Insights into current physical, chemical and hybrid technologies used for the treatment of wastewater contaminated with pharmaceuticals

Copyright © 2022 The Authors. The purpose of this article is to review the current physical, chemical and hybrid technologies practices employed in the removal of pharmaceuticals from liquid effluents originating from various resources including municipal waste, hospitals discharge with a focus on pharmaceutical manufacturing industry. Pharmaceutical pollutants are mostly persistent organic compounds that are not easily removed by conventional wastewater treatment processes. The literature reviewed shows that advanced oxidation processes are able to degrade these persistent pharmaceuticals. However, the oxidation may also introduce toxic oxidation intermediates/by-products if these processes are not properly monitored and operated. Physical treatments, like carbon adsorption and membrane filtration, can provide a barrier that prevents both parent compounds and toxic intermediates passing into treated wastewater. However, these processes are phase changing technologies in which contaminants are transferred from one phase to another hence, the retentate water and absorbent require further treatment, and properly managed disposal. The combination of different processes can be an ideal treatment scheme, for the retention and degradation of both parent and transformation compounds. Through hybrid technologies, the advantages of the methods are combined, leading to a maximization of contaminants removal. The review highlights the importance of installing combined wastewater treatment processes to reduce the amounts of pharmaceutical residues before the wastewater enters the environment. The use of advanced oxidation process, either as a pre-treatment or as a post-treatment combined with biological, adsorption, or filtration process is recommended as a promising option. Nevertheless, the optimum treatment methods for the pharmaceuticals-containing wastewater depends on the quality and quantity of wastewater, as well as on the pharmaceutical compounds residues and their hazardous effects.European Commission (Innovative Water Recovery Solutions through recycling of heat materials and water across multiple sectors: iWAYS

Staphylococcus aureus carriage status in patients with hidradenitis suppurativa: An observational cohort study in a tertiary referral hospital in Athens, Greece

Background: Hidradenitis suppurativa (HS) is a chronic, recurrent, auto-inflammatory disease that affects the pilosebaceous unit in apocrine gland-bearing areas. Bacteria are thought to play a role in the development and progression of disease. In addition, antibiotics are frequently used as first-line management for HS. We sought to determine the carriage status of Staphylococcus aureus and its resistance to antibiotics among patients with HS in a tertiary referral hospital in Athens, Greece. Methods: In this observational cohort study, 68 consecutive patients attending the HS clinic of "Attikon" General University Hospital in Athens, Greece, during a 9-month period were enrolled. All patients had not received any antibiotic therapy for any reason during the previous 3 months before enrollment. Nasal and oropharyngeal samplingwere obtained, and specimens were tested for the presence of S. aureus.Antibiotic susceptibility testing was performed using the VITEK 2 system. Standard statistical tests, descriptive statistics tests, and χ2 and Pearson correlation tests were performed, using IBM SPSS Statistics 25.The level of significance was set at a pvalue <0.05. Results: Sixty-eight patients with HS were studied. There were 44 females (64.7%) and 24 males (35.3%). The mean age was 36.63 ± 13.0 (IQR = 21), and the mean age at onset of disease was 23.90 ± 11.53 (IQR = 14). The mean duration of disease was 12.74 ± 10.20 years (IQR = 15). Fifteen (22.1%) of the patients were Hurley stage I, 22 (32.4%) were Hurley stage II, and 31 (45.6%) were Hurley stage III. S. aureus carriage was detected in 17 patients (25%). Six of them (35.3%) had MRSA strains. There was an increased prevalence of S. aureus colonization (p = 0.058) and MRSA (p = 0.101) in Hurley stage III patients, but this result was not statistically significant. Conclusions: We found a 25% prevalence of S. aureus colonization (17/68 patients) and a 35.3% prevalence of MRSA (6/17) among our HS patients. There was an increased prevalence of S. aureusand MRSA positivity in HS patients with Hurley stage III. Further studies are needed to clarify the possible clinical significance of S. aureus carriage in the disease development and progression as well as in the treatment outcome. © 2019 S. Karger AG, Basel

Carbapenemase-producing Enterobacteriaceae: Now that the storm is finally here, how will timely detection help us fight back?

Acquired carbapenemases of the Ambler Classes A, B and D have gradually disseminated over the past decade among isolates of the Enterobacteriaceae family. Located on highly mobile genetic elements, these enzymes have established their presence in successful bacterial clones, signaling the prelude to a novel endemic era in the hospital setting. In such a context, prompt detection of carbapenemase-producing microorganisms seems warranted, not only for the selection of an appropriate antibiotic regimen, but also for organizing and implementing effective surveillance and infection control measures. However, issues regarding detection, confirmatory testing and characterization persist. Determination of carbapenemase production via susceptibility pattern interpretation may not always be feasible, confirmatory testing remains debatable and precise characterization is a challenge for the clinical laboratory. We aim to review the current situation from a laboratory point of view, highlighting the tools that have been proposed in an effort to help outline reliable screening and detection procedures, with inhibitor-based phenotypic testing as the cornerstone of these strategies, and discuss the necessity for implementing identification of possible producers in the everyday workflow. © 2013 Future Medicine Ltd

In vitro activity of tigecycline against Acinetobacter baumannii: Global epidemiology and resistance mechanisms

Acinetobacter baumannii is a pathogen of increasing concern, commonly causing outbreaks in the hospital environment. Of particular concern, A. baumannii strains exhibiting resistance to carbapenems, which were previously considered the treatment of choice for infected patients, have dramatically increased worldwide, leaving a few antibacterial choices. Tigecycline, a broad-spectrum modified minocycline derivative, isconsidered as a last resort drug against multidrug-resistant A. baumannii. Though, resistance to tigecycline has emerged and is growing notably following increasing tigecycline usage. Comparative evaluation of the tigecycline resistance rates reported worldwide is challenging due to the absence of official interpretative criteria for in vitro susceptibility testing and the discrepancies among the different susceptibility methodologies used, with broth microdilution being considered the reference method. Tigecycline resistance is mainly associated with resistance-nodulationcell division (RND)-type transporters, mainly the AdeABC, AdeFGH and AdeIJK efflux pumps, but other resistance mechanisms have also been implicated. Tigecycline is still an attractive choice for A. baumannii, but further investigations are warranted so that treatment of MDR Α. baumannii could be guided by validated in vitro data. © Springer International Publishing Switzerland 2015