Is Bad Plumbing to Blame for Antibiotic Resistance?

Antibiotics were heralded as the closest thing to a panacea that modern medicine has ever developed, but bacteria are quickly wising up by evolving ways to survive even against the strongest of antibiotics. This phenomenon, known as antibiotic resistance, involves just one of these critters surviving an onslaught of antibiotics and reproducing, with their offspring having genes that can live through the same treatment. As a result, people are now staying in hospitals for longer, exacerbating medical costs.

Antibiotic resistance is quickly becoming one of the greatest threats to human life in this century, according to this report by the World Health Organization. The mechanism is widely understood, though scientists find it odd that one of the first areas with antibiotic-resistant bacteria come from hospitals. That is until a team from the National Institutes of Health in Maryland were able to find the answer—in plumbing.

A History of Antibiotic Abuse

The NIH Clinical Center in Bethesda, MD suffered an outbreak of antibiotic-resistant infections caused by bacteria known as Klebsiella pneumoniae. They used genome sequencing to find the specific antibiotics that the bacteria are resistant to, finally arriving at carbapenem. This is a class of potent antibiotics generally administered as a “last resort” for high-risk or highly contagious bacterial infections and is usually just present in hospital settings (such as in operating rooms).

To trace precisely how these organisms spread, the NIH team collected samples from areas in the hospitals, such as sinks, doorknobs, medical equipment, and drainage. Bacterial populations are present, of course, but they used the same process to sequence the genomes of their plasmids. These are “rings” of DNA that contain genetic information that can be passed down to offspring. What they found shocked them—the bacteria in the plumbing system tested positive for carbapenem resistance, unlike those tested outside, even in areas where the antibiotic is used.

The answer dawned on the researchers. Hospitals, which use antibiotics in no small degree, might be flushing used medicines or samples down the drains. This confers antibiotic resistance to the waiting microbes in the sewers, which go on in their merry way through the city’s plumbing system and from there to the wild.

Future Efforts

You might wonder why this is a concern, especially when Maryland is far away from Salt Lake City. Emergency plumbing contractors, however, are troubled about these developments, which means that it’s a good idea to look at what you flush down the drain, not just infected or biohazardous waste. For example, fatbergs, which are enormous conglomerations of human waste and non-biodegradable matter like wet wipes, have made the news lately for clogging sewers in England.

This also raises the critical consideration for tracking antibiotic-resistant bacteria, especially in hospital settings, and the proper disposal of antibiotics. This can help prevent infections not just in the hospital but in other areas, seeing that the plumbing system is connected to the entire city. An important ethical consideration, however, is should hospitals care about what they dump in the sewers as long as they don’t infect their patients?

The study concludes that bad plumbing is not at fault for antibiotic resistance, but how people flush their waste. The lesson here is if the trash is infected, don’t flush it down the toilet. Contact your plumber for your options.