As summer approaches, imagine sitting down to cool off with a nice cool glass of water — tainted by antibiotics, pesticides, and antibiotic-resistant bacteria. Not only does that sound unsavory, it could also come with unknown health effects.

Emerging contaminants — including pharmaceuticals and pesticides — may be accumulating in water resources with largely unknown impacts.

Amy Pruden, a University Distinguished Professor and faculty member in civil and environmental engineering, has pioneered research revealing antibiotic resistance genes as environmental contaminants. Antibiotic resistance genes are segments of DNA that allow disease-causing bacteria to survive antibiotic treatment.

As an expert in antimicrobial resistance (AMR) and lead author of the United Nations Environment Programme antimicrobial resistance spotlight report, Pruden was invited to speak at the Quadripartite Global Leaders Group on Antimicrobial Resistance held Feb. 7 in Barbados. The Global Leaders Group comprises world leaders and experts from across sectors working together to accelerate political action on AMR to achieve optimal and sustainable health outcomes for people, animals, and ecosystems.

“Modern DNA sequencing tools provide a tremendous opportunity to track public health threats in our air, water, and food,” said Pruden. “The present is a key moment in history when world leaders and scientists are recognizing the need to work together to address the threat of AMR, and that fighting pollution is a key strategy to prevent its spread. As an environmental engineer trained in microbiology, I found myself in a key position to help bridge this understanding and hopefully help move us toward a future where there is less disease and less human suffering as a result.”

Pruden spoke about how the overuse and misuse of antimicrobials, including antibiotics, antivirals, antifungals, and antiparasitics, in agriculture and human health care, as well as lack of treatment of pharmaceutical waste can lead to waterways polluted with antibiotic resistant bacteria. Addressing the problem, she said, can promote the health of communities and ecosystems and facilitate many of the United Nations' 17 Sustainable Development Goals, such as responsible consumption and production, and clean water and sanitation.

How can we prevent water supplies from becoming contaminated with antibiotic resistant bacteria and their antibiotic resistance genes? Pruden said minimizing and treating municipal, industrial, and agricultural waste streams is essential. While purification systems are currently required to meet high microbial reduction standards, those standards do not specifically address the need to attenuate antimicrobial resistance.

Globally, she said ,we must rethink how crops are grown and livestock are raised to promote overall health, eliminate the need for antimicrobials, and find alternatives where possible. Manure can be used more safely as a natural fertilizer when it is antimicrobial free and when barriers are placed to prevent runoff of bacteria to rivers and streams during storm events.

The World Health Organization lists antimicrobial resistance among the top 10 threats for global health and notes that limiting its emergence and spread is critical to preserving the ability to treat disease, reduce food safety and security risks, and protect the environment.

However, that task isn’t easy. Antimicrobials are important to modern medicine and help treat infections among humans, animals, and plants. As resistance to these medicines increases, these drugs will be less effective and infections will become more deadly. According to the spotlight report, estimates suggest that by 2050 up to 10 million additional direct deaths could occur annually from drug-resistant infections.

“Studies around the world have shown that human activities, specifically pollution-generating activities, elevate antibiotics, antimicrobials, and antibiotic resistant bacteria and their genetic material in our waterways like rivers, lakes, streams,” said Pruden. “These waterways are all receiving pollution. Agriculture activities need to be examined, and we need to rethink how we grow our crops and rear our livestock so there is less need for antibiotics and pesticides and fungicides. Additionally, we need to rethink the use of manure as a fertilizer.”

Pruden concluded that both pollution prevention and treatment are needed to address resistant organisms and their genetic material.

Antimicrobial resistance is a global health challenge that will require collaboration across all nations to resolve. AMR is linked closely to climate change, biodiversity and nature loss, and pollution and waste. Recommendations made by the spotlight report and the Global Leaders Group help identify concrete actions to ensure that life-saving antimicrobials are available for future generations.  

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