Navigating the environmental impacts and analytical methods of last-resort antibiotics: Colistin and carbapenems
Elipsha Sharma, Yan Chen, Céline Kelso, Muttucumaru Sivakumar, Guangming Jiang
Abstract
Colistin and carbapenems, vital last-resort antibiotics against severe bacterial infections unresponsive to common drugs, pose a significant threat when resistance develops, potentially leading to total antibiotic ineffectiveness. The estimation and quantification of colistin and carbapenems in environmental samples is notably challenging due to expected low concentrations, complex structures, stability issues, and potential interference from other substances. Despite known side-effects, the biological impact of their residues recirculated via environment has not yet been evaluated. This review provides an in-depth analysis of these two critical drugs, exploring their chemical and biological properties, current detection and identified 41 analytical studies on the quantitation of colistin and carbapenems, with 7 studies involved in the detection of these antibiotics from environmental matrices while the rest devised analytical methods of quantification from biological matrices. The reverse-phased chromatography and high-performance liquid chromatography tandem mass spectrometry, was majorly reported for both categories due to their polar nature. We also discuss the growing challenges associated with the release of colistin and carbapenems into environmental settings. We focus on the environmental entry pathways these antibiotic residues, as well as the development of resistance. These antibiotics primarily enter the environment through runoff from hospitals and agricultural sites, leading to their accumulation in wastewater, soil, and natural water bodies. This environmental exposure is particularly concerning due to the potential for resistance development. The spread of resistance genes is a complex process, often involving mechanisms like horizontal gene transfer, which are significantly facilitated by the presence of these antibiotic residues in the environment. Further research is crucial in understanding the environmental release of these critical antibiotics, the analytical methods of quantifying these antibiotics in environmental settings, and their role in the dissemination of antimicrobial resistance.