Degradation profiles of antibiotics within on-site sanitation

简介：抗菌素耐药性（AMR）的增加是21世纪世纪一个紧迫的全球公共卫生问题;耐药性的出现和传播对许多常见传染病的治疗构成日益严重的威胁（Bhatia和Narain，2010）。耐药细菌的进化和传播受它们所处的环境条件的影响;它们的环境具有充当耐药微生物的扩散途径和储存库的能力（Larsson等人，2018年）。一个巨大的环境压力是通过卫生基础设施释放和处置抗菌剂造成的，包括人类消化的抗生素代谢物和抗生素的处置（Prestinaci，Pezzotti和Pantosti，2015）。为了了解抗微生物剂耐药性，需要研究来识别和量化这些人造抗生素压力的区域，从而为正在进行的研究和技术解决方案提供信息（Laxminarayan等人，2013年）。目前正在研究如何在废水处理厂中去除抗生素和耐药性，主要集中在高收入国家。然而，这项研究不适用于现场卫生设施，全球有31亿人使用现场卫生设施，主要是在发展中国家（JMP，2019）。由于发展中国家的现场卫生设施普遍存在，加上它们对高水平耐药微生物的敏感性增加，因此必须确定现场卫生设施中的抗菌剂和耐药基因造成的潜在环境压力。因此，通过观察抗生素如何降解现场卫生，将有可能量化和了解其潜在的作用，增加抗生素存在的environment.Aims和Objectives：本研究的目的是建立现场卫生系统内的关键抗生素的降解概况在各种条件下。这项研究可以应用于研究卫生和抗生素及其代谢物的处置如何成为抗生素耐药性发展的驱动力，特别是在发展中国家，研究目标是确定关键指标抗生素，并通过模拟实验室测试和现场测试，确定这些抗生素在现场卫生条件下如何降解。然后，这些数据可以用于创建系统模型，用于进一步的研究和政策决策。研究问题：-抗生素在现场卫生条件下降解到什么程度，它们的降解情况如何？-关键现场卫生特征和环境条件的变化如何影响抗生素降解？现场卫生基础设施是否是“抗生素热点”，它们是否有可能促进抗生素耐药性的发展？研究需求：这项研究将是跨学科的，利用化学和微生物学的技能，并与地理学院合作。预计研究结果将用于进一步研究，因为抗生素耐药性和WASH领域相对较新，研究尚不充分。研究结果可能会产生一些社会科学和政策影响。有人呼吁研究水和卫生系统对增加抗菌素耐药性的贡献，世卫组织（世界卫生组织）在其关于抗菌素耐药性作为一种新兴水的简报中指出，需要进行研究，“以确定和量化环境介质中抗生素的来源、发生和运输”，环境卫生和个人卫生问题。目前，粪便废物/水/卫生系统作为抗生素储存库的相对重要性仍然未知。拟议的研究工作对EPSRC在水工程的目标。

Introduction: Increasing rates of antimicrobial resistance (AMR) is a pressing global public health problem of the 21st century; the emergence and dissemination of resistance poses a growing threat to the treatment of many common infectious diseases (Bhatia and Narain, 2010). The evolution and transmission of resistant bacteria is affected by the environmental conditions in which they are found; their environment has the ability to act as both a dispersal route and a reservoir of resistant microbials (Larsson et al., 2018). One large environmental pressure is caused by the release and disposal of antimicrobials through sanitation infrastructure, comprising of antibiotic metabolites digested by humans and the disposal of antibiotics (Prestinaci, Pezzotti and Pantosti, 2015). In order to understand antimicrobial resistance, research is needed to identify and quantify these areas of manmade antibiotic pressures, in turn informing ongoing research and technical solutions (Laxminarayan et al., 2013). Currently there is research ongoing into the removal of antibiotics and resistance within wastewater treatment plants, mostly focused in high-income countries. However, this research is not applicable to on-site sanitation, which is used by 3.1 billion people globally, predominantly in developing countries (JMP, 2019). Due to the high prevalence of on-site sanitation in developing countries combined with their increased susceptibility to high levels of resistant microbials, it is important to establish the potential environmental pressure caused by antimicrobials and resistant genes in on-site sanitation. Therefore, through looking at how antibiotics degrade in on-site sanitation it will be possible to quantify and understand their potential role in increasing antibiotic presence in the environment.Aims and Objectives: The aim of this research is to establish the degradation profile of key antibiotics within an on-site sanitation system under various conditions. This research can then be applicable in looking at how sanitation and the disposal of antibiotics and their metabolites could be a driver in the development of antibiotic resistance, especially within developing countries.The research objectives are to identify key indicator antibiotics and establish, through both modelled laboratory tests and field tests, how these antibiotics degrade under a range of conditions within on-site sanitation. This data can then be used to create a systems model for use in further research and policy decisions. Research Questions:-To what extent do antibiotics degrade within on-site sanitation and what is their degradation profile?-How do changes in key on-site sanitation characteristics and environmental conditions affect antibiotic degradation?-Is on-site sanitation infrastructure an 'antibiotic hotspot' and do they have the potential to contribute towards the development of antibiotic resistance?Research Need: The research will be interdisciplinary utilising skills from chemistry and microbiology as well as being in collaboration with the school of geography. The outcomes of the research are envisaged to be used in further research as the field of antibiotic resistance and WASH is relatively new and under researched. There may be some social science and policy impacts of the research outcomes.There has been a call for research into the contribution of water and sanitation systems to increasing antimicrobial resistance and WHO (World Health Organisation) have identified the need for research 'to identify and quantify the sources, occurrence and transport of antibiotics within environmental media' in their briefing note for antimicrobial resistance as an emerging water, sanitation and hygiene issue. Currently the relative importance of faecal waste / water / sanitation systems as antibiotic reservoirs remains unknown. The proposed research works towards EPSRC's goals in Water Engineering.