COVID-19, antibiotics and One Health: a UK environmental risk assessment

Antimicrobial resistance and COVID-19: Intersections and implications

“…New monitoring systems developed and implemented for COVID-19 could potentially be harnessed to reinforce environmental monitoring of AMR. For example, surveillance of waste water could be used for the early detection of both changes in COVID-19 and ARO prevalence ( Bivins et al, 2020 ; Hendriksen et al, 2019 ), as well as antibiotic concentrations ( Comber et al, 2020 ).…”

Will coronavirus disease (COVID-19) have an impact on antimicrobial resistance?

“…Increased physical distancing and use of face masks • Increased disinfection of the environment Cross-border spread • Fewer patient transfers of seriously ill patients between countries, resulting in less frequent cross-border spread of MDROs • Large decrease in international air travel, resulting in decreasing risk of global dissemination of antimicrobial-resistant bacteria and genes from highly endemic regions [8Shift in high-level policy making towards viral diseases and preparedness for emerging viruses • National plans and other initiatives to fight AMR are likely to have been slowed down, temporarily discontinued or even postponed because of COVID-19 public health emergencies and duties (similar to the WHO Global Strategy for Containment of Antimicrobial Resistance, which was launched on 11 September 2001 and went largely unnoticed by the global community, without any major impact on AMR activities for almost a decade, because of the disproportional focus on biosecurity issues)• Potential One Health impact of increased volumes of antibiotics from prescriptions in humans being released in the environment[3,51] • Gain in public and political attention for all threats related to communicable diseases, including already endemic issues such as AMR• Possible decrease in antimicrobial consumption in animals because of reduction in the size of livestock herds[52], possibly combined with difficulties in obtaining antibiotics AMR: antimicrobial resistance; CI: confidence interval; COVID-19: coronavirus disease; HCW: healthcare worker; ICU: intensive care unit; IPC: infection prevention and control; MDRO: multidrug-resistant organism; PPE: personal protective equipment; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; WHO: World Health Organization.…”

Sources of antibiotics pollutants in the aquatic environment under SARS-CoV-2 pandemic situation

“… Taiwan 331 ng L -1 [ 20 ] Azithromycin Inhibition of mRNA translation Domestic wastewater To treat middle ear infections, tonsillitis, throat infections, laryngitis, bronchitis, pneumonia, sinusitis, non-gonococcal urethritis, and cervicitis. Colombia 4120 ng L -1 [ 22 ] Doxycycline Inhibition of protein synthesis PEC data for the UK emergency hospital at Harrogate 95% treated Worst case scenario PNEC-ENV PNEC-MIC COVID-19 treatment UK 3 ng L -1 (Base line) 20 ng L -1 25100 ng L -1 2000 ng L -1 [ 4 ] Amoxicillin Inhibition of cell wall synthesis PEC data for the UK emergency hospital at Harrogate 95% treated Worst case scenario PNEC-ENV PNEC-MIC COVID-19 treatment UK 30 ng L -1 (Base line) 400 ng L -1 600 ng L -1 600 ng L -1 [ 4 ] a Note: PEC, Predicted Environmental Concentration Modelling tools; PNEC-ENV, Predicted No Effect Concentration, Environmental; PNEC-MIC, Predicted No Effect Concentration, Minimum Inhibitory Concentration. Chemical structures (ciprofloxacin CID: 2764 ; clarithromycin CID: 84029 ; erythromycin CID: 12560 ; ofloxacin CID: 4583 ; sulfamethoxazole CID: 5329 ; norfloxacin CID: 4539 ; flumequine CID: 3374 ; a...…”

“…In the recent work done at UK hospital the outcome suggests a strategic use of antibiotics as doxycycline as first line and amoxicillin as second line. Additionally, it predicts the increment of release of drug residues to UK rivers and coastal waters from the WWTPs [ 4 ].…”

“…Recently, due to the pandemic caused by the SARS-CoV-2 virus, which causes the COVID-19 disease, the use of antibiotics to prevent and treat secondary diseases of a bacterial and fungal nature has increased in patients with COVID- 19. This has generated an alert since the increase in the use of these antibiotics, and their discharge into water bodies can have environmental consequences [ 4 ].…”