Tackling Antimicrobial Resistance (AMR)

Antimicrobial Resistance: What is AMR?

Antimicrobial resistance (AMR) is a complex, global issue driven by many interconnected factors. But what causes AMR? AMR arises when microorganisms (such as bacteria, fungi, viruses, and parasites) mutate, following repeated or prolonged exposure to antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintic drugs). The global misuse and overuse of antimicrobials is accelerating this process, causing superbugs such as MRSA.

It is not just about overuse of antimicrobial drugs though. Pharmaceuticals contaminate our water supply, either from production facilities or through human or animal medication consumed and excreted. In addition, antimicrobial medication is often unused and disposed of in landfill, allowing pharmaceuticals to contaminate our water supply via ground water.

MDRO – Multidrug Resistance Organisms

The effluent produced by some pharmaceutical manufacturing facilities has been described as ‘a reservoir for the development of AMR’. Research shows that Active Pharmaceutical Ingredients (APIs) and other pharmaceutical residues within the wastewater from these facilities have adverse effects on aquatic life and greatly increase the prevalence of multidrug resistant organisms (MDRO) such as MRSA (Methicillin-Resistant Staphylococcus Aureus).

Pharmaceuticals in the Environment (PiE) and AMR

Pharmaceuticals in the Environment (PiE) and Antimicrobial Resistance (AMR) are closely interconnected. Increasing levels of pharmaceuticals are being detected in waterways due to inadequate wastewater treatment, run-off from intensive farming and sometimes even irresponsible disposal. This pollution of surface and ground water impacts water quality, drinking water supply, aquatic life, and also facilitates AMR.

Shoal of fish

Deaths from Superbugs Attributed to AMR

As a result of antimicrobial resistance, a diminishing pool of antimicrobial medicines are available to treat infections caused by superbugs. These superbugs result in infections that last longer in the body, increasing the risk of spread to others.

In 2019 it was concluded that 700,000 deaths per year could be attributed to AMR. Current assessments estimate that deaths from AMR could reach 10 million by 2050, according to a report from the World Health Organization (WHO).

It’s not just about deaths though. The estimation of the effects of AMR includes damage to the economy equivalent to the global financial crisis of 2008-9. By 2030 it is estimated by the WHO that AMR could cause extreme poverty to 24 million people worldwide.

How do Bacteria Become Resistant to Antibiotics?

This real life example of antibiotic misuse shows how antibiotic resistance can happen.

Using antibiotics as growth promoters has been banned in the European Union since 2006, and in the US their use was made illegal in 2017. Colistin was a ‘last hope’ antibiotic used to treat patients who are critically ill with infections which have become resistant to nearly all other drugs. Reports showed that Colistin was regularly being added to chicken feed in India. The discovery was met with panic in the medical community as this is clearly an example of severe antibiotic misuse which will result in the acceleration of AMR in the environment.

India has been named the epicentre of the global drug resistance crisis. A combination of factors described as a ‘perfect storm’ have come together to hasten the spread of superbugs – over prescription of antibiotics in humans and animals, poor sanitation and untreated wastewater from pharmaceutical manufacturing sites creates antibiotic resistant hotspots and fuels the spread of resistant bugs in the environment.

The animal farming industry, pharmaceutical manufacturers, policy makers, waste disposal management and consumers all have a part to play in the prevention of the antibiotic resistance pipeline. This diagram shows how pharmaceuticals enter the environment and sources used for drinking water.

Infographic showing how Active Pharmaceutical Ingredients (API) enter our environment

Environmental Pollution from Antimicrobials

Of course, the utilities, pharmaceutical manufacturers and agriculture industries make every effort to remove the active pharmaceutical ingredients (API) from the water. But existing water treatment processes are not entirely effective at pharmaceutical pollutant removal and harmful traces are left behind. This gives us all a mild dose of antibiotics, antifungal or antiviral medication through our drinking water, exacerbating the worldwide AMR problem.

