Tag Archives: antibiotic resistance

China’s Waterways Reveal Our Superbug Future

Somewhere on the planet, right now, there is a bacterial species quietly accumulating the genes that will turn it into the next superbug. There is still time to tackle antibiotic resistance.

By Michael Gillings, Macquarie University 
February, 2017

Antibiotics are medicines for treating infectious diseases caused by bacteria. They are one of the greatest medical discoveries of all time. They have saved my life, and probably saved yours as well. But we have used them unwisely.

We used them to treat viral infections, such as the flu, that don’t respond to antibiotics. We used them to promote growth rates in healthy agricultural animals. We have not followed instructions on how to take them properly.

These actions have serious consequences.

Bacteria have fought back; and all over the world, have become resistant to antibiotics. They do this by acquiring mutations, or by stealing genes that confer resistance to antibiotics from other bacteria.

The more we use antibiotics, the faster they become resistant. This has led to a major health crisis in the 21st century. It was recently estimated that by 2050, a total of 10 million people will die every year from antibiotic resistant infections. This is more than deaths from cancer.

The problem is so widespread that every person now carries antibiotic resistance genes in at least some of their gut bacteria or microbiome. This is not so bad because usually these bacteria do not cause disease, and they only have one or two resistance genes each. But it does lead to some unexpected and unwanted consequences.

The resistance genes in the human gut are eventually released into sewage, where they go on to pollute streams, rivers and waterways.

In a paper just published in Nature Microbiology, my colleagues and I show that antibiotic resistance genes have now become a major pollutant in estuaries, where rivers join the sea. Some estuaries in China have up to 100 million antibiotic resistance genes per gram of mud. That’s a million resistance genes in a fragment of mud that’s the size of a match head. None of these genes were there 100 years ago.

Estuaries are natural filtering points between fresh water and the ocean. They tend to accumulate pollutants, including resistance genes. This is the way the system works: human and agricultural animals excrete antibiotic resistance genes in their faeces. Sometimes this waste is released directly into rivers and streams. But even when waste does go through a waste-water treatment plant, resistance genes are often not effectively removed.

To make matters worse, many of the antibiotics used to treat humans and animals are also excreted unchanged. These molecules do not break down easily, and join the disinfectants, heavy metals and other pollutants that can be found in all urban waterways. That means bacteria in natural ecosystems get great benefits if they can pick up genes for resistance to these metals, antibiotics and disinfectants. By doing this, they gain a survival advantage in the face of human pollution.

As waste water coming from human settlements contains a complex mixture of bacteria, resistance genes and antibacterial agents, polluted waterways become a huge reactor for generating bacteria that carry multiple resistance genes. And these resistant bacteria end up in estuaries.

What’s more, the bacteria already present in the estuary mud can take up resistance genes from polluted water.

Why does this matter? Well, many food items, such as prawns, oysters, crabs and fish, are harvested from estuaries. And many of these animals feed in or live in sediment. That means there’s a direct pathway for bacteria from estuary mud to enter the human food chain. Some of these bacteria are bound to have combinations of resistance genes that have never been seen together before.

And these resistance genes could also end up in new bacteria that have never really been a health problem for humans or animals in the past. This is where a new crop of superbugs could come from. Somewhere on the planet, right now, there is a bacterial species quietly accumulating the genes that will turn it into the next superbug.

Our research was done in China, where antibiotics are often used during intensive animal production. This might mean that the situation in China could more extreme than in other parts of the world. Although, it’s important to note that most countries continue to use antibiotics in this way, or have done so in the past. And, of course, all countries use antibiotics for treating people who are unwell.

This means every waterway flowing from farms, towns or cities contains antibiotic resistance genes and antibiotics. The kind of pollution we found in China is likely to be present in every estuary that lies downstream from urban development or animal agriculture. We already suspect this is the case, because every single estuary along 4,000 kilometres of China’s coastline had similar pollution with resistance genes.

There are things we can do to lessen the potential problem. We certainly need to use antibiotics more cautiously; we need to only use the medicines for treating difficult infections, and not as food additives. We also urgently need to develop water treatment technologies that remove disinfectants, metals, antibiotics and the genes that confer resistance to these agents.

Otherwise, the next trip you take to the coast for a seafood dinner just might be your last.

