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Cited by 3,164Pharmaceutical and Antibiotic Environmental ImpactsAntibiotic Use and ResistanceAntibiotic Resistance in Bacteria

Antibiotic resistance in the environment

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Larsson, D. G. Joakim, Flach, Carl-Fredrik·2022·Nature Reviews Microbiology
DOI 10.1038/s41579-021-00649-xPMC PMC8567979
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Abstract

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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  • 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 [190]

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Cited by

Sorted by citations

Authors
Larsson, D. G. J., & Flach, C.-F.
Affiliations
University of Gothenburg (SE)
Corresponding author
Larsson, D. G. Joakim
ORCID
Venue
Nature Reviews Microbiology
Publisher
Springer Science and Business Media LLC
Published
2021-11-04
Volume
20
Issue
5
Pages
257-269
ISSN
  • 1740-1526 (ISSN-L)
  • 1740-1534
DOI
10.1038/s41579-021-00649-x
PMC
PMC8567979
OpenAlex
W3210890336
Cited by
3,164
References
4
Citations by year
2026: 813 · 2025: 872 · 2024: 751 · 2023: 500 · 2022: 223 · 2021: 3 · 2017: 1
FWCI
18.01
Type
journal article
Language
en
Open access
Licence
Locations
  • Nature Reviews Microbiology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Västra Götalandsregionen (ALFGBG-717901)
  • Svenska Forskningsrådet Formas (2108-00787, 2018-00833)
  • Vetenskapsrådet (2018-02835, 2018-05771)
Topics
  • Physical Sciences › Environmental Science › Pollution › Pharmaceutical and Antibiotic Environmental Impacts
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
Keywords
antibiotic resistance, environmental transmission, horizontal gene transfer, antibiotic pollution, resistance evolution, drug-resistant bacteria, antimicrobial resistance surveillance, risk assessment, zoonotic transmission
MeSH terms
Animals, Anti-Bacterial Agents, Bacteria, Bacterial Infections, Drug Resistance, Microbial, Drug Resistance, Bacterial

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