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High doses of antibiotics used in hospitals can affect the microbial composition of sewers, selecting resistant bacteria. In this sense, we evaluated the antibiotic resistance profile and the multiresistant phenotype of bacteria isolated in sewage from a tertiary hospital in the interior São Paulo state, Brazil. For bacteria isolation, 10 µL of sewage samples were sown in selective culture media and the isolates were identified using VITEK-2 automatized system. The antibiotic sensitivity test was performed by disk diffusion. High percentages of resistance were found for amoxicillin, ampicillin, ceftazidime, clindamycin, vancomycin and the multidrug-resistant phenotype (MDR) was attributed to 60.7% of the isolates. Our results show bacteria classified as critical/high priority by WHO List of Priority Pathogens (Enterococcus and Staphylococcus aureus resistant to vancomycin and Enterobacteriaceae resistant to carbapenems) in hospital sewage. Therefore, the implementation of disinfection technologies for hospital sewage would reduce the bacterial load in the sewage that will reach urban wastewater treatment plants, minimizing superficial water contamination and bacterial resistance spread in the environment.

In July 2003, duplicated samples of roots, stems and leaves of sugar cane (Saccharum spp.) were collected in 25 points of an area under direct influence of the municipal landfill site (MLS) and medical waste treatment system (MWTS) of Ribeirao Preto, São Paulo, Brazil. Cadmium (Cd), chromium (Cr), copper (Cu), mercury (Hg), manganese (Mn), lead (Pb) and zinc (Zn) were determined by atomic absorption spectrophotometry. The following concentrations (mg/kg) were found in roots: Cd, 0.22+/-0.12; Cr, 64.3+/-48.7; Cu, 140.6+/-27.7; Hg, 0.04+/-0.02; Mn, 561.6+/-283.3; Pb, 7.9+/-2.1 and Zn, 177.4+/-64.9. For some metals, these levels are higher than the concentrations previously reported for different plants, reaching, in some cases, values that might be considered toxic for vegetables. Metal levels in stems were 80-90% of those found in roots, while the concentrations detected in leaves were significantly lower than those in roots. The present results suggest that MLS and MWTS activities might have been increasing metal concentrations in edible tissues of sugar cane grown in the area under their influence. Moreover, the traditional agricultural practices in the production of sugar cane could be also another determinant factor to reach the current metal levels. The results of this study indicate that sugar cane is a crop that is able to grow in areas where metals in soils are accumulated.