US EPA

2149153 

Journal Article 

Comment 

Chronic arsenic exposure and microbial drug resistance 

McConville, MJ; Ralph, SA 

2013 

1 

Proceedings of the National Academy of Sciences of the United States of America
ISSN: 0027-8424
EISSN: 1091-6490 

110 

49 

19666–19667 

English 

24225851 

10.1073/pnas.1319659110 

WOS:000327744900020 

Resistance to antimicrobial drugs represents one of the greatest threats to the control of infectious diseases and is a particular problem in treating diseases caused by parasitic protists. These pathogens are of enormous medical importance, causing diseases such as malaria, toxoplasmosis, trypanosomiasis, and leishmaniasis. In the absence of effective vaccines, the control of these diseases is critically dependent on drug therapies that are often undermined by poor compliance or overuse in communities with struggling health care systems and endemic poverty. The development and spread of resistance to the antimalarial drug chloroquine from the 1950s onwards constitutes a spectacular example of drug failure caused by overuse. Similarly, the development of antimonial-resistance in Leishmania donovani in India in the 1970–1980s had all of the hallmarks of long-term misuse (1). L. donovani is the causative agent of visceral leishmaniasis (VL) or Kala-Azar, which kills many thousands of people in India each year. However, in PNAS, Perry et al. (2) provide compelling evidence that Leishmania-acquired antimonial resistance in India may be attributable, at least in part, to increased arsenic contamination of the drinking water. These findings highlight how environmental factors can contribute to the emergence of microbial drug resistance and have implications for drug development.