C (200-225 nm), has emerged as a successful, powerful, easy-to-apply, and inexpensive approach for bacterial eradication that still requires scientific assessment. This study investigated new strategies for disinfection based on far-UV-C (222 nm) combined with chlorine and mechanical cleaning, providing an innovative solution using low doses. The bactericidal activity of far-UV-C (222 nm) was tested at an intensity of irradiation from 78.4 μW/cm2 to 597.7 μW/cm2 (for 1 min) against Escherichia coli and Staphylococcus epidermidis adhered on polystyrene microtiter plates. It was further tested in combination with mechanical cleaning (ultrasounds for 1 min) and free chlorine (0.1, 0.5, and 1 mg/L for 5 min). The triple combination consisting of mechanical cleaning + free chlorine (0.5 mg/L) + far-UV-C (54 mJ/cm2) was tested against cells adhered to materials found in hospital settings and other public spaces: polyvinyl chloride (PVC), stainless steel (SS), and polyetheretherketone (PEEK). Disinfection with far-UV-C (54 mJ/cm2) and free chlorine at 0.5 mg/L for 5 min allowed a total reduction of culturable E. coli cells and a logarithmic reduction of 2.98 ± 0.03 for S. epidermidis. The triple combination of far-UV-C, free chlorine, and mechanical cleaning resulted in a total reduction of culturable cells for both adhered bacteria. Bacterial adhesion to PVC, SS, and PEEK occurred at distinct extents and influenced the bactericidal activity of the triple combination, with logarithmic reductions of up to three. The overall results highlight that, based on culturability assessment, far-UV-C (54 mJ/cm2) with chlorine (0.5 mg/L; 5 min) and mechanical cleaning (1 min) as an efficient disinfection strategy using mild conditions. The combination of culturability and viability assessment of disinfection is recommended to detect regrowth events and increase the effectiveness in microbial growth control.

Interphylum dissemination of NDM-5-positive plasmids in hospital wastewater from Fuzhou, China: a single-centre, culture-independent, plasmid transmission study

BACKGROUND

The global spread of plasmid-borne carbapenem resistance is an ongoing public health challenge; however, the nature of such horizontal gene transfer events among complex bacterial communities remains poorly understood. We examined the in-situ transfer of the globally dominant New Delhi metallo-β-lactamase (NDM)-5-positive IncX3 plasmid (denoted pX3_NDM-5) in hospital wastewater to simulate a real-world, One Health antimicrobial resistance context.

METHODS

For this transmission study, we tagged pX3_NDM-5 with the green fluorescent protein gene, gfp, using a CRISPR-based method and transferred the plasmid to a donor Escherichia coli strain. Bacteria were extracted from a hospital wastewater treatment plant (Fujian Provincial Maternity and Children's Hospital, Fuzhou, China) as the bacterial recipient community. We mixed this recipient community with the E coli donor strain carrying the gfp-tagged plasmid, both with and without sodium hypochlorite (NaClO) as an environmental stressor, and conducted several culture-based and culture-independent conjugation assays. The conjugation events were observed microscopically and quantified by fluorescence-activated cell sorting. We analysed the taxonomic composition of the sorted transconjugal pool by 16S rRNA gene amplicon sequencing and assessed the stability of the plasmid in the isolated transconjugants and its ability to transfer back to E coli.

FINDINGS

We show that the plasmid pX3_NDM-5 has a broad host range and can transfer across various bacterial phyla, including between Gram-negative and Gram-positive bacteria. Although environmental stress with NaClO did not affect the overall plasmid transfer frequency, it reduced the breadth of the transconjugant pool. The taxonomic composition of the transconjugal pool was distinct from that of the recipient communities, and environmental stress modulated the permissiveness of some operational taxonomic units towards the acquisition of pX3_NDM-5. Notably, pX3_NDM-5 transconjugants included the Gram-positive pathogen Enterococcus faecalis, and the plasmid could subsequently be reconjugated back to E coli. These findings suggest that E faecalis could act as a natural shuttle vector for the wide dissemination of pX3_NDM-5 plasmids.

INTERPRETATION

Our culture-independent conjugation model simulates natural environmental conditions and challenges the established theory that Gram-negative and Gram-positive bacteria rarely exchange clinically important plasmids. The data show that plasmids disseminate more widely across genera and phyla than previously thought. These findings have substantial implications when considering the spread of antimicrobial resistance across One Health sectors.

FUNDING

The Laboratory of Lingnan Modern Agriculture Project, the National Natural Science Foundation of China, the Natural Science Foundation of Fujian Province of China, and the Outstanding Young Research Talents Program of Fujian Agriculture and Forestry University.

Can microplastics and disinfectant resistance genes pose conceivable threats to water disinfection process?

Microplastic pollution in the environment has aroused widespread concerns, however, the potential environmental risks caused by excessive use of disinfectants are still unknown. Disinfectants with doses below the threshold can enhance the communication of resistance genes in pathogenic microorganisms, promoting the development and spread of antimicrobial activity. Problematically, the intensification of microplastic pollution and the increase of disinfectant consumption will become a key driving force for the growth of disinfectant resistance bacteria (DRB) and disinfectant resistance genes (DRGs) in the environment. Disinfection plays a crucial role in ensuring water safety, however, the presence of microplastics and DRGs seriously disturb the water disinfection process. Microplastics can reduce the concentration of disinfectant in the local environment around microorganisms and improve their tolerance. Microorganisms can improve their resistance to disinfectants or generate resistance genes via phenotypic adaptation, gene mutations, and horizontal gene transfer. However, very limited information is available on the impact of DRB and DRGs on disinfection process. In this paper, the contribution of microplastics to the migration and transmission of DRGs was analyzed. The challenges posed by the presence of microplastics and DRGs on conventional disinfection were thoroughly discussed. The knowledge gaps faced by relevant current research and further research priorities have been proposed in order to provide a scientific basis in the future.

Residual chlorine persistently changes antibiotic resistance gene composition and increases the risk of antibiotic resistance in sewer systems

During the COVID-19 pandemic, excessive amounts of disinfectants and their transformation products entered sewer systems worldwide, which was an extremely rare occurrence before. The stress of residual chlorine and disinfection by-products is not only likely to promote the spread of antibiotic resistance genes (ARGs), but also leads to the enrichment of chlorine-resistant bacteria that may also be resistant to antibiotics. Therefore, the potential impact of such discharge on ARG composition should be studied and the health risks should be assessed. Thus, this study combined high-throughput 16S rRNA gene amplicon sequencing and metagenomic analysis with long-term batch tests that involved two stages of stress and recovery to comprehensively evaluate the impact of residual chlorine on the microbial community and ARG compositions in sewer systems. The tests demonstrated that the disturbance of the microbial community structure by residual chlorine was reversible, but the change in ARG composition was persistent. This study found that vertical propagation and horizontal gene transfer jointly drove ARG composition succession in the biofilm, while the driving force was mainly horizontal gene transfer in the sediment. In this process, the biocide resistance gene (BRG) subtype chtR played an important role in promoting co-selection with ARGs through plasmids and integrative and conjugative elements. Moreover, it was further shown that the addition of sodium hypochlorite increased the risk of ARGs to human health, even after discontinuation of dosing, signifying that the impact was persistent. In general, this study strengthens the co-selection theory of ARGs and BRGs, and calls for improved disinfection strategies and more environmentally friendly disinfectants.

