by Ayush Kumar and Annemieke Farenhorst, originally posted on June 15, 2016

Drinking-water distribution systems on First Nations may be endangering the health of residents even in communities with a proper treatment plant. That was our conclusion after finding bacteria resistant to antibiotics in household drinking water from a Manitoba community with a perfectly good water-treatment plant.

Water is one of the most important factors contributing to the spread of infectious diseases. It is well-known communities that do not have access to clean drinking water tend to be more prone to various infectious diseases, including stomach and skin infections. It is also well-known rates of infectious diseases among Canadians living on reserves are much higher than those living off them.

Poor water quality is certainly one of the factors behind this.

With more than 100 reserves under a drinking-water advisory, one wonders how and why some Canadians don’t have the basic human right of access to safe and clean water. Many of these advisories are due to bacteria in the water, with fecal contamination the most common cause.

For water to be safe for drinking, it should have zero coliforms — bacteria commonly found in the human gut. However, in our recently published study, we found that water samples from a reserve in Manitoba contained coliforms, including E. coli. This community’s water-treatment plant is producing water free from bacteria, but once the water got into the distribution system, we started detecting coliforms.

Results were similar for samples collected from tap water, cisterns or community fountains, albeit the number of bacteria found in tap water was considerably lower than in cisterns or buckets. This suggests a problem with the distribution system.

We went a step further and tested the water samples for the presence of antibiotic-resistant genes. Antibiotic resistance of bacteria is one of the most pressing problems confronting health care. This is a phenomenon by which bacteria resist the action of antibiotics, which makes the treatment of infections challenging.

We were able to detect a number of antibiotic-resistant genes in the reserve’s water samples, including some that impart resistance to carbapenem antibiotics. Carbapenems are generally used as antibiotics of last resort to treat infections caused by resistant bacteria.

Based on the methodology we used, it can be assumed that at least some of the bacteria present in the water samples we tested have resistant genes, and therefore they are likely to be resistant to antibiotics. This is an alarming finding, which suggests rates of antibiotic-resistant infections are likely to be high in this community. Considering that many other First Nations reserves are struggling with bacteria in their drinking water, it is worth investigating the presence of antibiotic-resistant bacteria in more communities.

As alarming as the presence of resistance genes in water samples is, the solution to the problem is ensuring that water consumed by community members is free of coliforms. There has been a lot of discussion recently on the need to ensure that reserves have access to water-treatment plants, but our study shows proper design and maintenance of the distribution system is equally important.

In the meantime, people living outside cities who are concerned about their drinking water should find out the last time the water in their home was tested and ask for the results. If there are any coliform bacteria in the water, families need to boil it or drink bottled water instead. Almost all water from lakes and streams — even deep in the wilderness — contains germs that make it unsafe to drink without proper treatment.

Microbiologist Ayush Kumar and soil scientist Annemieke Farenhorst are University of Manitoba professors involved with the H2O program for water and sanitation security in First Nations.