The ConversationCreative Commons

Michael Gillings is a Professor of Molecular Evolution at Macquarie University. This article was originally published on The Conversation. Read the original article.

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Toxic Indian lake is cost of cheap drugs

A boy prepares to jump off a rock into the waters of the Osman Sagar Lake near the southern Indian city of Hyderabad May 29, 2011. REUTERS/Krishnendu Halder/File Photo

A boy prepares to jump off a rock into the waters of the Osman Sagar Lake near the southern Indian city of Hyderabad May 29, 2011. REUTERS/Krishnendu Halder/File Photo

By Zeba Siddiqui 
Fall, 2016

HYDERABAD, India (Reuters) – Centuries ago, Indian princes would bathe in the cool Kazhipally lake in Medak. Now, even the poorest villagers here in India’s baking south point to the barren banks and frothy water and say they avoid going anywhere near it.

A short drive from the bustling tech hub of Hyderabad, Medak is the heart of India’s antibiotics manufacturing business: a district of about 2.5 million that has become one of the world’s largest suppliers of cheap drugs to most markets, including the United States.

But community activists, researchers and some drug company employees say the presence of more than 300 drug firms, combined with lax oversight and inadequate water treatment, has left lakes and rivers laced with antibiotics, making this a giant Petri dish for anti-microbial resistance.

“Resistant bacteria are breeding here and will affect the whole world,” said Kishan Rao, a doctor and activist who has been working in Patancheru, a Medak industrial zone where many drug manufacturers have bases, for more than two decades.

Drugmakers in Medak, including large Indian firms Dr Reddy’s Laboratories Ltd <REDY.NS>, Aurobindo Pharma Ltd <ARBN.NS> and Hetero Drugs Ltd, and U.S. giant Mylan Inc <MYL.O>, say they comply with local environmental rules and do not discharge effluent into waterways.

National and local government are divided on the scale of the problem.

While the Central Pollution Control Board (PCB) in New Delhi categorizes Medak’s Patancheru area as “critically polluted”, the state PCB says its own monitoring shows the situation has improved.

The rise of drug-resistant “superbugs” is a growing threat to modern medicine, with the emergence in the past year of infections resistant to even last-resort antibiotics.

In the United States alone, antibiotic-resistant bacteria cause 2 million serious infections and 23,000 deaths annually, according to health officials.

Thirteen leading drugmakers promised last week to clean up pollution from factories making antibiotics as part of a drive to fight the rise of drug-resistant superbugs, while United Nations member countries pledged for the first time to take steps to tackle the threat.

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MAJOR EARNER

Patancheru is one of the main pharmaceutical manufacturing hubs in Telangana state, where the sector accounts for around 30 percent of GDP, according to commerce ministry data. Drug exports from state capital Hyderabad are worth around $14 billion annually.

Local doctor Rao pointed to studies by scientists from Sweden’s University of Gothenburg that have found very high levels of pharmaceutical pollution in and around Kazhipally lake, along with the presence of antibiotic-resistant genes.

The scientists have been publishing research on pollution in the area for nearly a decade. Their first study, in 2007, said antibiotic concentrations in effluent from a treatment plant used by drug factories were higher than would be expected in the blood of patients undergoing a course of treatment. That effluent was discharged into local lakes and rivers, they said.

“The polluted lakes harbored considerably higher proportions of ciprofloxacin-resistant and sulfamethoxazole-resistant bacteria than did other Indian and Swedish lakes included for comparison,” said their latest report, in 2015, referring to the generic names of two widely used antibiotics.

Those findings are disputed by local government officials and industry representatives.

The Hyderabad-based Bulk Drug Manufacturers Association of India (BDMAI) said the state pollution control board had found no antibiotics in its own study of water in Kazhipally lake. The state PCB did not provide a copy of this report, despite several requests from Reuters.

“I have not seen any credible report that says that the drugs are no longer there,” Joakim Larsson, a professor of environmental pharmacology at the University of Gothenburg who led the first Swedish study and took part in the others, told Reuters by email.

“There might very well have been improvements, but without data, I do not know.”

 

WATER TREATMENT

Local activists and researchers say the Common Effluent Treatment Plant (CETP) built in Medak in the 1990s was ill-equipped to handle large volumes of pharmaceutical waste.

