1.5.2 Drinking Water and Antibiotic Resistance
For more than a century, microbial quality testing of drinking water has focused on
the use of indicators for detecting waterborne pathogens. Adequate drinking water
disinfection destroys or inactivates pathogenic and non-pathogenic bacteria, including ARB, most viruses, and degrades some antibiotics (Rath and Patra 2018).
Compared to the wastewater, knowledge about the presence and public health
significance of ARB, ARGs, and antibiotics in drinking water, including treatment
plants, distribution systems, as well as the role of biofilms, is very less. Studies
reported that ARB and ARG levels were higher in tap water than the source waters,
indicating that there was regrowth of bacteria in drinking water during their distribution time. The investigators have hypothesized that chemical purification of water
increases the chances of bacteria to be antibiotic-resistant and further leads to spread
through drinking water supply systems. Such supply systems further turn into major
reservoirs for these ABR bacteria as they form biofilms in the inner surface of the
supply pipelines (Li and Gu 2019).
1.6 Intervening to Reduce Risk Caused Due to Water
Contamination
Almost all the countries are working to formulate a standardized protocol to eliminate these organisms and to make a regulatory body to monitor the strict implementation of these protocols. However, only a few nations have been successful in
achieving this target. Water Health Organization (WHO) has recommended risk-free
preventive approaches to minimize the exposure of pathogenic microorganisms to
the drinking water. Hence risk assessment becomes very essential in the formulation
and implementation of treatment guidelines, supply, and safety of drinking water
(Malik et al. 2012). Many such approaches are followed throughout the world,
ranging from “risk scoring in sanitary inspections” and “risk matrices to quantitative
microbial risk assessment (QMRA)” (Schijven et al. 2015). WHO needs to educate
different countries regarding QMRA to facilitate its proper implementation for the
supply of safe drinking water, its reuse, and even water recreation parks to effectively manage the risks linked with fecal pathogen-contaminated water. QMRA
describes a four-step method for water disinfection, its reuse in domestic, industrial
and recreational parks and lays out a clear guideline for controlling waterborne
infections across the world (Ramírez-Castillo et al. 2015; Brouwer et al. 2018).
Preventing diseases through reducing water contamination is a necessary intervention which could be made at every level of transmission, which includes:
12
S. Rath
For more than a century, microbial quality testing of drinking water has focused on
the use of indicators for detecting waterborne pathogens. Adequate drinking water
disinfection destroys or inactivates pathogenic and non-pathogenic bacteria, including ARB, most viruses, and degrades some antibiotics (Rath and Patra 2018).
Compared to the wastewater, knowledge about the presence and public health
significance of ARB, ARGs, and antibiotics in drinking water, including treatment
plants, distribution systems, as well as the role of biofilms, is very less. Studies
reported that ARB and ARG levels were higher in tap water than the source waters,
indicating that there was regrowth of bacteria in drinking water during their distribution time. The investigators have hypothesized that chemical purification of water
increases the chances of bacteria to be antibiotic-resistant and further leads to spread
through drinking water supply systems. Such supply systems further turn into major
reservoirs for these ABR bacteria as they form biofilms in the inner surface of the
supply pipelines (Li and Gu 2019).
1.6 Intervening to Reduce Risk Caused Due to Water
Contamination
Almost all the countries are working to formulate a standardized protocol to eliminate these organisms and to make a regulatory body to monitor the strict implementation of these protocols. However, only a few nations have been successful in
achieving this target. Water Health Organization (WHO) has recommended risk-free
preventive approaches to minimize the exposure of pathogenic microorganisms to
the drinking water. Hence risk assessment becomes very essential in the formulation
and implementation of treatment guidelines, supply, and safety of drinking water
(Malik et al. 2012). Many such approaches are followed throughout the world,
ranging from “risk scoring in sanitary inspections” and “risk matrices to quantitative
microbial risk assessment (QMRA)” (Schijven et al. 2015). WHO needs to educate
different countries regarding QMRA to facilitate its proper implementation for the
supply of safe drinking water, its reuse, and even water recreation parks to effectively manage the risks linked with fecal pathogen-contaminated water. QMRA
describes a four-step method for water disinfection, its reuse in domestic, industrial
and recreational parks and lays out a clear guideline for controlling waterborne
infections across the world (Ramírez-Castillo et al. 2015; Brouwer et al. 2018).
Preventing diseases through reducing water contamination is a necessary intervention which could be made at every level of transmission, which includes:
12
S. Rath