Antimicrobial Resistance & Its Connection to Water Quality

Antimicrobial resistance (often abbreviated to AMR) is quickly becoming a serious public health issue. You may have heard of things like the growing problem with MRSA in hospitals, but AMR generally is set to skyrocket as a public health issue on a global scale – with some researchers predicting that it’ll be on par with cancer as a leading cause of death by 2050 globally. 

What actually causes antimicrobial resistance is complex – involving numerous factors over large scales and timeframes – but one of the most overlooked factors is that of water quality.

Let’s look at what exactly AMR is, why it’s a problem, the role of water in its growth, and what can be done to avoid it.


What is Antimicrobial Resistance?

Antimicrobial drugs are the cornerstone of modern medicine – drugs like antibiotics, antifungals, antivirals, and antiparasitics are, in many cases, the last line of defence against each respective pathogen. Now, pathogens are alive, which means that they gradually evolve resistances to substances that harm them.

In short, antimicrobial resistance is a real-time proof of “survival of the fittest” at the microbial scale.. 

The core problem with the rise of AMR is that the misuse and overuse of antimicrobial medications in humans, animals, and agriculture has accelerated the evolution of resistance. This has led to the emergence of what many are calling “superbugs” that are largely or entirely immune to medicinal methods of treatment. This makes them extremely dangerous because, without medicinal backup, the only defence is a body’s immune system – which tends to not be particularly effective against new and aggressive pathogens.

We should note here that we’re using the term “pathogens” instead of “bacteria”, “viruses”, and so on because pathogens are specifically harmful microbes – there are actually countless microbes that we not only benefit from but that, as humans, we entirely rely on.


The role of water in the spread of AMR

Almost all pathogens will die quite quickly without access to water. Even airborne pathogens can only live for a maximum of 5-6 hours while in the air – and even then only if the air is humid enough. Some pathogens can survive for longer (sometimes up to a few days) on certain surfaces, but usually only when protected by water droplets or some water-carrying substance (like mucus). Most pathogens die within minutes outside of a host or suitable medium.

Essentially, water is to microbes what air is to humans.

That’s why water quality is so crucial here. 


How water gets contaminated

Water sources get contaminated in various ways. In order to not open up a serious can of worms, we’ll only refer to freshwater sources here rather than saltwater because saltwater contamination has a different and more complex cycle involving considerably more than AMR growth; for example, there’s credible evidence that marine life is being seriously affected by untreated pharmaceuticals from sewage released into the sea.

Freshwater sources such as rivers, lakes, underground aquifers, and reservoirs can become contaminated primarily through the release of untreated sewage, from agricultural runoff, and from industrial pollutants.

In practice, industrial pollutants aren’t such a significant factor for freshwater contamination in the UK anymore because of two main reasons. Firstly, we don’t have a great deal of manufacturing industry left and, secondly, manufacturers that remain are under greater scrutiny from regulatory bodies after the industrial excesses of the 19th and 20th centuries.

Untreated sewage and agricultural runoff, however, are really serious forms of contamination.


What happens when water is contaminated by pathogens?

The most immediate threat from contaminated water is simply that people become sick. This is, for the most part, not an issue when we’re referring to tap water because tap water is so heavily treated in the UK (through lots of filtration as well as various disinfectant methods) – but contaminated freshwater sources like rivers and lakes create ample opportunity for pathogens to infect humans.

For example, a dog might jump into a contaminated river, a person may swim in the river unknowingly (usually downstream from the contamination source, where contamination is no longer obvious), or pathogens may become “airborne” when water is kicked up by heavy winds.

Humans can then spread these pathogens in the same way any virus or bacteria is spread: through contact or shedding (such as sneezing and coughing).

But, most crucially, contaminated water creates the perfect breeding ground for more resistant microbes. When large numbers of pathogens are in regular contact 

with each other in a body of water, gene transfer can occur – where pathogens “pass on” certain resistances to each other. This can even happen between different pathogenic species, so it can quickly cause mutations that we couldn’t have imagined.


Can’t people choose not to swim in contaminated water?

Yes, people can certainly “choose” not to swim in contaminated water. But the personal choice of the human doesn’t justify the release of waste because we aren’t the only creatures to live around and depend upon water sources. These pathogens and contaminants also pose a serious threat for all life around those sources.

For example, sewage and industrial runoff affect all downstream habitats from the source of pollution. They can get into downstream marsh habitats that are also frequently used for grazing and then create a serious risk of contaminating the grazing animals themselves but also all of the wild birds and mammals that live in that habitat.

Those birds then tend to migrate – or at least move around a reasonably large area searching for food – which then poses threats to other farm animals and other wildlife. While it’s unclear how much of an effect water quality has had on it, avian flu is a perfect case to illustrate how easily spreadable pathogens can become when infecting migratory species.

There’s a moral issue to protect habitats here, but there’s also a fundamental need to protect them because we rely on their complexity for our survival.

The best ways to address contamination

There’s no single “best way” to address water contamination because it happens in such complex ways. But what needs to happen is tighter regulation, stricter consequences for failing to meet those regulations, and effective water monitoring to gather data and support regulatory efforts.

If you’re looking to invest in quality water quality monitoring equipment, browse our products or get in touch with our helpful team to discuss your needs.

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