Environment, animals, and food as reservoirs of antibiotic-resistant bacteria for humans: One health or more?

Antimicrobial resistance (AMR) is a significant public health issue, affecting soils, aquatic environments, and food. In high-income countries, effective sanitation infrastructure and limited pharmaceutical industries help control discharges. However, in low- and middle-income countries, population density, poor sanitation, and animal farming practices contribute to inter-reservoir transmissions. Environmental bacteria can also produce ARGs, potentially spreading through human-to-human transmission. To reduce AMR, improvements in wastewater treatment plants and sanitation infrastructure, reduced antibiotic use, less harmful antibiotics, and better pharmaceutical industry waste control are needed.