Microbial pathogens, such as some bacteria and fungi, are becoming increasingly resistant to the medicines designed to treat them, posing a significant health risk. Here, Isobel Stanton and Holly Tipper, microbiologists at the UK Centre for Ecology & Hydrology, discuss environmental antimicrobial resistance (AMR) as well as our scientists’ leading role in delivering key evidence for a research programme to minimise the impact on human health.
The widespread use of antimicrobials, for example antibiotics and antifungals, is leading to rising levels of resistance to these medicines in microorganisms, meaning that infections are becoming harder to treat. Estimates suggest that antimicrobial resistance (AMR) will be responsible for millions of deaths per year globally in the future, and will not only have an impact on human and animal health, but also on the economy and food security.
Drug-resistant microorganisms like bacteria and fungi, along with antimicrobials are released from polluting sources, such as human wastewater and agricultural runoff, into the environment. People can be exposed to these resistant microbes, thus acquiring AMR when they interact with the environment, for example through wild swimming or other water sports.
Given the diversity of sources and the many routes to exposure, environmental AMR represents a challenging and complex problem to solve. It requires a holistic, integrated approach that considers the interactions between humans, animals and the environment – a ‘One Health’ approach.
The Pathogen Surveillance in Agriculture, Food and Environment (PATH-SAFE) programme is a cross-governmental research programme funded by HM Treasury in 2021 and led by the Food Standards Agency, with multiple core partners including the Environment Agency.
Improved understanding
The Environment Agency commissioned multiple reports under the PATH-SAFE programme, covering a range of aspects related to the environmental dimensions of AMR.
A report led by Dr Isobel Stanton of UKCEH determined the concentrations of antifungals and antibiotics at which microorganisms develop resistance to these drugs – known as ‘selection’ for AMR – in water and soils. Meanwhile, Dr Holly Tipper led a report that reviewed how disinfectants enter the environment and their role in the development of AMR in the environment.
Collaborating on work led by the University of Exeter, UKCEH scientists comprehensively reviewed concentrations at which selection for AMR occurs, helping to inform mitigation to limit its development in the environment.
Other reports previously delivered by UKCEH under the PATH-SAFE programme investigated options for environmental AMR surveillance, for example in wild fauna and flora, river catchments, and bathing waters. These studies provide a baseline understanding of AMR in the environment which will help create and support future policies.
The work supports the UK’s recent National Action Plan, Confronting antimicrobial resistance 2024 to 2029, which will be the catalyst for:
- Taking forward recommendations highlighted in these reports to guide research and fill important knowledge gaps,
- Providing a thorough understanding of issues surrounding environmental AMR to inform monitoring strategies,
- Providing the tools needed to establish regulatory frameworks for both chemical and AMR pollution in the environment.
We were pleased to contribute to the PATH-SAFE programme, to inform environmental monitoring and research, and future policies to minimise the risk of AMR.
UKCEH staff involved in delivering this work were: Dr Holly Tipper, Dr Isobel Stanton, Dr Jennifer Shelton, Dr Dominic Brass, Dr Daniel Read and Dr Andrew Singer.
