Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Hospital effluent”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources

Early discharge after modified radical mastectomy.

Thirty-nine patients underwent modified radical mastectomy and were discharged with their suction drains and sutures in place after a mean postoperative stay of 4.7 days. Drains and sutures were removed at the first office visit. There were no infections, and late seromas developed in only 21 percent of the patients. Another group of patients were hospitalized until drainage effluent from their tubes was less than 30 ml/day, at which time the drains were removed and the patients discharged. This group had a mean postoperative stay of 9.5 days, and an incidence of late seroma of 43 percent. These data suggest it is both safe and effective to discharge patients 3 to 5 days after mastectomy at considerable potential cost savings due to the reduced hospital stay.

Adult↗

The isolation of antibiotic resistant coliforms from meat and sewage.

Beef and pig carcases, meat products, frozen chickens, and sewage were examined in 3 separate surveys for antibiotic resistant coliforms. Escherichia coli was isolated from 18 of 50 beef carcases; the numbers were low and resistance was found only to tetracycline. E. coli was isolated from 45 to 50 pig carcases; the numbers were high and showed a range of patterns of multiple antibiotic resistance. In meat products, the proportion of E. coli in contaminating organisms was low, and most resistance found was to tetracycline and streptomycin. E. coli was isolated from 66 of 75 chickens and these gave 23 patterns of antibiotic resistance, often multiple. Sewage from hospital or domestic origin and abattoir effluent yielded approximately 10(6) coliforms/ml, most of which were resistant to one or more antibiotics; few of those from hospital or domestic origin however, were classified as E. coli of faecal origin. Twenty-four patterns of resistance were found in coliforms from domestic sewage, 19 from hospital sewage and 11 from abattoir effluent. Transfer of resistance, often multiple, was achieved from 55% of 447 resistant strains to an E. coli K12 recipient. Much more information is required on the prevalence of R-factors in bacteria associated with food producing animals and their products.

Abattoirs↗

Environmental antibiotic contamination and AMR: Integrating pathways, impacts, and artificial intelligence-driven mitigation.

The widespread contamination of the environment with antibiotic residues is a significant factor contributing to the global crisis of antimicrobial resistance (AMR). Antibiotics from various sources, such as effluents from municipal and hospital wastewater treatment plants, agricultural runoffs, discharges from pharmaceutical manufacturing and improper disposal of expired or unused medicines, create selective pressures in the spread of antibiotic resistance genes. These environmental reservoirs act as hotspots for horizontal gene transfer, facilitating the emergence of multidrug-resistant pathogens. Conventional detection methods including culture-based assays, chromatographic quantification, and molecular diagnostics, provide essential insights but are limited by low throughput, reduced sensitivity to new Antibiotic Resistance Genes, and challenges in real-time monitoring across complex environments. Recent advances, such as whole-genome sequencing, metagenomics, and biosensor-based detection, help to address these gaps by enabling more comprehensive surveillance of the resistome. Artificial intelligence further enhances these approaches by improving data interpretation and pattern recognition, thus complementing traditional and molecular methods rather than replacing them. This review examines the pathways of environmental antibiotic contamination, ecological and health impacts of AMR, and limitations of conventional detection methods. It aims to clarify how these pathways contribute to the AMR crisis, assess the effectiveness of existing surveillance techniques, and identify gaps in current research.

Anti-Bacterial Agents↗

Effluent quality of a conventional activated sludge and a membrane bioreactor system treating hospital wastewater.