Evaluation of the impact of different disinfectants on new coronavirus and human health

A new health threat was appeared in 2019 known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19). The new coronavirus distributed all over the world and caused millions of deaths. One way to incomplete the process of COVID-19 transfer from one person to another is using disinfectants. A narrative review study was done on manuscript published documents about the stability of the virus, different types of disinfectants and the effects of disinfectants on SARS-CoV2 and environment from 2005 to 2022 based on Searched databases included Google Scholar, Springer, PubMed, Web of Science and Science Direct (Scopus). All relevant studies published 2005 until 2022 gathered. According to the databases, 670 articles were retrieved. Thirty studies were screened after review and 30 full-text articles entered into the analysis process. Finally, 14 articles were selected in this study. New coronavirus could survive until 9 days in room temperature; the surviving time decreases if temperature increases. The virus can survive in various plastic, glass, and metal surfaces for hours to days. Disinfectants, such as alcohol, isopropanol, formaldehyde, glutaraldehyde, and ethanol, can kill 70-90% viruses in up to 30 s but should be noted that these disinfectants are recognized by Occupational Safety and Health Administration (OSHA) as a potential carcinogen. According to the different reports, increased duration and level of disinfectant exposure can have negative impacts on human and animal health including upper and lower respiratory tract irritation, inflammation, edema, ulceration, and allergic reactions.

Therapeutic Potential of Marine Probiotics: A Survey on the Anticancer and Antibacterial Effects of Pseudoalteromonas spp

Due to the increasing limitations and negative impacts of the current options for preventing and managing diseases, including chemotherapeutic drugs and radiation, alternative therapies are needed, especially ones utilizing and maximizing natural products (NPs). NPs abound with diverse bioactive primary and secondary metabolites and compounds with therapeutic properties. Marine probiotics are beneficial microorganisms that inhabit marine environments and can benefit their hosts by improving health, growth, and disease resistance. Several studies have shown they possess potential bioactive and therapeutic actions against diverse disease conditions, thus opening the way for possible exploitation of their benefits through their application. Pseudoalteromonas spp. are a widely distributed heterotrophic, flagellated, non-spore-forming, rod-shaped, and gram-negative marine probiotic bacteria species with reported therapeutic capabilities, including anti-cancer and -bacterial effects. This review discusses the basic concepts of marine probiotics and their therapeutic effects. Additionally, a survey of the anticancer and antibacterial effects of Pseudoalteromonas spp. is presented. Finally, marine probiotic production, advances, prospects, and future perspectives is presented.

Advancements in the dominion of fate and transport of pharmaceuticals and personal care products in the environment-a bibliometric study

The study on the fate and transport of Pharmaceuticals and Personal Care Products, PPCPs (FTP) in the environment, has received particular attention for over two decades. The PPCPs threaten ecology and human health even at low concentrations due to their synergistic effects and long-range transport. The research aims to provide an inclusive map of the scientific background of FTP research over the last 25 years, from 1996 to 2020, to identify the main characteristics, evolution, salient research themes, trends, and research hotspots in the field of interest. Bibliometric networks were synthesized and analyzed for 577 journal articles extracted from the Scopus database. Consequently, seven major themes of FTP research were identified as follows: (i) PPCPs category; (ii) hazardous effects; (iii) occurrence of PPCPs; (iv) PPCPs in organisms; (v) remediation; (vi) FTP-governing processes; and (vii) assessment in the environment. The themes gave an in-depth picture of the sources of PPCPs and their transport and fate processes in the environment, which originated from sewage treatment plants and transported further to sediment/soils/groundwater/oceans that act as the PPCPs' major sink. The article provided a rigorous analysis of the research landscape in the FTP study conducted during the specified years. The prominent research themes, content analysis, and research hotspots identified in the study may serve as the basis of real-time guidance to lead future research areas and a prior review for policymakers and practitioners.

Environmental sporobiota: Occurrence, dissemination, and risks

Spore-forming bacteria known as sporobiota are widespread in diverse environments from terrestrial and aquatic habitats to industrial and healthcare systems. Studies on sporobiota have been mainly focused on food processing and clinical fields, while a large amount of sporobiota exist in natural environments. Due to their persistence and capabilities of transmitting virulence factors and antibiotic resistant genes, environmental sporobiota could pose significant health risks to humans. These risks could increase as global warming and environmental pollution has altered the life cycle of sporobiota. This review summarizes the current knowledge of environmental sporobiota, including their occurrence, characteristics, and functions. An interaction network among clinical-, food-related, and environment-related sporobiota is constructed. Recent and effective methods for detecting and disinfecting environmental sporobiota are also discussed. Key problems and future research needs for better understanding and reducing the risks of environmental sporobiota and sporobiome are proposed.

Bacterial drug-resistance and viability phenotyping upon disinfectant exposure revealed by single-nucleotide resolved-allele specific isothermal RNA amplification

Disinfectant abuse poses a risk of bacterial evolution against stresses, especially during the coronavirus disease 2019 (COVID-19) pandemic. However, bacterial phenotypes, such as drug resistance and viability, are hard to access quickly. Here, we reported an allele specific isothermal RNA amplification (termed AlleRNA) assay, using an isothermal RNA amplification technique, i.e., nucleic acid sequence-based amplification (NASBA), integrated the amplification refractory mutation system (ARMS), involving the use of sequence-specific primers to allow the amplification of the targets with complete complementary sequences. AlleRNA assay enables rapid and simultaneous detection of the single nucleotide polymorphism (SNP) (a detection limit, a LOD of 0.5 % SNP) and the viability (a LOD of 80 CFU) of the quinolone resistant Salmonella enterica. With the use of AlleRNA assay, we found that the quinolone resistant S. enterica exhibited higher survival ability during exposure toquaternary ammonium salt, 75 % ethanol and peracetic acid, which might be attributed to the upregulation of stress response-associated genescompared with the susceptible counterparts. Additionally, the AlleRNA assay indicated the potential risk in a high-frequency occurrence of viable but nonculturable (VBNC) quinolone resistant S. enterica induced by disinfectants due to the depression of ATP biosynthesis. The excessive usage of disinfectants during the COVID-19 pandemic should be carefully evaluated due to the latent threat to ecological and human health.

