There is a huge dearth of cleanliness in India--open defecation is rampant; garbage management in most cities is in shambles; toxic hospital and industrial wastes and sewage are allowed to drain into water sources and food products are laced with chemicals.
However, we still seem to be oblivious to the much more dangerous consequence of this incessant poisoning of our water, soil and environment and its impact on health and survival. For lurking behind the filth are superbugs or antibiotic resistant bacteria causing antimicrobial resistance.
Microorganisms such as bacteria have a remarkable capacity to adapt and survive in adverse environments. Antibiotic resistance arises when such bacteria evolve mechanisms to withstand or resist the effects of antibiotics targeted to destroy them and fight infection by changing themselves. They can do so by secreting enzymes that can inactivate the antibiotic, change the permeability of their cell membranes to prevent entry of the antibiotic etc. These microorganisms that develop resistance to multiple antibiotics are also referred to as ‘superbugs’.”
When superbugs develop resistance to a particular antibiotic used to treat infections like say diarrhoea, the antibiotics can become ineffective. This will result in the person continuing to suffer from the condition which could even become fatal, increasing the risk of spread to others.
Antimicrobial resistance is on the rise around the globe and indiscriminate usage of antibiotics to treat diseases coupled with insufficient wastewater treatment are to blame. However, there are very few studies that have looked at antimicrobial resistance in India, which is one of the largest manufacturers, consumers and polluters of antibiotics in the world.
Read more on antimicrobial resistance in India here
Patna, Bihar, is especially important as it is a rapidly developing city with inadequate wastewater infrastructure, situated along the mighty river Ganga, currently known to be contaminated by a range of organic contaminants informs this study titled 'Discovery of sulfonamide resistance genes in deep groundwater below Patna, India' published in Environmental Pollution.
Dependence on groundwater for drinking in the region is high. It is thus important to understand mechanisms that trigger surface-derived ingress and associated controls on the development of antimicrobial resistance in groundwater sources used for drinking in the state.
Among all the antibiotic groups found in water, sulfonamides are one of the oldest and least degradable. They are used and are highly effective against both gram-positive and gram-negative bacteria, along with some fungi and protozoa and are used to treat both human and animal bacterial infections.
This study aimed at quantifying and explaining the prevalence of three sulfonamide resistance genes (sulI, sulII and sulIII) in groundwater and surface water around the rapidly developing city of Patna, to build a new understanding of the development of sulfonamide resistance genes in Indian groundwater.
The presence of antibiotic residues and resulting resistance in groundwater and major rivers in countries such as India is a cause for serious concern. Adequate waste management and remediation of antibiotic residues in water supplies is critical and requires policymakers, practitioners, scientists and other relevant stakeholders to come together and develop, implement and manage appropriate and effective interventions to mitigate risks to health. There is also an urgent need to monitor and conduct research on antibiotics and AMR gene distribution in aqueous water sources, particularly in groundwater used as drinking supplies in rapidly developing cities.