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Antibiotics and antibiotic-resistant bacteria in water: Something to worry about? Volume 5, issue 4, Juillet-Août 2006

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Université Paris Sud 11, Faculté de pharmacie, EA 3542 Santé publique – environnement, 5, rue J.B. Clément, 92296 Chatenay-Malabry cedex www.u-psud.fr/labospe.nsf

The intense use of antibiotics in human and veterinary medicine has major effects on the environment: the presence of active drug residues and selection pressure on antibiotic-resistant bacteria. These two phenomena are related but do not raise the same questions in the areas of health risk and water quality management. Antibiotic residues must, like other undesirable organic micropollutants, be eliminated during the process of making water fit to drink. It is also important however to assess their impact on the biomass active in water purification and on the microbial ecology of soils. Preventive action is essential to reduce the quantity used and their release into the environment. Antibiotic-resistant bacteria exist naturally in numerous water sources, even in geographic areas without any real pressure from antibiotic use. Others are spread from zones of high-priority selection, such as livestock farms or healthcare facilities. It is essential to develop our knowledge about their fate in activated sludge and their capacity to transmit resistance to aquatic biomass. Repeated disinfection performed in water purification plants provides protection for potable water. A comprehensive and complex analysis of these risks must take into account the diverse exposures (contact, aerosols, water, food), especially to reduce the number of nosocomial infections.