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Air pollution may be a vector for superbugs, according to a new study that suggests a link between the two for the first time and raises the possibility that curbing smog could reduce antibiotic resistance globally.
A peer-reviewed study published in The Lancet Planetary Health on Monday found that antibiotic resistance increases in tandem with levels of small particulate matter, or PM2.5, which originates from engine combustion and can penetrate the lungs and bloodstream.
“The association has strengthened over time, with changes in PM2.5 levels leading to larger increases in antibiotic resistance in more recent years,” the researchers said. Especially high levels of both small particulate matter and antibiotic resistance were found in north Africa, the Middle East and south Asia.
The correlations were “consistent across the world in most antibiotic-resistant bacteria”, said the researchers.
The findings follow earlier discoveries of DNA from antibiotic-resistant organisms on particles polluting the air. Antimicrobial resistance is the emergence of bacteria impervious to existing antibiotics, which the World Health Organization has said is one of the top 10 global public health threats.
While the study suggests a correlation between pollution and antimicrobial resistance, it has not demonstrated that one causes the other.
Researchers said the results “provide new pathways for antibiotic-resistance control from an environmental perspective”. They analysed data from 116 countries between 2000 and 2018, but acknowledged limitations resulting from disparities in the figures available.
Hong Chen of Zhejiang University, China, a professor who led the research, said: “Antibiotic resistance and air pollution are each in their own right among the greatest threats to global health. Until now, we didn’t have a clear picture of the possible links between the two.”
“But this work suggests the benefits of controlling air pollution could be two-fold: not only will it reduce the harmful effects of poor air quality, it could also play a major role in combating the rise and spread of antibiotic-resistant bacteria.”
The main drivers of antimicrobial resistance are the misuse and overuse of antibiotics, not just in humans but also in the broader ecosystem, such as in animal farming.
About 1.27mn deaths were attributed to bacterial antimicrobial resistance in 2019 alone, according to a separate Lancet study. Estimates put the projected death toll at close to 10mn by 2050 if there is no substantial change before then.
Andrew Singer, principal scientist at the UK Centre for Ecology & Hydrology, who was not part of the study, noted that the research — as its authors acknowledged — was not experimental and did not offer data on the mechanism for any link.
But he added that the study “convincingly” raised PM2.5 “as an intriguing possible driver of [antimicrobial resistance] — one that hasn’t yet been examined in any great detail to date”.
“Like all good research, it raises more questions than it answers — but it will hopefully drive the research community to examine this in greater detail,” Singer said.
