The “post-antibiotic era”: new fears revealed by changing waters in Asia

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With the accumulation of antibiotic residues in the water of emerging countries such as India, China and its neighbors, health risks are increasing due to the growing resistance of diseases to antibiotics, both locally and globally.

Scientists warn that liquid waste and sewage treatment plants represent major regional hotbeds for this scientific phenomenon, as studies indicate that this problem is getting significantly worse.

“Collecting data helps to get an idea of ​​the existence of concentrations of a wide variety of antibiotics in different water bodies on the Asian continent, and the answer to this question is /yes/”, says Thomas Van Boekel, professor of health geography at the University of Gothenburg, Germany.

Experts speak of antibiotic resistance when the patient’s body does not respond to a particular antibiotic, that is, when the antibiotic does not eliminate the bacteria that cause a particular disease.

Van Boekel believes that antibiotic resistance in China or India, for example, also affects Europe, and he explains: “Many studies show that many pathogens that have developed drug resistance are spreading around the world.

And antibiotics reach rivers, lakes, oceans and groundwater from sewage from residential areas, hospitals and pharmaceutical companies, as humans and animals who receive treatment with such drugs excrete appreciable proportions. of these substances in a biologically effective form in urine and faeces.

And in regions classified by the World Health Organization as the “West Pacific region”, which includes China, and the “Southeast Asia region”, which includes India, nearly 90% of liquid waste enters in the human body without treatment, according to a recent study presented by a periodical. Planetary Health Lancet Scientist.

Studies indicate that China and India are among the largest producers and consumers of antibiotics in the world, but body resistance to these drugs has now become one of the most common causes of death worldwide. .

As antibiotic residues accumulate in the environment, the risk of the emergence of more drug-resistant pathogens or the emergence of new resistance pathways also increases. Different species of bacteria can transmit drug resistance mechanisms to each other, and thus resistant pathogens infiltrate the bodies of humans and animals, increasing the incidence of infections that cannot be successfully treated.

The problem is exacerbated in countries in the Western Pacific and Southeast Asia, as many people directly use water from rivers and lakes for washing and drinking, according to a study by a team of researchers from the Karolinska Institute in Stockholm, Sweden, led by researcher Nada Hana.

The research team evaluated 240 analytical studies of the situation in the countries of the two regions by measuring the quantities of water polluted by liquid waste and determining the water flows inside and outside the stations purification. It has been confirmed by studies that these stations represent major hotbeds of antibiotic resistance, as 92 different types of antibiotics for humans and animals have been monitored in the Western Pacific region and 45 species in Asian countries. from the South East.

According to the research group, the highest risk of antibiotic resistance in drinking water comes from the type of antibiotic “ciprofloxacin”, which is commonly used in China and other countries in the Western Pacific region. However, in many countries in both regions, there is still a lack of data on antibiotic levels in the environment, warns the study team.

Avoiding the misuse and unnecessary use of antibiotics is an important measure to combat the spread of antibiotic resistance, and studies have repeatedly shown that antibiotic use is often tolerated in emerging countries. According to a survey published by the scientific journal Antimicrobial Resistance and Infection Control Concerned with studies of microbes and infection control methods in 2020, it was found that it was possible to buy antibiotics without a prescription in the year 2019 in more than 80% of pharmacies included in the study, which included more than 1,100 pharmacies.

And 25% of these pharmacies dispensed antibiotics for limited symptoms of respiratory disease, and half of the antibiotics needed were sold after patients asked for them by name.

According to estimates by the World Health Organization, approximately 1.3 million people die each year due to the ineffectiveness of antibiotics in treating infections they have had. EU health authorities also report that by the end of 2022, more than 35,000 people will die of antibiotic resistance each year in the European Economic Area.

In the scientific journal Science Translational MedicineLast year, researchers Michael Cook and Gerard Wright of Canada’s Macalester University warned of a “post-antibiotic era” approach, meaning it will no longer be possible to treat some infections that were usually treated with drugs reached in the 20th century. . .

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