Too many antibiotics in the water plague China and India: millions of deaths worldwide every year

Created: 08/01/2023 19:29

A river in Baramulla in India (icon image).

© IMAGO/Nasir Kachroo

Antimicrobial resistance is an unknown but momentous affliction.

Researchers have now found that China and India are particularly affected and why.

Stockholm - Antibiotic residues in the waters of emerging countries pose a major challenge. In India, China and many other countries in this area, they provide potential resistance hotspots, reports a team of scientists in a review.

Wastewater and sewage treatment plants therefore appear to be the main sources for the development of antibiotic resistance in these regions.

“This data collection helps us to get an idea of ​​whether or not there is a high selective concentration of antibiotics in different water bodies in Asia.

And the answer is yes, there is,” said Thomas Van Boeckel, lecturer in health geography at the University of Gothenburg.

He himself was not involved in the study presented in the journal

.

Antibiotic resistance: spread to Europe possible

Van Boeckel thinks it is fundamentally possible that resistance will spread from China or India to Europe: "There are numerous studies that show that many drug-resistant pathogens have spread worldwide."

Antibiotics can get into rivers, lakes, seas and groundwater from sewage and waste, for example from municipalities, hospitals and pharmaceutical companies.

Humans and animals treated with such drugs excrete a significant part of the substances in biologically active form via urine and faeces.

In the Western Pacific (WPR, including China) and Southeast Asian (SEAR, including India) regions defined by the World Health Organization (WHO), about 80 to 90 percent of wastewater enters water bodies untreated, according to the analysis.

Antibiotic resistance: One of the leading causes of death worldwide

China and India are among the world's largest producers and consumers of antibiotics.

However, resistance to such drugs is now one of the leading causes of death worldwide.

The WHO estimates that 1.3 million people now die every year because antibiotics don't work on their infections.

With more antibiotic residues in the environment, the risk of the emergence of other resistant pathogens and new resistance pathways increases.

Bacteria of different species can pass resistance mechanisms on to each other, and resistant pathogens from the environment can reach humans and animals.

This can increase the number of cases in which infections can no longer be treated successfully.

Antimicrobial resistance: WPR and SEAR countries at particular risk

The entry into the environment of WPR and SEAR countries is also worrying because many people there use water from rivers and lakes directly for washing and as drinking water, explain the researchers led by Nada Hanna from the Karolinska Institute in Stockholm.

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The team evaluated 240 analyzes of the situation in countries in the two WHO regions.

In addition, they used a special method to determine where the concentration of antibiotics is so high that it is likely to contribute to the development of antibiotic resistance.

According to the results of the review, a total of 92 different human and veterinary antibiotics were detected in water bodies in the countries of the Western Pacific region and 45 in countries of Southeast Asia.

However, for many countries in the two regions there is still a lack of data on the occurrence of antibiotics in the environment, the authors caution.