@article{a63e14b88f0e48a6b81b0c47538b8675,
title = "Enantiomeric profiling of quinolones and quinolones resistance gene qnrS in European wastewaters",
abstract = "Wastewater-based epidemiology (WBE) was applied for the first time in seven cities across Europe with the aim of estimating quinolones consumption via the analysis of human urinary metabolites in wastewater. This report is also the first pan-European study focussed on the enantiomeric profiling of chiral quinolones in wastewater. By considering loads of (fluoro)quinolones in wastewater within the context of human stereoselective metabolism, we identified cities in Southern Europe characterised by both high usage and direct disposal of unused ofloxacin. In Northern European cities, S-(-)-ofloxacin loads were predominant with respect to R-(+)-ofloxacin. Much more potent, enantiomerically pure S-(-)-ofloxacin was detected in wastewaters from Southern European cities, reflecting consumption of the enantiomerically pure antibiotic. Nalidixic acid, norfloxacin and lomefloxacin were detected in wastewater even though they were not prescribed according to official prescription data. S,S-(-)-moxifloxacin and S,S-(-)-moxifloxacin-N-sulphate were detected in wastewater due to metabolism of moxifloxacin. For the first time, average population-normalised ulifloxacin loads of 22.3 and 1.5 mg day−1 1000 people−1 were reported for Milan and Castell{\'o}n as a result of prulifloxacin metabolism. Enrichment of flumequine with first-eluting enantiomer in all the samples indicated animal metabolism rather than its direct disposal. Fluoroquinolone loads were compared with qnrS gene encoding quinolone resistance to correlate usage of fluoroquinolone and prevalence of resistance. The highest daily loads of the qnrS gene in Milan corresponded with the highest total quinolone load in Milan proving the hypothesis that higher usage of quinolones is linked with higher prevalence of quinolone resistance genes. Utrecht, with the lowest quinolones usage (low daily loads) had also one of the lowest daily loads of the qnrS gene. However, a similar trend was not observed in Oslo nor Bristol where higher qnrS gene loads were observed despite low quinolone usage.",
keywords = "(fluoro)quinolones, Antibiotic resistance, Biomarkers, Chiral antibiotics, Enantioselective analysis, Wastewater-based epidemiology",
author = "Erika Castrignan{\`o} and Zhugen Yang and Feil, {Edward J.} and Richard Bade and Sara Castiglioni and Ana Causanilles and Emma Gracia-Lor and Felix Hernandez and Pl{\'o}sz, {Benedek G.} and Pedram Ramin and Rousis, {Nikolaos I.} and Yeonsuk Ryu and Thomas, {Kevin V.} and {de Voogt}, Pim and Ettore Zuccato and Barbara Kasprzyk-Hordern",
note = "Funding Information: This work was supported by the European Union{\textquoteright}s Seventh Framework Programme for Research, Technological Development and Demonstration [grant agreement 317205 , the SEWPROF MC ITN project, {\textquoteleft}A new paradigm in drug use and human health risk assessment: Sewage profiling at the community level{\textquoteright}] and by Natural Environment Research Council Project on {\textquoteleft}Impact of stereochemistry of antimicrobial agents on their environmental fate, biological potency and the emergence of resistance{\textquoteright} [grant NE/N019261/1 ]. Wastewater samples were provided by local WWTPs to the University of Bath (United Kingdom) by: Wessex Water, Norwegian Institute for Water Research (Norway), Swiss Federal Institute of Aquatic Science and Technology (Switzerland), Technical University of Denmark (Denmark), Mario Negri Institute for Pharmacological Research (Italy), KWR Watercycle Research Institute (The Netherlands), University Jaume I (Spain). Erika Castrignan{\`o} and Barbara Kasprzyk-Hordern planned and designed the study. Erika Castrignan{\`o}, Zhugen Yang, Richard Bade, Sara Castiglioni, Ana Causanilles, Emma Gracia-Lor, Felix Hernandez, Benedek G. Pl{\'o}sz, Pedram Ramin, Nikolaos I. Rousis, Yeonsuk Ryu, Kevin V Thomas, Pim de Voogt, Ettore Zuccato and Barbara Kasprzyk-Hordern organised the collection of the wastewater samples. Erika Castrignan{\`o} prepared and analysed the samples. Erika Castrignan{\`o} and Barbara Kasprzyk-Hordern interpreted the results, drafted the manuscript, which was critically revised by all co-authors. Jose A. Baz-Lomba from Norwegian Institute for Water Research (NIVA), Christoph Ort and Ann-Katrin McCall from Eawag are acknowledged for help with sample provision. Funding Information: This work was supported by the European Union's Seventh Framework Programme for Research, Technological Development and Demonstration [grant agreement 317205, the SEWPROF MC ITN project, ?A new paradigm in drug use and human health risk assessment: Sewage profiling at the community level?] and by Natural Environment Research Council Project on ?Impact of stereochemistry of antimicrobial agents on their environmental fate, biological potency and the emergence of resistance? [grant NE/N019261/1]. Wastewater samples were provided by local WWTPs to the University of Bath (United Kingdom) by: Wessex Water, Norwegian Institute for Water Research (Norway), Swiss Federal Institute of Aquatic Science and Technology (Switzerland), Technical University of Denmark (Denmark), Mario Negri Institute for Pharmacological Research (Italy), KWR Watercycle Research Institute (The Netherlands), University Jaume I (Spain). Erika Castrignan? and Barbara Kasprzyk-Hordern planned and designed the study. Erika Castrignan?, Zhugen Yang, Richard Bade, Sara Castiglioni, Ana Causanilles, Emma Gracia-Lor, Felix Hernandez, Benedek G. Pl?sz, Pedram Ramin, Nikolaos I. Rousis, Yeonsuk Ryu, Kevin V Thomas, Pim de Voogt, Ettore Zuccato and Barbara Kasprzyk-Hordern organised the collection of the wastewater samples. Erika Castrignan? prepared and analysed the samples. Erika Castrignan? and Barbara Kasprzyk-Hordern interpreted the results, drafted the manuscript, which was critically revised by all co-authors. Jose A. Baz-Lomba from Norwegian Institute for Water Research (NIVA), Christoph Ort and Ann-Katrin McCall from Eawag are acknowledged for help with sample provision. Publisher Copyright: {\textcopyright} 2020 Elsevier Ltd",
year = "2020",
month = may,
day = "15",
doi = "10.1016/j.watres.2020.115653",
language = "English",
volume = "175",
journal = "WATER RESEARCH",
issn = "0043-1354",
publisher = "Elsevier Limited",
}