Antibiotic usage in hospitals and its influence on bacterial diversity in wastewater

"Hospitals with their high antimicrobial selection pressure represent the presumably most important reservoir of multidrug-resistant human pathogens. Antibiotics administered in the course of treatment are excreted and discharged into the wastewater system. Not only in patients, but also in the sewer, antimicrobial substances exert selection pressure on existing bacteria and promote the emergence and dissemination of multidrug-resistant high-risk clones. In previous studys was investigated that NDM- and OXA-48-encoding K. pneumoniae and VIM-encoding P. aeruginosa isolates recovered between 2014 and 2021 from patients of oncological wards belonged to the two predominant clusters present in all sections of the investigated hospital wastewater network and found that the majority of isolates did. Patients constantly exposed to antibiotics can, in interaction with their persistently antibiotic-exposed sanitary facilities form a niche that is supportive for the emergence, the development and the maintenance of certain nosocomial pathogen populations in the hospital, due to antibiotic-induced selection pressure. It seems that complete prevention of these infections is practically infeasible as long as antibiotic-induced selection pressures in the wastewater sustain this niche. Hence, we went one step further and looked across multiple centres to see if hospital toilets exposed to high concentrations of antibiotics had lower microbial diversity to show that this was a global phenomenon. Aim is a general visualization of how crucially different the microbial environment is that we unwillingly surround our oncological patients with, globally, as a consequence of the way they are clinically managed."