noPILLS in Limoges, France

Limoges is a town in the centre of France, with about 140 000 inhabitants, crossed by the river Vienna. The University Hospital (CHU) of Limoges consists of five institutions for a total of about 2,000 beds or places. CHU has collaborated for many years with research teams of the Limoges University (Grese and INSERM) on the control of the quality of its discharges. Under the PILLS program, special and original attention has been given on the dissemination of antibiotic resistance bacteria (ARB) from the emission point (hospital) to the river Vienna through the wastewater treatment plant. Protocols have been implemented and validated in different European hospitals allowing to follow the potential spread of antibiotic résistance bacteria. Meanwhile, various studies are now conducted, covering the technical, sociological and management aspects for minimizing environmental impacts of micropollutants drug:

• monitoring of antibiotic resistance bacteria is carried across the watershed, considering both bacterial biofilms and diffuse dissemination,
• characterization of the effectiveness of different methods for upgrading existing stations,
• the management of the use of active substances in connection with their concentration in discharged water,
• the perception of drugs in water by the population, with, for objectives, our contribution to the knowledge development for minimizing drug impacts at the source.