Management Options for Reducing the Release of Antibiotics and Antibiotic Resistance Genes to the Environment

Abstract

Background: There is growing concern worldwide about the role of polluted soil and water environments in the development and dissemination of antibiotic resistance.Objective: Our aim in this study was to identify management options for reducing the spread of antibiotics and antibiotic-resistance determinants via environmental pathways, with the ultimate goal of extending the useful life span of antibiotics. We also examined incentives and disincentives for action.Methods: We focused on management options with respect to limiting agricultural sources; treatment of domestic, hospital, and industrial wastewater; and aquaculture.Discussion: We identified several options, such as nutrient management, runoff control, and infrastructure upgrades. Where appropriate, a cross-section of examples from various regions of the world is provided. The importance of monitoring and validating effectiveness of management strategies is also highlighted. Finally, we describe a case study in Sweden that illustrates the critical role of communication to engage stakeholders and promote action.Conclusions: Environmental releases of antibiotics and antibiotic-resistant bacteria can in many cases be reduced at little or no cost. Some management options are synergistic with existing policies and goals. The anticipated benefit is an extended useful life span for current and future antibiotics. Although risk reductions are often difficult to quantify, the severity of accelerating worldwide morbidity and mortality rates associated with antibiotic resistance strongly indicate the need for action.

Antibiotic resistance genes in manure-amended soil and vegetables at harvest

“…The spread and aggregation of antibiotic resistance genes (ARGs) in multidrug-resistant pathogens is one of the most intractable clinical challenges [1,2]. Large amount of antibiotics are poorly absorbed by livestock [3], and high concentrations of residual ate persistence of ARGs in soil as bacteria from manure may not be well adapted to the soil environment [11].…”

Fate of antimicrobials and antimicrobial resistance genes in simulated swine manure storage

“…Wastes generated from animal production represent a major source of antimicrobials and ARGs to the environment (Pruden et al, 2013;Wang et al, 2012).…”

Residues and potential ecological risks of veterinary antibiotics in manures and composts associated with protected vegetable farming

“…This may pose a potential human health risk associated with the vegetable consumption. The spread of antibiotic-resistant genes in the environment is assumed to create an even more important risk to human health (Martinez 2008;Pruden et al 2013;Zhu et al 2013). Correlations have been found between antibiotic use and the abundance of sulfonamide and tetracycline antibiotic-resistant genes (ARGs) in pig farms and cattle waste lagoons in China ) and the USA (McKinney et al 2010), suggesting a relationship between antibiotic use and environmental reservoirs of drug resistance.…”