The efficient removal of congo red and ciprofloxacin by peony seeds shell activated carbon with ultra-high specific surface area

Preparation of high-performance activated carbon from agroforestry waste biomass can effectively improve the shortcomings of traditional biomass carbon performance. Using the waste biomass peony seeds shell (PSS) as the precursors in this study, high performance activated carbon was prepared by the KOH two-step activation method and used to remove congo red (CR) and ciprofloxacin (CIP) in water pollution. The obtained PSS-based activated carbons (PSACs) were characterized by SEM, EDS, N₂ adsorption-desorption isotherm, FTIR, and XRD methods. The results showed that the activated carbon at 700 °C (PSAC-700) had an ultra-high specific surface area (2980.96 m²/g), excellent micropore volume (1.12 cm³/g), and abundant surface functional groups. The results of adsorption performance revealed that PSAC-700 exhibited excellent adsorption capacity for CR (q_max = 2003.2 mg/g) and CIP (q_max = 782.3 mg/g), which was superior to the carbon-based adsorbents reported reviously in the literature. Langmuir model could well describe the adsorption process of PSACs for CR and CIP, indicating that the pollutant molecules were uniformly adsorbed on the surface monolayer. The regeneration experiment suggested that after three cycles, the adsorption capacities of PSAC-700 for CR and CIP reached 1814 mg/g and 697 mg/g, respectively, with good repeatability. The preparation of PSAC-700 in this study has high adsorption capacity and strong application, which is an ideal material for wastewater purification adsorbent and has broad application prospect.

Fish liver damage related to the wastewater treatment plant effluents

Wastewater treatment plants (WWTPs) continuously release a complex mixture of municipal, hospital, industrial, and runoff chemicals into the aquatic environment. These contaminants are both legacy contaminants and emerging-concern contaminants, affecting all tissues in a fish body, particularly the liver. The fish liver is the principal detoxifying organ and effects of consistent pollutant exposure can be evident on its cellular and tissue level. The objective of this paper is thus to provide an in-depth analysis of the WWTP contaminants' impact on the fish liver structure, physiology, and metabolism. The paper also gives an overview of the fish liver biotransformation enzymes, antioxidant enzymes, and non-enzymatic antioxidants, their role in metabolizing xenobiotic compounds and coping with oxidative damage. Emphasis has been placed on highlighting the vulnerability of fish to xenobiotic compounds, and on biomonitoring of exposed fish, generally involving observation of biomarkers in caged or native fish. Furthermore, the paper systematically assesses the most common contaminants with the potential to affect fish liver tissue.

Disinfectants facilitate the transformation of exogenous antibiotic resistance genes via multiple pathways

The prevalence and spread of multidrug-resistant (MDR) bacteria pose a global challenge to public health. Natural transformation is one of the essential ways for horizontal transfer of antibiotic resistance genes (ARGs). Although disinfectants are frequently used during COVID-19, little is known about whether these disinfectants are associated with the transformation of plasmid-borne ARGs. In our study, we assessed the effect of some disinfectants on bacterial transformation using resistance plasmids as extracellular DNA and E. coli DH5α as the recipient bacteria. The results showed that these disinfectants at environmentally relevant concentrations, including benzalkonium bromide (BB), benzalkonium chloride (BC) and polyhexamethylene guanidine hydrochloride (PHMG), significantly enhanced the transformation of plasmid-encoded ARGs. Furthermore, we investigated the mechanisms underlying the promotive effect of disinfectants on transformation. We revealed that the addition of disinfectants significantly increased the membrane permeability and promoted membrane-related genes expression. Moreover, disinfectants led to the boosted bacterial respiration, ATP production and flagellum motility, as well as increased expression of bacterial secretion system-related genes. Together, our findings shed insights into the spread of ARGs through bacterial transformation and indicate potential risks associated with the widespread use of disinfectants.

Influence of habitats and physicochemical factors on trophic transfer processes of antibiotics in a freshwater ecosystem: Application of stable isotopes and human health risks

Habitats of species and physicochemical factors are of great importance in determining the trophic transfer of contaminants in freshwater ecosystems. There is little information on how multiple physicochemical factors and habitats influence the trophic transfer of antibiotics in freshwater food webs. This study investigated the concentrations of 7 sulfonamides (SAs), 4 fluoroquinolones (FQs), 4 tetracyclines (TCs) and 2 macrolides (MLs) in the Lake Dianshan food web. Stable isotope analysis (SIA), and mathematical models were used to assign trophic levels and distinguish between the benthic food web (BFW) and pelagic food web (PFW). Values of stable nitrogen isotope (δ¹⁵N‰) and stable carbon isotope (δ¹³C‰) ranged from 10.2 ± 0.11 to 19.72 ± 0.05 and -33.67 ± 0.18 to -20.79 ± 0.50, respectively. Total concentrations of antibiotics ranged from 36.63 ± 12.73 ng/g dry weight (dw) to 105.85 ± 12.95 ng/g dw for all species. The relative abundance of antibiotics was in the following order: ∑FQs (36.49 %) > ∑SAs (26.70 %), >∑MLs (12.63 %) for all biotas. Trophic magnification factor (TMFs) values for individual antibiotics ranged from 0.10 to 1.20 and 0.31 to 1.82 for PFW and BFW, respectively. Three classes of antibiotics ∑FQs (p < 0.05), ∑TCs (p < 0.05), and ∑MLs (p < 0.05) showed significant trophic dilution in PFW, opposite to non-significant trophic dilution in BFW. The influence of various physicochemical factors was not strong over trophic transfer (e.g., octanol-water partition coefficient-LogK_ow (r = -0.05 in PFW, r = -0.14 in BFW) and distribution coefficient-LogD (r = 0.06 in PWF, r = -0.28 in BFW)) except for aqueous solubility (LogS). Results indicated a significantly higher trophic dilution of antibiotics in the PFW than in the BFW. Among the studied six physicochemical factors, only LogS significantly influences (p < 0.05) the trophic transfer of antibiotics in the freshwater food web. Health risk assessments indicated that currently, there were no serious risks present for urban and rural populations.

A novel BC/g-C3N4 porous hydrogel carrier used in intimately coupled photocatalysis and biodegradation system for efficient removal of tetracycline hydrochloride in water

Intimately coupled photocatalysis and biodegradation (ICPB) is a promising technology to remove refractory contaminants from water. The key to successful ICPB is a carrier capable of accumulating biofilm and adhering photocatalyst firmly. Herein, BC/g-C₃N₄ was prepared into a three dimensional porous hydrogel and used as a carrier in ICPB system for the first time. Degradation experiments revealed that the removal rate of tetracycline hydrochloride (TCH) in water by the ICPB system was 96.0% after 10 h, which was significantly higher than that by the photocatalysis (PC, 76.3%), biodegradation (B, 32.5%), adsorption (AD, 17.2%), and photolysis (P, 5.0%) systems. Photo-electrochemical tests confirmed that ICPB system had superior electron transfer ability between photocatalysts and microorganisms. The removal efficiency of COD proved that microorganisms played an important role in the mineralization process of TCH by the ICPB system. After the ICPB degradation experiment, microorganisms maintained high activity and Pseudomonas, Burkholderiaceae and Flavobacterium which had TCH degradation or electron transport ability, were enriched. In conclusion, the novel ICPB carrier overcame shortcomings of the traditional ICPB carrier and the novel ICPB system had superior degradation performance for TCH. This study provided a possible method to promote the practical application of ICPB technology.

