Hundreds of rivers around the world from the Thames to the Tigris are awash with dangerously high levels of antibiotics, the largest global study on the subject said.
Antibiotic pollution is one of the key routes by which bacteria develop resistance to the life-saving medicines, rendering them ineffective for human use.
“A lot of the resistance genes we see in human pathogens originated from environmental bacteria,” said William Gaze, a microbial ecologist at the University of Exeter in England who studies antimicrobial resistance, but was not involved in the study.
The rise in bacteria that are resistant to antibiotics is a global health emergency that could kill 10 million people by 2050, the UN said last month.
The drugs find their way into rivers and soil via human and animal waste, and leaks from wastewater treatment plants and drug manufacturing facilities.
“It’s quite scary and depressing. We could have large parts of the environment that have got antibiotics at levels high enough to affect resistance,” said Alistair Boxall, an environmental scientist at the University of York in England, who co-led the study.
The research, presented on Monday last week at a conference in Helsinki, shows that some of the world’s best-known rivers are contaminated with antibiotics classified as critically important for the treatment of serious infections.
In many cases they were detected at unsafe levels, meaning resistance is much more likely to develop and spread.
Samples taken from the Danube in Austria contained seven antibiotics — including clarithromycin, which is used to treat respiratory tract infections such as pneumonia and bronchitis — at nearly four times the level considered safe.
The Danube, Europe’s second-largest river, was the continent’s most polluted. Eight percent of the sites tested in Europe were above safe limits.
The Thames, generally regarded as one of Europe’s cleanest rivers, was contaminated, along with some of its tributaries, by a mixture of five antibiotics.
One site on the river and three on its tributaries were polluted above safe levels. Ciprofloxacin, which treats infections of the skin and urinary tract, peaked at more than three times safe levels.
Even rivers contaminated with low levels of antibiotics are a threat, Gaze said.
“Even the low concentrations seen in Europe can drive the evolution of resistance and increase the likelihood that resistance genes transfer to human pathogens,” he said.
The researchers tested 711 sites in 72 countries and found antibiotics in 65 percent of them. In 111 of the sites, the concentrations of antibiotics exceeded safe levels, with the worst cases more than 300 times over the safe limit.
Lower-income countries generally had higher antibiotic concentrations in rivers, with locations in Africa and Asia performing worst.
They peaked in Bangladesh, where metronidazole, used to treat vaginal infections, was found at more than 300 times the safe level.
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