Hospital wastewater treated with a novel bacterial consortium (Alcaligenes faecalis and Bacillus paramycoides spp.) for phytotoxicity reduction in Berseem clover and tomato crops

Hospital wastewater (HWW) treatment in low- and middle-income countries: A systematic review of microbial treatment efficacy

BACKGROUND

Proper treatment of hospital wastewater (HWW) is crucial to minimize the long-term effects on human health and aquatic ecosystems. However, the majority of HWW generated in low and middle-income countries (LMICs), is discharged without adequate treatment. This systematic review aims to fill the knowledge gap in LMICs by examining the efficacy of HWW treatment and the types of technologies used.

METHODS

Studies included in the review offered valuable insights into the current state of HWW management in LMICs. Between 2000 and 2022, only 36 research studies focused on hospital-based wastewater treatment within LMICs. Data were extracted on wastewater treatment technologies in hospitals or healthcare settings in LMICs. Data on sampling techniques, effectiveness, microorganisms and risk of bias of included studies were recorded.

RESULTS

A total of 36 articles met the eligibility criteria: mentioned about 1) hospitals 2) wastewater treatment 3) LMICs and 4) treatment efficacy. Twenty-two studies were conducted in Asia (22/36), 17 were conducted in countries with high Human Development Index. Constructed wetland, and activated sludge process were the most common technologies used in LMICs. A few studies utilized membrane bioreactors and ozone/UV treatment. Fourteen studies reported the concentration reduction to assess the microbial efficacy of the treatment process, 29/36 studies did not meet the national standards for effluent discharge. Reporting on sampling methods, wastewater treatment processes and efficacy of HWW treatment were at high risk of bias. Extreme heterogeneity in study methods and outcomes reporting precluded meta-analysis.

CONCLUSIONS

The existing evidence indicates inadequate microbial treatment in low- and middle-income country hospitals, with this systematic review emphasizing the need for improvement in healthcare waste management. It underscores the importance of long-term studies using innovative treatment methods to better understand waste removal in LMIC hospitals and calls for further research to develop context-specific healthcare waste treatment approaches in these regions.

Biodegradation of Uric Acid by Bacillus paramycoides-YC02

High serum uric acid levels, known as hyperuricemia (HUA), are associated with an increased risk of developing gout, chronic kidney disease, cardiovascular disease, diabetes, and other metabolic syndromes. In this study, a promising bacterial strain capable of biodegrading uric acid (UA) was successfully isolated from Baijiu cellar mud using UA as the sole carbon and energy source. The bacterial strain was identified as Bacillus paramycoides-YC02 through 16S rDNA sequence analysis. Under optimal culture conditions at an initial pH of 7.0 and 38 °C, YC02 completely biodegraded an initial UA concentration of 500 mg/L within 48 h. Furthermore, cell-free extracts of YC02 were found to catalyze and remove UA. These results demonstrate the strong biodegradation ability of YC02 toward UA. To gain further insight into the mechanisms underlying UA biodegradation by YC02, the draft genome of YC02 was sequenced using Illumina HiSeq. Subsequent analysis revealed the presence of gene1779 and gene2008, which encode for riboflavin kinase, flavin mononucleotide adenylyl transferase, and flavin adenine dinucleotide (FAD)-dependent urate hydroxylase. This annotation was based on GO or the KEEG database. These enzymes play a crucial role in the metabolism pathway, converting vitamin B2 to FAD and subsequently converting UA to 5-hydroxyisourate (HIU) with the assistance of FAD. Notably, HIU undergoes a slow non-enzymatic breakdown into 2-oxo-4-hydroxy-4-carboxy-5-ureidoimidazoline (OHCU) and (S)-allantoin. The findings of this study provide valuable insights into the metabolism pathway of UA biodegradation by B. paramycoides-YC02 and offer a potential avenue for the development of bacterioactive drugs against HUA and gout.

Health risk assessment for uptake and accumulation of pharmaceuticals in jute mallow (Corchorus olitorius) irrigated with treated hospital wastewater

The use of reclaimed water for crop irrigation presents a route through which pharmaceuticals enter the agro-environment, raising concerns about their potential inclusion into the food chain and associated health risks. The main objective of this study was to determine the accumulation of six pharmaceuticals (paracetamol, diclofenac and ibuprofen, ciprofloxacin, tetracycline, and sulfamethoxazole) in edible part of jute mallow (JM) (Corchorus olitorius) irrigated with treated hospital wastewater (THWW) and potential health risks associated with the consumption of the contaminated JM. In a greenhouse experiment, JM vegetable was grown in soils irrigated with groundwater and THWW. After 4 weeks of cultivation, the pharmaceutical concentrations in the soil and JM tissues were determined. The uptake and accumulation of the pharmaceuticals in the irrigated JM and the human health risks associated with their consumption were evaluated. Results showed that the THWW-irrigated and groundwater-irrigated soils accumulated all the studied pharmaceuticals except paracetamol and sulfamethoxazole, with the concentrations in the soil before and after irrigation ranging from 0.01 to 0.14 μg g-1 and 0.03 to 1.35 μg g-1, respectively. In JM leaves, the accumulation was in the order of tetracycline > ciprofloxacin > ibuprofen > diclofenac and tetracycline > ciprofloxacin > diclofenac > ibuprofen under THWW-irrigated and groundwater-irrigated treatments, respectively. Under both treatments, the uptake and accumulation of the studied pharmaceuticals were in the order of roots > stem > leaves. The health risk assessment indicated that the consumption of the studied pharmaceuticals through JM implies some risks to human health and the risks were in the order of tetracycline > diclofenac > ciprofloxacin > ibuprofen > paracetamol > sulfamethoxazole. This study has demonstrated that irrigation with reclaimed water is a major route of pharmaceuticals into the food chain and a key determinant of associated health risks.

