The overall aim of the ResPHARM project is to attribute impacts of exposure to antimicrobial pharmaceutical manufacturing waste both via direct exposure of individuals and via indirect exposure to resistant bacteria resulting from environmental contaminations. We utilise a highly integrated UK-India work-flow to focus on a single, fast developing pharmaceutical hub and employ comparative analysis with a matched site without any significant pharmaceutical production facilities. We bring to bear the attention of some of the most talented antimicrobial resistance/waste treatment/molecular ecologists in India to establish the actual impact attributable to waste exposure complemented by a UK team of experts to work together on these two shared sites. The overarching aim is to track the fate of antimicrobial active pharmaceutical ingredients (APIs) and antibacterial agents (ABAs) from source to the major river and evaluate direct contribution to the levels of antimicrobial resistant bacteria (ARB) and antimicrobial resistant genes (ARGs) in the environment and within the human faecal resistome.
Key research objectives:
- Identify and quantify ABAs, APIs in industrial effluents, waste streams, waste treatment plants and rivers and sewage outlets in Baddi and Kangra.
- Evaluate the impact of ABA, API exposure on levels of ARB and ARG in the environment at both sites and in lab-based exposure systems.
- Document human exposure to environmental pollutants in pharmaceutical industry waste streams and rivers.
- Determine the impact of local levels of environmental ABAs and antimicrobial APIs on human faecal resistome and prevalence of resistant E. coli isolated from patients in hospitals, health centres and clinics.
- Investigate key drivers of ARG by development of mathematical models to establish impacts of antibiotic pollution and consumption on the local population at two sites.
- Develop recommendations for environmental monitoring guidelines to inform a risk assessment protocols across Indian and other relevant countries.
Project webpage link: RESPHARM