Question to the Department of Health and Social Care:

To ask Her Majesty’s Government what assessment they have made of the risk to public health of the antibiotic-resistant bacteria recently discovered in riverbeds downstream from sewage works.

Professor Wellington’s paper was co-authored by Professor Peter Hawkey, one of Public Health England’s (PHE) Lead Microbiologists. Investigating the presence of extended-spectrum β-lactamases (ESBLs) and other antimicrobial resistance genes in the environment is part of PHE’s antimicrobial resistance research programme. Few studies address the presence of ESBLs in the environment and assessing the level of public health risk is not easy.

PHE is assessing the occurrence of ESBL-producing E. coli from a variety of non-human sources, including sewage (but not river waters), to identify major reservoirs of the strains that cause human disease and to inform public health risk assessment. This Policy Research Programme-funded project will produce its final report in 2016.

Professor Wellington also reports the first carbapenem-resistant E. coli from a United Kingdom river. Carbapenem resistance is considered a critical resistance threat by PHE, the Chief Medical Officer, the Department and the World Health Organization. Although carbapenem resistance rates in the UK are low, the actual number of carbapenem-resistant bacteria seen by PHE from hospitals is increasing year on year. A member of PHE recently reviewed the small but growing number of reports from around the world of carbapenem-resistant strains from non-human sources in collaboration with colleagues from the Animal Health and Veterinary Laboratories Agency and the National Health Service.

The key public health message arising from the latest paper by Professor Wellington’s team is that members of the public should always inform their general practice that they've been swimming in rivers / streams if they become ill (most likely with gastro symptoms).