Environmental resistomes and antimicrobial resistance: integrating the One Health framework

Area of Science:

• Environmental microbiology
• One Health
• Antimicrobial resistance (AMR)

Background:

• AMR is a critical global health challenge driven by interconnected human, animal, and environmental systems.
• The "One Health" approach integrates these domains to address AMR comprehensively.
• Environmental microbiomes act as reservoirs and vectors for antimicrobial resistance genes (ARGs).

Purpose of the Study:

• To review the environmental dimension of AMR, focusing on microbiomes as ARG reservoirs and transmission vectors.
• To highlight emerging evidence, transmission pathways, detection methods, and policy gaps, particularly in low- and middle-income countries (LMICs).
• To emphasize the need for integrated "One Health" strategies and improved environmental surveillance.

Main Methods:

• In-depth literature synthesis across environmental, clinical, and molecular microbiology studies.
• Analysis of eco-evolutionary dynamics of resistance and ARG transmission routes.
• Evaluation of current surveillance models and novel detection technologies.

Main Results:

• Environmental resistomes in soil, water, air, and waste significantly contribute to ARG dissemination through horizontal gene transfer and mobile genetic elements.
• Co-selectors like heavy metals and biocides promote ARG persistence and evolution within complex microbial communities.
• Current surveillance systems often overlook environmental factors, especially in LMICs, hindering AMR mitigation.

Conclusions:

• Environmental microbiomes are central to AMR and require recognition in global control efforts.
• Integrated "One Health" strategies, enhanced environmental surveillance, policy reforms, and technological interventions are essential for AMR control.
• Bridging the research-policy gap and strengthening local surveillance are vital for improved resistance management and public health.