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Multi-resistant bacteria infiltrate nature

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The microscopic world of bacteria is on a war footing with humans and is bringing them to the brink of a new global crisis. Since the mid-20th century, after Alexander Fleming discovered penicillin, antibiotics have revolutionized medicine, turning hundreds of deadly infections into common illnesses. But over the years, its incorrect and excessive use is taking its toll on us.

The same thing has happened to antibiotics as to the summer hits that sound on loop on all radio stations in Spain during the summer period: they have died of success. During this time many bacteria have mutated to adapt to antibiotics so that they are not affected by the action of these drugs.

This war between macro and micro life does not only affect humans. The entire natural environment can suffer the effects of this conflict, since bacteria are in symbiosis with everything around us. Hence, it is committed to taking global measures in what is known as ‘One Health’ (a single health, which encompasses humans, animals and the rest of nature).

Spain is one of the countries that has made the most progress in this regard, taking measures in the agricultural world and in the health sector, within the framework of the National Antibiotic Resistance Plan (PRAN), achieving good initial results. But progress is slower when it comes to caring for the environment, where these drugs have also altered the fragile balance between the two worlds.

A reservoir for new pandemics

The United Nations Environment Program (UNEP) urges, therefore, to speed up the work being done on the environment. In a recent report, the institution highlights the environmental dimensions of antimicrobial resistance, warning that they are a reservoir of new diseases that can lead to new pandemics.

Experts warn that it is human activities themselves that favor the appearance of these resistant bacteria. Among them, the report highlights the pollution produced by discharges from the pharmaceutical and food industrythe health system and society as a whole.

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Antibiotics that are released into water and soil exert selective pressure on environmental bacteria, “promoting the dissemination of antibiotic resistance genes and, with it, the proliferation of resistant bacteria”, as highlighted by the biochemist of the Biofisika Institute of the Basque Country, Itiziar Alkorta in an article in The Conversation.

Spain, today, according to the annual report of the PRAN 2019-2020, is in the study phase of the existing data to alleviate the damage to the environment. In a first phase, the technicians focused on the identification of the emission points of resistant bacteria into the environment and on the characterization of the environmental behavior of the most widely used antibiotics.

A fight too slow

Although the right steps are being taken in theory to end antibiotic resistance, they seem too slow to researchers. “We move forward in a Ford Fiesta while the bacteria move away in a Ferrari”, highlights the microbiologist at the Hospital Universitario Nuestra Señora de La Candelaria and an expert in microbial resistance, Diego García.

This simile reflects very well the crisis that humanity is facing. And it is that, on average, it takes five years to reverse antibiotic resistance, but bacteria are capable of mutating several times a year to achieve resistance not only to one, but even to several drugs.

Furthermore, not all countries are taking action on the matter. “It is very difficult to stop this trend in the third world,” says the microbiologist, who highlights that China is one of the places where “the vast majority of resistant microorganisms” arise.

The positive thing is that this problem can be reversed, because the mutated bacteria have a much lower ability to replicate than those who lived with us from the beginning. This means that, in a natural environment, it will be the bacteria without mutations -and therefore without antibiotic resistance- that colonize the ecosystem faster. But to let the bacteria return to their natural balance, the antibiotics must disappear, at least in proportion.

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In 2019, antibiotic resistance was directly responsible for 1.27 million deaths worldwide. This figure could rise to almost 5 million deaths if those deaths from complications arising from infection by a resistant bacterium are counted.

If this situation is not curbed, in 2050 10 million people will die a year for this reason, the same ones that today die of cancer. But the impact will not be limited to health, it will also have a direct impact on the economy, which could suffer a loss of 3.8% of the world’s annual gross domestic product.

Multiresistance factors in nature

It is difficult to point to a single factor as the precursor to antibiotic resistance in the world. The challenge facing the world’s population is complex and multifactorial, and some of the reasons that have led to the problem moving to the natural world are the following.

● The misuse of antibiotics, in animals and in people. Spain has spent years implementing strategic plans to rationalize or directly ban the use of antibiotics in different circumstances. However, that does not happen all over the world.

Domestic sewage. More than 56% of domestic and industrial wastewater in the world is discharged into the environment with little or no treatment, which can lead to the antibiotics consumed being deposited in the environment.

Agricultural wastewater. 11% of all irrigated cropland globally receives insufficiently treated water

● Increase in movement of food, people and goods.

● The climate crisis: Increased temperature and deforestation can lead to an increase in transmission. Changes in environmental conditions can cause flooding that favors the overflow of sewers and untreated wastewater.

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Contact with the Environment section: crisisclimatica@prensaiberica.es

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