Inadvertent antibiotic exposure during pregnancy may increase the risk for neural tube defects in offspring

BACKGROUND

As emerging environmental contaminants, antibiotics pose potential threats to human health, in particular to pregnant women and infants. However, the potential harm of inadvertent antibiotic exposure (IAE) is often disregarded in light of the focus on intentional antibiotic use during pregnancy. Currently, little is known about the effects of IAE during pregnancy on fetal neural tube development.

METHODS

In this case-control study, we used questionnaire data from 855 subjects to investigate the effects of intentional antibiotic use in early pregnancy on neural tube defects (NTDs). Then we tested for placental antibiotics in mothers who had not intentionally used antibiotics, and the compounds were detected in 379 subjects; these were considered IAE cases. We assessed the association between IAE during pregnancy and fetal NTDs using both multivariable logistic and multi-pollutant exposure models. We also analyzed the correlation between maternal dietary habits and placental antibiotics to explore possible sources of IAE.

RESULTS

Only 50 of 855 participants (5.8%) intentionally used antibiotics and such use showed no significant association with NTD risk (odds ratio [OR] = 1.92, confidence interval [95%CI] = [0.66, 5.59]). However, 14 of 15 placental antibiotics were detected in 378 of 379 subjects (99.7%) and multivariable logistic analysis indicated that high levels of placental macrolides were significantly associated with increased NTD risk (4.42 [2.01-10.45]). Multi-pollutant exposure analysis suggested an increase in NTD risk with an increase in exposure to a mixture of placental antibiotics, among which macrolides were the most important contributor. In addition, the level of placental macrolides was positively correlated with the intake frequency of milk. Finally, mothers who drank river, well, or pond water had higher levels of placental macrolides than those who drank only tap water.

CONCLUSIONS

Intentional antibiotic use during early pregnancy may not be associated with NTDs, while IAE during pregnancy is associated with higher NTD risk in offspring. Macrolides are crucial risk factors. Milk, and river, well, or pond water may be important sources of IAE.

Environmental consequences of transformation products from an antibiotic mixture and their mitigation in a wastewater microbiome using an HCl-modified adsorbent

This study enhanced our understanding of antibiotic mixtures' occurrence, transformation, toxicity, and ecological risks. The role of acid-modified biochar (BC) in treating antibiotic residues was explored, shedding light on how BC influences the fate, mobility, and environmental impact of antibiotics and transformation products (TPs) in an activated sludge (AS) microbiome. A mixture of oxytetracycline and sulfamethoxazole was found to synergistically (or additively) inhibit cell growth of AS and disrupt the microbiome structure, species richness/diversity, and function. The formation of TPs with potentially higher toxicity and persistence than the original compounds was identified, explaining the microbiome disruption. Agricultural waste-derived BC was optimized for contaminant adsorption, leading to a reduction in toxicity when added to AS by sequestering TPs on its surface. This work highlighted adsorbents as a practical engineering strategy for mitigating liquid-phase contaminants' toxicological consequences, proactively controlling the fate and effects of antibiotics and TPs.

Variations in antibiotic resistance genes during long-term operation of an upflow anaerobic sludge blanket reactor

Antibiotic resistance genes (ARGs) have been widely detected in the environment. Anaerobic digestion (AD) has the potential ability to remove ARGs, and a comprehensive study is needed on the variations in ARGs during AD. In this study, variations in antibiotic resistance genes (ARGs) and microbial communities were investigated during the long-term operation of an upflow anaerobic sludge blanket (UASB) reactor. An antibiotic mixture of erythromycin, sulfamethoxazole and tetracycline was added to the UASB influent and the operation period was 360 days. The abundances of 11 ARGs and class 1 integron-integrase gene were detected in the UASB reactor, and the correlation between the ARGs and the microbial community was analyzed. The composition of ARGs indicated that the main ARGs in the effluent were sul1, sul2, and sul3, whereas the main ARG in the sludge was tetW. Correlation analysis indicated a negative correlation between microorganisms and ARGs in the UASB. In addition, most of ARGs showed a positive correlation with norank_f_Propionibacteriaceae and Clostridum_sensu_stricto_6, which were identified as potential hosts. These findings may help develop a feasible strategy for removing ARGs from aquatic environments during anaerobic digestion.