ST7 Becomes One of the Most Common Staphylococcus aureus Clones After the COVID-19 Epidemic in the City of Wuhan, China

Background

Staphylococcus aureus (S. aureus) was able to rapidly evolve and adapt under the pressure of antibiotics, host immune and environmental change. After Corona Virus Disease 2019 (COVID-19) epidemic in Wuhan, China, a large number of disinfectants were used, which might result in rapid evolution of S. aureus.

Methods

A total of 619 S. aureus isolates were collected from Zhongnan Hospital, Wuhan University from 2018 to 2021, including group BEFORE (309 strains collected before COVID-19 pandemic) and group AFTER (310 strains collected after COVID-19 pandemic), for comparing the changes of molecular epidemiology. The molecular characteristics of isolates were analyzed by Multi-locus sequence typing (MLST), spa, chromosomal cassette mec (SCCmec) typing, virulence genes were screened by the PCR, antibiotic susceptibility test was carried out by the VITEK system.

Results

Thirty-six sequence types (STs) belonging to 14 clone complexes (CCs) were identified. ST5 was the most prevalent clone in both groups, and ST7, ranking the sixth in group BEFORE, became the second dominant clone in group AFTER (6.5% vs 10.0%), whereas ST239 decreased from the seventh to the fourteenth (5.8% vs 1.9%). ST7 in group AFTER had a higher positive rate of virulence genes, including hlb, fnbB, seb, lukDE, sdrE and the proportion of ST7-t091 MRSA strains increased from 19.1% to 50% compared with group BEFORE. Though no significant difference of MRSA proportion was found between two groups, SCCmec type-III in group AFTER decreased (p<0.01). Though the rate of multidrug-resistance (MDR) decreased, the virulence genes hlb, hlg, fnbB, seb and pvl carrying rates were significantly elevated in MRSA strains of group AFTER.

Conclusion

After COVID-19 pandemic, ST7 becomes one of the predominant S. aureus clones in Wuhan and the carrying rate of SCCmec and virulence genes is on the rise. Therefore, it is essential to strengthen the surveillance of ST7 S. aureus clone.

Airborne antibiotic resistome and human health risk in railway stations during COVID-19 pandemic

Antimicrobial resistance is recognized as one of the greatest public health concerns. It is becoming an increasingly threat during the COVID-19 pandemic due to increasing usage of antimicrobials, such as antibiotics and disinfectants, in healthcare facilities or public spaces. To explore the characteristics of airborne antibiotic resistome in public transport systems, we assessed distribution and health risks of airborne antibiotic resistome and microbiome in railway stations before and after the pandemic outbreak by culture-independent and culture-dependent metagenomic analysis. Results showed that the diversity of airborne antibiotic resistance genes (ARGs) decreased following the pandemic, while the relative abundance of core ARGs increased. A total of 159 horizontally acquired ARGs, predominantly confering resistance to macrolides and aminoglycosides, were identified in the airborne bacteria and dust samples. Meanwhile, the abundance of horizontally acquired ARGs hosted by pathogens increased during the pandemic. A bloom of clinically important antibiotic (tigecycline and meropenem) resistant bacteria was found following the pandemic outbreak. 251 high-quality metagenome-assembled genomes (MAGs) were recovered from 27 metagenomes, and 86 genera and 125 species were classified. Relative abundance of ARG-carrying MAGs, taxonomically assigned to genus of Bacillus, Pseudomonas, Acinetobacter, and Staphylococcus, was found increased during the pandemic. Bayesian source tracking estimated that human skin and anthropogenic activities were presumptive resistome sources for the public transit air. Moreover, risk assessment based on resistome and microbiome data revealed elevated airborne health risks during the pandemic.

Resolving the "health vs environment" dilemma with sustainable disinfection during the COVID-19 pandemic

The overuse of disinfection during the COVID-19 pandemic leads to an emerging "health versus environment" dilemma that humans have to face. Irresponsible and unnecessary disinfection should be avoided, while comprehensive evaluation of the health and environmental impacts of different disinfectants is urgently needed. From this discussion, we reach a tentative conclusion that hydrogen peroxide is a green disinfectant. Its on-demand production enables a circular economy model to solve the storage issues. Water, oxygen, and electrons are the only feedstock to generate H2O2. Upon completion of disinfection, H2O2 is rapidly converted back into water and oxygen. This model adopts several principles of green chemistry to ensure overall sustainability along the three stages of its whole life cycle, i.e., production, disinfection, and decomposition. Physical methods, particularly UV irradiation, also provide sustainable disinfection with minimal health and environmental impacts.

Enhanced photocatalytic activity of Fe-, S- and N-codoped TiO2 for sulfadiazine degradation

The composite material based on N-, S-, and Fe-doped TiO2 (NSFe-TiO2) synthesized by wet impregnation was used as a photocatalyst to rapidly degrade sulfadiazine. The photocatalytic degradation behavior and mechanism of sulfadiazine on NSFe-TiO2 were investigated for revealing the role of degradation under ultraviolet light. The results showed that compared with TiO2, NSFe-TiO2 markedly improved the efficiency in photocatalytic degradation of sulfadiazine: more than 90% of sulfadiazine could be removed within 120 min by NSFe-TiO2 dosage of 20 mg L-1. The process conformed to first-order reaction kinetics model. The parameters such as loaded amount of NSFe-TiO2, solution pH value, humic acid concentration and recycle numbers on removal efficiency were also studied. Compared to neutral and alkaline conditions, acidic condition was not conducive to the photocatalysis. HA, Ca2+, Cu2+ and Zn2+ in the actual water body had mild inhibition on sulfadiazine degradation in UV/NSFe-TiO2 system. Fragments screened by high-resolution mass spectrometry were conducted to explore the oxidation mechanism and pathways of sulfadiazine degradation. On the whole, UV/NSFe-TiO2 photocatalysis has a good effect on sulfadiazine removal.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13762-023-04771-6.