With enhanced technology, water analysis is improving and water testing is becoming more refined. Alongside this, regulations are getting stricter in an effort to improve water quality to reduce AMR. This is driving the need for new water treatment technology which can tackle the problem of environmental pollution from antimicrobials.

 

Fast flowing river

How Do You Address AMR?

The main drive for tackling AMR is to restrict the use of antimicrobials on a worldwide basis. This means regulating pharmaceuticals for both human and veterinary purposes. On top of these controls, we also need to clean up our water and improve water quality worldwide.

The serious consequences of PiE have led to increasing pressure on the pharmaceutical industry to take action. On top of their pro-active approach, one of the recommendations outlined in a recent UN report to tackle antimicrobial resistance, was to introduce stricter regulatory systems for responsible handling of antimicrobials.

The production of an ever-increasing range of pharmaceutical products results in wastewater with a complex composition.

Improving Water Quality

The complex composition of pharmaceutical wastewater is notoriously difficult to treat with existing water treatment technologies. It is particularly hard to treat pharmaceutical wastewater to low levels of parts per trillion in compliance with regulation from industry authorities.

Failure to comply with regulations can result in a loss of permit, operational downtime, limited production volume and severe fines. We need to pull together to solve this problem, supporting our pharmaceutical and utility industries.

Water testing

A New Water Technology Solution is Needed

As traditional municipal wastewater treatment plants are not designed to tackle such varied and persistent compounds, manufacturers are challenged to remove the pharmaceutical residues, including antibiotics, prescription and non-prescription drugs at source.

But many existing treatment processes are not able to remove the organic pollutants. And the ones that can remove these specific organics, such as ozonation, have been brought into question by REACH for the environment impact of ozone itself, which is under assessment for being an Endocrine Disrupting Chemical (EDC).

This has forced the development of new environmentally friendly water treatment solutions to work alongside existing treatment processes.

New Water Pollution Solutions

Arvia’s Nyex™ Wastewater Treatment Systems offer a unique solution for the reduction of hard-to treat organics, micropollutants and colour from water and wastewater streams.

Arvia Nyex-a system delivered in a container

Each on-site system is tailored to meet specific water treatment requirements, ensuring environmental and regulatory discharge limits are achieved. Furthermore, Nyex™ Treatment Systems can also be designed and optimised to ensure treated water is suitable for reuse, contributing to the circular economy.

Eco Friendly Wastewater Treatment Plant

The ability to safely reuse process water does not only reduce utility costs but also builds positive Corporate Social Responsibility through the protection of the environment in water stressed times.

Nyex™ systems provide a chemical free and environmentally sound solution which combines adsorption with electrochemical oxidation in a single, scalable unit. Problematic contaminants are concentrated on the surface of Arvia’s proprietary Nyex™ media, which is non-porous with high electrical conductivity. This patented adsorbent media allows for targeted and continuous oxidation.

 

Graphical representation of Nyex treatmentUnlike granular activated carbon, Nyex™ media is effectively regenerated in-situ. There is a 2-4% top up which is necessary once a year, but this only takes less than 30 minutes for us to administer. Apart from this tiny amount of maintenance, the process can continue without interruption or replacement. There is no need to double up your CapEx by investing in a duty and standby, as there is for GAC.

Results are achieved without chemical dosing or the generation of sludge, reducing costs in terms of transport of chemicals and specialist waste disposal. But it’s not just about cost savings, your CSR messaging can benefit from our eco-friendly credentials too.

Benefits of Nyex™ Treatment

Speak to one of our application experts today to discuss the targeted removal of APIs and Pharmaceutical residues from your wastewater with Nyex™.

  • Targeted treatment of Active Pharmaceutical Ingredients (APIs) and pharmaceutical residues without chemical dosing or the production of secondary waste.
  • Compliance with increasingly stringent regulation using a scalable and optimisable treatment solution to meet changing business needs.
  • An asset in the sustainable delivery of products, removing concerns of operational downtime or legal action due to water treatment failures.

Speak to one of our application experts today to discuss the targeted removal of APIs and Pharmaceutical residues from your wastewater with Nyex™.

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