Contamination of Surface Water and River Sediments by Antibiotic and Antiretroviral Drug Cocktails in Low and Middle-Income Countries: Occurrence, Risk and Mitigation Strategies

Abstract

Presence of antimicrobial cocktails in the hydrological cycles is of interest because of their potential to mediate antimicrobial resistance within the natural environment. In this study, we determined the concentrations of selected antibiotics and antiretroviral drugs (ARVDs) in wastewater treatment plant (WWTP) effluent, effluent suspended particulate matter (SPM), surface waters and river sediments in Kenya in order to determine the extent of pollution within the sampled environment. Target analysis for the most common antibiotics and ARVDs was done. Sulfamethoxazole (SMX), ciprofloxacin (CIP), trimethoprim (TMP), norfloxacin (NOR), zidovidine (ZDV), lamivudine (3TC) and nevirapine (NVP) were analyzed using LC-ESI-MS/MS. Effluent aqueous phase had concentrations ranging between 1.2 µg L−1 to 956.4 µg L−1 while the effluent SPM showed higher concentrations, ranging between 2.19 mg Kg−1 and 82.26 mg Kg−1. This study shows emission of active pharmaceutical ingredients (APIs) from WWTP to the environment mainly occurs via the SPM phase, which is usually overlooked in environmental analyses. Concentrations in surface waters and river sediments ranged between 1.1 µg L−1 to 228 µg L−1 and 11 µg Kg−1 to 4125 µg Kg−1 respectively. ARVDs occurred at consistently higher concentrations than antibiotics in both the aqueous and solid samples. The wastewater treatment plants and lagoons where sludge degradation should occur, are sources of active pharmaceutical ingredients (APIs) including transformational products, nutrients and organic matter that are released back to the aqueous phase.