Antibiotic Resistant Pathogens in Drinking Water Due to Arsenic Contamination

A recent study that deals with areas having high levels of arsenic contamination in drinking water and the higher prevalence of antibiotic-resistant Escherichia coli in both water and child stool samples was published by Mohammad Aminul Islam of Washington State University and colleagues. The rapid emergence of resistant bacteria is threatening the efficacy of antibiotics, which have transformed medicine and saved millions of lives. Bacterial infections have resurfaced many decades after the first patients were treated with antibiotics. The antibiotic resistance crisis has been attributed to overuse and misuse of these medications, as well as a lack of new drug development by the pharmaceutical industry due to reduced economic incentives and difficult regulatory requirements (1^✔ ✔Trusted Source
The antibiotic resistance crisis: part 1: causes and threats

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Researchers collected water and stool samples from mothers and young children from 100 families in two rural subdistricts of Bangladesh for the new study. Families in the Hajiganj subdistrict get their drinking water from arsenic-laden shallow tube wells, whereas Matlab residents get theirs from arsenic-free deep tube wells.

The median arsenic concentration in the 50 water samples from Hajiganj was 481 g/L, while it was 0 g/L in the 50 water samples from Matlab.

Overall, 84% of all water and stool samples tested positive for E. coli at both sites. Antibiotic-resistant E. coli is common and was significantly higher in Hajiganj water (48%) than in Matlab water (22%, p 0.05) and in Hajiganj children (94%) than in Matlab children (76%, p 0.05), but not in mothers. Furthermore, a higher proportion of multiple antibiotics, including penicillin, cephalosporin, and chloramphenicol, were resistant to E. coli from Hajiganj.

"The positive association detected between arsenic exposure and antibiotic resistance carriage among children in arsenic-affected areas in Bangladesh is an important public health concern that warrants redoubling efforts to reduce arsenic exposure," the authors say.

Dr. Islam adds, "Heavy metals such as arsenic are more stable than antibiotics in the environment, and they continue to exert selective pressure on bacteria over a more extended period, driving the evolution and expansion of antimicrobial resistance in the community.” “The extent to which this phenomenon drives the observed higher rates of antimicrobial resistance, as opposed to other confounders, would benefit from further study; nevertheless, it is critical to contain this environmental driver of antimicrobial resistance along with responsible antimicrobial usage in medicine and agriculture (2^✔ ✔Trusted Source
Effects of chronic exposure to arsenic on the fecal carriage of antibiotic-resistant Escherichia coli among people in rural Bangladesh

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What Influences Antibiotic Resistant E.coli?

The study identified four major factors influencing antibiotic-resistant E. coli infections in Peruvian children. Recent antibiotic use by children and household members increased the risk of resistance, with the latter likely acting through household contamination with resistant bacteria. Living in an area where a higher proportion of households served home-raised chicken protected against resistance, presumably by reducing the environmental load of drug-resistant bacteria caused by more frequent consumption of intensively antibiotic-raised market-purchased chicken. Contamination of the environment with antibiotic-resistant bacteria appeared to play at least as large a role in children's carriage of resistant E. coli in these poor communities in a developing country, with inadequate protection of excreta and water. E. coli, as did the children's use of antibiotics.

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More research is needed to determine whether this finding applies to other similar settings with heavy agricultural use of antibiotics and limited sewage and water protection. Nonetheless, it adds to the evidence supporting reduced antibiotic use in agriculture. Reduced antibiotic use among household members and children may also be important protective measures. Finally, regardless of their exposure to antibiotics or chicken, older children are protected from resistance. More research is needed to determine whether this is due to an unknown exposure or a host factor (3^✔ ✔Trusted Source
Risk Factors for Antibiotic-Resistant Escherichia coli Carriage in Young Children in Peru: Community-Based Cross-Sectional Prevalence Study

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The advent of multidrug resistance among pathogenic bacteria is imperiling the worth of antibiotics, which have previously transformed the medical sciences. Comprehensive efforts are needed to minimize the pace of resistance by studying emergent microorganisms, resistance mechanisms, and antimicrobial agents. Multidisciplinary approaches are required across health care settings as well as the environment and agriculture sectors. There is a great need to implement new policies, renew research efforts, and pursue steps to manage the crisis.

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Progressive alternate approaches, including probiotics, antibodies, and vaccines, have shown promising results in trials that suggest the role of these alternatives as preventive or adjunct therapies in the future, and the level of arsenic contamination must be monitored and kept under control.

References:

1. The antibiotic resistance crisis: part 1: causes and threats - (https://pubmed.ncbi.nlm.nih.gov/25859123/)
2. Effects of chronic exposure to arsenic on the fecal carriage of antibiotic-resistant Escherichia coli among people in rural Bangladesh - (https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1010952)
3. Risk Factors for Antibiotic-Resistant Escherichia coli Carriage in Young Children in Peru: Community-Based Cross-Sectional Prevalence Study - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2861397/)

Source-Medindia