Two lab scale wastewater treatment plants treating hospital wastewater in parallel were compared in terms of performance characteristics. One plant consisted of a conventional activated sludge system (CAS) and comprised an anoxic and aerobic compartment followed by a settling tank with recycle loop. The second pilot plant was a plate membrane bioreactor (MBR). The wastewater as obtained from the hospital had a variable COD (Chemical Oxygen Demand) ranging from 250 to 2300 mg l(-1). Both systems were operated at a similar hydraulic residence time of 12 hours. The reference conventional activated sludge system did not meet the regulatory standard for effluent COD of 125 mg l(-1) most of the time. Its COD removal efficiency was 88%. The plate MBR delivered an effluent with a COD value of 50 m g l(-1) or less, and attained an efficiency of 93%. The effluent contained no suspended particles. In addition, the MBR resulted in consistent operational parameters with a flux remaining around 8-10 l m(-2) h(-1) and a trans membrane pressure < 0.1 bar without the need for backwash or chemical cleaning. The CAS and the MBR system performed equally well in terms of TAN removal and EE2 removal. The CAS system typically decreased bacterial groups for about 1 log unit, whereas the MBR decreased these groups for about 3 log units. Enterococci were decreased below the detection limit in the MBR and indicator organisms such as fecal coliforms were decreased for 1.4 log units in the CAS system compared to a 3.6 log removal in the MBR.

Bioreactors↗

The use of wall suction as a lipoaspirator.

Hospital wall suction, standard tubing, and liposuction cannulas have been used successfully for liposuction. Benefits include convenience, simplicity, cost effectiveness, and reduction of effluent dispersion. Our experiences indicates that hospital wall suction can be used as an efficacious lipoaspirator.

Humans↗

Fate of 5-fluorouracil, doxorubicin, epirubicin, and daunorubicin in hospital wastewater and their elimination by activated sludge and treatment in a membrane-bio-reactor system.

Antineoplastic agents are applied in cancer therapy and end up in hospital wastewater by human excretions. In this study, the raw wastewater of the sewer of the oncologic in-patient treatment ward of the Vienna University Hospital was monitored for 98 d over 2 years for the cytostatics 5-fluorouracil (5-FU), doxorubicin (DOX), epirubicin, and daunorubicin. In a next step, the elimination of the drugs by a membrane-bio-reactor system was investigated. In addition, their fate in wastewater and elimination by activated sludge was investigated with radio-labelled substances. During the monitoring periods, concentration levels ranging from <8.6 to 124 microgl(-1) for 5-FU and from <0.26 to 1.35 microgl(-1) for DOX were determined. The concentrations analysed fitted the lower ranges calculated by an input-output model. Treatment of oncologic wastewater in the membrane bio-reactor as well as the analysis of the effluents of the Vienna University Hospital resulted in concentrations below the limit of detection. Investigations with radio-labelled compounds showed that 5-FU is eliminated from the liquid phase below the limit of detection. But, up to 25% of radio-labelled equivalents of the drug's amount were found in the gaseous phase and only a marginal part in the solid phase, this indicates that at least one part of the drug is biodegraded. For the anthracyclines more than 90% was eliminated from the liquid phase. In this case, adsorption to suspended solids seems to be the major elimination pathway, as up to 30% of the radio-labelled equivalents of the drug's amount was detected in the solid phase. Our results indicate that the investigated anticancer drugs are eliminated by sewage treatment plants, either by biodegradation or adsorption.

Bioreactors↗

Selective nonroutine microbial surveillance of in-use hospital nebulizers by aerosol entrapment and direct sampling analyses of solutions in reservoirs.

