Mapping and Analysing Potential Sources and Transmission Routes of Antimicrobial Resistant Organisms in the Environment using Geographic Information Systems-An Exploratory Study.

Carlos Chique,John Cullinan,Brigid Hooban,Dearbhaile Morris

doi:10.3390/antibiotics8010016

Abstract

Antimicrobial resistance (AMR) is one of the leading threats to human health worldwide. The identification of potential sources of antimicrobial resistant organisms (AROs) and their transmission routes in the environment is important for improving our understanding of AMR and to inform and improve policy and monitoring systems, as well as the identification of suitable sampling locations and potential intervention points. This exploratory study uses geographic information systems (GIS) to analyse the spatial distribution of likely ARO sources and transmission routes in four local authority areas (LAAs) in Ireland. A review of relevant spatial data in each LAA, grouped into themes, and categorised into sources and transmission routes, was undertaken. A range of GIS techniques was used to extract, organise, and collate the spatial data into final products in the form of thematic maps for visual and spatial analysis. The results highlight the location of ‘clusters’ at increased risk of harbouring AMR in each LAA. They also demonstrate the relevance of aquatic transmission routes for ARO mobility and risk of human exposure. The integration of a GIS approach with expert knowledge of AMR is shown to be a useful tool to gain insights into the spatial dimension of AMR and to guide sampling campaigns and intervention points.

Highlights

The World Health Organisation (WHO) has highlighted antimicrobial resistance (AMR) as one of the most substantial threats to human health worldwide, with a growing number of critical infections becoming increasingly difficult to treat with the current line of antibiotics [1]
The concern associated with the introduction of antibiotics into the environment stems from the fact that low concentrations of antibiotics may not be capable of killing the bacteria, they do employ a selective pressure that encourages them to adapt [7]
Summary statistics for potential sources of antimicrobial resistant organisms (AROs), livestock index estimates, and healthcare facilities identified in the mapping exercise are presented in Table 2 for local authority areas (LAAs)

Summary

Introduction

The World Health Organisation (WHO) has highlighted antimicrobial resistance (AMR) as one of the most substantial threats to human health worldwide, with a growing number of critical infections becoming increasingly difficult to treat with the current line of antibiotics [1]. The production of antibiotics is a natural occurrence by environmental organisms, hypothesised to be a means of communication [4], and many mechanisms of resistance are embedded in basic survival components of the bacteria. These include efflux pumps, which function in the detoxification. The concern associated with the introduction of antibiotics into the environment stems from the fact that low concentrations of antibiotics may not be capable of killing the bacteria, they do employ a selective pressure that encourages them to adapt [7] This confers a survival advantage over susceptible isolates and enables them to multiply in numbers, facilitating their transmission and further dissemination of resistance genes. Resistance genes become widespread among bacteria through repeated exposure to sub-therapeutic levels of antibiotics

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Discussion

Conclusion