How effective are strategies to control the dissemination of antibiotic resistance in the environment? A systematic review

Environmental Evidence

Céline Roose-Amsaleg¹  Sophie Courtois²  Drifa Belhadi³  Barbara Livoreil⁴  Marion Vittecoq⁵  Dominique Patureau⁶  Antoine Andremont⁷  Cédric Laouénan⁸  Alexandre Descamps⁸  Anaïs Goulas⁹  Nathalie Grall^1,10  David Makowski^1,11  Sylvie Nélieu^1,12  Pierre Benoit^1,12  Sylvie Nazaret^1,13  Christophe Dagot^1,14  Fabienne Petit^1,15 

[1] CNRS-UMR Ecobio, Université de Rennes, 263 avenue du général Leclerc, 35042, Rennes Cedex, France;Centre International de recherche sur l’Eau et l’Environnement, SUEZ, 78230, Le Pecq, France;Département d’Epidémiologie Biostatistiques et Recherche Clinique, Hôpital Bichat–Claude-Bernard, AP-HP, 78018, Paris, France;Fondation pour la Recherche sur la Biodiversité, 75005, Paris, France;Institut de recherche de la Tour du Valat, Arles, France;UMR IRD-CNRS-UM MIVEGEC, Montpellier, France;LBE, Univ Montpellier, INRA, 11100, Narbonne, France;UMR 1137 IAME, INSERM, Universités Paris-Nord et Paris-Diderot, 75018, Paris, France;UMR 1137 IAME, INSERM, Universités Paris-Nord et Paris-Diderot, 75018, Paris, France;Département d’Epidémiologie Biostatistiques et Recherche Clinique, Hôpital Bichat–Claude-Bernard, AP-HP, 78018, Paris, France;UMR 1137 IAME, INSERM, Universités Paris-Nord et Paris-Diderot, 75018, Paris, France;Fondation pour la Recherche sur la Biodiversité, 75005, Paris, France;UMR 1137 IAME, INSERM, Universités Paris-Nord et Paris-Diderot, 75018, Paris, France;Laboratoire de Microbiologie, AP-HP, Hôpital Bichat, 75018, Paris, France;UMR Agronomie, INRA, AgroParisTech, Université Paris-Saclay, 78850, Thiverval-Grignon, France;Centre International de Recherche sur l’Environnement et le Développement (CIRED)- CIRAD, UMR 8568, Nogent-sur-Marne, France;UMR EcoSys, INRA, AgroParisTech, Université Paris-Saclay, 78850, Thiverval-Grignon, France;UMR Ecologie Microbienne CNRS 5557, INRA 1418, VetAgroSup, Université Lyon 1, 69622, Villeurbanne Cedex, France;UMR INSERM 1092, Université Limoges, Limoges, France;UniRouen, UniCaen, CNRS, UMR M2C, Normandie Université, Rouen, France;UPMC, CNRS, EPHE, UMR 7619 METIS, Sorbonne Universités, Paris, France;

关键词: Antimicrobial;    Agriculture;    Livestock;    Aquaculture;    Wastewater;    Organic waste;    Ecosystems;    Wildlife;    One-Health;    Meta-analysis;   

DOI  :  10.1186/s13750-020-0187-x

来源: Springer

【 摘 要 】

BackgroundAntibiotic resistance is a major concern for public and environmental health. The role played by the environment in disseminating resistance is increasingly considered, as well as its capacity for mitigation. We reviewed the literature on strategies to control dissemination of antibiotic-resistant bacteria (ARB), antibiotic resistance genes (ARG) and mobile genetic elements (MGE) in the environment.MethodsThis systematic review focused on three main strategies: (i) restriction of antibiotic use (S1), (ii) treatments of liquid/solid matrices (S2) and (iii) management of natural environment (S3). Articles were collected from seven scientific databases until July 2017 and from Web of Science until June 2018. Only studies reporting measurements of ARB, ARG or MGE in environmental samples were included. An evidence map was drawn from metadata extracted from all studies eligible for S1, S2 and S3. Subsets of studies were assessed for internal and external validity to perform narrative and quantitative syntheses. A meta-analysis was carried out to assess the effects of organic waste treatments (random-effect models).Review findingsNine hundred and thirty-one articles representing 1316 individual studies (n) were eligible for S1 (n = 59), S2 (n = 781) and S3 (n = 476) strategies, respectively. Effects of interventions to control the dissemination of antibiotic resistance in the environment were primarily studied in strategy S2. A partial efficiency of wastewater treatment plants (WWTPs) to reduce antibiotic resistance in treated effluent was reported in 118 high validity studies. In spite of the heterogeneity in published results, the meta-analysis showed that composting and drying were efficient treatments to reduce the relative abundance of ARG and MGE in organic waste, by 84% [65%; 93%] and 98% [80%; 100%], respectively. The effect of anaerobic digestion was not statistically significant (51% reduction [− 2%; 77%]) when organic waste treatments were compared together in the same model. Studies in strategies S1 and S3 mainly assessed the effects of exposure to sources of contamination. For instance, 28 medium/high validity studies showed an increase of antibiotic resistance in aquatic environments at the WWTP discharge point. Some of these studies also showed a decrease of resistance as the distance from the WWTP increases, related to a natural resilience capacity of aquatic environments. Concerning wildlife, nine medium/high validity studies showed that animals exposed to anthropogenic activities carried more ARB.Conclusions and implicationsKnowledge gaps were identified for the relationship between restriction of antibiotic use and variation of antibiotic resistance in the environment, as well as on possible interventions in situ in natural environment. Organic waste treatments with thermophilic phase (> 50 °C) should be implemented before the use/release of organic waste in the environment. More investigation should be conducted with the datasets available in this review to determine the treatment efficiency on ARG carried by specific bacterial communities.

【 授权许可】

CC BY