Effluent aerosols and liquid reservoir samples from 255 in-use hospital nebulization devices were analyzed by Aero-Test samplers (Olympic Corp.) and direct dilution procedures (0.1-, 0.01-, and 0.001-ml plated samples). Thirty-five percent (89 of 255) of the in-use hospital reservoir samples were positive by direct dilution, and 24% (61 of 255) were positive by Aero- Test samplers. Acinetobacter calcoaceticus var. anitratus was found either alone or in association with Pseudomonas spp. in 50% of all the contaminated in-use reservoirs. This indicates a high endemicity for Acinetobacter in the environment studied. Viable microbes in the reservoirs of contaminated nebulizers ranged from as few as 20 to >2 x 10(5) colony-forming units/ml. Microbial contamination at moderate to heavy levels (1 x 10(4) to >2 x 10(5)) was regularly detected by both procedures. Microbial densities of 10(3) colony-forming units/ml and less in contaminated reservoirs often were negative in the Aero- Test but positive by direct dilution techniques. These hospital-based results were similar to laboratory data obtained with sterile nebulizers intentionally contaminated in graduated densities with either Staphylococcus aureus or Pseudomonas aeruginosa. Sensitivity of the Aero- Test system was best when >/=10(4) colony-forming units/ml were present in the reservoirs of operating nebulizers. The manufacturer suggests that five or less colonies appearing after sampling on Aero- Test plates upon 48-h incubation does not indicate contamination of the reservoir. Our data show that even a single colony, particularly if it is typical, water-associated, gram-negative bacterial species, may well indicate low levels of reservoir contamination. Both the Aero- Test and direct dilution methods indicated the need for more rigorous management of the in-use respiratory therapy equipment in the hospital surveyed. These studies demonstrate the value of selective nonroutine surveillance for identifying potential or actual contamination problems of in-use nebulizing equipment, particularly when recommended care guidelines are not followed due to choice or unawareness. Ameliorative-corrective measures, which included routine 24-h substitution of old units with new sterile units, were initiated as a result of this surveillance program.

Acinetobacter↗

Coagulase-negative staphylococci in a major Danish university hospital: diversity in antibiotic susceptibility between wards.

Over a one-year period, all coagulase-negative staphylococci (CoNS) from blood cultures, cerebrospinal fluids and peritoneal effluents from patients in a major Danish university hospital were investigated for susceptibility to penicillin G; methicillin; gentamicin; netilmicin; amikacin; erythromycin; clindamycin; fusidic acid; rifampicin; tetracycline; chloramphenicol; ciprofloxacin; teicoplanin; and vancomycin. Among the CoNS-isolates, 56% were resistant to methicillin, 51% to gentamicin, 28% to ciprofloxacin, and 5% to teicoplanin. Blood culture CoNS-isolates from patients with a central venous catheter (CVC) were more often resistant to various antibiotics compared to CoNS-isolates from patients without a CVC, e.g. methicillin (72% vs 21%), gentamicin (65% vs 22%) (p<0.00000001). Great diversity in antibiotic resistance between the wards was found; methicillin resistance (in most cases multiple antibiotic resistance) was in particular associated with consumption of broad-spectrum beta-lactams, quinolones, and total antibiotic consumption in a ward. Thus, the antibiotic policy of a ward is an important factor for antibiotic resistance among CoNS.

Coagulase↗

Relapsing Bacillus licheniformis peritonitis in a continuous ambulatory peritoneal dialysis patient.

Bacillus licheniformis is a rare pathogen in continuous ambulatory peritoneal dialysis (CAPD) peritonitis. Only one case of B. licheniformis peritonitis has been previously reported but relapsing peritonitis by same species has not been reported. A 31-year-old man undergoing CAPD was admitted to our hospital with diarrhoea and turbid peritoneal effluent. Although B. licheniformis was cultured at his previous admission, we did not consider the species as a pathogen. After the same species was cultured twice consecutively at the subsequent admission, we confirmed that B. licheniformis was a pathogen of CAPD peritonitis. After appropriate intraperitoneal antibiotics therapy, the patient improved. He is currently undergoing CAPD without catheter removal.

Adult↗

Biological degradation of cyclophosphamide and its occurrence in sewage water.