After protests and court cases brought by local villagers a 20-km (12-mile) pipeline was built to take effluent to another plant near Hyderabad. But activists say that merely diverted the problem – waste sent there, they say, mixes with domestic sewage before the treated effluent is discharged into the Musi river.

A study published this year by researchers from the Indian Institute of Technology, Hyderabad, found very high levels of broad-spectrum antibiotics in the Musi, a tributary of the Krishna, one of India’s longest rivers.

Local government officials responsible for the plants did not respond to Reuters’ requests for comment.

Nearly a dozen current and former officials from companies producing medicines in Patancheru told Reuters that factory staff from various firms often illegally dump untreated chemical effluent into boreholes inside plants, or even directly into local water bodies at night.

All the officials spoke on condition of anonymity and Reuters was unable to independently verify those allegations.

Major manufacturers in the area, including Dr Reddy’s and Mylan, said they operated so-called zero liquid discharge (ZLD) technology and processed waste onsite.

“Mylan is not dumping any effluent into the environment, borewells or the CETP,” said spokeswoman Nina Devlin.

Dr Reddy’s said it recycled water onsite and complied with all environmental regulations.

The same industry officials who spoke to Reuters said the pollution control board rarely checked waste-treatment practices at factories, adding that penalties for breaches were meager.

The Telangana state government did not respond to requests for comment.

“We are aware some companies are releasing more than the allowed effluent, but they are profit-making companies,” said state PCB spokesman N. Raveendher. “We do try and take action against the offenders, but we cannot kill the industry also.”

Many smaller companies also lacked the funds to install expensive machinery for treating waste, he added.

COURT BATTLES

A series of local court cases have been filed stretching back two decades, accusing drug companies of pollution and local authorities of poor checks. In some cases, companies have been ordered to pay annual compensation to villagers, but many are still grinding through India’s tortuous legal system.

Wahab Ahmed, 50, owns five acres of land near the shores of Kazhipally lake, where he grew rice until a decade ago. He says the worsening industrial pollution from several nearby pharmaceutical factories left his land barren.

“We have protested, sued, and done all sorts of things over the years … that’s how some of us are now getting around 1,700 rupees (roughly $20) a year from the companies,” he said.

“But what can you do with that small sum today?”

More than 200 companies were named as respondents in the case he was referring to, filed by a non-profit organization on behalf of villagers.

While pollution of farmland is a serious problem for villagers who depend on it for their livelihood, the potential incubation of “superbugs” in Medak’s waterways has wider implications.

The issue is particularly worrisome in India, where many waterways also contain harmful bacteria from human sewage. The more such bacteria are exposed to antibiotics, the greater the chances they will mutate and render such drugs ineffective against them.

The risk is that resistant bacteria would then infect people and be spread by travel.

So far, most of the focus worldwide on antimicrobial resistance has been on over-use of drugs in human medicine and farming.

“Pollution from antibiotic factories is a third big factor in causing antimicrobial resistance,” the chairman of one of the world’s largest drugmakers told Reuters. “But it is largely overlooked.”

Copyright Reuters 2016

(Additional reporting by Ben Hirschler in LONDON; Editing by Clara Ferreira Marques and Alex Richardson)

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Facts and Opinions is a boutique journal of reporting and analysis in words and images, without borders. Independent, non-partisan and employee-owned, F&O is funded by our readers. It is ad-free and spam-free, and does not solicit donations from partisan organizations. To continue we require a minimum payment of .27 for one story, or a sustaining donation. Details here; donate below. Thanks for your interest and support.

F&O’s CONTENTS page is updated each Saturday. Sign up for emailed announcements of new work on our free FRONTLINES blog; find evidence-based reporting in Reports; commentary, analysis and creative non-fiction in OPINION-FEATURES; and image galleries in PHOTO-ESSAYS. If you value journalism please support F&O, and tell others about us.

