Does environmental exposure to pharmaceutical and personal care product residues result in the selection of antimicrobial-resistant microorganisms, and is this important in terms of human health outcomes?

Stanton, Isobel C. ORCID: https://orcid.org/0000-0002-2700-2407; Tipper, Holly J. ORCID: https://orcid.org/0000-0002-1857-9204; Chau, Kevin; Klümper, Uli; Subirats, Jessica; Murray, Aimee K.. 2024 Does environmental exposure to pharmaceutical and personal care product residues result in the selection of antimicrobial-resistant microorganisms, and is this important in terms of human health outcomes? [in special issue: Pharmaceuticals and personal care products in the environment: what have we learned and where should we go?] Environmental Toxicology and Chemistry, 43 (3). 623-636. https://doi.org/10.1002/etc.5498

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Abstract/Summary

The environment plays a critical role in the development, dissemination, and transmission of antimicrobial resistance (AMR). Pharmaceuticals and personal care products (PPCPs) enter the environment through direct application to the environment and through anthropogenic pollution. Although there is a growing body of evidence defining minimal selective concentrations (MSCs) of antibiotics and the role antibiotics play in horizontal gene transfer (HGT), there is limited evidence on the role of non-antibiotic PPCPs. Existing data show associations with the development of resistance or effects on bacterial growth rather than calculating selective endpoints. Research has focused on laboratory-based systems rather than in situ experiments, although PPCP concentrations found throughout wastewater, natural water, and soil environments are often within the range of laboratory-derived MSCs and at concentrations shown to promote HGT. Increased selection and HGT of AMR by PPCPs will result in an increase in total AMR abundance in the environment, increasing the risk of exposure and potential transmission of environmental AMR to humans. There is some evidence to suggest that humans can acquire resistance from environmental settings, with water environments being the most frequently studied. However, because this is currently limited, we recommend that more evidence be gathered to understand the risk the environment plays in regard to human health. In addition, we recommend that future research efforts focus on MSC-based experiments for non-antibiotic PPCPS, particularly in situ, and investigate the effect of PPCP mixtures on AMR.

Item Type:	Publication - Article
Digital Object Identifier (DOI):	https://doi.org/10.1002/etc.5498
UKCEH and CEH Sections/Science Areas:	Pollution (Science Area 2017-) Soils and Land Use (Science Area 2017-)
ISSN:	0730-7268
Additional Information. Not used in RCUK Gateway to Research.:	Open Access paper - full text available via Official URL link.
Additional Keywords:	antimicrobials, personal care products, pharmaceuticals, soil ecotoxicology, water quality
NORA Subject Terms:	Biology and Microbiology
Date made live:	19 Apr 2023 15:13 +0 (UTC)
URI:	https://nora.nerc.ac.uk/id/eprint/533626

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