The mutagenic and cancerogenic antineoplastic agent cyclophosphamide (CP) is released into sewage water by cancer patient excretion. To assess the biological degradability of CP two standardized test systems, the Zahn-Wellens/EMPA test (OECD 302B) and a laboratory scale sewage treatment plant, were used. In both test systems the agent exhibited only poor degradability. To verify the expected occurrence of CP in hospital sewage, water samples were analyzed for CP with GC/MS after enrichment by solid-phase extraction. CP could be detected in concentrations ranging from 20 ng/L to 4.5 micrograms/L. The occurrence of the agent could also be proved in samples from the influent and the effluent of the communal sewage treatment plant into which the hospital's sewage water is shed. Concentrations ranged from 7 to 143 ng/L. In an attempt to assess the contribution of CP to the genotoxicity detected in hospital waste water in a recent study, the effects of CP in the umuC test, a bacterial genotoxicity assay, were investigated. However, no genotoxic effects of CP were found up to concentrations of 1 g/L.

Antineoplastic Agents, Alkylating↗

Expression of cancer antigen 125 by peritoneal mesothelial cells is not influenced by duration of peritoneal dialysis.

OBJECTIVE: To investigate the presence of cancer antigen 125 (CA125) on mesothelial cells in the effluent of peritoneal dialysis (PD) patients and to analyze the effect of duration of PD on the number of mesothelial cells in peritoneal effluent, the number of CA125-positive cells, and dialysate CA125 concentration. DESIGN: A cross-sectional study in which long-dwell peritoneal effluents were investigated for mesothelial cells and CA125. SETTING: A university hospital population of chronic PD patients. PATIENTS: 33 stable PD patients who were free of peritonitis during the investigation and during the 4 weeks prior to the study. METHODS: Examination of cytospin preparations of peritoneal effluent stained with May-Grünwald Giemsa, and also with an immunocytochemical double-staining method consisting of anticalretinin (pan-mesothelial cell marker) and OC125. RESULTS: A close relationship was present between the numbers of mesothelial cells counted with the two staining methods (r= 0.998, p < 0.001). On average, 92% of mesothelial cells were positive for CA125, ranging between 75% and 100% in 80% of the patients. Correlations were found between the effluent CA125 concentration and the total number of mesothelial cells (r = 0.64, p < 0.001), and also the number of CA125-positive cells (r = 0.66, p < 0.001). A negative effect of time was seen on the effluent CA125 concentration, the total number of mesothelial cells, and the number of CA125-positive mesothelial cells. However, no effect of time was present on the percentage CA125-positive cells. CONCLUSIONS: On average, 92% of mesothelial cells in peritoneal effluent are positive for CA125. This figure is not dependent on the duration of PD. Long-term PD is associated with low dialysate CA125 concentrations, a low number of mesothelial cells, and a low number of CA125-positive mesothelial cells in effluent. These results support the hypothesis that dialysate CA125 can be used as a marker of mesothelial cell mass in stable PD patients.

Ascitic Fluid↗

Radio-iodine in thyroid glands of swans, farm animals and humans, also in algae and river water from the Thames Valley, England.

A highly sensitive counting system has been used to measure radio-iodine in environmental samples from the Thames Valley. Iodine-125 and occasionally iodine-131 have been found in the thyroid glands of most of the swans that have died on the River Thames, the River Wey and the Grand Union Canal, and in algae and water samples from the Thames and many of its tributaries. The presence of this activity is ascribed to the waste discarded into the drainage system by hospitals and research laboratories, reaching the rivers via the effluent from sewage treatment works. The Thames is used as a source of drinking water, particularly in London and its western approaches. Weed and water samples collected from river water abstraction points, reservoirs, tap water supplies, and animal water troughs fed from this supply all contained low levels of iodine-125. The drinking water route can account for the iodine-125 found in the thyroids of farm animals from west Surrey and in a few people living in London. The amounts found constitute a trivial radiation dose to man and animals as they are far below the acceptable limit of exposure for man.

Animals↗

Biomedical waste in laboratory medicine: audit and management.