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G7 warns of risks to economic growth, health

(From L) European Council President Donald Tusk, Italian Prime Minister Matteo Renzi, German Chancellor Angela Merkel, U.S. President Barack Obama, Japanese Prime Minister Shinzo Abe, French President Francois Hollande, British Prime Minister David Cameron, Canadian Prime Minister Justin Trudeau and European Commission President Jean-Claude Juncker pose for the family photo during the first day of the Group of Seven (G7) summit meetings in Ise Shima, Japan, May 26, 2016.  REUTERS/Pool

(From L) European Council President Donald Tusk, Italian Prime Minister Matteo Renzi, German Chancellor Angela Merkel, U.S. President Barack Obama, Japanese Prime Minister Shinzo Abe, French President Francois Hollande, British Prime Minister David Cameron, Canadian Prime Minister Justin Trudeau and European Commission President Jean-Claude Juncker pose for the family photo during the first day of the Group of Seven (G7) summit meetings in Ise Shima, Japan, May 26, 2016. REUTERS/Pool

by F&O
May 27, 2016

U.S. President Barack Obama, right, Italian Prime Minister Matteo Renzi, left, and German Chancellor Angela Merkel participate in a G-7 Working Session in Shima, Japan, Friday, May 27, 2016, during the G-7 Summit. REUTERS/Carolyn Kaster/Pool

U.S. President Barack Obama, right, Italian Prime Minister Matteo Renzi, left, and German Chancellor Angela Merkel participate in a G-7 Working Session in Shima, Japan, Friday, May 27, 2016, during the G-7 Summit. REUTERS/Carolyn Kaster/Pool

The G7 wrapped up its 2016 summit with warnings, of risks to economic growth, health threats from microbes resistant to antibiotics and the handling of health emergencies, as well as a loss of public trust in tax systems to the need for infrastructure investment and trade agreements.

Always a document crafted of diplomacy, with hard issues at times reduced to milquetoast, this year’s statement ran over 30 pages and occasionally bristled.

 

Threats to global growth include the risk of a “Brexit” — British exit from Europe — in the United Kingdom referendum in June;  “escalated geo-political conflicts, terrorism and refugee flows;”  and violent extremism and terrorist attacks that “pose serious threat to the existing rule based international order, and common values and principles of “freedom, democracy, the rule of law and respect for human rights.”

The G7  statement, following a summit in Japan from May 26 to 27, is worth at least a scan, not least because the organization — more so than the United Nations and its agencies — is arguably the closest thing the world has to a global government body with real-world influence. The criteria for membership includes wealth and a  high Human Development Index, and today includes Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States, with the European Union represented,

Global growth is the urgent priority, and the group said it would support fiscal, monetary and structural policies to strengthen demand and tackle supply constraints.

Members said they would “increase global assistance” to short and long term refugee needs.

Free trade and several free trade agreements now in progress  —  many increasingly contentious in the current American election cycle and cited as helping the rise of far-right  factions — ranked third on a list of commitments. “We reaffirm our commitment to keep our markets open and to fight all forms of protectionism” said the G7, and stressed its commitment to eliminate”market distorting measures” — specifically citing the steel sector, a contentious issue with China.

The group committed to tackle medical research and development including on microbial resistance to antibiotics, and “to promote Universal Health Coverage,” a hot-button topic in America. It pledged to lead the response to public health emergencies, usually the bailiwick of the World Health Organization. And, in a sharp comment, it said “the Ebola outbreak turned into a major epidemic partly due to the lack of swift and coordinated actions among relevant stakeholders,” and said reform of the WHO is needed for “prompt and effective responses to public health emergencies.”

Equality for and empowerment of women received a separate note of commitment, identifying a need for education and training and promoting women in science, technology, engineering and math.

Other pledges included “an accessible, open, interoperable, reliable and secure cyberspace;” a pledge to fight corruption and improve transparency, and law enforcement cooperation.

Climate change was listed at the bottom of the G7’s priorities, a placement that may or may not have meaning. The group statement said:

“The G7, continuing to take a leadership role, commits to taking the necessary steps to secure ratification, acceptance or approval of the Paris Agreement as soon as possible, and calls on all Parties to do so striving for a goal of entry into force in 2016. We commit to take the lead by early, transparent and robust implementation of our nationally determined contributions, and promoting increased ambition over time. We also commit to actively participate in the regular review of global stock-take progress every five years. We commit to formulate and communicate ambitions mid-century long-term low greenhouse gas (GHG) emission development strategies well ahead of the 2020 deadline. “

It added, “we are determined to accelerate our work towards the transition to an energy system that enables a decarbonization of the global economy, and commit to further invest in supporting innovation in energy technologies and encouraging clean energy and energy efficiency …

Read the full G7 Ise-Shima Leaders’ Declaration here: http://www.mofa.go.jp/files/000160266.pdf

—  Deborah Jones         

Copyright Facts and Opinions 2016

Links:

G7 Summit site: http://www.japan.go.jp/g7/summit/documents/index.html

Wikipedia page for the G7: of Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States.