MoSe2-modified ZIF-8 novel nanocomposite for photocatalytic remediation of textile dye and antibiotic-contaminated wastewater

COVID-19-led antibiotic waste generated from hospitals and health centres may cause serious health issues and significantly impact the environment. In the coming decades, antibiotic resistance will be one of the most significant threats to global human health. Photocatalytic water remediation is an effective and promising environmental solution that can be utilized to address this issue, to convert antibiotic waste into non-toxic products by utilizing renewable and abundant solar energy. In the present study, a novel nanocomposite of zeolitic imidazolate frameworks (ZIF-8) and molybdenum diselenide (MoSe₂) was efficiently synthesized by the solvothermal method for the complete degradation of the antibiotics and textile waste from water. The morphology, crystallinity and band gap of the samples were characterized by field emission scanning electron microscopy (FESEM), X-ray diffraction (XRD) and UV-visible spectroscopy. Fourier transform infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS) provide the binding information of the sample. The photocatalytic activity was tested for degradation of the antibiotics (tetracycline hydrochloride (TC) and metronidazole (MNZ)) used in COVID-19 treatment and textile dye (malachite green). Time-resolved photoluminescence spectroscopy confirmed the enhanced charge separation in the MoSe₂@ZIF-8 nanocomposite with an average lifetime of 4.72 ns as compared to pristine samples. The nanocomposite showed ~ 100% removal efficiency with rate constants of 63 × 10^-3, 49 × 10^-3 and 42 × 10^-3 min^-1 for TC, MNZ and malachite green, respectively. The photocatalytic degradation of TC was carried out under different pH conditions (4, 7 and 9), and the degradation mechanism was explained on the basis of zeta potential measurements and active species trapping experiment. The by-products of the photocatalytic treatment of TC antibiotics were tested using liquid chromatography-mass spectroscopy (LC-MS), and they were found to be non-toxic for aquatic and human life. The regeneration property of the nanocomposite was confirmed by FESEM with regeneration efficiency of 88.7% in the 4th cycle. Thus, MoSe₂@ZIF-8-based photocatalysts have potential application in water remediation, especially in making the antibiotic waste less toxic.

Environmental impacts of the widespread use of chlorine-based disinfectants during the COVID-19 pandemic

Chlorinated disinfectants are widely used in hospitals, COVID-19 quarantine facilities, households, institutes, and public areas to combat the spread of the novel coronavirus as they are effective against viruses on various surfaces. Medical facilities have enhanced their routine disinfection of indoors, premises, and in-house sewage. Besides questioning the efficiency of these compounds in combating coronavirus, the impacts of these excessive disinfection efforts have not been discussed anywhere. The impacts of chlorine-based disinfectants on both environment and human health are reviewed in this paper. Chlorine in molecular and in compound forms is known to pose many health hazards. Hypochlorite addition to soil can increase chlorine/chloride concentration, which can be fatal to plant species if exposed. When chlorine compounds reach the sewer/drainage system and are exposed to aqueous media such as wastewater, many disinfection by-products (DBPs) can be formed depending on the concentrations of natural organic matter, inorganics, and anthropogenic pollutants present. Chlorination of hospital wastewater can also produce toxic drug-derived disinfection by-products. Many DBPs are carcinogenic to humans, and some of them are cytotoxic, genotoxic, and mutagenic. DBPs can be harmful to the flora and fauna of the receiving water body and may have adverse effects on microorganisms and plankton present in these ecosystems.

Global Coinfections with Bacteria, Fungi, and Respiratory Viruses in Children with SARS-CoV-2: A Systematic Review and Meta-Analysis

Background: Coinfection with bacteria, fungi, and respiratory viruses has been described as a factor associated with more severe clinical outcomes in children with COVID-19. Such coinfections in children with COVID-19 have been reported to increase morbidity and mortality. Objectives: To identify the type and proportion of coinfections with SARS-CoV-2 and bacteria, fungi, and/or respiratory viruses, and investigate the severity of COVID-19 in children. Methods: For this systematic review and meta-analysis, we searched ProQuest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus, and Nature through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for studies on the incidence of COVID-19 in children with bacterial, fungal, and/or respiratory coinfections, published from 1 December 2019 to 1 October 2022, with English language restriction. Results: Of the 169 papers that were identified, 130 articles were included in the systematic review (57 cohort, 52 case report, and 21 case series studies) and 34 articles (23 cohort, eight case series, and three case report studies) were included in the meta-analysis. Of the 17,588 COVID-19 children who were tested for co-pathogens, bacterial, fungal, and/or respiratory viral coinfections were reported (n = 1633, 9.3%). The median patient age ranged from 1.4 months to 144 months across studies. There was an increased male predominance in pediatric COVID-19 patients diagnosed with bacterial, fungal, and/or viral coinfections in most of the studies (male gender: n = 204, 59.1% compared to female gender: n = 141, 40.9%). The majority of the cases belonged to White (Caucasian) (n = 441, 53.3%), Asian (n = 205, 24.8%), Indian (n = 71, 8.6%), and Black (n = 51, 6.2%) ethnicities. The overall pooled proportions of children with laboratory-confirmed COVID-19 who had bacterial, fungal, and respiratory viral coinfections were 4.73% (95% CI 3.86 to 5.60, n = 445, 34 studies, I2 85%, p < 0.01), 0.98% (95% CI 0.13 to 1.83, n = 17, six studies, I2 49%, p < 0.08), and 5.41% (95% CI 4.48 to 6.34, n = 441, 32 studies, I2 87%, p < 0.01), respectively. Children with COVID-19 in the ICU had higher coinfections compared to ICU and non-ICU patients, as follows: respiratory viral (6.61%, 95% CI 5.06−8.17, I2 = 0% versus 5.31%, 95% CI 4.31−6.30, I2 = 88%) and fungal (1.72%, 95% CI 0.45−2.99, I2 = 0% versus 0.62%, 95% CI 0.00−1.55, I2 = 54%); however, COVID-19 children admitted to the ICU had a lower bacterial coinfection compared to the COVID-19 children in the ICU and non-ICU group (3.02%, 95% CI 1.70−4.34, I2 = 0% versus 4.91%, 95% CI 3.97−5.84, I2 = 87%). The most common identified virus and bacterium in children with COVID-19 were RSV (n = 342, 31.4%) and Mycoplasma pneumonia (n = 120, 23.1%). Conclusion: Children with COVID-19 seem to have distinctly lower rates of bacterial, fungal, and/or respiratory viral coinfections than adults. RSV and Mycoplasma pneumonia were the most common identified virus and bacterium in children infected with SARS-CoV-2. Knowledge of bacterial, fungal, and/or respiratory viral confections has potential diagnostic and treatment implications in COVID-19 children.

Experimental Research on the Treatment of Stormwater Contaminated by Disinfectants Using Recycled Materials-Hemp Fiber and Ceramzite

Pollution caused by the use of disinfectants in public spaces is a relatively new form of environmental contamination. During the COVID-19 pandemic of 2020-2021, early research showed a sevenfold increase in the use of disinfectants to clean outdoor spaces and a corresponding increase in environmental pollution. Typically, after entering stormwater systems, disinfectants are carried to surface waters (e.g., rivers, seas and lakes) where they react with various elements to form harmful compounds. In the absence of data, it is not possible to determine accurate levels of pollution according to the latest scientific information. Our enquiry demonstrates that stormwater pollution indicators (pH, conductivity, turbidity and color intensity) change depending on the amounts of disinfectants present. Laboratory tests were conducted using hemp fiber and ceramzite, in which filtered stormwater samples contaminated with different amounts of disinfectants showed decreases in the amounts of active chlorine from 2.93 ppm to 1.0 ppm. Changes in pH levels, conductivity, turbidity and color intensity were monitored before and after filtration; pH indicators changed slightly (from 7.81 to 7.85), turbidity changes varied in the range of 0.070-0.145 NTU and the highest value of color intensity (1.932 AV) was obtained when 50 mL of disinfectant was added to the investigated sample water. This article presents the results of our research into the impact of disinfectants on stormwater. Further investigation is needed in order to determine the impacts of chemical substances on our water ecosystem.