Pathology, microbiology, blood bank and other diagnostic laboratories generate sizable amount of biomedical waste (BMW). The audit of the BMW is required for planning proper strategies. The audit in our laboratory revealed 8 kgs anatomical waste, 600 kgs microbiology waste, 220 kgs waste sharps, 15 kgs soiled waste, 111 kgs solid waste, 480 litres liquid waste along with 33,000 litres per month liquid waste generated from labware washing and laboratory cleaning and 162 litres of chemical waste per month. Section wise details are described in the text. Needle sharps are collected in puncture proof containers and the needles autoclaved before sending to needle pit. The glass forms the major sharp category and is disinfected with hypochlorite before washing/recycling. All microbiology waste along with containers/plates/tubes are autoclaved before recycling/disposal. The problem of formalin fixed anatomical waste as histology specimens is pointed out. The formalin containing tissues cannot be sent for incineration for the fear of toxic gas release and the guidelines by the Biomedical waste rule makers need to be amended for the issue. The discarded/infected blood units in blood bank need to be autoclaved before disposal since chemical treatments are difficult or inefficient. The liquid waste management needs more attention and effluent treatment facility needs to be viewed seriously for hospital in general. The segregation of waste at source is the key step and reduction, reuse and recycling should be considered in proper perspectives.

Hospitals↗

Development of a biparametric bioanalyser for creatinine and urea. Validation of the determination of biochemical parameters associated with hemodialysis.

The construction and evaluation of an automated urea and creatinine biparametric biosystem using flow injection analysis (FIA) are described. The biosystem uses enzyme reactions that hydrolyse urea and creatinine producing ammonium ions. The enzymes used were creatinine deiminase and urease, which are immobilized covalently in flow reactors. The reactor with creatinine deiminase has the enzyme immobilized on controlled-pore glass beads, whereas urease is immobilized on a nylon open tubular reactor. Detection is realised with a flow-through ammonium ion-selective electrode with an inner solid-state contact (graphite-epoxy composite). Ammonium ions are separated from alkali ion interferents through a gas-diffusion cell. The bioanalyser is fully automated using software and electronics developed ex profeso in our laboratories. The analyser was validated off-line by measuring urea and creatinine from discrete effluent samples from hemodialysis equipment. Results agreed with concurrent analyses realised using hospital laboratory methods. There were no significant differences between the two sets of results at the 95% confidence level. Finally, the biparametric bioanalyser was validated on-line by measuring creatinine and urea levels in artificial kidney effluents. These measurements were useful in the determination of key biochemical parameters of clinical interest such as the mass of urea and creatinine extracted from the patient as well as the initial concentration of creatinine and urea in blood plasma. When the results of the bioanalyser were compared with those yielded by the usual methods, they showed no significant differences at the 95% confidence level when determining the mass of the analytes extracted by the hemodialyser or when determining the urea concentration in blood plasma. However, when measuring the creatinine concentration in blood plasma using the developed bioanalyser, significant differences appeared.

Biological Assay↗

Removal of silver from photographic wastewater effluent using Acinetobacter baumannii BL54.

Acinetobacter baumannii BL54, a silver (Ag) resistant micro-organism was isolated from clinical samples collected at the Armed Forces Medical College hospital in Pune, India. The strain BL54 removed a high quantity of silver (2.85 mg/g biomass) from photographic wastewater effluent. Treatment of the cells with 10 mM EDTA or agitating the culture did not affect the removal process, while altering pH of the wastewater or pre-treating the cells with 0.5 mM 2,4-dinitrophenol (DNP), 20 microM N,N'-dicyclohexylcarbodiimide (DCC), 25 micrograms/mL cefotaxime, and polymyxin-B resulted in considerable decrease in removal of silver by the organism. Dead cells, or a Ags plasmid-cured derivative (BL54.1) removed little silver, which was mainly surface bound. The results, compared with accumulation of Ag by a sensitive culture of Escherichia coli K12 J53.2, suggest that A. baumannii BL54 has good potential for bioremediation of silver from photographic wastewater effluents.

Acinetobacter↗

Occurrence of estrogenic effects in sewage and industrial wastewaters in Beijing, China.

