High antibiotic and antifungal concentrations in wastewater from anti-infective drug production may exert selection pressure for multidrug-resistant (MDR) pathogens. This study investigated the environmental presence of active pharmaceutical ingredients and their association with MDR bacteria in Hyderabad, South India, a major production area for the global bulk drug market.
Water samples were collected from the direct environment of bulk drug manufacturing facilities. Samples were analyzed for 25 anti-infective pharmaceuticals. All environmental specimens from 28 different sampling sites were contaminated with antimicrobials.
High concentrations of moxifloxacin, voriconazole, and fluconazole as well as increased concentrations of eight other antibiotics were found in sewers. Corresponding analyses revealed an extensive presence of enterobacteria. Insufficient wastewater management by bulk drug manufacturing facilities leads to unprecedented contamination of water resources with antimicrobial pharmaceuticals, which seems to be associated with the selection and dissemination of pathogens. The development and global spread of antimicrobial resistance present a major challenge for pharmaceutical producers and regulatory agencies.
Citation: Lübbert, C., Baars, C., Dayakar, A. et al. 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 Infection (2017). Published online on April 26,2017.