New research: Air pollution or exacerbation of antibiotic resistance | Air pollution | New research
Recently, a team of Chinese and British researchers published a research report in The Lancet: Planet Health, stating that air pollution is likely one of the reasons for the continued exacerbation of antibiotic resistance worldwide. This study presents new possibilities for identifying the culprits leading to antibiotic resistance and is expected to provide new solutions for curbing antibiotic resistance.
First proposed
Antibiotics were once regarded as a "weapon" to eliminate pathogens at the beginning of their birth. However, in recent years, the rapid growth of antibiotic resistance worldwide has attracted attention. As more and more bacterial infections become untreatable with antibiotics, infected individuals face a greater risk of death.
According to a study published in the Lancet in December last year, approximately 1.27 million deaths worldwide were related to antibiotic resistance in 2019 alone. The World Health Organization has listed antibiotic resistance as one of the top ten public health threats globally.
Previously, antibiotic abuse was seen as the main reason for exacerbating drug resistance. However, a team of Chinese and British researchers published a research report in The Lancet Planet Health on the 7th, stating that air pollution is likely to be one of the culprits.
From 2000 to 2018, researchers from Zhejiang University and the University of Cambridge collected relevant data from 116 countries, including air pollution levels and antibiotic use, from institutions such as the European Center for Disease Control and Prevention, and created a model to observe the relationship between the two.
In terms of air pollution, researchers mainly focus on particles with a diameter less than or equal to 2.5 micrometers in the air. According to the World Health Organization, PM2.5 poses a particularly serious threat to public health, as it can not only be inhaled into the lungs, but can even enter the bloodstream, causing respiratory and cardiovascular diseases. In addition to natural sources, factors such as motor vehicle exhaust, industrial emissions, construction and road dust, and waste incineration are also considered important sources of PM2.5.
In terms of antibiotic usage, this study focused on 9 pathogens and 43 antibiotics.
This peer-reviewed research report states that antibiotic resistance intensifies with the increase of PM2.5 levels and strengthens over time. On a global scale, if PM2.5 levels increase by 10% annually, it may lead to a 1.1% increase in antibiotic resistance levels. Researchers speculate that in 2018, approximately 480000 deaths worldwide may be related to antibiotic resistance caused by air pollution.
From the perspective of bacterial species, this correlation is also reflected in most bacteria in the world that are resistant to antibiotics. From a regional perspective, this correlation is particularly evident in North Africa, the Middle East, and South Asia.
"Our analysis provides strong evidence that the increase in air pollution levels is associated with an increased risk of antibiotic resistance. This analysis for the first time demonstrates how air pollution affects antibiotic resistance globally."
Further research is needed
"Antibiotic resistance and air pollution are both serious threats to global health," said Chen Hong, one of the study authors and professor at the School of Environment and Resources at Zhejiang University.
The research team also stated that there are limitations to this study. On the one hand, this study takes an observational perspective and although it reveals a link between air pollution and antibiotic resistance, the specific mechanisms involved still need further investigation.
However, there are currently several speculations. One reason is that particulate matter pollution may help spread antibiotic resistant bacteria, which may come from hospitals, farms, and sewage treatment plants where antibiotics are used. A study published in the Journal of the International Society of Microbial Ecology in September 2020 pointed to this possibility.
The second is that environmental pollution may be changing the morphology of bacteria, causing them to develop drug resistance. A study published in the academic journal Environmental Health Perspectives in April 2015 showed that when particulate matter pollution comes into contact with bacteria, the toxicity of the bacteria becomes stronger. Particle pollution may even alter the internal genes of bacteria, leading to drug resistance.
According to CNN, Albert Rizzo, Chief Medical Officer of the American Lung Association, another possibility is that more exposure to air pollution means more lung infections, which could lead to antibiotic abuse.
On the other hand, in terms of research methods, some countries lack data to reveal the severity of antibiotic resistance. Secondly, countries may have different assessment methods for air pollution and antibiotic resistance, making it difficult to compare them. In addition, even within the same country, there may be differences in air pollution levels and antibiotic use among different regions.
However, researchers say that this study still "provides a new way to curb antibiotic resistance from an environmental perspective" and suggests how controlling air pollution may bring multiple benefits.
In addition, if the direction of this research result is correct and the level of particulate matter pollution continues to remain at the current level, the global level of antibiotic resistance may be about 17% higher by 2050 than it is now. This means that approximately 840000 people may die each year from diseases that cannot be treated with antibiotics.
According to the Financial Times, Andrew Singh, chief scientist at the UK Centre for Ecology and Hydrology, the study "convincingly" suggests that PM2.5 may be a significant factor leading to antibiotic resistance. "Like all good research, this study raises more questions than it answers, and has the potential to drive further exploration in academia."
