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Environmental antimicrobial resistance and its drivers: a potential threat to public health
Open accessAbstract
Imprudent and overuse of clinically relevant antibiotics in agriculture, veterinary and medical sectors contribute to the global epidemic increase in antimicrobial resistance (AMR). There is a growing concern among researchers and stakeholders that the environment acts as an AMR reservoir and plays a key role in the dissemination of antimicrobial resistance genes (ARGs). Various drivers are contributing factors to the spread of antibiotic-resistant bacteria and their ARGs either directly through antimicrobial drug use in health care, agriculture/livestock and the environment or antibiotic residues released from various domestic settings. Resistant micro-organisms and their resistance genes enter the soil, air, water and sediments through various routes or hotspots such as hospital wastewater, agricultural waste or wastewater treatment plants. Global mitigation strategies primarily involve the identification of high-risk environments that are responsible for the evolution and spread of resistance. Subsequently, AMR transmission is affected by the standards of infection control, sanitation, access to clean water, access to assured quality antimicrobials and diagnostics, travel and migration. This review provides a brief description of AMR as a global concern and the possible contribution of different environmental drivers to the transmission of antibiotic-resistant bacteria or ARGs through various mechanisms. We also aim to highlight the key knowledge gaps that hinder environmental regulators and mitigation strategies in delivering environmental protection against AMR.
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“Furthermore, the continued overuse of antimicrobials, both in human health and in agriculture, produces an environment that selects for increasingly resistant bacteria.16”
From Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050 (2024) · cites this paper as [16]
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Metadata
- Authors
- Samreen, Ahmad, I., Malak, H. A., & Abulreesh, H. H.
- Affiliations
- Aligarh Muslim University (IN)
- Umm al-Qura University (SA)
- Corresponding author
- Ahmad, Iqbal
- Venue
- Journal of Global Antimicrobial Resistance
- Publisher
- Elsevier BV
- Published
- 2021-12
- Volume
- 27
- Pages
- 101-111
- ISSN
- 2213-7165 (ISSN-L)
- OpenAlex
- W3195695566
- Cited by
- 727
- References
- 153
- Citations by year
- 2026: 157 · 2025: 228 · 2024: 184 · 2023: 108 · 2022: 46 · 2021: 3
- FWCI
- 4.22
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Global Antimicrobial Resistance (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Department of Biotechnology, Ministry of Science and Technology, India (9102 || BT/IN/Indo-UK/AMR-Env/04/IQ/2020-21)
- Topics
- Physical Sciences › Environmental Science › Pollution › Pharmaceutical and Antibiotic Environmental Impacts
- Health Sciences › Medicine › Infectious Diseases › Antibiotic Use and Resistance
- Health Sciences › Medicine › Microbiology (medical) › Antibiotic Resistance in Bacteria
- Keywords
- antimicrobial resistance, antimicrobial resistance genes, antibiotic-resistant bacteria, antibiotic residues, hospital wastewater, agricultural waste, wastewater treatment plants, infection control, sanitation, clean water access, public health
- MeSH terms
- Anti-Infective Agents, Anti-Bacterial Agents, Public Health, Drug Resistance, Bacterial, Wastewater
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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