Antimicrobial Resistance and Human Mobility

Abstract

Antimicrobial resistance (AMR) is of increasing global concern. Human mobility is one factor that has recently been associated with AMR, though the extent of its impact has not yet been well established due to the limited availability of rigorous data. This review examines the existing literature regarding various types of human mobility including shortterm travelers, forcibly displaced persons, migrant populations, and their association with global rates of AMR.

Migrants' living conditions, perceived health needs and implications for the use of antibiotics and antimicrobial resistance in the United Kingdom: A qualitative study

“…The lack of quick development of new antibiotic classes together with overuse and misuse of antibiotics raises concerns around the insufficiency of the medical sector to tackle antimicrobial resistance 2,3 . Migration and international travel are thought to play important roles in the acquisition and spread of AMR 4,5 . Resistant strains are consistently associated with preventable deaths and excess costs across high‐ and low‐income countries and have been found across countries in every continent, 6,7 emphasizing the need for a global united approach in analysing and tackling AMR 8 .…”

“…This may in turn inform effective policies and avoid holding migrants, including refugees and asylum seekers, responsible for AMR in host countries, which may negatively affect immigration policies. 5,13 In 2021, there were an estimated six million Individuals born outside the UK living in the United Kingdom, including migrants who came for purposes of work, study, family, or seeking asylum or refuge. 14 As of November 2022, there were 231,597 refugees, 127,421 pending asylum cases, and 5483 stateless people.…”

“…More robust research is needed to understand the drivers of antibiotic use and resistance in different migrant groups. This may in turn inform effective policies and avoid holding migrants, including refugees and asylum seekers, responsible for AMR in host countries, which may negatively affect immigration policies 5,13 …”

Screening of global microbiomes implies ecological boundaries impacting the distribution and dissemination of clinically relevant antimicrobial resistance genes

“…The enormous amount of antibiotics that are regularly released into the environment could generate selection to govern the dissemination and fate of ARGs across biomes; a recent survey reported that 53,800 tons of antibiotics were released into the environment in China alone during 2013 12 . Physical and biological forces (e.g., wind, river, and animal migration) 13 and human mobility 14 could further weaken the geographic barriers for ARG dissemination. The characteristics of biomes where ARGs exist could have an environmental selection on ARGs-harboring microorganisms and prophages 15 , 16 ; the phylogeny of such microorganisms could influence ARGs distribution 17 ; genetic elements (plasmid, insertion sequences, and integrons) could promote horizontal gene transfer of ARGs across microorganisms 15 ; or ARGs distribution could be random due to stochastic processes (e.g., random birth/death events, uncertain dispersal for random chance of microbial colonization, ecological drift, and environmental disturbance 18 ).…”

Antimicrobial resistance in Democratic Republic of Congo: the way forward

“…is the most studied bacterial genus in DR Congo as a result of the research set up and is still ongoing since 2008 on bacteremia. Indeed, since the first publications on bacteremia, the prevalence of resistance to ampicillin, chloramphenicol, and cotrimoxazole popularly called sceptrin is particularly high (90%-100%) [10][11][12] . Further work is required to set up a surveillance system for antibiotic resistance in DRC.…”