Hospital wastewater reveals a substantial pool of antibiotic resistance, as both antibiotic use and average patient length of stay were linked to greater abundance of antibiotic resistant genes detected in molecular assays, UK researchers found.

Use of antimicrobials, as well as patient length of stay was reflected in the portion of antimicrobial resistant genes in the hospital wastewater — or water affected by human use, such as that from toilets, sinks, and showers, reported Meghan R. Perry, MD, of the University of Edinburgh in Scotland, and colleagues in a manuscript published on the preprint server medRxiv.

The results of this study are not surprising, but they emphasize the importance of antimicrobial stewardship programs in hospitals. And it’s not only hospital wastewater, but all of the sewage outputs from commercial and domestic properties. Then there are all of the other drug substances, the excipients and inevitably the myriad or metabolites the biological and environmental impacts of which are almost completely unknown.

We really do need better systems for drug waste disposal in the community, and perhaps that should include the residues of antiseptic and disinfectant products, the environmental impacts of which are barely understood. And what we need most of all is a better sewage treatment system capable of removing or neutralising these compounds since at present we are reliant on systems developed by the Victorians!