Estrogenic potencies of the effluents or water samples from wastewater treatment plants (WWTPs), industries and hospitals and some receiving rivers in Beijing city were estimated by using a human estrogen receptor recombinant yeast assay. Estrogenic activity of industrial wastewaters was found to range from 0.1 to 13.3 ng EEQ/L and decreased to the range of 0.03-1.6 ng EEQ/L after treatment. Estrogenic activity in WWTP influent ranged from 0.3 to 1.7 ng EEQ/L and decreased to the range of 0.05-0.5 ng EEQ/L after treatment. In the receiving river waters, the estrogenic effect range was 0.1-4.7 ng EEQ/L. These data suggest that treated industrial effluents and WWTP effluents of concern are not the only source of estrogenic pollution in surface waters in Beijing city. EEQ levels in Beijing river water are likely attributable to untreated municipal and industrial wastewaters discharged directly into the river.

China↗

Application of ion-chromatography for the determination of the organic-group parameters AOCl, AOBr and AOI in water.

A method of differential AOX-analysis, i.e. the simultaneous determination of AOCl, AOBr and AOI is described. Individual steps of the method including enrichment at activated carbon, combustion in an oxygen stream and ion-chromatographic detection were optimized. In most cases quantitative recoveries of various organic Cl, Br and I containing substances of different polarity and structure were obtained. The method was applied to the determination of AOX-fractions in municipal and hospital wastewater. A good agreement between conventional coulometric and the described ion-chromatographic determination was found. High concentrations up to 130 microg/L I of organic iodine compounds were measured in the influent and effluent of a municipal treatment plant in Berlin and up to 10 mg/L I in a hospital waste-water.

Chromatography, Ion Exchange↗

Ultrafiltration of the waste plasma effluent from cardiopulmonary bypass circuit contents processed with a cell-washing device.

Blood conservation methods are commonly practiced throughout most hospitals that conduct cardiothoracic surgery. In an effort to reduce patients' exposure to homologous blood products and due to cost effectiveness of blood conservation techniques, this present study combines autotransfusion of the remaining blood in the extracorporeal circuit and ultrafiltration of the plasma effluent, and describes the resulting product. Seven patients, greater than 19 years of age, requiring cardiopulmonary bypass (CPB) were incorporated into this study. Exclusion criteria included age limitation. At termination of CPB, the remaining blood in the circuit was transferred to an autotransfusion machine and processed. Plasma (1054 +/- 206 ml) effluent was collected directly from the centrifugal bowl and processed through a ultrafiltrator, with a constant flow rate and negative pressure, until the plasma effluent concentrated down to an end processed volume of approximately 150 ml. The following variables were either measured or calculated: plasma-concentrate volumes per three minute interval, inlet/outlet pressures of an ultrafiltrator, transmembrane pressure (TMP), plasma free hemoglobin, fibrinogen, total protein, and colloid osmotic pressure. The average ultrafiltrate volume taken off from the plasma effluent was 828 +/- 237 ml, with an average ultrafiltrate volume of 115 ml in every three minute interval. The TMP did not change over the first 15 minutes of processing but became significantly elevated at the 18th minute interval and continued to increase and reach a maximum TMP of 286.5 +/- 2.1 mmHg at the end of concentration. Fibrinogen levels increased from pre-concentration values of 118.2 +/- 64 to 317 +/- 177 mg/dl (p = .03) along with increases in plasma free hemoglobin from 97.7 +/- 46 to 402.1 +/- 180 mg/dl (p = .0002). The total protein concentration increased by over 330% from baseline values. Ultrafiltrating plasma effluent from autotransfused cell salvaged CPB circuit contents could prove beneficial, but further study is required to discover ways to separate unfavorable products, such as activated platelet-leukocyte products and reduced plasma free hemoglobin, and to lower heparin concentrations of the plasma-concentrate.

Blood Transfusion, Autologous↗