Hospital sewers help resistant bacteria thrive, Swedish study finds

Antibiotic residues in Swedish hospital wastewater can give resistant bacteria an advantage before the water reaches a treatment plant, a study of ten hospitals has found.

Researchers led by Gothenburg University examined wastewater from hospitals in eight Swedish cities and tested its effects on E. coli. Their study, published in Nature Communications on 29 October, also compared bacteria in wastewater with those living in films inside sewer pipes.

Hospital wastewater favoured resistance in laboratory experiments. Resistant bacteria were also enriched in hospital sewer biofilms, supporting the finding that selection occurs inside the pipes. The corresponding municipal sites did not show the same pattern.

The researchers identified ciprofloxacin and cefotaxime as important drivers. The findings concern bacteria in wastewater and sewers; the study did not measure resulting infections among patients.

Joakim Larsson, professor of environmental pharmacology, told Sahlgrenska Liv that patients’ medical needs must govern antibiotic use. His group is developing a method to make ciprofloxacin unavailable to bacteria in hospital wastewater, targeting resistance closer to its source. The paper discloses that Larsson and two co-authors have applied for a patent on treating antibiotic-contaminated wastewater.

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