Environmental Determinants of Antimicrobial Resistance
TL;DR
This review examines the major environmental determinants of AMR-chemical contaminants, water systems, soil and agriculture, wildlife and ecosystems, and climate change and explores mechanisms by which environmental exposures promote resistance, including selective pressures, horizontal gene transfer, and biofilm formation.
Abstract
Antimicrobial resistance (AMR) has become a critical global health challenge, threatening the effectiveness of antibiotics, antivirals, antifungals, and antiparasitic drugs. Although clinical misuse of antibiotics in humans and animals has traditionally been highlighted as the primary driver of resistance, environmental factors play an equally significant and complex role in the emergence, persistence, and dissemination of resistant microbes and resistance genes. The environment serves as a reservoir and conduit for antimicrobial compounds and resistant organisms originating from healthcare settings, agricultural systems, industrial effluents, and community waste. This review examines the major environmental determinants of AMR-chemical contaminants, water systems, soil and agriculture, wildlife and ecosystems, and climate change. It also explores mechanisms by which environmental exposures promote resistance, including selective pressures, horizontal gene transfer, and biofilm formation. By integrating evidence from environmental science, microbiology, and public health, this article highlights emerging research frontiers and offers policy recommendations for tackling AMR within ecological contexts. A One Health approach, recognizing the interconnectedness of human, animal, and environmental health, is essential to design effective interventions that reduce the burden of antimicrobial resistance globally. Keywords: Antimicrobial resistance, environmental determinants, antibiotic pollution, One Health, horizontal gene transfer.