There are a lot of germs in Ubers
Dangerous germs in streams, rivers and lakes
A man falls into a stream, almost drowns. At the clinic, doctors find multi-resistant pathogens in his lungs. Shortly afterwards the man dies. The exact cause of death remains unclear. But one thing is clear: after the death, the health department examines the stream water and actually discovers dangerous, resistant germs. This message from Frankfurt last spring was the reason for months of research and a trip across Lower Saxony. Journalists from the NDR broadcast Panorama - the reporters wanted to know whether such germs could possibly also be found in water here.
VIDEO: On the trail of the super germs (30 min)
They took samples at a total of twelve locations: from streams, rivers and two bathing lakes, the Zwischenahner Meer and the Thülsfeld dam. Renowned scientists from the Technical University of Dresden and the University Hospital Gießen then examined them for multi-resistant pathogens - i.e. for germs against which many antibiotics are no longer effective. And they found something everywhere.
"This is really alarming," says antibiotic expert Dr. Tim Eckmanns from the Robert Koch Institute on the finds. "The pathogens have apparently reached the environment and to an extent that surprises me." So far it has been clear that antibiotic-resistant pathogens can be found in the environment and can spread there. How heavily water bodies are polluted is largely unknown, as there are no systematic controls for such pathogens to date.
Resistance to important reserve antibiotics
The results of the samples surprised the researchers involved. Nobody had expected them before in this kind and variety. In all of the bodies of water they examined, the scientists also detected pathogens in which particularly important drugs, so-called reserve antibiotics, are no longer effective.
The germs found are multi-resistant gram-negative bacteria (MRGN). Doctors are increasingly concerned about them - now significantly more than the known MRSA pathogens. Because they can lead to serious illnesses that are difficult to treat. And the number of infections caused by such pathogens is increasing. In Germany, it is estimated that several thousand people die each year from diseases caused by multi-resistant germs. Previously ill, weakened people, but also the elderly or newborns, are particularly at risk.
Germs can be introduced into clinics
It is undisputed that the germs are fundamentally a risk. However, it is still largely unclear how high the health risk from such pathogens is in the environment, for example at polluted bathing lakes. In healthy people, the germs usually do not lead to illness, explains the doctor Can Imirzalioglu from the Giessen University Hospital. But they could settle in the intestines, for example. Later, this could possibly lead to an infection - for example in the event of a weakened immune system or if operations have to be carried out. There is also the risk that the bacteria will be passed on and introduced into clinics, for example. There they can be life-threatening for weakened people.
In fact, more and more patients bring such germs into the clinic, so they already carry them before they are admitted, says Prof. Trinad Chakraborty, the head of microbiology at the Giessen University Clinic. "There is a source of resistance outside of the clinic, and that is a problem that we are increasingly interested in."
Some "very dangerous" pathogens in samples
His colleague, the doctor Dr. Can Imirzalioglu says that there were some germs in the samples from Lower Saxony that would cause him greater concern. "We have found pathogens that can cause serious infections in certain patients and have already been described as very virulent, ie very dangerous pathogens." They would not have expected that.
A particularly worrying find was the detection of a specific gene in five of the twelve sample locations, the so-called mcr-1 gene. The important reserve antibiotic colistin no longer works in bacteria that carry such a gene. The rescue medication is only used in life-threatening situations when all other antibiotics fail.
Scientists believe it is likely that the resistance gene comes from animal husbandry, where colistin is used in larger quantities in contrast to human medicine. In fact, the gene was detected in several samples from a region with intensive animal husbandry. Resistant pathogens can get from the stables, for example via manure or liquid manure, to fields and thus into the environment. Animals such as insects, birds and dogs also spread germs.
Problematic germs behind sewage treatment plants
Another problematic pathogen was found in a small stream in a forest in southern Lower Saxony. The treated wastewater from a private small sewage treatment plant in a nursing home ends up there. The researchers detected various multi-resistant pathogens in the water and in the sediment of the stream. Among them was a germ against which almost no antibiotics are effective and which is feared in clinics and nursing homes because it permanently damages the lungs and bronchi.
The scientists also found pathogens in the river Hase in Osnabrück, just behind the outlet of the municipal sewage treatment plant, against which almost no remedy can be used in the event of an illness. In addition, they measured very high concentrations of multi-resistant germs there. Both samples show a general problem: sewage treatment plants in Germany are currently not designed to completely filter out multi-resistant pathogens.
Map: Rehearsal locations in Lower Saxony
Federal Environment Ministry for retrofitting and more controls
In view of the results of the samples, the Federal Environment Agency is now urging that at least all larger sewage treatment plants be retrofitted. This is technically feasible. The costs for this would be around 1.3 billion euros a year - that would be just under 16 euros for every German citizen, says the President of the Federal Environment Agency Maria Krautzberger in an interview for the program Panorama - die reporter. These are "means that one should definitely consider, also for the protection of the individual," said Krautzberger.
The Federal Environment Ministry also informed the NDR on request that it considered retrofitting sewage treatment plants to be sensible. It also sees a need for action, for example with bathing waters. In future, they should be examined for multi-resistant pathogens, according to the Federal Environment Ministry. However, the federal states are responsible for both.
At the request of the NDR, however, the state ministries in Lower Saxony announced that they assessed the health risk as low and saw no particular need for action. They referred to existing regulations and controls. An examination of bathing lakes or other bodies of water for antibiotic-resistant germs has therefore not yet taken place, but was not seen as necessary by the Lower Saxony ministries either. The Lower Saxony Ministry of Health did not want to evaluate the results of the samples carried out by the NDR.
Environment Minister of Lower Saxony announces rehearsals
However, after the results of the investigation were published, Lower Saxony's Environment Minister Olaf Lies (SPD) said: "We take the issue seriously and we can understand that people are worried when suddenly such measurement results are available." However, the risk for humans of becoming infected with antibiotic-resistant pathogens when bathing in officially monitored bathing waters is very low. However, they would now have the results of the NDR checked in detail "in order to take further steps if necessary." In the meantime, the ministry has announced that it will have its own samples taken.
Regarding the sewage treatment plants in Lower Saxony, the answer from the Ministry of the Environment to the NDR request said that they would meet the legal requirements. The introduction of an additional cleaning stage is "therefore not currently planned". The Ministry of the Environment only considered the treatment of fertilizers to be "effective" in order to reduce the entry of resistant pathogens into the environment. But Lower Saxony's Ministry of Agriculture is responsible for this. This in turn does not consider such a measure to be justified.
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Panorama - the reporters | 02/06/2018 | 9:15 pm
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