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Cited by 425Pharmaceutical and Antibiotic Environmental ImpactsAntibiotic Resistance in BacteriaAntibiotic Use and Resistance

Role of the Environment in the Transmission of Antimicrobial Resistance to Humans: A Review

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Huijbers, Patricia M. C., Blaak, Hetty, de Jong, Mart C. M., Graat, Elisabeth A. M., Vandenbroucke-Grauls, Christina M. J. E., de Roda Husman, Ana Maria·2015·Environmental Science & Technology
DOI 10.1021/acs.est.5b02566
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Abstract

To establish a possible role for the natural environment in the transmission of clinically relevant AMR bacteria to humans, a literature review was conducted to systematically collect and categorize evidence for human exposure to extended-spectrum β-lactamase-producing Entero­bacteriaceae, methicillin-resistant Staphylococcus aureus, and vancomycin-resistant Enterococcus spp. in the environment. In total, 239 datasets adhered to inclusion criteria. AMR bacteria were detected at exposure-relevant sites (35/38), including recreational areas, drinking water, ambient air, and shellfish, and in fresh produce (8/16). More datasets were available for environmental compartments (139/157), including wildlife, water, soil, and air/dust. Quantitative data from exposure-relevant sites (6/35) and environmental compartments (11/139) were scarce. AMR bacteria were detected in the contamination sources (66/66) wastewater and manure, and molecular data supporting their transmission from wastewater to the environment (1/66) were found. The abundance of AMR bacteria at exposure-relevant sites suggests risk for human exposure. Of publications pertaining to both environmental and human isolates, however, only one compared isolates from samples that had a clear spatial and temporal relationship, and no direct evidence was found for transmission to humans through the environment. To what extent the environment, compared to the clinical and veterinary domains, contributes to human exposure needs to be quantified. AMR bacteria in the environment, including sites relevant for human exposure, originate from contamination sources. Intervention strategies targeted at these sources could therefore limit emission of AMR bacteria to the environment.

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  • Residues of antibiotics used in humans and animals often end up in the environment, especially water sources, leading to persistence of antibiotic residues and resistance genes in the environment.

    “Residues of antibiotics used in humans and animals often end up in the environment, 189,190 especially water sources, leading to the persistence of antibiotic residues and resistance genes in the environment.”

    From Antimicrobial Resistance Rates and Surveillance in Sub-Saharan Africa: Where Are We Now? (2022) · cites this paper as [189]

    The Discussion (page not provided) says antibiotic residues reach the environment through wastewater and manure, and reports that some residues persist in manure for days to months. It discusses resistance genes in soil and AMR bacteria in surface water, but does not establish that water is the principal destination for antibiotic residues or that those residues cause resistance genes to persist in the environment. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Hospital waste, farm, industrial, human waste, and waste water treatment plants become reservoirs and dissemination pathways of AMR.

    “Consequently, hospital waste, farm, industrial, human waste, and waste water treatment plants become reservoirs and dissemination pathways of AMR.189”

    From Antimicrobial Resistance Rates and Surveillance in Sub-Saharan Africa: Where Are We Now? (2022) · cites this paper as [189]

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Authors
Huijbers, P. M. C., Blaak, H., de Jong, M. C. M., Graat, E. A. M., Vandenbroucke-Grauls, C. M. J. E., & de Roda Husman, A. M.
Affiliations
  • National Institute for Public Health and the Environment (NL)
  • Wageningen University , , P.O. Box 338, 6700 AH Wageningen ,
  • Wageningen University & Research (NL)
  • VU University Medical Center , , P.O. Box 7057, 1007 MB Amsterdam ,
  • National Institute for Public Health and the Environment (RIVM) , , P.O. Box 1, 3720 BA Bilthoven ,
Corresponding author
Blaak, Hetty
ORCID
Venue
Environmental Science & Technology
Publisher
American Chemical Society (ACS)
Published
2015-09-10
Volume
49
Issue
20
Pages
11993-12004
ISSN
  • 0013-936X (ISSN-L)
  • 1520-5851
DOI
10.1021/acs.est.5b02566
OpenAlex
W2276210217
Cited by
425
References
1
Citations by year
2026: 34 · 2025: 38 · 2024: 49 · 2023: 34 · 2022: 57 · 2021: 50 · 2020: 40 · 2019: 41 · 2018: 36 · 2017: 20 · 2016: 25
FWCI
2.09
Type
journal article
Language
en
Open access
Licence
Locations
  • Environmental Science & Technology (publishedVersion)
  • PubMed (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • Pure Amsterdam UMC (acceptedVersion, other-oa)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • Socio-Environmental Systems Modeling (submittedVersion)
  • Rivm (National Institute for Public Health and the Environment) (submittedVersion)
  • Utrecht University Repository (Utrecht University) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • Ministerie van Volksgezondheid, Welzijn en Sport
  • Netherlands Organisation for Health Research and Development (20500095001)
Topics
  • Physical Sciences › Environmental Science › Pollution › Pharmaceutical and Antibiotic Environmental Impacts
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
Keywords
antimicrobial resistance, environmental transmission, human exposure, extended-spectrum beta-lactamase, Enterobacteriaceae, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, wastewater, manure, drinking water, shellfish, fresh produce, wildlife, soil, ambient air, dust, recreational areas
MeSH terms
Animals, Anti-Bacterial Agents, Bacteria, beta-Lactamases, Enterobacteriaceae, Environment, Feces, Food Microbiology, Humans, Manure, Recreation, Soil Microbiology, Water Microbiology, Drug Resistance, Bacterial, Methicillin-Resistant Staphylococcus aureus, Vancomycin-Resistant Enterococci

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