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Objective: The objective of this scoping review is to identify and map existing evidence of antimicrobial resistance (AMR) in water in Latin America and the Caribbean (LAC), while also identifying the gaps in AMR information in the region in eight themes of interest. Introduction: Antimicrobial resistance is a public health concern that has gained increasing global awareness. Concerns have been raised toward the importance of the environment's role in the dissemination of clinically relevant AMR. Although studies on AMR have been conducted, the reality of the role of the environment in the LAC region has not been studied. Inclusion criteria: Articles that examine AMR in water in the LAC region will be considered for inclusion. Antimicrobial resistance will be defined as a natural process that arises when the microorganisms that cause infection (e.g. bacteria) survive exposure to a drug that would normally kill them or stop their growth. The search will focus on eight themes of interest, as defined in the protocol, relating to the presence of resistant microorganisms in water sources and reported negative health effects. Qualitative and quantitative studies will be considered for inclusion. Reviews and gray literature will be excluded. Methods: The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews. A search for published literature will be performed in PubMed, Web of Science and Scopus. Independent screening of articles will be performed by examining the abstracts and then the full texts, utilizing pre-defined inclusion and exclusion criteria. Data for specific variables will be extracted, and descriptive examination will be performed.

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Downy mildew, caused by Plasmopara halstedii (Farl.) Berl. & De Toni in Sacc., is an economically important disease of sunflower (Helianthus annuus L.) in Europe and the United States (1). The disease was first noticed in South Africa in a commercial field near Standerton and in a seed production field near Kroonstad during the 1993 to 1994 planting season. During the 1995 to 1996 season, downy mildew was found in experimental hybrids near Heilbron, and in commercial fields near Heil-bron, Marikana, and Potchefstroom. At Heilbron, five hybrids were infected with P. halstedii, whereas three others showed symptoms of downy mildew at Potchefstroom and Marikana. All commercially cultivated hybrids have been developed in South Africa. Disease incidence in all the fields was low, with less than 1% of plants affected by the disease. Diseased plants were dwarfed and displayed veinal chlorosis of leaves typically associated with downy mildew of sunflower. White fungal growth commonly occurred on lower leaf surfaces. Sunflower seedlings inoculated with P. halstedii produced symptoms characteristic of downy mildew. The occurrence of the disease in many geographic areas and on various hybrids in South Africa suggests that the fungus is well established. Recent outbreaks can be attributed to the cool, wet, climatic conditions of the 1993 to 1994 and 1995 to 1996 seasons. The susceptibility of local hybrids suggests that downy mildew is a potentially dangerous disease of sunflower in South Africa. Reference: (1) J. F. Miller and T. J. Gulya. Crop Sci. 27:210, 1987.