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Environmental pollution as a critical driver of antimicrobial resistance emergence
Summary
Researchers argue that environmental pollution — including microplastics, antibiotics, and heavy metals — is fueling the spread of antimicrobial resistance (AMR) by allowing bacteria to swap resistance genes in rivers, soils, and wastewater, yet most global AMR policies still ignore environmental pathways. The authors call for stricter discharge limits and better monitoring of contaminated environments as part of a One Health approach.
Environmental processes are becoming known as paramount determinants of the emergence and spread of antimicrobial resistance (AMR). Antimicrobial residues, resistant microbes, and co-selective pollutants can be found in various environmental matrices at levels that drive the development of resistance. The sub-inhibitory concentrations of antimicrobials, heavy metals, microplastics, and biocides contribute to genetic selection as well as horizontal transfer of resistance determinants, which facilitate the development of persistent environmental reservoirs. Through such exposures, resistance determinants are selected, allowing for an interaction between environmental reservoirs and human and animal interfaces. This evidence notwithstanding, the majority of AMR frameworks still pay significantly more attention to clinical and agricultural misuse, and the significant environmental pathways are not adequately covered. This perspective article highlights the need to integrate environmental protection into the central part of the One Health response to AMR. Pharmaceutical industries, hospitals and municipal wastewater production, animal rearing, and domestic releases fill ecosystems with biologically active compounds, which increase in resistance and mobility. Additionally, the hydrological variation caused by climate can redistribute contaminants, thereby expanding the geographical area of contamination hotspots associated with AMR. A key set of priorities revealed through this article is to improve the environmental aspect of AMR governance, such as establishing enforceable discharge levels for antibiotic-contaminated waste, developing treatment technologies that can potentially remove co-selective pollutants, enhancing monitoring of environments considered at risk, and aligning responsibility among contributing sectors. Such considerations should be incorporated into AMR policies in countries and globally to mitigate the environmental impact of drug resistance and safeguard the future effectiveness of antimicrobial agents.