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Critical knowledge gaps and research needs related to the environmental dimensions of antibiotic resistance

Review article
Authors D. G. Joakim Larsson
Antoine Andremont
Johan Bengtsson-Palme
K. K. Brandt
A. M. D. Husman
P. Fagerstedt
J. Fick
Carl-Fredrik Flach
W. H. Gaze
M. Kuroda
Kristian Kvint
R. Laxminarayan
C. M. Manaia
K. M. Nielsen
L. Plant
M. C. Ploy
C. Segovia
P. Simonet
K. Smalla
J. Snape
E. Topp
A. J. van Hengel
D. W. Verner-Jeffreys
M. P. J. Virta
E. M. Wellington
A. S. Wernersson
Published in Environment International
Volume 117
Pages 132-138
ISSN 0160-4120
Publication year 2018
Published at Institute of Biomedicine, Department of Infectious Medicine
Centre for antibiotic resistance research, CARe
Pages 132-138
Language en
Keywords Antimicrobial resistance, Infectious diseases, Risk assessment, Risk management, Environmental, horizontal gene-transfer, antimicrobial resistance, risk-assessment, escherichia-coli, waste-water, policy interventions, protection goals, bacteria, pathogens, evolution, Environmental Sciences & Ecology, . European Commission, 2017, IENCESRoyal Society Discussion Meeting on Antimicrobial Resistance Addressing the Threat to Global, ENIHR. Scientific committee on emerging and newly identified health risks (SCENIHR), 2009
Subject categories Infectious Medicine


There is growing understanding that the environment plays an important role both in the transmission of antibiotic resistant pathogens and in their evolution. Accordingly, researchers and stakeholders world-wide seek to further explore the mechanisms and drivers involved, quantify risks and identify suitable interventions. There is a clear value in establishing research needs and coordinating efforts within and across nations in order to best tackle this global challenge. At an international workshop in late September 2017, scientists from 14 countries with expertise on the environmental dimensions of antibiotic resistance gathered to define critical knowledge gaps. Four key areas were identified where research is urgently needed: 1) the relative contributions of different sources of antibiotics and antibiotic resistant bacteria into the environment; 2) the role of the environment, and particularly anthropogenic inputs, in the evolution of resistance; 3) the overall human and animal health impacts caused by exposure to environmental resistant bacteria; and 4) the efficacy and feasibility of different technological, social, economic and behavioral interventions to mitigate environmental antibiotic resistance.(1)

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