ReviewAntibiotics in surface water of East and Southeast Asian countries: A focused review on contamination status, pollution sources, potential risks, and future perspectives
Graphical abstract
Introduction
Since the discovery of penicillin by A. Fleming in 1929 (Fleming, 1929), antibiotics from multiple classes have been produced and used worldwide for the treatment human, animal, and plant diseases caused by pathogenic bacteria (Thakare et al., 2020). As a result, substantial amounts of antibiotics have been released into the environment through discharge from households, hospitals, pharmaceutical companies, wastewater treatment plants (WWTPs), and aquaculture and livestock farms (Kümmerer, 2009a; Danner et al., 2019; Kovalakova et al., 2020). Antibiotics have been considered as emerging classes of pollutants because of their omnipresence at elevated concentrations in surface water, groundwater, soil, sediment, and biota in virtually all parts of the world (Kümmerer, 2009a; Carvalho and Santos, 2016; Binh et al., 2018; Danner et al., 2019; Felis et al., 2020; Kovalakova et al., 2020; Lyu et al., 2020). The presence of multiple antibiotics in the water environment can pose ecological risks to aquatic organisms, and is responsible for the promotion of antibiotic resistance genes (ARG) and antibiotic-resistant bacteria (ARB) in the aquatic ecosystems (Kümmerer, 2009b; Carvalho and Santos, 2016; Danner et al., 2019; Kumar et al., 2019; Kovalakova et al., 2020). This situation raises serious concerns regarding antibiotic residues in the aquatic environment, especially in developing countries where management practices of antibiotic use and antibiotic-related waste have not been effectively performed (Segura et al., 2015; Lundborg and Tamhankar, 2017; Binh et al., 2018; Kumar et al., 2019).
The East and Southeast Asia consists of nineteen countries and special administrative regions with a total population of about 2.3 billion people, accounting for 30% of the global population in 2018 (United Nations, 2018). China is considered as the biggest producer and consumer of antibiotics in the world with a total national production and usage amounts of 248,000 and 162,000 tons in 2013, respectively (Zhang et al., 2015). The number of scientific publications (including original papers and critical reviews) about the contamination status and relevant risks of antibiotics in Chinese aquatic environment has gradually increased over the last decade, illustrating the interest in this issue in China (Z. Li et al., 2020; Lyu et al., 2020). Elevated releases of antibiotics and prevalence of ARG and ARB from WWTPs and aquaculture and livestock sectors in South Korea have been also addressed (Sim et al., 2011; Jang et al., 2018; Kim and Kim, 2016; Kim et al., 2019; Kim et al., 2020). Moreover, the production, use, and environmental residues of antibiotics are expected to increase in Southeast Asia region, as a result of rapid economic development and population growth together with the ubiquity of tropical infectious diseases and improper habits of drug usage (Shimizu et al., 2013; Lundborg and Tamhankar, 2017; Binh et al., 2018).
There are several review articles that provide comprehensive insights into the occurrence, fate, sources, and risks of antibiotics in water bodies of global (Kümmerer, 2009a; Danner et al., 2019; Felis et al., 2020; Kovalakova et al., 2020), regional (e.g., Europe, Carvalho and Santos, 2016; Szymańska et al., 2019; and Africa, Faleye et al., 2018), and national scales (e.g., China, W. Zhao et al., 2016; Guan et al., 2017; Li et al., 2018a; Liu et al., 2018; Z. Li et al., 2020; Lyu et al., 2020; and Vietnam, Thuy and Nguyen, 2013; Binh et al., 2018). However, to the best of our knowledge, no review paper has focused on antibiotics in surface water in the East and Southeast Asian countries. The review presented here, based on data compiled from peer-reviewed papers published mainly during 2007–2020, provides a compendious picture on the concentrations and profiles of antibiotics in receiving water and their potential sources. Relevant comparisons are made between several countries in the East and Southeast Asia. Target antibiotics comprise compounds of multiple classes such as β-lactams (BLs), fluoroquinolones (FQs), macrolides (MLs), sulfonamides (SFs), tetracyclines (TCs), and other classes. Basic information about major antibiotics described in this review is summarized in Table 1. Current understanding of the environmental behavior, fate, and negative impacts of antibiotics in surface water of these countries is included. In addition, general comments and future perspectives on different aspects regarding antibiotics in the aquatic environment of the investigated regions are provided, heading towards effective monitoring, assessment, management, and remediation schemes for these emerging pollutants in the East and Southeast Asia.
