1887
Perspective Open Access
Like 0

Abstract

The development, and in some cases increasing prevalence, of resistance to antimicrobials used in clinical and veterinary settings has long been recognised. In recent years, the concept of ‘One Health’ has added recognition of the role that the environment plays in health protection along with the need for protection of the health of the environment itself. Organisations including the World Health Organization, United Nations Environment Programme, and national governments have identified a need for surveillance of antimicrobial resistance in the environment to sit alongside the surveillance carried out in clinical, veterinary and food sectors. However, having recognised the need for environmental surveillance there are multiple challenges in deciding what this should entail. For example, what pathogens or genes to monitor, who or what we wish to protect and what measures we wish to enable to decrease infection risks. That might include sampling near a source of resistant organisms entering the environment or conversely sampling where the exposure actually occurs. Choices need to be made at both policy and technical levels based on the detailed purposes of surveillance. This paper discusses these issues from the perspective of a national environmental regulator.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2023.28.11.2200367
2023-03-16
2024-10-09
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.11.2200367
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/28/11/eurosurv-28-11-6.html?itemId=/content/10.2807/1560-7917.ES.2023.28.11.2200367&mimeType=html&fmt=ahah

References

  1. Singer AC, Shaw H, Rhodes V, Hart A. Review of antimicrobial resistance in the environment and its relevance to environmental regulators. Front Microbiol. 2016;7:1728.  https://doi.org/10.3389/fmicb.2016.01728  PMID: 27847505 
  2. Stanton IC, Bethel A, Leonard AFC, Gaze WH, Garside R. Existing evidence on antibiotic resistance exposure and transmission to humans from the environment: a systematic map. Environ Evid. 2022;11(1):8.  https://doi.org/10.1186/s13750-022-00262-2  PMID: 35308196 
  3. United Nations Environment Programme (UNEP). Frontiers 2017 Emerging Issues of Environmental Concern. Nairobi: United Nations Environment Programme; 2017, 84 p.
  4. O’Neill J. Tackling Drug-Resistant Infections Globally Final Report and Recommendations. Review on Antimicrobial Resistance. London: Welcome Trust, Her Majesty’s Government; 2016, 44 p.
  5. World Health Organisation (WHO). WHO integrated global surveillance on ESBL-producing E. coli using a “One Health” approach: implementation and opportunities. Geneva: WHO; 2021.
  6. Anjum MF, Schmitt H, Börjesson S, Berendonk TU, Donner E, Guedes Stehling E, et al. . The potential of using E. coli as an indicator for the surveillance of antimicrobial resistance (AMR) in the environment. Curr Opin Microbiol. 2021;64:152-8.  https://doi.org/10.1016/j.mib.2021.09.011  PMID: 34739920 
  7. Her Majesty’s (HM) Government. Tackling antimicrobial resistance 2019-2024 The UK’s five-year national action plan. London: HM Government; 2019.
  8. Fisher MC, Hawkins NJ, Sanglard D, Gurr SJ. Worldwide emergence of resistance to antifungal drugs challenges human health and food security. Science. 2018;360(6390):739-42.  https://doi.org/10.1126/science.aap7999  PMID: 29773744 
  9. Prigitano A, Venier V, Cogliati M, De Lorenzis G, Esposto MC, Tortorano AM. Azole-resistant Aspergillus fumigatus in the environment of northern Italy, May 2011 to June 2012. Euro Surveill. 2014;19(12):20747.  https://doi.org/10.2807/1560-7917.ES2014.19.12.20747  PMID: 24698139 
  10. Ridley L, Mace A, Stroda E, Parrish G, Rainford J, MacArthur R, et al. Pesticide usage survey Report 295. Arable crops in the United Kingdom 2020. FERA report. 105 p.
  11. Angulo FJ, Nunnery JA, Bair HD, Wint W. Antimicrobial resistance in zoonotic enteric pathogens. Rev Sci Tech. 2004;23(2):485-96.  https://doi.org/10.20506/rst.23.2.1499  PMID: 15702715 
  12. Leonard AFC, Zhang L, Balfour AJ, Garside R, Hawkey PM, Murray AK, et al. Exposure to and colonisation by antibiotic-resistant E. coli in UK coastal water users: Environmental surveillance, exposure assessment, and epidemiological study (Beach Bum Survey). Environ Int. 2018;114:326-33.  https://doi.org/10.1016/j.envint.2017.11.003  PMID: 29343413 
  13. Green Leaves. Guidelines for environmental risk assessment and management: Green leaves III. London: Department for Environment, Food & Rural Affairs; 2011. 84 p.
  14. Gudipati S, Zervos M, Herc E. Can the One Health Approach Save Us from the Emergence and Reemergence of Infectious Pathogens in the Era of Climate Change: Implications for Antimicrobial Resistance? Antibiotics (Basel). 2020;9(9):599.  https://doi.org/10.3390/antibiotics9090599  PMID: 32937739 
  15. Larsson DGJ, Andremont A, Bengtsson-Palme J, Brandt KK, de Roda Husman AM, Fagerstedt P, et al. Critical knowledge gaps and research needs related to the environmental dimensions of antibiotic resistance. Environ Int. 2018;117:132-8.  https://doi.org/10.1016/j.envint.2018.04.041  PMID: 29747082 
  16. UK-VARSS. Veterinary Antibiotic Resistance and Sales Surveillance Report (UK-VARSS 2020). New Haw, Addlestone: Veterinary Medicines Directorate; 2021. 140 p.
  17. Campo N, De Flora C, Maffettone R, Manoli K, Sarathy S, Santoro D, et al. Inactivation kinetics of antibiotic resistant Escherichia coli in secondary wastewater effluents by peracetic and performic acids. Water Res. 2020;169:115227.  https://doi.org/10.1016/j.watres.2019.115227  PMID: 31706126 
  18. Ballesté E, Demeter K, Masterson B, Timoneda N, Sala-Comorera L, Meijer WG. Implementation and integration of microbial source tracking in a river watershed monitoring plan. Sci Total Environ. 2020;736:139573.  https://doi.org/10.1016/j.scitotenv.2020.139573  PMID: 32474276 
  19. Murray AK, Stanton IC, Wright J, Zhang L, Snape J, Gaze WH. The ‘SELection End points in Communities of bacTeria’ (SELECT) Method: A Novel Experimental Assay to Facilitate Risk Assessment of Selection for Antimicrobial Resistance in the Environment. Environ Health Perspect. 2020;128(10):107007.  https://doi.org/10.1289/EHP6635  PMID: 33084388 
  20. Bengtsson-Palme J, Larsson DG. Concentrations of antibiotics predicted to select for resistant bacteria: Proposed limits for environmental regulation. Environ Int. 2016;86:140-9.  https://doi.org/10.1016/j.envint.2015.10.015  PMID: 26590482 
/content/10.2807/1560-7917.ES.2023.28.11.2200367
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error