13
These water bodies harbor many bacteria causing water-borne diseases such as
E. coli, Salmonella spp., Shigella spp., Vibrio spp., etc., many of which could be
antibiotic resistant. The situation of antimicrobial resistance in these water bodies is
a result of many factors including edaphic, antibiotic levels, nutrient levels, bioaccumulation, environmental and the frequency of interactions with life forms including animals, plants and microbes (Ding and He 2010).
The levels of antibiotics, antibiotic resistant bacteria and antibiotic resistance
genes in the water bodies are drastically affected by manure supplemented agricultural runoff, wildlife fecal contamination, accidental discharge from industrial and/
or sewage treatment plants (Oluyege et al. 2015). There are many challenges faced
by developing countries in safe disposal of their waste water and maintaining water
distribution pipes. This frequently leads to mixing of waste water and drinking
water, thereby exposing humans directly to fecal coliforms and cause infections,
many of which might be antibiotic resistant. In developing countries, many regions
do not have proper sewage disposal system and the sewage/waste water is frequently
disposed-off in rivers. This increases the fecal coliforms and the load of antibiotic
resistant bacteria in the ‘rivers’, which due to water scarcity is also used for drinking, and thus directly affecting the general population with infections and diseases
(Normark and Normark 2002). Many genetic determinants of resistance such as
ESBLs (bla CTX-M-15 , bla CTX-M-15 bla OXA-58 ) were found in similar studies which signify
the role of rivers as a possible carrier or sink for these genes. Regardless, being
involved in daily life of a large population, it poses health risk to the humans and
animals in vicinity of the rivers (Adelowo et al. 2018; Cacace et al. 2019).
Mass gathering events (especially religious congregations, sporting events) have
important epidemiological implications and have been found to increase the number
of coliforms (indicator for water quality) and other microbes in the aquatic bodies
including many resistant strains and antibiotic resistance genes (Khan et al. 2010a,
b; Jani et al. 2018). Similar deterioration in water quality has been reported in case
of recreational activities too, for example multi drug resistant bacteria belonging to
Enterobacter spp., Serratia spp., Klebsiella spp., Citrobacter spp. and Pantoea spp.
were found in samples taken from a resort in Malaysia (Lihan et al. 2016). Similar
reports for presence of antibiotic resistant heterotrophic marine bacteria, has been
observed from niches where intensive human activities exist such as fishing, high
population, water sports, beaches, etc. in Iran, South Africa and Brazil (World
Health Organization 2003; De Oliveira et al. 2010; Leonard et al. 2015). These
events also require mass movement of animals for food and rituals, many of which
might be sourced from countries where regulations are not stringent and good manufacturing practices are not adhered to. These sites become important hotspots for
movement of infectious agents and exchange of antimicrobial resistance determinants (Memish 2001).
Another big concern is contamination of groundwater with antibiotics and/or
antibiotic resistant pathogens and has been known to cause outbreaks in different
parts of the world (Lihan et al. 2016). Since this is the main source of drinking water
for urban population and is usually considered free from harmful pathogens. But
1 Antimicrobial Resistance Paradigm and One-Health Approach
These water bodies harbor many bacteria causing water-borne diseases such as
E. coli, Salmonella spp., Shigella spp., Vibrio spp., etc., many of which could be
antibiotic resistant. The situation of antimicrobial resistance in these water bodies is
a result of many factors including edaphic, antibiotic levels, nutrient levels, bioaccumulation, environmental and the frequency of interactions with life forms including animals, plants and microbes (Ding and He 2010).
The levels of antibiotics, antibiotic resistant bacteria and antibiotic resistance
genes in the water bodies are drastically affected by manure supplemented agricultural runoff, wildlife fecal contamination, accidental discharge from industrial and/
or sewage treatment plants (Oluyege et al. 2015). There are many challenges faced
by developing countries in safe disposal of their waste water and maintaining water
distribution pipes. This frequently leads to mixing of waste water and drinking
water, thereby exposing humans directly to fecal coliforms and cause infections,
many of which might be antibiotic resistant. In developing countries, many regions
do not have proper sewage disposal system and the sewage/waste water is frequently
disposed-off in rivers. This increases the fecal coliforms and the load of antibiotic
resistant bacteria in the ‘rivers’, which due to water scarcity is also used for drinking, and thus directly affecting the general population with infections and diseases
(Normark and Normark 2002). Many genetic determinants of resistance such as
ESBLs (bla CTX-M-15 , bla CTX-M-15 bla OXA-58 ) were found in similar studies which signify
the role of rivers as a possible carrier or sink for these genes. Regardless, being
involved in daily life of a large population, it poses health risk to the humans and
animals in vicinity of the rivers (Adelowo et al. 2018; Cacace et al. 2019).
Mass gathering events (especially religious congregations, sporting events) have
important epidemiological implications and have been found to increase the number
of coliforms (indicator for water quality) and other microbes in the aquatic bodies
including many resistant strains and antibiotic resistance genes (Khan et al. 2010a,
b; Jani et al. 2018). Similar deterioration in water quality has been reported in case
of recreational activities too, for example multi drug resistant bacteria belonging to
Enterobacter spp., Serratia spp., Klebsiella spp., Citrobacter spp. and Pantoea spp.
were found in samples taken from a resort in Malaysia (Lihan et al. 2016). Similar
reports for presence of antibiotic resistant heterotrophic marine bacteria, has been
observed from niches where intensive human activities exist such as fishing, high
population, water sports, beaches, etc. in Iran, South Africa and Brazil (World
Health Organization 2003; De Oliveira et al. 2010; Leonard et al. 2015). These
events also require mass movement of animals for food and rituals, many of which
might be sourced from countries where regulations are not stringent and good manufacturing practices are not adhered to. These sites become important hotspots for
movement of infectious agents and exchange of antimicrobial resistance determinants (Memish 2001).
Another big concern is contamination of groundwater with antibiotics and/or
antibiotic resistant pathogens and has been known to cause outbreaks in different
parts of the world (Lihan et al. 2016). Since this is the main source of drinking water
for urban population and is usually considered free from harmful pathogens. But
1 Antimicrobial Resistance Paradigm and One-Health Approach