Antibiotic resistance in the environment

Antibiotic resistance is a global health challenge, involving the transfer of bacteria and genes between humans, animals and the environment. Although multiple barriers restrict the flow of both bacteria and genes, pathogens recurrently acquire new resistance factors from other species, thereby redu...

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Bibliographic Details
Published in:Nature reviews. Microbiology Vol. 20; no. 5; pp. 257 - 269
Main Authors: Larsson, D G Joakim, Flach, Carl-Fredrik
Format: Journal Article
Language:English
Published: England Nature Publishing Group 01.05.2022
Subjects:
Animals
Anti-Bacterial Agents - pharmacology
Antibiotic resistance
Antibiotics
Bacteria
Bacteria - genetics
Bacterial diseases
Bacterial Infections - drug therapy
Drug resistance
Drug Resistance, Bacterial
Drug Resistance, Microbial - genetics
Evolution
Genes
Global health
Health surveillance
Pathogens
Public health
Resistance factors
Surveillance systems
ISSN:1740-1526, 1740-1534, 1740-1534
Online Access:Get full text
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Summary:Antibiotic resistance is a global health challenge, involving the transfer of bacteria and genes between humans, animals and the environment. Although multiple barriers restrict the flow of both bacteria and genes, pathogens recurrently acquire new resistance factors from other species, thereby reducing our ability to prevent and treat bacterial infections. Evolutionary events that lead to the emergence of new resistance factors in pathogens are rare and challenging to predict, but may be associated with vast ramifications. Transmission events of already widespread resistant strains are, on the other hand, common, quantifiable and more predictable, but the consequences of each event are limited. Quantifying the pathways and identifying the drivers of and bottlenecks for environmental evolution and transmission of antibiotic resistance are key components to understand and manage the resistance crisis as a whole. In this Review, we present our current understanding of the roles of the environment, including antibiotic pollution, in resistance evolution, in transmission and as a mere reflection of the regional antibiotic resistance situation in the clinic. We provide a perspective on current evidence, describe risk scenarios, discuss methods for surveillance and the assessment of potential drivers, and finally identify some actions to mitigate risks.
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ISSN:1740-1526
1740-1534
1740-1534
DOI:10.1038/s41579-021-00649-x