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Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
Published on: March 3, 2023
Understanding the mechanisms and drivers of antimicrobial resistance
Alison H Holmes1, Luke S P Moore1, Arnfinn Sundsfjord2
1National Institute of Health Research Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, and Department of Infectious Diseases, Imperial College London, London, UK.
Abstract:
To combat the threat to human health and biosecurity from antimicrobial resistance, an understanding of its mechanisms and drivers is needed. Emergence of antimicrobial resistance in microorganisms is a natural phenomenon, yet antimicrobial resistance selection has been driven by antimicrobial exposure in health care, agriculture, and the environment. Onward transmission is affected by standards of infection control, sanitation, access to clean water, access to assured quality antimicrobials and diagnostics, travel, and migration. Strategies to reduce antimicrobial resistance by removing antimicrobial selective pressure alone rely upon resistance imparting a fitness cost, an effect not always apparent. Minimising resistance should therefore be considered comprehensively, by resistance mechanism, microorganism, antimicrobial drug, host, and context; parallel to new drug discovery, broad ranging, multidisciplinary research is needed across these five levels, interlinked across the health-care, agriculture, and environment sectors. Intelligent, integrated approaches, mindful of potential unintended results, are needed to ensure sustained, worldwide access to effective antimicrobials.
Insights
Antimicrobial resistance (AMR) is a major threat. Understanding AMR drivers and implementing comprehensive, multidisciplinary strategies across health, agriculture, and environment sectors is crucial for sustained access to effective antimicrobials.
Area of Science:
- Microbiology
- Public Health
- Environmental Science
Background:
- Antimicrobial resistance (AMR) poses a significant threat to human health and biosecurity.
- AMR emergence is natural but accelerated by antimicrobial use in healthcare, agriculture, and the environment.
- Transmission of AMR is influenced by infection control, sanitation, water access, diagnostics, travel, and migration.
Purpose of the Study:
- To highlight the need for understanding AMR mechanisms and drivers.
- To emphasize the limitations of solely removing antimicrobial selective pressure.
- To advocate for comprehensive, multidisciplinary research and integrated strategies to combat AMR.
Main Methods:
- Review of existing literature on AMR emergence, selection, and transmission.
- Analysis of factors influencing AMR spread and the effectiveness of mitigation strategies.
- Identification of research needs across multiple levels and sectors.
Main Results:
- Antimicrobial selective pressure in various sectors significantly drives AMR.
- Effective AMR reduction requires addressing factors beyond selective pressure, including fitness costs.
- A holistic approach considering microorganism, drug, host, and context is essential.
Conclusions:
- Minimizing AMR necessitates a comprehensive, multidisciplinary approach across healthcare, agriculture, and environmental sectors.
- Integrated strategies are required to ensure sustained global access to effective antimicrobials.
- Further research is needed to understand AMR mechanisms and develop intelligent, unintended-consequence-aware solutions.
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01:30Development of Antibiotic Resistance
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01:28Antimicrobial Effectiveness
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