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2.
  • Jarnheimer, Per-åke, et al. (author)
  • Fluoroquinolone Antibiotics in a Hospital Sewage Line; Occurrence, Distribution and Impact on Bacterial Resistance
  • 2004
  • In: Scandinavian Journal of Infectious Diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 36:10, s. 752-5
  • Journal article (peer-reviewed)abstract
    • In hospital sewage lines, human faecal bacteria are exposed to antibiotics, posing a risk for selection of antibiotic resistant microorganisms. We constructed a system for continuous sampling in a hospital sewage line that allowed us to study longitudinal establishment of bacteria, concentrations of antibiotics, and selection of bacterial resistance in waste water, sediment and biofilm. The focus in this study was on fluoroquinolones, a widely used group of antibiotics with increasing resistance problems. We found low levels of ciprofloxacin and ofloxacin in waste water but high concentrations in sediment. Despite the high levels of fluoroquinolones bound to sediment, we did not find any development of resistance against fluoroquinolones in Enterobacteriacae spp. and faecal enterococci isolated from sediment.
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3.
  • Johansson, Magnus, et al. (author)
  • Screening av antibiotika i avloppsvatten, slam och fisk under 2002/2003
  • 2003
  • Reports (other academic/artistic)abstract
    • Tretton olika antibiotika har undersökts i en screeningstudie i Sverige under 2002/2003. Avloppsvatten, slam och fiskprover har ingått i denna studie. Provtagningar har genomförts vid två tillfällen och fem reningsverk av olika karaktärer. Kemiska analysmetoder har utvecklats och validerats för samtliga dessa matriser. För första gången har intern standard metoden (struktur analoger) utnyttjats fullt ut för bestämningar av antibiotika i miljöprover. Resultaten visar att penicilliner och cefalosporiner har korta halveringstider. Enstaka substanser av dessa grupper har detekterats i 50 % av alla avloppsvattenprover och då endast i undantagsfall i utgående vatten. Fluorokinoloner, trimetoprim och doxycyklin har detekterats i samtliga avloppsvattenprover (20 av 20). I slam förekommer främst fluorokinoloner och doxycyklin. Fluorokinolonerna förekommer i relativt höga halter (summa fluorokinoloner ~6.5 mg kg-1 TS). Detta kan utgöra en risk om detta material sprids ut i miljön men mer kunskap krävs om dessa substansers mobilitet och toxicitet för att göra denna bedömning.
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5.
  • Lindberg, Richard, et al. (author)
  • Determination of antibiotic substances in hospital sewage water using solid phase extraction and liquid chromatography/mass spectrometry and group analogue internal standards
  • 2004
  • In: Chemosphere. - : Elsevier BV. - 0045-6535. ; 57:10, s. 1479-88
  • Journal article (peer-reviewed)abstract
    • A method for determination of antibiotics in hospital sewage water has been developed and validated. Analogue internal standards for fluoroquinolones, sulfonamides, trimethoprim, β-lactams (penicillins and cephalosporines), nitroimidazoles and tetracyclines were successfully used for calibration and shown to generally improve precision compared to external calibration. Matrix components caused ion suppression/enhancement effects during the MS detection for all analytes studied. Two effects were observed: general suppression and short-term variations in the MS response.In the hospital sewage water large temporal variations in the analyte concentration were observed during the course of the sampling period (seven grab samples in 13 h). Analyte concentrations varied within the following ranges (in μg l−1): ciprofloxacin, 3.6–101.0; metronidazole, 0.1–90.2; sulfamethoxazole, 0.4–12.8; ofloxacin, 0.2–7.6; trimethoprim, 0.6–7.6; and doxycycline, 0.6–6.7.
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6.
