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Urinary antibiotic concentrations in preschool children from eastern China and health risk assessment

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Abstract

Despite limited biomonitoring studies suggesting extensive antibiotic exposure in general population, the body burden of antibiotics in young children and their potential health risks remain unclear. To assess the antibiotic exposure levels in young children, 508 preschoolers aged 3–6 years were recruited from eastern China in 2022, and a total of 50 representative antibiotics from 8 categories, including 17 human antibiotics (HAs), 4 antibiotics preferred as HAs (PHAs), 16 veterinary antibiotics (VAs), and 13 antibiotics preferred as VAs (PVAs), were analyzed by UPLC-MS/MS. Hazard quotient (HQ) and hazard index (HI) were calculated to evaluate the health risks, and multivariate logistic regression was applied to examine diet with antibiotic exposure. Our results showed that there were 41 antibiotics detected in children’s urine, and the overall detection frequency was as high as 100%. Sulfonamides, macrolides, β-lactams, quinolones, and azoles were the predominant categories of antibiotic detected. Among the studied children, 6.5% had a sum of estimated daily intake (EDI) of all VAs and PVAs larger than 1 μg/kg/day. Notably, 10.0% of the children had a microbiological HI value exceeding 1, primarily contributed by ciprofloxacin. Children with higher consumption of seafood had a relatively increased exposure to multiple categories of antibiotics, including HAs, VAs, quinolones, azoles, and others. Principal component analysis suggested that “Aquatic products and viscera preferred dietary pattern” scores were positively correlated with the exposure levels of ciprofloxacin (OR: 1.23; 95% CI: 1.02–1.47) and carbadox (OR: 1.32; 95% CI: 1.10–1.59), and a relatively increased exposure of PHAs was realized in children with higher “Meat-egg preferred dietary pattern” scores (OR: 1.24; 95% CI: 1.03–1.50). In conclusion, there was a widespread exposure to antibiotics among preschool children from eastern China, and children who consumed more animal-derived foods may had an increased exposure to antibiotics.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank the teachers (Yuru Cheng and Zhenzhen Jiang) in the kindergartens selected in Nanjing and Suzhou City of Eastern China for their help in urine collection and questionnaire survey.

Funding

This study was supported by Jiangsu provincial key research and development program (No. BE2020626 & BE2021740) and Medical Scientific Research Project of Jiangsu Provincial Health Commission (No. M2021028).

Author information

Authors and Affiliations

  1. Nanjing Maternity and Child Health Care Institute, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, Jiangsu, China

    Juan Wen, Shijie Geng, Lijun Zhu & Xiaodie Yao

  2. Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Road 172, Gulou District, Nanjing, 210000, Jiangsu, China

    Yonglin Zhou, Fei Shen, Zongli Huo & Feng Zhu

  3. School of Chemical Engineering and Light Industry, Guangdong University of Technology, Guangzhou, 510006, China

    Zhe Wang

  4. Wenchang Experimental Kindergarten of Suzhou High-Tech Zone, Suzhou, 215011, China

    Yinghua Ma & Yifang Feng

Authors
  1. Juan Wen
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  2. Shijie Geng
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  3. Lijun Zhu
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  4. Xiaodie Yao
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  5. Yonglin Zhou
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  6. Fei Shen
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  7. Zhe Wang
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  8. Yinghua Ma
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  9. Yifang Feng
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  10. Zongli Huo
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  11. Feng Zhu
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Shijie Geng, Lijun Zhu, Xiaodie Yao, Yonglin Zhou, Fei Shen, Zhe Wang, Yinghua Ma, Yifang Feng, and Zongli Huo. The first draft of the manuscript was written by Juan Wen and Feng Zhu agreed to be accountable for all aspects of the work. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Feng Zhu.

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Ethics approval

This study was reviewed and approved by the Institutional Ethics Committee of Women’s Hospital of Nanjing Medical University and was conducted under the principles of the Helsinki Declaration.

Consent to participate

Written informed consent was obtained from the parents or guardians of the participants prior to the study.

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Agreement to submit the article has been obtained from all the authors. All the authors give consent for this version of the article to be published.

Competing interests

The authors declare no competing interests.

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Responsible Editor: Lotfi Aleya

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Juan Wen, Shijie Geng, and Lijun Zhu are co-first authors; they contributed to this study equally.

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Wen, J., Geng, S., Zhu, L. et al. Urinary antibiotic concentrations in preschool children from eastern China and health risk assessment. Environ Sci Pollut Res 30, 82547–82559 (2023). https://doi.org/10.1007/s11356-023-28209-1

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  • DOI: https://doi.org/10.1007/s11356-023-28209-1

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