Occurrence and source identification of antibiotics and antibiotic resistance genes in groundwater surrounding urban hospitals

Urban groundwater, serving as a critical reservoir for potable water, faces susceptibility to contamination from discrete sources such as hospital wastewater. This study investigates the distribution and plausible origins of antibiotics and antibiotic resistance genes (ARGs) in urban groundwater, drawing comparisons between areas proximal to hospitals and non-hospital areas. Ofloxacin and oxytetracycline emerged as the prevalent antibiotics across all samples, with a discernibly richer array of antibiotic types observed in groundwater sourced from hospital-adjacent regions. Employing a suite of multi-indicator tracers encompassing indicator drugs, Enterococci, ammonia, and Cl/Br mass ratio, discernible pollution from hospital or domestic sewage leakage was identified in specific wells, correlating with an escalating trajectory in antibiotic contamination. Redundancy analysis underscored temperature and dissolved organic carbon as principal environmental factors influencing antibiotics distribution in groundwater. Network analysis elucidated the facilitating role of mobile genetic elements, such as int1 and tnpA-02 in propagating ARGs. Furthermore, ARGs abundance exhibited positive correlations with temperature, pH and metallic constituents (e.g., Cu, Pb, Mn and Fe) (p < 0.05). Notably, no conspicuous correlation manifested between antibiotics and ARGs. These findings accentuate the imperative of recognizing the peril posed by antibiotic contamination in groundwater proximal to hospitals and advocate for the formulation of robust prevention and control strategies to mitigate the dissemination of antibiotics and ARGs.