A new study led by Zhejiang University (ZJU) and the University of Cambridge has recently found significant correlations between two of the world’s most urgent public health concerns: worsening air pollution and increased antibiotic resistance.
By employing a model examining the relation between levels of air pollutants known as PM2.5 (consisting of minuscule particles of solids and liquids in the air such as dust, soot, and dirt) and levels of antibiotic resistance in 166 countries over a period of 18 years, the researchers discovered that, as air pollution increased, so did levels of antibiotic resistance.
Antibiotic resistance has recently become a major problem worldwide, causing an estimated 700,000 deaths each year and prompting scientists to warn about a “silent pandemic” stealthily wreaking havoc on public health.
Until recently, researchers found evidence that the increase in antibiotic resistance we are currently witnessing is mainly caused by factors such as overprescribing or misusing antibiotics, overuse of antibiotics in farm animals, poor infection control in hospitals, and poor sanitation. This new study identifies yet another major factor in the rise of antibiotic resistance: increases in air pollution worldwide.
Currently, almost the entire global population breathes air exceeding quality limits set by the World Health Organization. In addition, the number of “very unhealthy” or “hazardous” air quality days has risen substantially – partly due to climate change – increasing the risk of developing a variety of illnesses including cancer, stroke, dementia, depression, and cardiovascular issues.
According to the recent analysis, air pollution is also to blame for 11 percent of changes in average antibiotic resistance levels around the world. By examining nine bacterial pathogens and 43 types of antibiotics, the researchers found that every one percent rise in air pollution is associated with increases in antibiotic resistance between 0.5 and 1.9 percent, depending on the pathogen.
Although these findings will need to be further tested, if they are accurate and if particle pollution continues at the same pace, the levels of antibiotic resistance worldwide in 2050 will be about 17 percent higher than now, meaning that 840,000 additional people could die prematurely due to diseases impossible to be treated with antibiotics.
Since the study was observational, it cannot prove a connection between particle pollution and antibiotic resistance, nor can it clearly explain what the connection is.
However, a possibility is that pollution may be helping spread antibiotic-resistant bacteria by acting as an energy source that carries bacteria along with it. Moreover, the pollution itself may be changing bacteria and make them more virulent and resistant to antibiotics.
“Antibiotic resistance and air pollution are each in their own right among the greatest threats to global health,” said senior author Hong Chen, an expert in System Dynamics and Control Engineering at ZJU. “Until now, we didn’t have a clear picture of the possible links between the two, but this work suggests the benefits of controlling air pollution could be twofold: Not only will it reduce the harmful effects of poor air quality, it could also play a major role in combating the rise and spread of antibiotic-resistant bacteria.”
“Pollution has a massive effect on human health even without considering antibiotic resistance. This correlation between antibiotic resistance and this type of pollution provides another incentive to tackle pollution,” concluded co-author Mark A. Holmes, a professor of Microbial Genomics and Veterinary Science at Cambridge.
The study is published in the journal Lancet Planetary Health.
Antibiotic resistance is a significant global health concern. It occurs when bacteria or other microbes evolve to resist the effects of an antibiotic to which they were once sensitive.
Antibiotic resistance can develop through the overuse or misuse of antibiotics. When bacteria are exposed to an antibiotic, those that are sensitive to the drug will be killed, but some may have natural mutations that enable them to survive. These resistant strains can then multiply.
When bacteria become resistant to antibiotics, infections that were once easily treatable can become more difficult to manage. This can lead to longer illnesses, more hospital stays, and even increased mortality.
Measures to combat antibiotic resistance include promoting the proper use of antibiotics, developing new drugs, enhancing infection control practices in healthcare settings, and implementing surveillance systems to track resistance patterns.