Short-Term Benzalkonium Chloride (C12) Exposure Induced the Occurrence of Wide-Spectrum Antibiotic Resistance in Agricultural Soils

Antibiotic resistance genes (ARGs) are global pollutants that pose a potential risk to human health. Benzalkonium chloride (C₁₂) (BC) disinfectants are thought to exert selection pressure on antibiotic resistance. However, evidence of BC-induced changes in antibiotic resistance in the soil environment is lacking. Here, we established short-term soil microcosms to investigate ARG profile dynamics in agricultural soils amended with sulfamethazine (SMZ, 10 mg kg^-1) and gradient concentrations of BC (0-100 mg kg^-1), using high-throughput quantitative PCR and Illumina sequencing. With the increase in BC concentration, the number of ARGs detected in the soil increased, but the normalized ARG abundance decreased. The added SMZ had a limited impact on ARG profiles. Compared to broad-spectrum fungicidal BC, the specificity of SMZ significantly affected the microbial community. Network analysis found that low-medium BC exposure concentrations resulted in the formation of small but strong ARG co-occurrence clusters in the soil, while high BC exposure concentration led to a higher incidence of ARGs. Variation partitioning analysis suggested that BC stress was the major driver shaping the ARG profile. Overall, this study highlighted the emergence and spread of BC-induced ARGs, potentially leading to the antimicrobial resistance problem in agricultural soils.

Evaluation of 1,4-naphthoquinone derivatives as antibacterial agents: activity and mechanistic studies

The diverse and large-scale application of disinfectants posed potential health risks and caused ecological damage during the 2019-nCoV pandemic, thereby increasing the demands for the development of disinfectants based on natural products, with low health risks and low aquatic toxicity. In the present study, a few natural naphthoquinones and their derivatives bearing the 1,4-naphthoquinone skeleton were synthesized, and their antibacterial activity against selected bacterial strains was evaluated. In vitro antibacterial activities of the compounds were investigated against Escherichia coli and Staphylococcus aureus. Under the minimum inhibitory concentration (MIC) of ⩽ 0.125 µmol/L for juglone (1a), 5,8-dimethoxy-1,4-naphthoquinone (1f), and 7-methyl-5-acetoxy-1,4-naphthoquinone (3c), a strong antibacterial activity against S. aureus was observed. All 1,4-naphthoquinone derivatives exhibited a strong antibacterial activity, with MIC values ranging between 15.625 and 500 µmol/L and EC₅₀ values ranging between 10.56 and 248.42 µmol/L. Most of the synthesized compounds exhibited strong antibacterial activities against S. aureus. Among these compounds, juglone (1a) showed the strongest antibacterial activity. The results from mechanistic investigations indicated that juglone, a natural naphthoquinone, caused cell death by inducing reactive oxygen species production in bacterial cells, leading to DNA damage. In addition, juglone could reduce the self-repair ability of bacterial DNA by inhibiting RecA expression. In addition to having a potent antibacterial activity, juglone exhibited low cytotoxicity in cell-based investigations. In conclusion, juglone is a strong antibacterial agent with low toxicity, indicating that its application as a bactericidal agent may be associated with low health risks and aquatic toxicity.

ELECTRONIC SUPPLEMENTARY MATERIAL

Supplementary material is available in the online version of this article at 10.1007/s11783-023-1631-2 and is accessible for authorized users.

Fate, toxicity and effect of triclocarban on the microbial community in wastewater treatment systems

Triclocarban (TCC), one of the typical antimicrobial agents, is a contaminant of emerging concern commonly found in high concentration in water environments. However, the fate and toxicity of TCC in wastewater treatment systems remain poorly understood. Here, we investigated how TCC impacts chemical oxygen demand and inorganic nitrogen transformation in a hydrolytic anaerobic-anoxic/oxic process. In the anaerobic section, the transformation of TCC was dominated by reductive dechlorination and supplemented by two amid bonds hydrolysis. In the anoxic and oxic sections, the hydrolysis of amid bonds dominated. The toxicity was reduced after the treatment (IC₅₀ from 0.09 to 0.54). TCC inhibited NH₄⁺-N removal in the anaerobic section and led to the NO₃^--N accumulation (2.84-4.13 mg/L) after treatment, with the abundance of N-removal bacteria decreased by 6%. Furthermore, the original ecological niche was gradually replaced by TCC-resistant/degradative bacteria, formating new microbial modules to resist the TCC stress. Importantly, fourteen genera including Methanosaeta, Longilinea, Dokdonella and Mycobacterium as potential bioindicators warning TCC and its intermediates were proposed. Overall, this study provides new insights into the fate of TCC in biological wastewater treatment systems and suggests a great importance for TCC control to ensure the health and resilience of ecosystems.

Studies on antimicrobial stress with reference to biofilm formation of faecal microbial communities from Apatani tribe of Arunachal Pradesh

PURPOSE

Antibiotic resistant bacteria have created serious health conditions worldwide, disseminating various infections to people and community along with direct clinical implications in therapeutic options.

METHODS

The present study analysed 20 samples from human faeces of Apatani tribe, Arunachal Pradesh, India. Biofilm assay, antimicrobial susceptibility tests and antimicrobial profiling were performed along with phylogenetic analysis.

RESULTS

Phenotypic screening indicated the presence of 21 aerobic isolates comprising Escherichia sp 42.8% (n ​= ​9), Citrobacter sp 9.52% (n ​= ​2), Klebsiella sp 23.8% (n ​= ​5) and Enterococcus sp 23.8% (n ​= ​5). Tetracycline, ciprofloxacin, ceftadizime, gentamicine, vancomycin and erythromycin were observed to highly dominate the biofilm producing bacteria. Antimicrobial activity of Escherichia sp, Citrobacter sp, Klebsiella sp, and Enterococcus sp inhibited the growth of at least one of the tested pathogens. Phylogenetic analysis revealed that antibiotic resistant Klebsiella sp belonged to Klebsiella pneumonia; Escherichia sp belonged to Escherichia fergusonii and Escherichia coli; Enterococcus sp belonged to Enterococcus faecium while Citrobacter sp belonged to Citrobacter freundii.

