Rethinking the words hotspot reservoir and pristine in the environmental dimensions of antimicrobial resistance

Helliwell, Richard; Ewin, Isabel; Williams, Alexander D.; Levine, Diane T.; Singer, Andrew C.; Raman, Sujatha; Morris, Carol; Stekel, Dov J.

NORA

Rethinking the words hotspot reservoir and pristine in the environmental dimensions of antimicrobial resistance

Helliwell, Richard; Ewin, Isabel; Williams, Alexander D.; Levine, Diane T.; Singer, Andrew C. ORCID: https://orcid.org/0000-0003-4705-6063; Raman, Sujatha; Morris, Carol; Stekel, Dov J. ORCID: https://orcid.org/0000-0002-2492-8079. 2025 Rethinking the words hotspot reservoir and pristine in the environmental dimensions of antimicrobial resistance. npj Antimicrobials and Resistance, 3, 11. 7, pp. 10.1038/s44259-025-00080-9

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Abstract

We assess three words commonly used to represent the environmental dimensions of antimicrobial resistance (AMR) – ‘hotspot’, ‘reservoir’ and ‘pristine’ – through two questions: how are these terms used in published research; and how do these terms shape research being conducted? We advocate for the community to reflect on and improve its use of language, and suggest four potentially more productive and precise terms for AMR hazard: prevalence; transmission; evolution and connectivity.

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