Antimicrobial resistance and environmentally related issues

Jean-Yves Madec1

1ANSES, Lyon, France

Drivers of AMR include antimicrobial use in humans and animals, and the spread of resistant bacteria and genes within and between these sectors. Besides, pollution by antibiotics and AMR bacteria through industrial, hospital, community and farm waste is also expanding the environment resistome, and even more importantly, has an impact on bacterial population genetics and microbiomes. Therefore, the environment not only plays a role in transmitting AMR already circulating in humans and animals but also in the emergence of new resistance determinants of potential public health relevance. Such evolutionary events remain very hard to predict and trace but we may assume that the selective pressure exerted on the environment by the current practices related to antibiotics at the globe level promotes the mobilization and spread of those genes. On the other side, environmental microorganisms have long been a source of natural antibiotics, highlighting the dual nature of this complex setting. Since the human, animal and environmental habitats are interconnected, and that bacteria often cross species boundaries, no doubt that a One Health approach is needed as a collaborative effort to tackle AMR in people, domestic animals, plants, and all components of the environment. The lecture will review our current understanding of the place of the environment as a whole- including water (rivers, sea, effluents), soils and wildlife- in the global AMR burden and discuss possible actions or strategies that may help mitigate risks of emergence, evolution and spread of AMR, and in the end, reduce its negative impact on Global Health.