Tag Archives: antimicrobial resistance

Water Currents: WASH and Antimicrobial Resistance

Water Currents: WASH and Antimicrobial Resistance – October 1, 2019

Antimicrobial resistance (AMR) occurs when microorganisms such as bacteria or virus change to resist the action of antimicrobials (e.g., antibiotics). Currently, it is estimated that at least 700,000 people die each year due to drug-resistant diseases.

Each year, more and more common diseases are becoming untreatable and lifesaving medical procedures are becoming much riskier due to AMR. A recent UN report on AMR (“No Time to Wait,” listed below) states that drug-resistant diseases could cause 10 million deaths each year by 2050, and that by 2030, AMR could force up to 24 million people into extreme poverty. amr

This issue of Water Currents contains recent studies on the connection between AMR and water and sanitation, the One Health approach to tackling AMR, country situation reports, and other AMR–related topics.

USAID’s priorities under the U.S. Government Global Water Strategy—improving good governance, water access, and sanitation and hygiene—are considered essential to prevent and counteract the spread of global microbial resistance. In addition, USAID’s Bureau for Global Health works with international organizations and local governments, academia, and private sector partners across Asia and Africa to promote prudent use of antimicrobials in the livestock, aquaculture, and crop production sectors to minimize the likelihood of AMR development and spread.

We would like to thank staff from the Sanitation and Hygiene Applied Research for Equity (SHARE) project, Emory University’s Center for Global Safe Water, Sanitation, and Hygiene, and Global Water 2020 for suggesting AMR as a topic and for contributing content to this issue.

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Overviews 
Antimicrobial Resistance: An Emerging Water, Sanitation and Hygiene IssueWorld Health Organization (WHO), 2015. This briefing note provides an overview on the role of water and waste in combating AMR and identifies key areas to explore related to risk assessment management, policy, and research.

No Time to Wait: Securing the Future from Drug-Resistant InfectionsWHO, April 2019. AMR is a global crisis that threatens a century of progress in health and achievement of the Sustainable Development Goals. Because the drivers of AMR lie in humans, animals, plants, food, and the environment, a sustained One Health response is essential to engage and unite all stakeholders around a shared vision and goals.

Differential Drivers of Antimicrobial Resistance Across the WorldAccounts of Chemical Research, March 2019. Researchers show that high population densities in cities that suffer from poor sanitation and solid-waste disposal can potentially impact the dissemination of resistance.

Global Antimicrobial Resistance: A Complex and Dire Threat with Few Definite AnswersTropical Medicine and International Health, March 2019. Global AMR data and projections are simply alarming. Despite widespread recognition of the issue’s magnitude and urgency, the key drivers of global AMR dissemination, and how best to contain it, remain poorly defined.

The Economics of Antimicrobial Resistance and the Role of Water and Sanitation ServicesWASHeconomics, January 2019. Water, wastewater, and feces play a key role in the carriage of microorganisms and their genetic material. For example, water can act as a reservoir of antimicrobial-resistant bacteria and exposure route to humans (and animals).

Read the complete issue.

After Hyderabad, drug-resistant typhoid emerges in Karachi

After Hyderabad, drug-resistant typhoid emerges in Karachi. The International News, February 8, 2018.

Following two sub-districts of Hyderabad, drug-resistant typhoid in children has emerged in Karachi where cases of patients not responding to antibiotics commonly used to treat the enteric fever have been reported, leading gastroenterologists and paediatricians have told The News. pakistan

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To a query, Dr Memon said sewage-mixed water was the main cause of typhoid among people in Karachi but added that people were becoming resistant to third-generation antibiotics because of overuse of antibiotics, which were being prescribed by doctors and consumed by the patients as if they were food.

Read the complete article.

Frontiers 2017: Emerging Issues of Environmental Concern

Frontiers 2017: Emerging Issues of Environmental Concern. UN Environment, 2018.

From antimicrobial resistance to off-grid solar: Frontiers 2017 explores the newest environmental issues facing the planet. Frontiers2017-cover-d8

How does our careless disposal of antimicrobial drugs produce bacteria that can resist them? Why are Marine Protected Areas vital to achieving the Sustainable Development Goals? Can off-grid solar plug the energy gap for cities in the developing world?

UN Environment experts will address these and other emerging issues with the launch of Frontiers 2017, its latest annual report on the most novel environmental challenges facing the planet.

The report covers six key emerging issues: the environmental dimension of antimicrobial resistance; nanomaterials; Marine Protected Areas and sustainable development; sand and dust storms; off-grid solar solutions; and environmental displacement.

The Role of WASH in Healthcare Settings to Reduce Transmission of Antimicrobial Resistance

The Role of Water, Sanitation and Hygiene (WASH) in Healthcare Settings to Reduce Transmission of Antimicrobial Resistance. Antimicrobial Resistance Control, July 2016.

