Mapping the evidence of the effects of environmental factors on the prevalence of antibiotic resistance in the non-built environment.
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Deza-Cruz Iñaki, de Menezes Alexandre, Gardner Brian, Aktan Ílknur, Alnajjar Sarhad, Betson Martha, Cabal Rosel Adriana, Caniça Manuela, Chambers Mark A, Tarrant Georgina, Contadini Francesca, Daramola Olukayode, de la Rivière Rani, Egan Bernadette, Ekiri Abel, Finnegan Catherine, Gonzalez Villeta Laura C, Green Richard, Hall Belinda, Hassan Marwa M, Hawes Martin, Healy Sara, Holbrook Lisa, Kaya Damla, Kumar Prashant, La Ragione Roberto M, Maupin Daniel, Mehat Jai W, Messina Davide, Moon Kelly, Mumford Elizabeth, Nichols Gordon, Olivença Daniel V, Prada Joaquin M, Price Claire, Proudman Christopher, Queenan Retha, Ramos Miguel, Closa Jaime Riccomini, Ritchie Jennifer M, Santorelli Lorenzo A, Selemetas Nick, Spick Matt, Subbannayya Yashwanth, Surendran Shelini, Teixeira Pedro, Tharmakulasingam Mukunthan, Valle Damian, van Vliet Arnoud H M, Videira Marco, Wallace-Williams Hazel, Wanelik Klara M, Woegerbauer Markus, Wright Sydney, Lo Iacono Giovanni
Аннотация
METHODS: We systematically searched English-language literature (1990-2021) in MEDLINE, Embase, and Web of Science, plus grey literature. Titles, abstracts, and keywords were screened, followed by full-text reviews using a structured codebook and dual-reviewer assessments.
RESULTS: Of 13,667 records screened, 738 met the inclusion criteria. Most studies focused on freshwater and terrestrial environments, particularly associated with wastewater or manure sources. Evidence of research has predominantly focused on Escherichia coli and Pseudomonas spp., with a concentration on ARGs conferring resistance to sulphonamides (sul1-3), tetracyclines (tet), and beta-lactams. Additionally, the People's Republic of China has produced a third of the studies-twice that of the next country, the United States-and research was largely domestic, with closely linked author networks.
CONCLUSION: Significant evidence gaps persist in understanding antibiotic resistance in non-built environments, particularly in marine, atmospheric, and non-agricultural settings. Stressors such as climate change and microplastics remain notably under-explored. There is also an urgent need for more research in low-income regions, which face higher risks of antibiotic resistance, to support the development of targeted, evidence-based interventions.