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Review
. 2022 Oct 5;11(10):1362.
doi: 10.3390/antibiotics11101362.

Antimicrobial Resistance and Its Drivers-A Review

Mohammad Irfan  1 , Alhomidi Almotiri  1 , Zeyad Abdullah AlZeyadi  1
Affiliations
Review

Antimicrobial Resistance and Its Drivers-A Review

Mohammad Irfan et al. Antibiotics (Basel). .

Abstract

Antimicrobial resistance (AMR) is a critical issue in health care in terms of mortality, quality of services, and financial damage. In the battle against AMR, it is crucial to recognize the impacts of all four domains, namely, mankind, livestock, agriculture, and the ecosystem. Many sociocultural and financial practices that are widespread in the world have made resistance management extremely complicated. Several pathways, including hospital effluent, agricultural waste, and wastewater treatment facilities, have been identified as potential routes for the spread of resistant bacteria and their resistance genes in soil and surrounding ecosystems. The overuse of uncontrolled antibiotics and improper treatment and recycled wastewater are among the contributors to AMR. Health-care organizations have begun to address AMR, although they are currently in the early stages. In this review, we provide a brief overview of AMR development processes, the worldwide burden and drivers of AMR, current knowledge gaps, monitoring methodologies, and global mitigation measures in the development and spread of AMR in the environment.

Keywords: antibiotics; antimicrobial resistance; biocides; environmental drivers; public health; spread of resistance.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of the data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Mechanisms of antibiotic resistance in bacteria. Bacterial cell membrane barriers and membrane protein can prevent antibiotics uptake, or bacteria can reduce intracellular concentration by efflux pumps. Also, antibiotic targets can be modified to reduce affinity. Finally, some antibiotics can be deactivated by specialized enzymes like β-lactamases. Sometimes, several mechanisms of resistance act in concert to provide high-level resistance.
Figure 2
Figure 2
AMR is a global problem that impacts not only people but also animals and ecosystems, both domestic and nondomestic. It is fueled by clinical, biological, social, political, economic, and environmental factors. The presence of AMR bacteria in the environment is a consequence of all of these drivers.
See this image and copyright information in PMC

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