This article by USAID’s Rochelle Rainey and Merri Weinger concludes that antimicrobial resistance is a multisectoral problem that requires a comprehensive strategy, including WASH improvements, to prevent emergence and transmission.

The lack of safe water, functional toilets, and handwashing facilities in healthcare settings poses significant health risks to patients, healthcare workers and nearby communities. The ongoing global problem of health facility-acquired infections (HAI) has highlighted the consequences of the lack of water and sanitation facilities and practice of key hygiene behaviours.

Antimicrobial resistance (AMR) is a multisectoral problem that requires a comprehensive strategy, including WASH improvements, to prevent emergence and transmission. Hand hygiene has been cited as the single most important practice to reduce HAI, and improved hand hygiene practices have been associated with a sustained decrease in the incidence of antimicrobial-resistant infections in healthcare settings.

WASH also plays a role in the cleaning of surfaces and bedding for preventing transmission of HAI. Leadership and commitment is needed from governments, international and local organizations, donors and civil society to implement the global action plan to achieve universal access to WASH in healthcare facilities.

Antibiotic waste is polluting India and China’s rivers; big pharma must act

Antibiotic waste is polluting India and China’s rivers; big pharma must act. The Guardian, October 25, 2016.

Pollution from drugs factories, many in India and China, is causing the spread of anti-microbial resistance. Pharma companies are under pressure to act 

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A strain of the E coli bacteria. Pollution from pharmaceutical production is a factor in the rise of antibiotic-resistant bacteria. Illustration: Janice Carr/AP

Antibiotic-resistant superbugs are a fundamental threat to global health, UN secretary general Ban Ki-moon recently told a general assembly meeting. Failure to address the problem, he said, would make it “difficult if not impossible” to provide universal healthcare, “and it will put the sustainable development goals in jeopardy”.

For pharmaceutical companies the attention on antimicrobial resistance has also brought a focus on one of its key drivers: the unabated environmental pollution of drug factories in developing countries.

In India and China, where a large proportion of antibiotics are produced, the poorly regulated discharge of untreated wastewater into soils and rivers is causing the spread of antibiotic ingredients which cause bacteria to develop immunity to antibiotics, creating superbugs.

A study of wastewater factories in China found that antibiotic-resistant bacteria were not only escaping purification but also breeding. For every bacterium that entered one waste treatment plant, four or five antibiotic-resistant bacteria were released into the water system, tainting water, livestock and communities.

Read the complete article.

Superbugs 1, the world 0

Superbugs 1, the world 0 | Source: The Conversation, Oct 5 2016 |

World leaders have committed US$790m to fighting superbugs. These are infectious diseases that don’t respond to treatment using antibiotics – an essential defence against infections after surgery.

They are also essential in complex treatment programmes, such as chemotherapy. But antibiotics are being misused. They are often wrongly prescribed for viral diseases, such as the flu, and they are increasingly used in livestock to encourage growth. This abuse of antibiotics is leading to strains of bacteria that are resistant to all antibiotics. Without urgent action, it is estimated that antimicrobial resistance will result in 10m deaths annually by 2050.

Read the complete article.

Water, sanitation, and hygiene must be the first lines of defence against antimicrobial resistance

Water, sanitation, and hygiene must be the first lines of defence against antimicrobial resistance. The Lancet Global Health Blog, Sept 21, 2016 |

Author : Yael Velleman. Yael Velleman is a WaterAid senior policy analyst on health and hygiene

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WaterAid/Anna Kari

As world leaders meet at the UN General Assembly to discuss the rise of drug-resistant micro-organisms globally, they would do well to consider the experience of the midwives at Kiomboi hospital, in the Iramba district of Tanzania.

Before a WaterAid intervention earlier this year, Kiomboi’s taps were dry for 23 hours per day, leaving medical professionals faced with a difficult choice: risk the transmission of infection during childbirth because the delivery room and instruments could not be properly cleaned, or prescribe precious antibiotics as a preventive measure, possibly contributing to the emerging problem of drug-resistant infections.

It is difficult to describe what it is like for medical professionals like these, delivering babies and caring for patients in a hospital without adequate access to clean water or proper sanitation. The water supply to the wards runs for just 1 hour per day, medical equipment is washed in the same sink that waste from the maternity ward is disposed into, and expectant mothers wash their babies’ clothes in the dirty water of a nearby river. The only toilet is fetid and dank and the shower is next to an open sewer. Dirty hands and dirty water mean that pathogens spread quickly and babies and their mothers risk infections like sepsis.

In March, when Kiomboi was without water for 3 consecutive weeks, staff told WaterAid they had to turn first to unpredictable collection of rainwater, and then had to send a car to collect water from a river. Without readily available clean water, midwives were not able to do their jobs safely. At least 12 babies developed sepsis during this period, and two of them died. Midwives were then faced with the torturous question of whether those babies’ deaths were their fault: were those infections transmitted in the delivery process?

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