A team of U.S. and Indian researchers has raised concerns of antimicrobials polluting the city’s environment through a study done among pregnant women at Gandhi Hospital.
The team set out to identify risk factors for community-acquired antimicrobial resistance (CA-AMR). They focused on bacteria that produce Extended-spectrum Beta-lactamases (ESBL), enzymes that help these organisms resist many commonly-used antibiotics. Infection with ESBL bacteria is relatively tough to treat, due to drug resistance acquired by the pathogen.
For their study, researchers tested urine samples of 1,836 first-time pregnant women between October 1, 2015, and September 29, 2016. They found bacteria in the urine of 7% or 126 women. About 48 % of these urine isolates had ESBL-producing bacteria. The researchers noted that poorer women in the study group had the highest risk of CA-AMR, and with ESBL-bacteria.
“The most likely explanation appears to be that the poor are exposed to an environmental source of antimicrobial drugs that is placing them at a higher risk for CA-AMR than their wealthier peers, resulting in the CA-AMR wealth gradient that we observed,” they said, while describing the findings in the August issue of Emerging Infectious Diseases, (EID) a journal published by the U.S. Center for Disease Control and Prevention.
“In Hyderabad, where we conducted this study, other researchers have noted levels of many antimicrobial drugs in waste water treatment plants and treatment plant effluents, including ciprofloxacin, that are several-fold higher than maximal therapeutic plasma levels,” they further said.
While pointing fingers at environmental contamination, researchers said they found ESBL-bacteria in women who had no reported history of antibiotic ingestion, and were less likely to have been hospitalised, when compared to those who did not have ESBL-bacterial isolates in their urine.
Studies in developed nations have shown a hospital stay increases risk of CA-AMR. However, authors of the EID study said they specifically chose women carrying pregnancy to term for the first-time as these respondents were not hospitalised for a pregnancy-related event in the past.
