Potential Causes of Spread of Antimicrobial Resistance and Preventive Measures in One Health Perspective-A Review

Abstract

Antimicrobial resistance, referring to microorganisms' capability to subsist and proliferate even when there are antimicrobials is a foremost threat to public health globally. The appearance of antimicrobial resistance can be ascribed to anthropological, animal, and environmental factors. Human-related causes include antimicrobial overuse and misuse in medicine, antibiotic-containing cosmetics and biocides utilization, and inadequate sanitation and hygiene in public settings. Prophylactic and therapeutic antimicrobial misuse and overuse, using antimicrobials as feed additives, microbes resistant to antibiotics and resistance genes in animal excreta, and antimicrobial residue found in animal-origin food and excreta are animals related contributive factors for the antibiotic resistance emergence and spread. Environmental factors including naturally existing resistance genes, improper disposal of unused antimicrobials, contamination from waste in public settings, animal farms, and pharmaceutical industries, and the use of agricultural and sanitation chemicals facilitatet its emergence and spread. Wildlife has a plausible role in the antimicrobial resistance spread. Adopting a one-health approach involving using antimicrobials properly in animals and humans, improving sanitation in public spaces and farms, and implementing coordinated governmental regulations is crucial for combating antimicrobial resistance. Collaborative and cooperative involvement of stakeholders in public, veterinary and ecological health sectors is foremost to circumvent the problem effectively.

Keywords: animal; antimicrobial resistance; antimicrobial resistance gene; environment; one health; wildlife.

Figure 1

Final ranking of antibiotic-resistant bacteria. Reprinted from Lancet Infect Dis. 18(3), Tacconelli E, Carrara E, Savoldi A, et al. Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis. Lancet Infect Dis. 318–327, Copyright 2018, with permission from Elsevier. In the above figure, Mean (SD) pathogen weights derived by the software from the survey participants’ preferences and the segments represent the contribution of each criterion to each pathogen’s final weight.

Figure 2

Mutant selection window (MSW) and mutant prevention concentration (MPC). Figure 2. illustrates that when the concentration of an antimicrobial is between the minimum inhibitory concentration (MIC) and the (MPC), there is a selection pressure that promotes the persistence of a population of resistant microbes. As the concentration exceeds the MPC, the selection of resistant mutants is unlikely, and the susceptible population is eradicated. Conversely, when the concentration is below the MIC, there is no effect on both the susceptible and resistant subpopulations.

Figure 3

Antibiotic selection pressure leads to methicillin-resistance. Figure 3, depicts that exposure to amoxicillin-clavulanate may allow the emergence of methicillin-resistant S. aureus (MRSA) over methicillin-sensitive S. aureus (MSSA). Similarly, exposure to other antibiotics (cephalosporins, clindamycin, macrolides, fluoroquinolones and fusidic acid) to which MRSA is more likely to be resistant compared to MSSA may also favor the emergence of MRSA.

Figure 4

Schematic flow of antibiotic resistance from hotspots of evolution. Reprinted from Kraemer SA, Ramachandran A, Perron GG. Antibiotic pollution in the environment: from microbial ecology to public policy. Microorganisms. 2019;7(6):180. Creative Commons.

Figure 5

Spread of ARB and ARGs from animal faeces to the environment and human health. Reprinted from Iwu CD, Korsten L, Okoh AI. The incidence of antibiotic resistance within and beyond the agricultural ecosystem: a concern for public health. MicrobiologyOpen. 2020;9(9):e1035. © 2020 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd. Creative Commons.

Figure 6

Transmission pathways of AMRM and ARGs from wastewater hotspots to the other environment, animals and humans. Reprinted from J Environ Chem Eng; 8(1), Gwenzi W, Musiyiwa K, Mangori L. Sources, behaviour and health risks of antimicrobial resistance genes in wastewaters: a hotspot reservoir. 102220, Copyright 2020, with permission from Elsevier.

Figure 7

Transmission loop of AMRM and ARG among agronomic production, plants, animals, and human systems. Reprinted from Yan Z, Xiong C, Liu H, et al. Sustainable agricultural practices contribute significantly to one health. J Sustain Agric Environ. 2022;1(3):165–176. © 2022 The Authors. Journal of Sustainable Agriculture and Environment published by Global Initiative of Crop Microbiome and Sustainable Agriculture and John Wiley & Sons Australia, Ltd. Creative Commons. AMR microorganism and ARG in wastewater, raw manure, or contaminated water adds to the leaf and flowers (the nectar and pollens), fruits, and seeds phyllosphere microbiomes and reach humans via raw foods.

Figure 8

General routes of transmission of AMR microbes and ARG in the funeral industry. Reprinted from Sci Total Environ; 749, Gwenzi W. The ‘thanato-resistome’-The funeral industry as a potential reservoir of antibiotic resistance: early insights and perspectives. 141120, Copyright 2020, with permission from Elsevier.

Figure 9

Contribution of wildlife to the spread of antibiotic resistance. Reprinted from Laborda P, Sanz-García F, Ochoa-Sánchez LE, et al. Wildlife and antibiotic resistance. Front Cell Infect Microbiol. 2022;12:568. Creative Commons.