CONCLUSION

The present work shows that antibiotic resistant bacteria-Klebsiella sp, Enterococcus sp, Escherichia sp and Citrobacter sp were highly prevalent in the faecal microbial communities of Apatani tribe from Arunachal Pradesh. Presence of such antibiotic resistance and biofilm formation in faecal microbiota poses serious concerns regarding health and therapeutic options as this tribe mostly resides in remote vicinities of Arunachal Pradesh. Thus, exploring the mechanisms for dissemination of antibiotic resistance in this tribe helped us to identify key factors pertaining to the health of this tribe as well as their environment.

Disinfectant and heavy metal resistance profiles in extended spectrum β-lactamase (ESBL) producing Escherichia coli isolates from chicken meat samples

Biocidal compounds are frequently used as disinfectants in poultry industry and their widespread usage has risen concern due to the co-selection and persistence of antimicrobial resistance among bacteria. In this study, extended spectrum β-lactamase producing (ESBL) Escherichia coli isolates (n = 60) obtained from chicken meat were characterized by Pulsed Field Gel Electrophoresis (PFGE) and further tested for disinfectant and heavy metal resistance phenotypically and genotypically. Plasmid replicon types of these isolates were also determined. ESBL producing E. coli isolates were found to be resistant to ciprofloxacin (48.3 %) and gentamicin (15 %). The majority of these isolates (46.5 %) carried bla_CTX-M-55 gene. The isolates showed higher minimal inhibitory concentrations to cetylpyridinium chloride (90 %), cetyltrimethylammonium bromide (50 %), hexadecyltrimethylammonium bromide (46.7 %), triclosan (38.3 %), benzalkonium chloride (28.3 %), chlorhexidine (21.7 %), acriflavine (3.3 %), benzethonium chloride (1.7 %) and N-alkyl dimethyl benzyl ammonium chloride (1.7 %), but 18.3 % of the isolates were resistant to triclosan. Of the quaternary ammonium compounds (QACs) tolerance genes, mdfA, sugE(c), ydgE and ydgF were most present in all isolates, but the qacE, qacG, oqxA and oqxB genes were not detected. Of genes mediating the heavy metal resistance, the zitB gene was detected in all isolates, whereas the copA and cueO genes were detected in 96.67 % and 95 % of isolates, respectively. The IncFIB plasmid was commonly present (93.3 %) in ESBL producing E. coli isolates. Consequently, given the detection of genes mediating disinfectant and heavy metal resistance commonly in ESBL producing E. coli isolates as well as high rate of MICs against disinfectant compounds, the use of QACs for decontamination of the facilities may not be as effective as expected in poultry sector in Turkey.

Relevance of the Consensus Principles for Appropriate Antibiotic Prescribing in 2022

BACKGROUND

In the late 1990s, as a response to rising antimicrobial resistance (AMR), an independent multinational, interdisciplinary group was formed specifically targeting primary care antibiotic prescribing for community-acquired respiratory tract infections (CA-RTIs). The group comprised senior clinicians from Canada, Israel, Spain, Sweden, UK and USA. The group's objectives were to provide recommendations for antibiotic stewardship in the community because, whilst it was widely accepted that inappropriate antibiotic use was contributing to AMR, it remained difficult to change prescribing behaviour. The group aimed to identify principles underlying appropriate antibiotic prescribing and guideline formulation to reduce morbidity from CA-RTIs, limit therapeutic failure and, importantly, curb AMR emergence. The group published a report in 2002, which has become known as the Consensus Principles.

OBJECTIVES

(i) To consider the relevance of the Consensus Principles in 2022 by reviewing current global approaches to rising AMR. A wide range of factors, such as antibiotic overuse, most recently seen in COVID-19 patients, are still driving rising AMR even though there has been a high-level international response to the AMR threat; and (ii) as an introduction to this Supplement, which reports the findings of analyses of how AMR is being addressed in nine disparate countries (Brazil, India, Kuwait, Mexico, Pakistan, Russia, Saudi Arabia, Türkiye and Vietnam). Understanding how these initiatives are being pursued in different countries helps identify areas where more information is needed.

CONCLUSIONS

Adherence to the Consensus Principles remains as important now as it was in 2002. Achieving appropriate antibiotic prescribing is a vital objective in order that the right patient receives the right antibiotics at the right time to ensure optimal clinical outcomes while at the same time helping to limit further increases in AMR.

Occurrence, transformation, bioaccumulation, risk and analysis of pharmaceutical and personal care products from wastewater: a review

Almost all aspects of society from food security to disease control and prevention have benefited from pharmaceutical and personal care products, yet these products are a major source of contamination that ends up in wastewater and ecosystems. This issue has been sharply accentuated during the coronavirus disease pandemic 2019 (COVID-19) due to the higher use of disinfectants and other products. Here we review pharmaceutical and personal care products with focus on their occurrence in the environment, detection, risk, and removal.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10311-022-01498-7.

Disinfectants against SARS-CoV-2: A Review

The pandemic due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has emerged as a serious global public health issue. Besides the high transmission rate from individual to individual, indirect transmission from inanimate objects or surfaces poses a more significant threat. Since the start of the outbreak, the importance of respiratory protection, social distancing, and chemical disinfection to prevent the spread of the virus has been the prime focus for infection control. Health regulatory organizations have produced guidelines for the formulation and application of chemical disinfectants to manufacturing industries and the public. On the other hand, extensive literature on the virucidal efficacy testing of microbicides for SARS-CoV-2 has been published over the past year and a half. This review summarizes the studies on the most common chemical disinfectants and their virucidal efficacy against SARS-CoV-2, including the type and concentration of the chemical disinfectant, the formulation, the presence of excipients, the exposure time, and other critical factors that determine the effectiveness of chemical disinfectants. In this review, we also critically appraise these disinfectants and conduct a discussion on the role they can play in the COVID-19 pandemic.

Fast Synthesis of Graphene Oxide-β-Lactam as a Residue-Free Environmental Bacterial Inhibitor

Common pathogenic bacteria contaminate the environment through various modes of transmission. It is thus crucial to develop simple preparation methods of residue-free environmental disinfectants. β-Lactam antibiotics are frequently prescribed in clinical practice to treat bacterial infections. In this study, we used electrochemical exfoliation to synthesize graphene oxide (GO) with abundant ketene functional groups. A residue-free GO-β-lactam (GOβL) was subsequently obtained by mixing ketene and azomethine-H via a [2 + 2] cycloaddition reaction in the aqueous phase. GOβL has shown broad-spectrum bacterial inhibition against four bacteria (Staphylococcus aureus, Escherichia coli, Salmonella enterica, and Shigella dysenteriae), and it degrades rapidly within 24 h. This study provides a fast and easy method for the synthesis of GOβL, which can be employed as a promising environmental bacteriostatic disinfectant in real-life applications.