  • Lindberg, Richard, 1977- (author)
  • Determination of Antibiotics in the Swedish Environment with Emphasis on Sewage Treatment Plants
  • 2006
  • Doctoral thesis (other academic/artistic)abstract
    • Metoder har utvecklats för att kunna bestämma tolv antibiotikasubstanser, vanliga inom human medicin, i miljöprover. Fokus lades på trimetoprim samt substanser från följande grupper: fluorokinoloner, sulfonamider, penicilliner, cefalosporiner, nitroimidazoler, tetracykliner samt makrolider. Vid extraktion användes fast-fas extraktion för vattenprover och ultraljuds-assisterad fast-fas/vätske extraktion för fasta prover. För separering och bestämning användes vätskekromatografi tandemmasspektrometri. Interna standarder nyttjades för att öka noggrannhet och precision. Extraktionsutbyte låg mellan 50% och 100% för vattenfaser och 14% och 100% för fasta faser. Koncentrationer och massflöden bestämdes för antibiotikasubstanser i inkommande och utgående vatten och slam, från fem avloppreningsverk i Sverige, samt i avloppsvatten från ett sjukhus. I sjukhusavloppsvattnet så påträffades ciprofloxacin (en fluorokinolon) och metronidazol (en nitroimidazol) i höga halter (µg/L nivå). Screening-studien vid de fem avloppsreningsverken visade att norfloxacin, ofloxacin, ciprofloxacin och doxycyklin ofta förekom i inkommande och utgående vatten och slam. Trimetoprim och sulfametoxazol påvisades inte i slam men förekom i snarlika koncentrationer i det utgående vattnet relativt det inkommande. I vattenfasen så förekom de sex antibiotikasubstanserna i ng/L nivån och i slam förekom norfloxacin, ofloxacin, ciprofloxacin, och doxycyklin i låga mg/kg nivån. En studie genomfördes där beteendet hos antibiotikasubstanser under avloppsrening studerades. De två fluorokinolonerna, norfloxacin och ciprofloxacin, adsorberade till slam och mindre än 5% av den totala mängd som kommer till avloppsreningsverket påvisades i det utgående vattnet. I slam var motsvarande andel 70%. Resultat från en process som värmebehandlar rötat avvattnat slam antyder att cirka 50% av de två fluorokinolonerna bryts ner. Trimetoprim adsorberade inte till slam och 100% av total mängd återfanns i det utgående vattnet. Teoretiska beräkningar av koncentrationer och massflöden visade god korrelation till kvantitativa resultat. Ökad noggrannhet i beräkningarna fås genom att beakta stabilitet och fasfördelning. Effekten av antibiotikasubstanser i miljön är idag okänd. Resultat från testprotokoll där deras toxicitet bedöms är i många fall irrelevanta. Tester där organismer är kroniskt exponerade av biologiskt aktiva substanser vid låga koncentrationer är få. Dessutom så fokuserar de ej på de stora potentiella effekterna såsom utveckling eller bevaring av resistenta stammar av bakterier i miljön. Ytterligare studier av förekomst, öde och effekt av antibiotikasubstanser i miljön är nödvändiga.
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7.
  • Lindberg, Richard H, et al. (author)
  • Behavior of fluoroquinolones and trimethoprim during mechanical, chemical, and active sludge treatment of sewage water and digestion of sludge
  • 2006
  • In: Environmental Science and Technology. - Washington : American Chemical Society. - 0013-936X .- 1520-5851. ; 40:3, s. 1042-1048
  • Journal article (peer-reviewed)abstract
    • The behavior and fate of three fluoroquinolones (norfloxacin, ofloxacin, and ciprofloxacin), one sulfonamide (sulfamethoxazole), and trimethoprim were investigated at a sewage treatment plant in Umeå, Sweden, in 2004. This plant uses conventional mechanical, chemical, and activated sludge methods to treat the sewage water and digest the sludge; the dewatered digested sludge is pelleted (dry weight > 90% of total weight). Raw sewage water and particles as well as effluents and sludge from specific treatment areas within the plant were sampled. In addition to quantifying the antibiotics within the plant, we characterized the sample matrixes to facilitate evaluation of the results. Of the five substances examined, only norfloxacin, ciprofloxacin, and trimethoprim were present in concentrations higher than their limits of quantification. Norfloxacin and ciprofloxacin sorbed to sludge in a manner that was independent of changes in pH during sewage treatment, and more than 70% of the total amount of these compounds passing through the plant was ultimately found in the digested sludge. The results suggest that fluoroquinolones undergo thermal degradation during pelleting, but more studies are needed to confirm this. Trimethoprim was found in the final effluent at approximately the same concentration and mass flow as in the raw sewage, and could not be quantified in any solid sample. Predicted environmental concentrations, based on consumption data for Umeå municipality, correlated well with the results obtained, especially when the predicted concentrations were corrected to account for the amount of each active substance excreted in urine. The results obtained were compared to those of previous studies of these three substances' behavior and fate and were found to be similar, although some of the other plants studied employed the various treatment steps in different orders.
