Tools for Tracking Antibiotic Resistance

Environmental Health Perspectives, May 2011 | Go to article overview

Tools for Tracking Antibiotic Resistance

When a team of researchers from Sweden first started measuring chemicals in a river near Patancheru, India, they found shocking concentrations of drugs flowing downstream--for example, levels of the potent antibiotic ciprofloxacin greater than those found in the blood of humans taking the drug. A major source of these drugs was treated wastewater from pharmaceutical manufacturing plants that was discharged into the river and surrounding environs, as Joakim Larsson and his colleagues from the University of Gothenburg reported several years ago.(1) An update published in PLoS ONE2 now links the drugs with downstream development of microbes with genetic resistance to multiple antibiotics typically used to treat human illness.

The researchers found snippets of genetic material in bacteria from river sediments downstream of the treatment plant that confetted resistance not only to ciprofloxacin, a fluoroquinolone, but also to betalactams, aminoglycosides, sulfonamides, and other classes of antibiotics. Several genes that provide resistance to ciprofloxacin and have the ability to transfer between different bacteria were extremely common at some of the sampling sites. (2)

What if the bacteria in Patancheru could develop ways to survive the daily onslaught of ciprofloxacin, most likely over the course of years in their river environment, and ended up passing on their new genetic resistance to pathogenic bacteria that could be a threat to human health? Although Larsson's team has yet to catalog antibiotic resistance in the local population, people in the region are continually exposed to resistant microbes as they use the river water for agriculture and everyday home life. "This is a huge scary experiment in nature," Larsson says.

Just how isolated these kinds of drug "hot spots" are remains unknown, although researchers have pressed for global monitoring of antibiotic use and resistance for the past several decades, across disciplines as diverse as clinical medicine and ecotoxicity. Bringing together these fields reflects the breadth of challenges in tracking antibiotic resistance, but new technologies and ideas hold promise for the near future.

Overcoming a Lack of Coordination

"Misuse of antibiotics is obviously what creates the basic factors that produce drug resistance," says Mario Raviglione, director of the World Health Organization (WHO) department charged with tuberculosis control; this is true in both the developing and developed worlds. And despite educational campaigns by the U.S. Centers for Disease Control and Prevention (CDC) (3) and others aimed at improving clinicians' use of antibiotics, overprescribing remains a problem for multiple reasons. (4) Moreover, patient compliance--for example, taking the full course of prescribed antibiotics--can be lax, which leads to the evolution of more antibiotic-resistant pathogens.

Agricultural use of human drugs adds to the threat of drug resistance. After World War II, antibiotics started to be used for purposes such as growth promotion in livestock. Since then, antibiotics--and in some cases, the genes for resistance to multiple drugs--have been found on industrial cattle, swine, and shrimp farms, (5), (6), (7), (8), measured on chicken skins in grocery stores, (9) and even detected in apple orchards sprayed with drugs originally intended for human use. (10)

For World Health Day in April 2011 the WHO chose the theme of the global spread of antibiotic resistance, marking a little over a decade since the organization first called for patient and doctor guidelines to protect antibiotics from becoming obsolete. (11) A document issued by the WHO in 2001 put forth a series of recommendations for patients and the general community, prescribers and dispensers, hospitals, agricultural enterprises, national governments and health systems, and drug developers and promoters. (12) However, in general "very few countries, if any, have made a comprehensive effort to do any of the measures included in the older guidelines," says Raviglione, who led preparations for World Health Day 2011. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Cite this article

Cited article

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)


1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25,

Cited article

Tools for Tracking Antibiotic Resistance


Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25,

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.