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      Environmental dissemination of antibiotic resistance genes and correlation to anthropogenic contamination with antibiotics

      review-article
      , MSc, PhD *
      Infection Ecology & Epidemiology
      Co-Action Publishing
      antibiotic resistance, antibiotics, environment, horizontal gene transfer, integrons

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          Abstract

          Antibiotic resistance is a growing problem which threatens modern healthcare globally. Resistance has traditionally been viewed as a clinical problem, but recently non-clinical environments have been highlighted as an important factor in the dissemination of antibiotic resistance genes (ARGs). Horizontal gene transfer (HGT) events are likely to be common in aquatic environments; integrons in particular are well suited for mediating environmental dissemination of ARGs. A growing body of evidence suggests that ARGs are ubiquitous in natural environments. Particularly, elevated levels of ARGs and integrons in aquatic environments are correlated to proximity to anthropogenic activities. The source of this increase is likely to be routine discharge of antibiotics and resistance genes, for example, via wastewater or run-off from livestock facilities and agriculture. While very high levels of antibiotic contamination are likely to select for resistant bacteria directly, the role of sub-inhibitory concentrations of antibiotics in environmental antibiotic resistance dissemination remains unclear. In vitro studies have shown that low levels of antibiotics can select for resistant mutants and also facilitate HGT, indicating the need for caution. Overall, it is becoming increasingly clear that the environment plays an important role in dissemination of antibiotic resistance; further studies are needed to elucidate key aspects of this process. Importantly, the levels of environmental antibiotic contamination at which resistant bacteria are selected for and HGT is facilitated at should be determined. This would enable better risk analyses and facilitate measures for preventing dissemination and development of antibiotic resistance in the environment.

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          Most cited references88

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          Call of the wild: antibiotic resistance genes in natural environments.

          Antibiotic-resistant pathogens are profoundly important to human health, but the environmental reservoirs of resistance determinants are poorly understood. The origins of antibiotic resistance in the environment is relevant to human health because of the increasing importance of zoonotic diseases as well as the need for predicting emerging resistant pathogens. This Review explores the presence and spread of antibiotic resistance in non-agricultural, non-clinical environments and demonstrates the need for more intensive investigation on this subject.
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            Antibiotics and antibiotic resistance in water environments.

            Antibiotic-resistant organisms enter into water environments from human and animal sources. These bacteria are able to spread their genes into water-indigenous microbes, which also contain resistance genes. On the contrary, many antibiotics from industrial origin circulate in water environments, potentially altering microbial ecosystems. Risk assessment protocols for antibiotics and resistant bacteria in water, based on better systems for antibiotics detection and antibiotic-resistance microbial source tracking, are starting to be discussed. Methods to reduce resistant bacterial load in wastewaters, and the amount of antimicrobial agents, in most cases originated in hospitals and farms, include optimization of disinfection procedures and management of wastewater and manure. A policy for preventing mixing human-originated and animal-originated bacteria with environmental organisms seems advisable.
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              Antibiotics and antibiotic resistance genes in natural environments.

              The large majority of antibiotics currently used for treating infections and the antibiotic resistance genes acquired by human pathogens each have an environmental origin. Recent work indicates that the function of these elements in their environmental reservoirs may be very distinct from the "weapon-shield" role they play in clinical settings. Changes in natural ecosystems, including the release of large amounts of antimicrobials, might alter the population dynamics of microorganisms, including selection of resistance, with consequences for human health that are difficult to predict.
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                Author and article information

                Journal
                Infect Ecol Epidemiol
                Infect Ecol Epidemiol
                IEE
                Infection Ecology & Epidemiology
                Co-Action Publishing
                2000-8686
                08 September 2015
                2015
                : 5
                : 10.3402/iee.v5.28564
                Affiliations
                Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
                Author notes
                [* ]Correspondence to: Björn Berglund, Department of Clinical and Experimental Medicine, Linköping University, SE-581 85 Linköping, Sweden, Email: bjorn.berglund@ 123456liu.se

                Responsible Editor: Tanja Strand, Uppsala University, Sweden.

                Article
                28564
                10.3402/iee.v5.28564
                4565060
                26356096
                95a153fc-ce08-42d1-9935-c8bb88f8ab19
                © 2015 Björn Berglund

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 May 2015
                : 28 July 2015
                : 05 August 2015
                Categories
                Review Article

                Infectious disease & Microbiology
                antibiotic resistance,antibiotics,environment,horizontal gene transfer,integrons

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