Why is Drug Resistance on the Up? — Chromatography Investigates

One of the major healthcare concerns society has is the rise of drug resistant bacteria. Put simply, our current batch of antibiotics are fast becoming obsolete. It is such an important topic that even the World Health Organisation (WHO) has a global action plan and regularly offers updated advice regarding the use of certain antibiotics and other drugs.

A recent paper published in the journal Infection highlights the growing problem of multidrug resistant pathogens — Environmental pollution with antimicrobial agents from bulk drug manufacturing industries in Hyderabad, South India, is associated with dissemination of extended-spectrum beta-lactamase and carbapenemase-producing pathogens. So why are we in this mess?

MDR — but not a case of ‘Mort de Rire’

Multi-drug resistant (MDR) bacteria is a global problem — it is not just rich Western countries that have MDR pathogen issues. The rise of MDR pathogens is not just fuelled by too many prescriptions given out by harassed GPs either — — as highlighted by the paper referenced above.

When a microbe becomes resistant to a medication that has been previously been used to treat it, then the microbe is said to show antimicrobial resistance (AMR). AMR covers many different types of resistance — it is an umbrella term covering antibiotic, antiviral, antifungals and other drug types. MDR is defined to be when a bacterium — or other microorganism — is resistant to multiple antimicrobial drugs.

Manufacturing adds to the problem

In the study referenced above, effluent from pharmaceutical manufacturers was found to contain high levels of antibiotics. The researchers focused on the area of Hyderabad where many of India’s pharmaceuticals are manufactured for export.

By collecting water samples from the areas close to the manufacturing sites, the team could assess the impact of the manufacturing plants on the local sewage and water supply. The team then analysed the samples using liquid chromatography – tandem mass spectrometry (LC-MS/MS). The use of LC-MS/MS as a method to analyse pharmaceuticals is discussed in the article, Accelerated Development of Quantitative Assays for Antibody Drug Conjugates.

The team analysed samples for over 20 different drugs including antibiotics and antifungals. They also looked for MDR pathogens — particularly the ones resistant to specific antibiotics. They found that almost all the samples contained samples that would be classed as resistant to multiple drugs and contained samples of antibiotics and antifungals.

As the authors state in the paper: ‘The development and global spread of antimicrobial resistance present a major challenge for pharmaceutical producers and regulatory agencies’. The problem is on the increase, and it is going to take action from manufacturers and health professionals — alongside an increased awareness from patients — to prevent common infections from becoming killers again.