SWOT-SOR Analysis of Activated Carbon-Based Technologies and O3/UV Process as Polishing Treatments for Hospital Effluent

The management and treatment of hospital wastewater are issues of great concern worldwide. Both in the case of a dedicated treatment or co-treatment with urban wastewater, hospital effluent is generally subjected to pre-treatments followed by a biological step. A polishing treatment is suggested to promote (and guarantee) the removal of micropollutants still present and to reduce the total pollutant load released. Activated carbon-based technologies and advanced oxidation processes have been widely investigated from technical and economic viewpoints and applied in many cases. In this study, the potential exploitation of these technologies for the polishing treatment of hospital effluent is investigated by combining a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis with a Strategic Orientation (SOR) analysis. This approach allows a coherent strategy to be extracted from the SWOT-SOR data, increasing the chances of success of each technology. It emerges that both technologies present relevant and sometimes similar strengths and can present opportunities. At the same time, activated carbon-based technologies are more likely to contain the main identified threats than O3/UV technology. The study also finds that, for both technologies, further research and development could improve their potential applications in the treatment of hospital wastewater.

High Frequency of the EMRSA-15 Clone (ST22-MRSA-IV) in Hospital Wastewater

Hospital wastewaters often carry multidrug-resistant bacteria and priority pathogens, such as methicillin-resistant Staphylococcus aureus (MRSA). Pathogens and antibiotic resistance genes present in wastewaters may reach the natural environment facilitating their spread. Thus, we aimed to isolate MRSA from wastewater of 3 hospitals located in the north of Portugal and to characterize the isolates regarding the antimicrobial resistance and genetic lineages. A total of 96 wastewater samples were collected over six months. The water was filtered, and the filtration membrane was immersed in BHI broth supplemented with 6.5% of NaCl and incubated. The inoculum was streaked in ORSAB agar plates for MRSA isolation. The isolates susceptibility testing was performed against 14 antimicrobial agents. The presence of resistance and virulence genes was accessed by PCR. Molecular typing was performed in all isolates. From the 96 samples, 28 (29.2%) were MRSA-positive. Most isolates had a multidrug-resistant profile and carried the mecA, blaZ, aac(6′)-Ie-aph(2″)-Ia, aph(3′)-IIIa, ermA, ermB, ermC, tetL, tetM, dfrA dfrG and catpC221 genes. Most of the isolates were ascribed to the immune evasion cluster (IEC) type B. The isolates belonged to ST22-IV, ST8-IV and ST105-II and spa-types t747, t1302, t19963, t6966, t020, t008 and tOur study shows that MRSA can be found over time in hospital wastewater. The wastewater treatment processes can reduce the MRSA load. The great majority of the isolates belonged to ST22 and spa-type t747 which suggests the fitness of these genetic lineages in hospital effluents.

Machine Learning Approach to Predict Quality Parameters for Bacterial Consortium-Treated Hospital Wastewater and Phytotoxicity Assessment on Radish, Cauliflower, Hot Pepper, Rice and Wheat Crops

Raw hospital wastewater is a source of excessive heavy metals and pharmaceutical pollutants. In water-stressed countries such as Pakistan, the practice of unsafe reuse by local farmers for crop irrigation is of major concern. In our previous work, we developed a low-cost bacterial consortium wastewater treatment method. Here, in a two-part study, we first aimed to find what physico-chemical parameters were the most important for differentiating consortium-treated and untreated wastewater for its safe reuse. This was achieved using a Kruskal–Wallis test on a suite of physico-chemical measurements to find those parameters which were differentially abundant between consortium-treated and untreated wastewater. The differentially abundant parameters were then input to a Random Forest classifier. The classifier showed that ‘turbidity’ was the most influential parameter for predicting biotreatment. In the second part of our study, we wanted to know if the consortium-treated wastewater was safe for crop irrigation. We therefore carried out a plant growth experiment using a range of popular crop plants in Pakistan (Radish, Cauliflower, Hot pepper, Rice and Wheat), which were grown using irrigation from consortium-treated and untreated hospital wastewater at a range of dilutions (turbidity levels) and performed a phytotoxicity assessment. Our results showed an increasing trend in germination indices and a decreasing one in phytotoxicity indices in plants after irrigation with consortium-treated hospital wastewater (at each dilution/turbidity measure). The comparative study of growth between plants showed the following trend: Cauliflower > Radish > Wheat > Rice > Hot pepper. Cauliflower was the most adaptive plant (PI: −0.28, −0.13, −0.16, −0.06) for the treated hospital wastewater, while hot pepper was susceptible for reuse; hence, we conclude that bacterial consortium-treated hospital wastewater is safe for reuse for the irrigation of cauliflower, radish, wheat and rice. We further conclude that turbidity is the most influential parameter for predicting bio-treatment efficiency prior to water reuse. This method, therefore, could represent a low-cost, low-tech and safe means for farmers to grow crops in water stressed areas.