Leaders attend the the first Outreach Session during the second day of the Group of Seven (G7) summit meetings in Ise Shima, Japan, May 27, 2016. REUTERS/Jim Watson/Pool

Leaders attend the the first Outreach Session during the second day of the Group of Seven (G7) summit meetings in Ise Shima, Japan, May 27, 2016. REUTERS/Jim Watson/Pool

G7 warns on global glut of steel

By Yuka Obayashi and Ami Miyazaki

Japanese Prime Minister Shinzo Abe speaks at a news conference during the G7 Ise-Shima Summit in Shima, Japan, May 27, 2016. REUTERS/Issei Kato

Japanese Prime Minister Shinzo Abe speaks at a news conference during the G7 Ise-Shima Summit in Shima, Japan, May 27, 2016. REUTERS/Issei Kato

TOKYO/ISE-SHIMA, JAPAN (Reuters) – Leaders of the Group of Seven (G7) pledged on Friday to tackle a global glut in steel, though their statement did not single out China, which produces half of the world’s steel and is blamed by many countries for flooding markets with cheap steel.

While not included in the text, China was brought up in the discussions among leaders of the G7 industrial powers, a senior Japanese government spokesman told reporters.

China insists that its steel exports do not violate trade rules nor are its policies designed to encourage mills to sell overseas. It also says it has sought to reduce tax rebates on exported steel.

But with steel mills from Australia to Britain under threat of closure, pressure is mounting on Beijing to cut capacity after output hit a record high earlier this year.

“We recognise the negative impact of global excess capacity across industrial sectors, especially steel, on our economies, trade and workers,” said the statement.

“We are committed to moving quickly in taking steps to address this issue by enhancing market function, including through coordinated actions that identify and seek to eliminate … subsidies and support,” it added.

Leaders of the G7 – which comprises Britain, Canada, France, Germany, Italy, Japan and the United States – met this week near Nagoya, a Japanese car production and steel manufacturing centre.

“The reference to steel overcapacity is significant as it underlines that the G7 nations are firmly united in dealing with the issue,” a Japanese industry ministry official told Reuters.

But Yusuke Miura, senior economist at Mizuho Research Institute, saw little direct impact from the G7 call.

“China’s main focus is domestic issues rather than foreign concerns, such as protecting jobs and preventing bankruptcies,”

said Miura.

China has cut 90 million tonnes of steel capacity and plans to cut another 100-150 million tonnes through 2020.

Yet China’s crude steel output hit a record high of 70.65 million tonnes in March as rising prices and better margins prompted some mills to resume production.

“China knows it needs to slash capacity, but it will take time,” Miura said, predicting trade actions and price competition worldwide to continue.

EU lawmakers rejected this month any loosening of trade defences against China, whose eligibility for market economy status is being debated by the European Union.

Meanwhile, the United States slapped Chinese steelmakers with import duties of 522 percent on cold-rolled flat steel used for car body panels and construction.

The G7 should acknowledge that government subsidies and China’s state-owned steel mills are the major contributors to the global excess capacity, Philip Bell, president of the U.S. Steel Manufacturers Association, said in an email.

Copyright Reuters 2016

(Additional reporting by Nick Carey in CHICAGO and David Stanway in BEIJING; Editing by Aaron Sheldrick and Ed Davies)

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Facts and Opinions is a boutique journal of reporting and analysis in words and images, without borders. Independent, non-partisan and employee-owned, F&O is funded by our readers. It is ad-free and spam-free, and does not solicit donations from partisan organizations. To continue we require a minimum payment of .27 for one story, or a sustaining donation. Details here; donate below. Thanks for your interest and support.

F&O’s CONTENTS page is updated each Saturday. Sign up for emailed announcements of new work on our free FRONTLINES blog; find evidence-based reporting in Reports; commentary, analysis and creative non-fiction in OPINION-FEATURES; and image galleries in PHOTO-ESSAYS. If you value journalism please support F&O, and tell others about us.

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