Towards monitoring of antimicrobial resistance in the environment: For what reasons, how to implement it, and what are the data needs?

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

  • Johan Bengtsson-Palme - , University of Gothenburg (Author)
  • Anna Abramova - , University of Gothenburg (Author)
  • Thomas U Berendonk - , Institute of Hydrobiology, Chair of Limnology (Author)
  • Luis Pedro Coelho - , Fudan University (Author)
  • Sofia K Forslund - , Experimental and Clinical Research Center (ECRC) (Author)
  • Rémi Gschwind - , Sorbonne Paris North University, Université Paris Cité (Author)
  • Annamari Heikinheimo - , University of Helsinki (Author)
  • Víctor Hugo Jarquín-Díaz - , Experimental and Clinical Research Center (ECRC) (Author)
  • Ayaz Ali Khan - , University of Malakand (Author)
  • Uli Klümper - , Institute of Hydrobiology, Chair of Limnology (Author)
  • Ulrike Löber - , Experimental and Clinical Research Center (ECRC) (Author)
  • Marmar Nekoro - , Swedish Medical Products Agency (Author)
  • Adriana D Osińska - , Norwegian University of Life Sciences (Author)
  • Svetlana Ugarcina Perovic - , Fudan University (Author)
  • Tarja Pitkänen - , University of Helsinki (Author)
  • Ernst Kristian Rødland - , Norwegian Institute of Public Health (Author)
  • Etienne Ruppé - , Sorbonne Paris North University, Université Paris Cité (Author)
  • Yngvild Wasteson - , Norwegian University of Life Sciences (Author)
  • Astrid Louise Wester - , Norwegian Institute of Public Health (Author)
  • Rabaab Zahra - , Quaid-I-Azam University (Author)

Abstract

Antimicrobial resistance (AMR) is a global threat to human and animal health and well-being. To understand AMR dynamics, it is important to monitor resistant bacteria and resistance genes in all relevant settings. However, while monitoring of AMR has been implemented in clinical and veterinary settings, comprehensive monitoring of AMR in the environment is almost completely lacking. Yet, the environmental dimension of AMR is critical for understanding the dissemination routes and selection of resistant microorganisms, as well as the human health risks related to environmental AMR. Here, we outline important knowledge gaps that impede implementation of environmental AMR monitoring. These include lack of knowledge of the 'normal' background levels of environmental AMR, definition of high-risk environments for transmission, and a poor understanding of the concentrations of antibiotics and other chemical agents that promote resistance selection. Furthermore, there is a lack of methods to detect resistance genes that are not already circulating among pathogens. We conclude that these knowledge gaps need to be addressed before routine monitoring for AMR in the environment can be implemented on a large scale. Yet, AMR monitoring data bridging different sectors is needed in order to fill these knowledge gaps, which means that some level of national, regional and global AMR surveillance in the environment must happen even without all scientific questions answered. With the possibilities opened up by rapidly advancing technologies, it is time to fill these knowledge gaps. Doing so will allow for specific actions against environmental AMR development and spread to pathogens and thereby safeguard the health and wellbeing of humans and animals.

Details

Original languageEnglish
Article number108089
JournalEnvironment international
Volume178
Early online date5 Jul 2023
Publication statusPublished - Aug 2023
Peer-reviewedYes

External IDs

Scopus 85164730937
Mendeley 1b74081a-7594-3e0d-8bf0-20634c28b3ef
ORCID /0000-0002-4169-6548/work/142247390
ORCID /0000-0002-9301-1803/work/161409834

Keywords

Sustainable Development Goals

ASJC Scopus subject areas

Keywords

  • AMR, Antibiotic resistance, Infectious diseases, One-health, Surveillance, Transmission, Environmental Monitoring, Animals, Bacteria/genetics, Humans, Drug Resistance, Bacterial/genetics, Anti-Bacterial Agents/pharmacology