Emergence of Antibiotic Residues and Antibiotic-Resistant Bacteria in Hospital Wastewater: A Potential Route of Spread to African Streams and Rivers, a Review

Medicinal activities carried out within hospitals lead to high consumption of antibiotics and subsequently result in a high excretion rate of antibiotic residues. When consumed by humans, these antibiotics are not fully absorbed by the body and are often discharged into the environment along with biological waste from infected human patients. The significant water consumption in hospitals and the pharmaceutical impact on wastewater from healthcare facilities facilitate the emergence and spread of antibiotic-resistant bacteria (ARB) and antibiotic-resistant genes (ARGs) in the environment. Hospital effluents could be doubly involved in the dissemination of antibiotic molecules and multidrug-resistant bacteria in various ecosystems. The aim of this review is to characterize hospital effluents by assessing antibiotic concentrations and the diversity of antibiotic-resistant bacteria in these hospital wastewaters within the environment (aquatic environments; rivers) as well as to inventory the bacteria present and those carrying antibiotic resistance in both hospital wastewater and the environment.