An assessment of hospital wastewater and biomedical waste generation, existing legislations, risk assessment, treatment processes, and scenario during COVID-19

Hospitals release significant quantities of wastewater (HWW) and biomedical waste (BMW), which hosts a wide range of contaminants that can adversely affect the environment if left untreated. The COVID-19 outbreak has further increased hospital waste generation over the past two years. In this context, a thorough literature study was carried out to reveal the negative implications of untreated hospital waste and delineate the proper ways to handle them. Conventional treatment methods can remove only 50%-70% of the emerging contaminants (ECs) present in the HWW. Still, many countries have not implemented suitable treatment methods to treat the HWW in-situ. This review presents an overview of worldwide HWW generation, regulations, and guidelines on HWW management and highlights the various treatment techniques for efficiently removing ECs from HWW. When combined with advanced oxidation processes, biological or physical treatment processes could remove around 90% of ECs. Analgesics were found to be more easily removed than antibiotics, β-blockers, and X-ray contrast media. The different environmental implications of BMW have also been highlighted. Mishandling of BMW can spread infections, deadly diseases, and hazardous waste into the environment. Hence, the different steps associated with collection to final disposal of BMW have been delineated to minimize the associated health risks. The paper circumscribes the multiple aspects of efficient hospital waste management and may be instrumental during the COVID-19 pandemic when the waste generation from all hospitals worldwide has increased significantly.

Machine Learning Approach to Predict Quality Parameters for Bacterial Consortium-Treated Hospital Wastewater and Phytotoxicity Assessment on Radish, Cauliflower, Hot Pepper, Rice and Wheat Crops

Raw hospital wastewater is a source of excessive heavy metals and pharmaceutical pollutants. In water-stressed countries such as Pakistan, the practice of unsafe reuse by local farmers for crop irrigation is of major concern. In our previous work, we developed a low-cost bacterial consortium wastewater treatment method. Here, in a two-part study, we first aimed to find what physico-chemical parameters were the most important for differentiating consortium-treated and untreated wastewater for its safe reuse. This was achieved using a Kruskal–Wallis test on a suite of physico-chemical measurements to find those parameters which were differentially abundant between consortium-treated and untreated wastewater. The differentially abundant parameters were then input to a Random Forest classifier. The classifier showed that ‘turbidity’ was the most influential parameter for predicting biotreatment. In the second part of our study, we wanted to know if the consortium-treated wastewater was safe for crop irrigation. We therefore carried out a plant growth experiment using a range of popular crop plants in Pakistan (Radish, Cauliflower, Hot pepper, Rice and Wheat), which were grown using irrigation from consortium-treated and untreated hospital wastewater at a range of dilutions (turbidity levels) and performed a phytotoxicity assessment. Our results showed an increasing trend in germination indices and a decreasing one in phytotoxicity indices in plants after irrigation with consortium-treated hospital wastewater (at each dilution/turbidity measure). The comparative study of growth between plants showed the following trend: Cauliflower > Radish > Wheat > Rice > Hot pepper. Cauliflower was the most adaptive plant (PI: −0.28, −0.13, −0.16, −0.06) for the treated hospital wastewater, while hot pepper was susceptible for reuse; hence, we conclude that bacterial consortium-treated hospital wastewater is safe for reuse for the irrigation of cauliflower, radish, wheat and rice. We further conclude that turbidity is the most influential parameter for predicting bio-treatment efficiency prior to water reuse. This method, therefore, could represent a low-cost, low-tech and safe means for farmers to grow crops in water stressed areas.

Investigation on biofilm formation activity of Enterococcus faecium under various physiological conditions and possible application in bioremediation of tannery effluent

Treatment of tannery effluent (TE) using bacterial biofilm is a trending approach in the current scenario, due to greater survival and adaptation in stress conditions. The present study is concerned with the characterization of biofilm-forming bacterium Enterococcus faecium from tannery sludge and the investigation of their activity under different physiological conditions. Biofilm formation by E. faecium was strongly affected by variable physiological conditions. The optimum conditions were pH 7.5, temperature 28 °C, incubation time up to 96 h, glucose 1%, yeast extract 0.1-0.5%, NaCl 0.1-0.5%, tannery effluent-TE up to 50% v/v and Cd, Cr (VI) and Ni from 0.25 to 0.5 mM. Further, E. faecium treated TE was less phytotoxic on the fenugreek plant than the TE treated by non-biofilm forming isolate. The toxicity of TE could be reduced by the potentially biofilm-forming bacteria, which may be used in the bioremediation process.