Removal performance and inhibitory effects of combined tetracycline, oxytetracycline, sulfadiazine, and norfloxacin on anaerobic digestion process treating swine manure

Combined veterinary antibiotics (CVAs) belonging to different antibiotics classes could cause exacerbated impacts on the anaerobic digestion (AD) process of swine manure. Four different antibiotics "two tetracyclines: tetracycline (TC) and oxytetracycline (OTC), one fluoroquinolones: norfloxacin (Norf), and one sulfonamides: sulfadiazine (SDZ)" were combined to evaluate their removal performances and its inhibition effects on AD. Results indicated that CVAs removal decreased from 84.3 to 63.7 %, with an increase in the initial concentration from 12.5 to 50 mg L^-1, where the removal of CVAs occurring in the order OTC > TC > Norf > SDZ. An average of 9.5, 7.5, 9.5, and 32.1 % of the spiked TC, OTC, SDZ, and Norf were remained in the sludge, respectively. With 50 mg L^-1 of CVAs, a competitive adsorption phenomenon was found to have a notable impact on biodegradation microorganisms' activity leading a 73.1 % decrease in CH₄ production. CVAs caused a temporal inhibition to the acidogenic activity followed by partial inhibition to methanogenic by 66.8 %, and IC₅₀ was 38.5 mg L^-1. Moreover, CVAs resulted in acetate accumulation, while 26 % and 48 % lower in TS and COD removal, respectively, were observed. A significant reduction in the relative abundance of bacteria and archaeal genera was also mentioned. The findings of this research would provide a more in-depth understanding of AD's performance in treating swine manure contaminated with combined antibiotics.

Physiological response of Simocephalus vetulus to five antibiotics and their mixture under 48-h acute exposure

Antibiotics, widely known as major environmental xenobiotics, are increasingly being released into ecosystems due to their essential functions in human health and production. During the COVID-19 pandemic waves, antibiotic use increases remarkably in treating bacterial coinfections. Antibiotics were initially expected only to affect prokaryotes, but recent research has shown that they can disturb the biological systems of eukaryotes, especially vulnerable aquatic creatures, through both direct and indirect processes. However, their toxicity to the freshwater cladoceran Simocephalus vetulus, an essential link in the aquatic food web, has never been evaluated. The effects of four fluoroquinolones (ciprofloxacin: CFX, ofloxacin: OFX, gatifloxacin: GFX, delafloxacin: DFX), tetracycline (TET), and a mixture of these medicines (MIX) on S. vetulus thoracic limb rate (TLR) were examined in this study. After S. vetulus was exposed to 20 and 40 mg GFX L^-1, 90% and 100% mortality rates were recorded. At 2.5-10 mg L^-1, GFX dramatically lowered the TLR of S. vetulus, resulting in a median effective concentration of 9.69 mg L^-1. TLRs increased when the organisms were exposed to 10-40 mg L^-1 of CFX and 1.25-40 mg L^-1 of OFX. However, DFX and TET exposures did not affect TLRs. Exposure to MIX reduced TLR only at 40 mg L^-1, suggesting an antagonistic interaction among the five pharmaceuticals. This study demonstrated that S. vetulus physiological responses to antibiotics, even in the same class, are complex and elusive. Beyond a common additive concentration principle, the antagonistic interaction of antibiotic mixture indicates a high level of uncertainty in terms of ecological dangers. We initially introduce S. vetulus to ecotoxicological studies of antibiotics, presenting the species as a low-cost model for physiological investigations of environmental xenobiotics.

Inhibitory effects of antibiotic combinations on syntrophic bacteria, homoacetogens and methanogens

Antibiotics have the potential to adversely affect the microbial community that is present in biological wastewater treatment processes. The antibiotics that exist in waste streams directly inhibit substrate degradation and also have an influence on the composition of the microbial community. The aim of this study was to evaluate the short-term inhibition impact that various antibiotic combinations had on the syntrophic bacteria, homoacetogenic and methanogenic activities of a microbial community that had been fed with propionate and butyrate as the sole carbon source and VFA mixture (acetate, propionate and butyrate). Acute tests were constructed using on a two way-factorial design, where one factor was the composition of antibiotic mixture and another was the concentration of antibiotics added. In addition, the inhibitory effect of antibiotics was evaluated by monitoring biogas production and the accumulation of individual volatile fatty acids. Specific methanogenic activity batch tests showed a significant (p<0.05) decrease in the maximum methane production rate in the presence of 1 mg L(-1) of antibiotics for the substrate in a VFA mixture and propionate; 1 mg L(-1) of ETS, 25 mg L(-1) of ET, 10 mg L(-1) of ST and ES combination for substrates butyrate. The addition of antibiotics to the batch tests affected the utilization of acetate, propionate and butyrate. This study indicated that antibiotic mixtures have an effect on homoacetogenic bacteria and methanogens, which may exert inhibitory effects on propionate and butyrate-oxidizing syntrophic bacteria, resulting in unfavorable effects on methanogenesis.