Antibiotics in surface water of East and Southeast Asian countries: A focused review on contamination status, pollution sources, potential risks, and future perspectives

Highlights

• Antibiotic contamination status in East/Southeast Asia's surface water is reviewed.

• Antibiotics are ubiquitous in surface water, especially in aquaculture and urban areas.

• Antibiotic levels varied greatly from few ng/L to hundreds μg/L in surface water.

• Ecological risks and prevalence of antibiotic resistance were widely observed.

• Regional monitoring studies and environmental guidelines for antibiotics are needed.

Abstract

This review provides focused insights into the contamination status, sources, and ecological risks associated with multiple classes of antibiotics in surface water from the East and Southeast Asia based on publications over the period 2007 to 2020. Antibiotics are ubiquitous in surface water of these countries with concentrations ranging from <1 ng/L to hundreds μg/L and median values from 10 to 100 ng/L. Wider ranges and higher maximum concentrations of certain antibiotics were found in surface water of the East Asian countries like China and South Korea than in the Southeast Asian nations. Environmental behavior and fate of antibiotics in surface water is discussed. The reviewed occurrence of antibiotics in their sources suggests that effluent from wastewater treatment plants, wastewater from aquaculture and livestock production activities, and untreated urban sewage are principal sources of antibiotics in surface water. Ecological risks associated with antibiotic residues were estimated for aquatic organisms and the prevalence of antibiotic resistance genes and antibiotic-resistant bacteria were reviewed. Such findings underline the need for synergistic efforts from scientists, engineers, policy makers, government managers, entrepreneurs, and communities to manage and reduce the burden of antibiotics and antibiotic resistance in water bodies of East and Southeast Asian countries.

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.