The risk is that doctors will opt for what is known as a broad-spectrum antibiotic, a powerful drug that is able to kill many different types of bacteria. These drugs should be a last resort, because bacteria that mutate to resist them could be dangerous and potentially untreatable.
Wastewater monitoring can reveal which bacteria are spreading in a community and which antibiotics those bugs are vulnerable to. And if scientists see an increase in genes that confer resistance to a specific antibiotic, they could advise doctors in the area to avoid prescribing that drug, Kirby says.
We can also use water monitoring to monitor how antibiotic resistance genes might be contaminating the environment. “When we take a course of antibiotics, up to 90% is excreted … in the stool or urine, and that can end up in our sewers,” says Leonard. And some of this wastewater can end up in rivers, lakes and the sea.
This means that not only are we releasing our own AMR bugs into the environment, but we could be encouraging the development of new antibiotic-resistant bacteria in surface water and animal habitats. And these bacteria, or at least their antibiotic resistance genes, could return to people.
Leonard has been looking for antibiotic resistance in the coastal waters of England, Wales and Northern Ireland. It has found that people who spend a lot of time in the water, such as surfers, are more likely to have antibiotic-resistant bacteria in their gut. People who bathe in the sea are “three times more likely to carry these resistant bacteria compared to non-bathers,” he says.
Not a very pleasant thought. Especially because even if these bugs don’t make people sick, they can exchange genes with other bacteria in a person’s gut. And we really don’t know if harmful, drug-resistant bacteria of any kind will occur.
My covid test was negative, I probably have a standard cold. I know I also have billions of bugs in my gut and throughout my body, some of which are probably resistant to antibiotics. I hope they don’t become any of the dangerous ones.
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The response to covid involved concentration, determination and large amounts of money. We should use the same approach to tackle antimicrobial resistance, wrote Maryn McKenna in 2021.