Acute Toxicity Evaluation of the Disinfectant Containing Percarbonate and Tetraacetylethylenediamine by Measuring Behavioral Responses of Small Fish Using Image Analysis

Disinfectants containing percarbonate and tetraacetylethylenediamine (TAED) has been developed as an effective and relatively safe disinfectant to destroy viruses and bacteria in animals and humans, however it is known that most disinfectants can cause danger to living organisms including humans. In the current study, acute toxicity of the disinfectant composed of percarbonate and TAED was assessed by measuring behavioral responses as well as lethal concentrations of aquatic organisms such as medaka and zebrafish when they were exposed to it. First, the breeding water properties were determined by measuring dissolved oxygen (DO) and pH changes over time up to 96 h in acute toxicity tests using the medaka, and the lethal concentration 50% (LC50, 88.39 ppm) was calculated using the lethality rate of the fish. This experiment was conducted in compliance with traditional OECD guidelines. Second, the assessment of behavioral responses (locomotive activity and swimming speed) with the zebrafish were assessed by the image analysis to capture the images per second for three hours, and the collected data were processed using image analysis to calculate the locomotive activity and swimming speed. Finally, the LC50 (135.76 ppm) of the disinfectant to the fish was also measured after three hours. Overall, the data revealed that LC50 of the disinfectant may be affected by the pH of the water exposed to the disinfectant, not by the DO in the water. In addition, the results from the image analysis indicated that the behavioral responses of the fish can further assess the acute toxicity of the disinfectant at concentrations below the LC50 and there was a relationship (R² = 0.85) between the behavioral responses and the survival rate of the fish.

A microfluidic system for viability determination of microalgae upon disinfectant treatment under continuous flow

The extensive use of quaternary ammonium compounds (QACs) has raised concerns regarding their environmental fate and potential risks to the ecosystem. As sensitive pollution indicators, green microalgae could readily monitor the aquatic toxicity of QACs as reflective of the changes in cell viability. Recent microfluidic-based systems have been designed for environmental biomonitoring and ecotoxicity studies while overall information of cell viability cannot be directly visualized under flowing conditions. In the present study, we developed a multifunctional microfluidic platform with the integration of analytical techniques including laser speckle contrast imaging and fluorescence spectroscopy for monitoring algal activity in response to QAC treatment. The biocidal efficiency of a representative QAC benzalkonium bromide (BAB) on a typical aquatic algae Chlorella vulgaris was determined by collecting the bio-speckles and chlorophyll autofluorescence in real-time, where dose-dependent and time-dependent decrease of algal growth was found with the increase of BAB concentration and interaction time. The integrated system was capable of rapid detection of the aquatic toxicity of QACs along with macroscopical visualization of algal activities under flowing conditions in time-course, which could be extended to future implementation for broad ecotoxicity analysis of versatile environmental samples.

Investigation of biocidal efficacy of commercial disinfectants used in public, private and workplaces during the pandemic event of SARS-CoV-2

This study investigated the performance of 24 commercial disinfectants present on the market during last year according to the manufacturer’s instructions. Recently, national and international organizations of public health performed studies on disinfection products due to the increasing awareness of the potential and growing risks on human health, such as skin damage and reactions in the mucosal lining, especially for the healthcare workers in their frequent daily use. However, there are many limitations in the common cleaning/disinfection products on market as in the selection of effective disinfectants to decontaminate inanimate surfaces. We analyzed the disinfection power of hydrogen peroxide, quaternary ammonium compounds, alcohols, phenols and aldehydes used as active principles according to international guidelines. The antimicrobial properties were assessed by broth microdilution, and antibiofilm properties against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus); their virucidal efficacy was tested against Herpes simplex virus type 1 (HSV-1) and Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The quaternary ammonium compounds demonstrated better efficacy than others and in some cases ready to use products had also virucidal and antimicrobial activities after dilution at 0.125%. The scientific evidence indicates that many commercial products are used at high concentrations and high doses and this could have deleterious effects both on human health and the environment. A lower concentration of active ingredients would avoid the excessive release of chemicals into the environment and improve skin tolerance, ensuring the health and safety protection of workers, including the healthcare operators at their workplace.

COVID-19 and antimicrobial resistance: A cross-study

Antimicrobial resistance (AMR) is emerging as a severe concern due to the escalating instances of resistant human pathogens encountered by health workers. Consequently, there is a shortage of antibiotics to treat Multidrug Resistance (MDR) and Extensively Drug Resistance (XDR) patients. The primary cause of AMR is the vast array of anthropogenic disturbances in natural microfauna brought about by the extensive use of antibiotics. Coronavirus Disease of 2019 (COVID-19) has crashed antibiotic stewardship and single-handedly increased the global usage of antibiotics, Personal Protective Equipment (PPE), and biocide, causing a ripple effect in the existing global AMR problem. This surge in antibiotic usage has escalated the residual antibiotics reaching Wastewater Treatment Plants (WWTPs) from pharmaceutical companies, health care centers, and domestic settings. Ultimately the natural water bodies receiving their effluents will have higher concentrations of emerging contaminants as the WWTPs cannot remove the Pharmaceuticals and Personal Care Products (PPCPs) completely. Furthermore, increased biocides usage will increase AMR by co-resistance, and increasing plastics will turn into microplastics and get converted to plastisphere, which will further enhance its propagation. Therefore, it is crucial to curb antibiotic usage, implement antibiotic stewardship dynamically; and, ameliorate the present condition of WWTPs to remove residual PPCPs efficiently. The need of the hour is to address the grave threat of AMR, which is loitering silently; if not the mankind will endure more affliction hereafter.

Inhibition of nucleotide excision repair and damage response signaling by dibromoacetonitrile: A novel genotoxicity mechanism of a water disinfection byproduct

Dibromoacetonitrile (DBAN) is a carcinogenic disinfection byproduct (DBP) but how it precipitates cancer is unknown. Nucleotide excision repair (NER) is a versatile repair mechanism for removing bulky DNA lesions to maintain genome stability, and impairment of this process is associated with cancer development. In this study, we found that DBAN inhibited NER and investigated its mechanism with other DNA damage responses. Human keratinocytes HaCaT were treated with DBAN followed by ultraviolet (UV) as a model inducer of DNA damage, pyrimidine dimers, which require NER for the removal. DBAN pretreatment exacerbated UV-cytotoxicity, and inhibited the repair of pyrimidine dimers. DBAN treatment delayed the recruitment of NER proteins, transcription factor IIH (TFIIH) and xeroderma pigmentosum complementation group G (XPG), to DNA damaged sites, and subsequent gap filling process. Moreover, DBAN suppressed the UV-induced double strand breaks (DSBs) formation, as well as phosphorylated histone H2AX (γ-H2AX), a widely used DNA damage marker. Altogether, DBAN could negatively impact the NER process and phosphorylation pathway responding to DNA damage. This study was the first to identify the inhibition of NER and damage response signaling as a genotoxicity mechanism of a class of DBPs and it may serve as a foundation for DBP carcinogenesis.