Section snippets
Production, import, and export
China is the largest producer and exporter of antibiotics in the world with total production and export amounts of 248,000 and 88,000 tons in 2013, respectively, while the imported amount was only 600 tons (Zhang et al., 2015). In Japan, antibiotic research and production started in the 1940s and a total of 117 antibiotics and bioactive microbial products being discovered during 1946–1995, among them 41 agents have been licensed internationally (Kumazawa and Yagisawa, 2002). In South Korea, the
China
There has been a great number of studies on the occurrence of antibiotics in the aquatic environment of China. Our discussion is mainly based on systematic reviews and recent research papers on large-scale water systems with the goal of providing an up-to-date and comprehensive view regarding contamination status and trend of antibiotics in Chinese surface water. A total of >90 antibiotics belonging to five main classes (i.e., SFs, FQs, TCs, MLs, and BLs) were monitored in water samples from
Phase distribution characteristics
The distributions of antibiotics between dissolved and particulate phases, and between water and sediment are important factors that affect contamination levels and fate of these substances. Most of previous studies used membrane filtration (e.g., usually 0.45-μm filter and sometimes together with 0.22-μm filter) as a sample pretreatment step, therefore, measured concentrations represented dissolved phase concentrations basically. To date, few studies have discussed the occurrence and partition
Pollution sources of antibiotics
The pollution sources of antibiotics in the aquatic environments of East and Southeast Asia are, as anywhere, quite complex and can be classified into five main groups: (1) effluent from hospitals and pharmaceutical companies; (2) effluent from aquaculture and livestock farms; (3) untreated municipal sewage; (4) effluent from WWTPs, and (5) landfill leachates. Concentrations and profiles of antibiotics in their sources from some East and Southeast Asian countries are summarized in Table 2. In
Ecological risks
The occurrence of antibiotics and their degradation products in the aquatic ecosystems can pose a threat to non-target organisms of different trophic levels including bacteria, algae, plants, invertebrates, and fish (Carvalho and Santos, 2016; Danner et al., 2019; Kumar et al., 2019; Felis et al., 2020). Most of the available studies on antibiotic contamination of surface water included ecological risk assessments using risk quotient (RQ) schemes. RQs of an antibiotic in water to certain
Academic and technical aspects
As described above, there are many information gaps about the occurrence, distribution, and risks of antibiotics in surface water from East and Southeast Asia. To our knowledge, so far, available data on concentrations and patterns of antibiotics in surface water and in pollution sources for several countries in these two regions (e.g., Mongolia, North Korea, Brunei, Cambodia, Laos, Myanmar, and Timor-Leste) are still limited. Furthermore, except for China where a huge number of studies have
Summary
The occurrence of antibiotics and antibiotic resistance in surface water and wastewater from East and Southeast Asia was reviewed to evaluate their spatial distribution, behavior and fate, pollution sources, and risks, and to address research gaps and future requirements. Antibiotics belonging to multiple classes that applied to treat both human and animal infection have been widely detected in receiving water and wastewater of these countries with individual concentrations varying from ng/L to
Declaration of competing interest
The authors declare that there is no conflict of interest regarding the publication of this article.
Acknowledgement
This study was funded by the Asia-Pacific Network for Global Change Research (APN) (grant number CRRP2019-10MY-Le). The support of Fund for the Promotion of Joint International Research (Fostering Joint International Research (B)) (no. 18KK0300) from the Japan Society for the Promotion of Science (JSPS) was also acknowledged.
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