Risk Ranking of Antimicrobials in the Aquatic Environment from Human Consumption: An Irish Case Study

A mechanistic model is presented for determination of antimicrobial presence in the environment, using antimicrobial characteristics and Irish-specific usage data. The model simulates release of antimicrobials into the aquatic environment by integrating the effects of antimicrobial use, metabolism, degradation, and dilution. Predicted environmental concentrations (PECs) were ranked in relation to their potential to select for resistant bacteria, toxicity (chronic and acute), and hazard quotient (HQ). The simulated mean PECs of penicillins (PEN), β-lactams (BET), tetracyclines (TET), macrolides (MAC), quinolone/fluoroquinolones (Q/F), and sulphonamides/trimethoprim (S/T) were 1.05, 0.19, 0.06, 0.07, 0.02, and 0.08 mg/m³, respectively. All antimicrobials, excluding Q/F, showed a low HQ (<1) indicating low toxicity. Q/F had a HQ of 1.51 indicating moderate toxicity. All antimicrobial groups expressed varying resistance formation potential with Q/F having the highest. Q/F also exhibited the lowest degradation rate. A sensitivity analysis indicated a possible role for considering metabolism during regulation of new antimicrobials as this can significantly influence PEC values. The observed results suggest that current antimicrobial use can lead to levels in the environment that may increase resistance formation. The results and limitations presented here accentuate the need for further investigation into antimicrobials in the environment and contribution to resistant strains.