Abstract
Antibiotic resistance represents a global health concern. Soil, water, livestock and plant foods are directly or indirectly exposed to antibiotics due to their agricultural use or contamination. This selective pressure has acted synergistically to bacterial competition in nature to breed antibiotic-resistant (AR) bacteria. Research over the past few decades has focused on the emergence of AR pathogens in food products that can cause disease outbreaks and the spread of antibiotic resistance genes (ARGs), but One Health approaches have lately expanded the focus to include commensal bacteria as ARG donors. Despite the attempts of national and international authorities of developed and developing countries to reduce the over-prescription of antibiotics to humans and the use of antibiotics as livestock growth promoters, the selective flow of antibiotic resistance transmission from the environment to the clinic (and vice-versa) is increasing. This review focuses on the mechanisms of ARG transmission and the hotspots of antibiotic contamination resulting in the subsequent emergence of ARGs. It follows the transmission of ARGs from farm to plant and animal food products and provides examples of the impact of ARG flow to clinical settings. Understudied and emerging antibiotic resistance selection determinants, such as heavy metal and biocide contamination, are also discussed here.
Highlights
Antibiotic-resistant (AR) bacteria impose a significant burden on healthcare
Contaminated foods end up into the gastrointestinal tract of humans, where antibiotic resistance emerges from antibiotic presence or is transferred from antibiotic resistance genes (ARGs) to gut microbiota
We suggest that ubiquitous bacteria harbor multiple ARGs of clinical importance
Summary
Antibiotic-resistant (AR) bacteria impose a significant burden on healthcare. In 2017, the Centers for Disease Control (CDC) estimated that there were 2.8 million infections and more than 35,000 deaths in the U.S due to infections caused by AR bacteria [1]. Other mechanisms are based on direct modification of the target site and include mutations, enzymatic alteration (for example, methylation), replacement, or overproduction of the target [21,25,26] Such mechanisms are facilitated by two major genetic strategies: mutational resistance and horizontal gene transfer (HGT) [21]. Another way for bacteria to survive exposure to antibiotics is tolerance. Contaminated foods end up into the gastrointestinal tract of humans, where antibiotic resistance emerges from antibiotic presence or is transferred from ARGs to gut microbiota The endpoints of this antibiotic resistance transmission are human pathogens, which develop AR infections.
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