This rapid evidence assessment (REA) collated and critically evaluated published and grey research literature to identify which pathways are most responsible for disseminating ‘resistance’ from the aquatic environment into humans. The REA also describe the volume, nature and characteristics of key findings, identifed knowledge gaps and implications for policy and research.
The emergence of antibiotic resistant bacteria of clinical significance, is one of the greatest global threats to humanity. Aquatic environments are not only reservoirs of clinically important antibiotic resistant bacteria (ARB), antimicrobial resistance (AMR) and antibiotic resistance genes (ARGs) but also as a medium for the spread and evolution of resistance genes. The routes by which humans can come into contact with these resistant bacteria and microbes via aquatic environments are numerous. For example the consumption of irrigated crops, shellfish, fish or drinking water, and recreational water sports. This REA aimed to provide a better understanding of the pathways that are most responsible for disseminating ‘resistance’ from the aquatic environment into humans so that relevant authorities are better placed to develop effective strategies for dealing with the risks.
The primary question of the REA was:
‘What pathways are most responsible for disseminating ‘resistance’ from the aquatic environment into humans?’
Two secondary questions were also addressed:
1. ‘What are the factors affecting the transmission of AMR and ARGs from the water environment into humans?’
2. ’What evidence is there that exposure to the pathways is contributing to clinical infections that cannot be treated with existing antibiotics?’
Funded by the Department for Environment, Food and Rural Affairs (Defra) under Defra work order WT1588.
This project forms part of the work carried out by the Centre for Evidence-Based Agriculture based at Harper Adams University.
Department for Environment, Food and Rural Affairs
Harper Adams University
European Centre for Environment and Human Health, University of Exeter Medical School; School of Life Sciences, University of Warwick