a variety of pharmaceutical pills
India's antibiotic manufacturing may be contributing to the spread of potentially fatal ‘superbugs’

University of Birmingham experts are joining forces with their counterparts in India to investigate the impact that antibiotic manufacturing has on the spread of potentially fatal drug-resistant infections or ‘superbugs’.

An estimated 58,000 babies die in India every year from superbug infections passed on from their mothers, whilst drug resistant pathogens cause between 28,000 to 38,000 extra deaths in the European Union every year.

Now two teams from Birmingham are exploring the impact of the antibiotic industry on the environment as part of £8 million package of UK-India Government-backed research aimed deepening existing scientific research collaboration with five new programmes to tackle anti-microbial resistance (AMR) that could lead to important advances in the global fight against antibiotic-resistant bacteria and genes.

The AMRflows research programme, led by our experts and the Indian Institute of Technology (IIT) Hyderabad has received £1.2 million of funding to explore the role played by India’s rivers in increasing antimicrobial resistance.

Experts will sample and model two contrasting river networks in India - the Musi river in Hyderabad, which has high concentrations of antibiotics released from production facilities, and the less polluted Adyar river in Chennai.

The team aims to learn how far resistant bacteria travel before they die or are eaten by other organisms in a unique combination of experiments, field sampling and mathematical modelling of resistance dynamics and water flows.

UK project lead Dr. Jan Kreft, from the University of Birmingham, commented: “We don’t know how quickly antibiotics are degraded in the environment and how much they are diluted by rainfall and by entering larger rivers.”

“In our AMRflows project, we will learn how antibiotics from manufacturing and the resistant bacteria they select will flow through river networks and how far they can be transported in rivers, from where they can spread onto fields and into communities during floods - allowing us to make a quantitative risk assessment to help create environmental standards for safe concentrations of antibiotics in water bodies.”

Indian project lead Professor Shashidhar Thatikonda, from the Indian Institute of Technology Hyderabad commented: “We know from previous research that the River Musi is now a factory of superbugs. Modelling water flows will be crucial in predicting the fate of resistant bacteria in the environment and we aim to create models that will be applicable in other rivers and countries.”

The SELECTAR project will explore how waste generated by India’s drug manufacturing industry could be damaging environmental bacteria and creating ‘superbugs’ that are resistant to antibiotics – prompting a UK-India scientific intervention.

British and Indian researchers will investigate the impact of waste release on microbial ecosystems - determining how much active antibiotic is released and which other potentially toxic chemicals are contained in the waste that may affect bacteria.

Led by University of Birmingham  scientists, the SELECTAR project includes experts from the University of Leeds, Aligarh Muslim University, Panjab University, CSIR-Central Drug Research Institute, in Lucknow, Indian Institute of Technology (IIT) Delhi, Jamia Millia Islamia University, in Delhi.

Supported by over £790,000 of funding, the UK-Indian team of scientists will sample environments into which antibiotic production waste is released, and compare them to pristine environments.

Most of the world’s antibiotics are produced in Indian pharmaceutical factories - either by chemical synthesis or growing vast numbers of the micro-organisms which naturally produce them. 

Either method generates large quantities of waste, potentially containing active antibiotics and chemicals which may be toxic to bacteria and other cell types. This waste goes through treatment plants before being released into the environment. 

Project lead Professor Alan McNally, from the University of Birmingham, commented: “Without antibiotics we are unable to treat the majority of infectious diseases and chronic infections. Antibiotics prevent the deaths of patients suffering from respiratory diseases such as CF and COPD, and are the corner stone of treatments for cancer and leukaemia. 

“However, manufacturing these wonder drugs generates waste which is treated before being released into the environment, creating an enormous potential issue. Put simply, the more we expose bacteria to antibiotics the more likely they may be to evolve resistance to the drugs meaning they can’t be used to treat infections. 

“We desperately need to know exactly how much the release of antibiotic production waste leads to increasing antimicrobial resistance, which could ultimately plunge medicine back into the dark ages.”

The experts will carefully examine the waste to determine exactly how much active antibiotic is released but also which other potentially toxic chemicals it contains that may affect bacteria. They will also test the ability of these chemicals to create resistant bacteria, as a consequence of them trying to avoid chemical killing.

Professor Iqbal Ahmed, of Aligarh Muslim University commented: “Release of waste from the manufacturing process creates an enormous potential issue in India and beyond, as the more we expose bacteria to antibiotics the faster they evolve resistance to the drugs meaning they can’t be used to treat infections. Our approach will allow us to determine exactly what effect the waste has on the microbial ecosystem; does it kill all beneficial bacteria to only leave harmful resistant bacteria alive.”

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