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8.
  • Lindberg, R. H., et al. (author)
  • Environmental risk assessment of antibiotics in the Swedish environment with emphasis on sewage treatment plants
  • 2007
  • In: Water Research. - : Elsevier BV. - 0043-1354 .- 1879-2448. ; 41:3, s. 613-619
  • Journal article (peer-reviewed)abstract
    • The potential risks associated with antibiotics present in the Swedish environment were assessed using concentrations found in hospital effluent, and sewage treatment waters and sludge, in combination with data on their environmental effects obtained from the literature. For the aqueous environment, measured environmental concentrations and effect/no observed effect concentration ratios were much lower than one in most cases. The only exceptions, where concentrations of the investigated substances were high enough to pose potential risks, were the concentrations of the two fluoroquinolones, ofloxacin and ciprofloxacin, in the hospital effluent. Treating digested dewatered sludge by heat did not fully eliminate norfloxacin or ciprofloxacin, thus pellets may still contain high amounts of these substances (sub to low mg kg(-1) dw). In leaching tests less than 1% of the amounts of these fluoroquinolones in the sludge or pellets reached the aqueous phase, indicating that their mobility is limited if sludge is used to fertilize soil. (c) 2006 Elsevier Ltd. All rights reserved.
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9.
  • Lindberg, Richard, et al. (author)
  • Screening of human antibiotic substances and determination of weekly mass flows in five sewage treatment plants in Sweden
  • 2005
  • In: Environmental Science and Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 39:10, s. 3421-3429
  • Journal article (peer-reviewed)abstract
    • Twelve antibiotic substances for human use, including trimethoprim and representatives of the fluoroquinolone (FQ), sulfonamide (SA), penicillin (PE), cephalosporin (CE), nitroimidazole (NI), tetracycline (TC), and macrolide (MA) groups, were subjected to a screening study at five Swedish sewage treatment plants (STPs) during one week in 2002 and one week in 2003. The analytes were extracted from raw sewage water, final effluent, and sludge by solid-phase extraction (SPE) or liquid-solid extraction (as appropriate) and then identified and quantified by liquid chromatography/tandem mass spectrometry. The most frequently detected antibiotics in the matrices considered in this study were norfloxacin, ofloxacin, ciprofloxacin, trimethoprim, sulfamethoxazole, and doxycycline. The other analytes were only detected in a few samples. Analysis of the weekly mass flows through each STP showed that FQs were partly eliminated from the water during sewage water treatment and the highest amounts of these substances were found in sludge. Sulfamethoxazole and trimethoprim were mainly found in raw sewage water and final effluent, but these substances had balancing mass flows, indicating that they too can withstand sewage water treatment. The mass flow patterns for doxycycline were more complex, with high amounts occurring in sludge in some cases, suggesting that the behavior of this analyte may be more strongly influenced by the treatment process and other variables at individual STPs. The environmental load (the sum of the amounts in the final effluent and sludge) normalized to the number of inhabitants in the catchment area of each investigated STP compared with theoretical predictions based on consumption data (in parentheses) showed good correlations: norfloxacin, 0.8 (0.9); ofloxacin, 0.3 (0.2); ciprofloxacin, 1.3 (3.5); sulfamethoxazole, 0.2 (0.4); trimethoprim, 1.1 (1.0); and doxycycline, 0.7 (0.4) mg per person per week. The results show that reasonably accurate predictions of environmental load of these antibiotics can be time-effectively derived from consumption data without additional measurements.
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