Minimizing Risks of Antimicrobial Resistance Development in the Environment from a Public One Health Perspective

Abstract

Antimicrobial resistance (AMR) is a globally recognized crisis with meaningful engagement across humans, animals, and the environment as in the One Health approach. The environment is the potential source, reservoir, and transmission route of AMR, and it plays a key role in AMR development from the One Health perspective. Animal farming, hospitals, and the pharmaceutical industry are identified as the main emission sources in the environment. Minimizing emissions and determining antimicrobial emission limits are priorities in the containment of environmental AMR development. From the perspectives of environmental management and environmental engineering, some important actions to minimize risks of AMR development are summarized, including the recent progress in enhanced hydrolysis pre-treatment technology to control the development of antibiotic resistance genes (ARGs) during biological wastewater treatment. It is desirable to establish a holistic framework to coordinate international actions on the containment of environmental AMR development. To establish a community with a shared future for humanity, China should and could play an important role in international cooperation to cope with AMR challenges. IDENTIFICATION OF MAIN EMISSION SOURCESNatural AMR is common among environmental bacteria, including in pristine locations relatively untouched by anthropogenic activities (5-7). However, the use of antimicrobial agents in humans China CDC Weekly Chinese Center for Disease Control and Prevention CCDC Weekly / Vol. 4 / No. 49 Action types Year Actions International actions 2013 Green procurement for pharmaceutical manufacturing (WHO and UNEP meeting) 2015 Global Action Plan on AMR (WHO) 2016 Creation of the AMR Industry Alliance 2017 Developing priorities for WHO activities on anti-microbial resistance and the environment (WHO expert meeting) 2018 List of antibiotic manufacturing discharge targets following the launch of the Common Antibiotic Manufacturing Framework (AMR Industry Alliance) 2019 Antibiotic use and wastewater residue (WHO expert meeting) 2020 Technical brief on water, sanitation, hygiene and wastewater management to prevent infections and reduce the spread of antimicrobial resistance (WHO/FAO/WOAH) 2022 Antibiotic manufacturing standards: Minimizing risk of developing antibiotic resistance and aquatic ecotoxicity in the environment resulting from the manufacturing of human antibiotics (AMR Industry Alliance) Actions of China 2002 Antibiotic fermentation residues were listed as prohibited drugs in forage and animal drinking water 2008 Antibiotic fermentation residues were officially included in Directory of National Hazardous Wastes in 2008 and remained in the revised versions in 2016 and 2021 2016 National action plan to contain antimicrobial resistance in China (2016-2020) 2017 Ministry of Agriculture and Rural Affairs of China formally banned colistin as an animal growth promoter 2019 Ministry of Agriculture and Rural Affairs withdrew all types of growth promoters from animal feed except Chinese ...