According to a recent study by Mohammad Aminul Islam of Washington State University and colleagues, areas in rural Bangladesh with high levels of arsenic contamination in drinking water have a higher prevalence of antibiotic-resistant Escherichia coli in both water and child stool samples than areas with lower contamination.
One of the main reasons people die and end up in hospitals around the world is antibiotic resistance. Antibiotic abuse and overuse are the main causes of antibiotic resistance, although other natural factors, including heavy metals, can also contribute to it.
Researchers in the current study took water and stool samples from 100 families in two rural Bangladeshi subdistricts, including mothers and young children. While Matlab households obtain their drinking water from deep tube wells devoid of arsenic, families in the Hajiganj subdistrict obtain it from shallow tube wells where there is a high proportion of arsenic.
The median arsenic concentration in the 50 water samples from Hajiganj was 481 μg/L while the median arsenic concentration in the 50 water samples from Matlab was 0 μg/L. E. coli was discovered in 84% of all water and stool samples tested at both sites.
Heavy metals such as arsenic are more stable than antibiotics in the environment, and they continue to exert selective pressure on bacteria over a more extended period driving the evolution and expansion of antimicrobial resistance in the community. The extent to which this phenomenon drives the observed higher rates of antimicrobial resistance, as opposed to other confounders, would benefit from further study; nevertheless, it is critical to contain this environmental driver of antimicrobial resistance along with responsible antimicrobial usage in medicine and agriculture.
Mohammad Aminul Islam
Prevalence of antibiotic resistant E. coli was significantly higher in water in Hajiganj (48%) compared to water in Matlab (22%, p<0.05) and among children in Hajiganj (94%) compared to children in Matlab (76%, p<0.05), but not among mothers.
Moreover, a higher proportion of E. coli from Hajiganj were resistant to multiple antibiotics, including penicillin, cephalosporin, and chloramphenicol.
“The positive association detected between arsenic exposure and antibiotic resistance carriage among children in arsenic-affected areas in Bangladesh is an important public health concern that warrants redoubling efforts to reduce arsenic exposure,” the authors say.
Dr. Islam adds, “Heavy metals such as arsenic are more stable than antibiotics in the environment, and they continue to exert selective pressure on bacteria over a more extended period driving the evolution and expansion of antimicrobial resistance in the community. The extent to which this phenomenon drives the observed higher rates of antimicrobial resistance, as opposed to other confounders, would benefit from further study; nevertheless, it is critical to contain this environmental driver of antimicrobial resistance along with responsible antimicrobial usage in medicine and agriculture.”