An opportunity for using constructed wetland technology in hospital wastewater treatment: a preliminary study

The problem faced by many hospitals in Indonesia is the low efficiency of Waste Water Treatment Plant (WWTP) hospitals. If it does not get the attention, it will have an impact on health and environmental pollution. Various technologies have been used but experienced many obstacles. Constructed wetlands based on aquatic plants that have been used in developed countries are very prospects of being developed in regions such as Indonesia with a tropical climate. A preliminary study is needed with the first step to investigate the quality of hospital wastewater in Palu City, Indonesia, as a sample. This study aims to obtain a description of hospital wastewater characteristics and to evaluate the performance of the hospital WWTP in Palu. Data collection was done by taking data indirectly through laboratory test results during 2015-2019. Tabulating data using Excel software to illustrate statistics, then presented in the form of bar charts, interpreting according to the quality standards. Investigation results showed that the characteristics of hospital inlet wastewater in Palu are parameter values varying with four high concentration parameters: total coliform, TSS, Ammonia Nitrogen, and COD. The efficiency level of WWTP hospitals in Palu is relatively low in removing pollutants.

Fate of Pharmaceuticals in a Submerged Membrane Bioreactor Treating Hospital Wastewater

The fate of 12 pharmaceutical pollutants was investigated to understand their removal mechanism during hospital wastewater (HWW) treatment in submerged membrane bioreactor (SMBR). High concentrations of anti-depressant (venlafaxine and desvenlafaxine), analgesic (ibuprofen and hydroxy-ibuprofen), and caffeine were detected in the HWW during the entire study period. The SMBR showed high removal >70% of antibiotics (sulfamethoxazole and clarithromycin), beta-blocker (acebutolol), hormone (estrone), and caffeine via biodegradation. The partial degradation of diclofenac, venlafaxine, and desvenlafaxine in SMBR indicates the growth promoter or agent requirement, which could facilitate the metabolism and co-metabolism of these pharmaceuticals by microorganisms. The study demonstrated that the major removal mechanism of pharmaceuticals in SMBR at optimized treatment conditions was biodegradation for the majority of examined pharmaceuticals. The assessment of SMBR performance at the low temperature of 15 and 10°C resulted in the drop of biodegradation efficiency of SMBR, affecting overall pharmaceuticals removal.

Association of exopolysaccharide genes in biofilm developing antibiotic-resistant Pseudomonas aeruginosa from hospital wastewater

The study aimed to examine the relationship between antibiotic resistance, biofilm formation and genes responsible for biofilm formation. Sixty-six Pseudomonas aeruginosa isolates were obtained from hospital wastewater and analyzed for their antibiotic resistance. Biofilm production among the isolates was tested by quantitative method crystal violet assay. Biofilm-associated genes among these isolates psl, alg, and pel were also checked. The maximum resistance was observed for ampicillins (88.24%) followed by nalidixic (83.82%), and nitrofurantoin (64.71%), respectively. Biofilm phenotypes are distributed in the following categories: high 39.39% (n = 26); moderate 57.57% (n = 38), and weak 3.0% (n = 2). Among the total isolates, biofilm-associated genes were detected in 84.84% (n = 56) of isolates and the remaining isolates 15.15% (n = 10) did not harbor any genes. In this study, pslB was the most predominant gene observed (71.21%, n = 47) followed by pslA (57.57%, n = 38), pelA (45.45%, n = 30), algD (43.93%, n = 29), and pelD (27.27%, n = 18), respectively. The present study reveals that the majority of the isolates are multidrug resistant being moderate and high biofilm formers. The study implies that biofilm acts as a machinery for bacteria to survive in the hospital effluent which is an antibiotic stress environment.