Multidrug-Resistant Bacteria and Antibiotics in Hospital Effluents: A Bibliometric Analysis of the Hidden Threat to Public Health

Abstract

bacteria and antibiotics in hospital effluents indexed in Scopus between 2010 and 2024, identifying key trends and applications. A total of 199 documents were processed using Boolean operators and tools such as VOSviewer and Biblioshiny-based RStudio. China, India, and Japan led publication output, followed by the United States and Brazil; in Europe, the United Kingdom and Germany stood out for their high levels of international collaboration. Original research articles accounted for 86% of the publications, while reviews made up 11%. Chen L., Diwan V., and Tamhankar AJ. emerged as the most prolific authors. The co-authorship map revealed five thematic clusters focused on genetic modeling, metagenomic characterization, chemical monitoring, bioremediation, and molecular mechanisms. Dominant methodologies included isolation on selective media, minimum inhibitory concentration assays, HPLC-DAD, LC-MS/MS, quantitative PCR, and shotgun metagenomics. Identified gaps include the lack of standardized protocols, limited coverage of Latin America and Africa, and insufficient integration of chemical and genomic data for predictive modeling. Future directions point to CRISPR-based biosensors, digital twins of treatment plants, artificial intelligence applications, and advanced purification technologies to mitigate the “hidden threat” posed by these effluents.