Epidemiological, ecological, and public health effects of antibiotics and AMR/ARGs

Worldwide morbidity and mortality caused by infectious diseases is high, mandating high rates of antibiotic use among humans and animals. Antibiotics of anthropogenic origin often contaminate the environment. The arising ecological pressure results in alteration of bacterial “biomes,” high resistance rates in environmental microorganisms, and increase in the gene pool which contributes to antibiotic resistance. A number of such antibiotic resistance genes are carried on mobile genetic elements that can easily be exchanged between bacteria. The ecological net effect is an expanding population of resistant organisms contributing to spread of antibiotic resistance in both the clinical and the nonclinical environments. In nonclinical environments, antibiotics upset the natural symbiotic balance between microorganism and macroorganism communities. In clinical environments, while therapeutic antibiotic adverse effects are easily observed, the, impact of sub-inhibitory concentrations of antimicrobials on human health are less apparent and require investigations. In summary, impact of antimicrobial resistance is extensive, threatening not just health and food safety but also our environment. Actions are thus required to both safeguard efficacies of antimicrobial agents, and also to protect the environment from damage by them.