Human Health Risk Assessment (HHRA) for Environmental Development and Transfer of Antibiotic Resistance
By Nicholas Ashbolt, A. Amézquita, T. Backhaus, P. Borriello, K. Brandt, P. Collignon, A. Coors, R. Finley, W. Gaze, T. Heberer and 9 more. Environmental Health Perspectives, 2013
619 citations recorded by the source corpus.
Background: Only recently has the environment been clearly implicated in the risk of antibiotic resistance to clinical outcome, but to date there have been few documented approaches to formally assess these risks. Objective: We examined possible approaches and sought to identify research needs to enable human health risk assessments (HHRA) that focus on the role of the environment in the failure of antibiotic treatment caused by antibiotic-resistant pathogens. Methods: The authors participated in a workshop held 4–8 March 2012 in Québec, Canada, to define the scope and objectives of an environmental assessment of antibiotic-resistance risks to human health. We focused on key elements of environmental-resistance-development “hot spots,” exposure assessment (unrelated to food), and dose response to characterize risks that may improve antibiotic-resistance management options. Discussion: Various novel aspects to traditional risk assessments were identified to enable an assessment of environmental antibiotic resistance. These include a) accounting for an added selective pressure on the environmental resistome that, over time, allows for development of antibiotic-resistant bacteria (ARB); b) identifying and describing rates of horizontal gene transfer (HGT) in the relevant environmental “hot spot” compartments; and c) modifying traditional dose–response approaches to address doses of ARB for various health outcomes and pathways. Conclusions: We propose that environmental aspects of antibiotic-resistance development be included in the processes of any HHRA addressing ARB. Because of limited available data, a multicriteria decision analysis approach would be a useful way to undertake an HHRA of environmental antibiotic resistance that informs risk managers. Citation: Ashbolt NJ, Amézquita A, Backhaus T, Borriello P, Brandt KK, Collignon P, Coors A, Finley R, Gaze WH, Heberer T, Lawrence JR, Larsson DG, McEwen SA, Ryan JJ, Schönfeld J, Silley P, Snape JR, Van den Eede C, Topp E. 2013. Human health risk assessment (HHRA) for environmental development and transfer of antibiotic resistance. Environ Health Perspect 121:993–1001; http://dx.doi.org/10.1289/ehp.1206316
Subfields: Applied Microbiology and Biotechnology, Organic Chemistry, Pollution
View Paper: https://www.semanticscholar.org/paper/aef400eac72623d01820a1b2ca11e49a81917416
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Citations in the corpus
- Metagenomic analysis reveals wastewater treatment plants as hotspots of antibiotic resistance genes and mobile genetic elements. (2017, background): “The presence of these environmental ARB (Ashbolt et al., 2013) might be associated with 266 two reasons: (1) horizontal gene transfer between pathogenic bacteria and indigenous environmental 267 bacteria might be existed; (2) selection pressures (e.g. antibiotics or heavy metal in wastewater)…”
- Removal of antibiotic resistance genes (ARGs) in various wastewater treatment processes: An overview (2020, background): “At present, AR is considered as one of the most significant public health issues in this century (Ashbolt et al., 2013; Frieri et al., 2017; Lulijwa et al., 2020; WHO, 2014).”
- Antimicrobials and Antibiotic-Resistant Bacteria: A Risk to the Environment and to Public Health (2020, background): “HGT is believed to take place via mobile genetic elements, such as plasmids, transposons, integrons and prophages, as indicated by the fact that identical sequences of drug-resistance genes have been identified in the DNA of environmental and clinical bacterial strains [17,57].”
- Environmental factors influencing the development and spread of antibiotic resistance (2017, neutral): “…the role of the environment as an important source and dissemination route of resistance has been increasingly recognized (Martinez 2008; Wright 2010; Ashbolt et al. 2013; Finley et al. 2013; Pruden et al. 2013; Bengtsson-Palme et al. 2014b; Bondarczuk, Markowicz and Piotrowska-Seget 2015), but .”