Category: Publications

Antibiotic resistance is a major challenge to public health, but human-caused environmental changes have not been widely recognized as its drivers. Here, we provide a comprehensive overview of the relationships between environmental degradation and antibiotic resistance, demonstrating that the former can potentially fuel the latter with significant public health outcomes. We describe that (i) global warming favors horizontal gene transfer, bacterial infections, the spread of drug-resistant pathogens due to water scarcity, and the release of resistance genes with wastewater; (ii) pesticide and metal pollution act as co-selectors of antibiotic resistance mechanisms; (iii) microplastics create conditions promoting and spreading antibiotic resistance and resistant bacteria; (iv) changes in land use, deforestation, and environmental pollution reduce microbial diversity, a natural barrier to antibiotic resistance spread. We argue that management of antibiotic resistance must integrate environmental goals, including mitigation of further increases in the Earth’s surface temperature, better qualitative and quantitative protection of water resources, strengthening of sewage infrastructure and improving wastewater treatment, counteracting the microbial diversity loss, reduction of pesticide and metal emissions, and plastic use, and improving waste recycling. These actions should be accompanied by restricting antibiotic use only to clinically justified situations, developing novel treatments, and promoting prophylaxis. It is pivotal for health authorities and the medical community to adopt the protection of environmental quality as a part of public health measures, also in the context of antibiotic resistance management.

The widespread nature of plastic pollution has given rise to wide scientific and social concern regarding the capacity of these materials to serve as vectors for pathogenic bacteria and reservoirs for Antimicrobial Resistance Genes (ARG). In- and ex-situ incubations were used to characterise the riverine plastisphere taxonomically and functionally in order to determine whether antibiotics within the water influenced the ARG profiles in these microbiomes and how these compared to those on natural surfaces such as wood and their planktonic counterparts.

Pollution caused by plastic production and waste has severe consequences on global economies, social inequalities, and ecosystems. Likewise, antimicrobial resistance (AMR) is one of the greatest One Health challenges. These threats are typically considered in isolation, but there is likely a complex interplay between the two. By adopting a systems approach and looking across the whole life cycle of plastics, we propose the range of ways in which plastic may influence AMR. Starting with raw material extraction processes where the leaching of potentially AMR co-selective chemicals used in pumping or piping of plastic feedstocks may influence AMR development in environmental microbial communities. Then, during production and manufacture, the use of plastic additives may impose selection for AMR. Finally, during use, collection or disposal, plastics can transport AMR biofilms in the community, clinical, agricultural, or aquatic settings. By linking these two important One Health threats, we may be better equipped and informed to combat them.