More focus needed on AMR in the environment, study warns

Antimicrobial resistance (AMR) in the environment has not received enough attention from researchers, a study has found.

A team of more than 50 scientists, led by the University of Surrey in conjunction with the Royal (Dick) School of Veterinary Studies and University of Galway, conducted a literature review of AMR studies published between 1990 and 2021.

While AMR in human and veterinary medicine continues to be well-explored, the team found knowledge gaps and inconsistent focus on AMR in rural environments and called on researchers to expand their efforts to include other regions and settings.

Waterbodies

Of the 13,367 studies reviewed, they identified 738 (5.4%) that concentrated on antibiotic resistance in natural areas such as waterbodies, grasslands and in the air.

The researchers found the majority of those studies focused on wealthy countries and freshwater over marine environs.

One third (33.8%) of the studies came from China, more than twice that of the next country, the US (14.2%), with many conducted domestically.

Impact on health

But fewer than 1% were led by researchers from low-income countries such as Afghanistan, Ethiopia, Mali, and Uganda, where the authors say AMR is likely to have the highest impact on health.

Links between AMR and factors such as climate change and microplastics are also said to be under-explored.

While focus on the environment is increasing – 360 (48.8%) of the identified studies came between 2009 and 2018, while 333 (45.1%) came between 2019 and 2021 – the researchers warned against the impact such gaps could have on human and animal health.

‘Frighteningly little’

Brian Gardner, research fellow in computational biology at the University of Surrey’s School of Veterinary Medicine, said: “Despite a growing body of research, our study confirms that we know frighteningly little about how antibiotic resistance behaves in certain regions and environmental contexts.

“This is a silent emergency, and unless the scientific community works quickly to plug this knowledge gap, we risk letting antibiotic resistance spread unchecked in places we’re not appropriately monitoring.”

Iñaki Deza-Cruz, senior lecturer in veterinary public health at Royal (Dick) School of Veterinary Studies, added: “To understand the development of AMR in the environment, it is key that we study it comprehensively, across a range of circumstances and socio-economic settings.

“This complex, urgent challenge needs to be understood in terms of its impact across the health of people, animals and the environment, so that mitigating measures can be effective.”