Investigating of the Link between Antibiotic Resistance in Patients and the Environment: A Contribution to the One Health Approach

Abstract

Purpose Antibiotic resistance is a growing global concern with far-reaching implications for public health. This study investigates the link between human and environmental health monitoring data in Lower Saxony, adopting the One Health approach. Methods Health and environmental monitoring data are analyzed to examine the prevalence of antibiotic-resistant bacteria (ARB). To achieve this goal, existing reports publicly available in internet were reviewed and spatial and statistical tools such as ArcGIS Pro and R programming language were utilized. Health monitoring data is collected annually as part of the sentinel system ARMIN (Antimicrobial Resistance Monitoring), launched in 2006 by the Public Health Agency of Lower Saxony (Germany). Environmental monitoring data were extracted from one study conducted in 2018. Results Key findings suggest that the role of wastewater treatment plants (WWTPs) as sources of ARB in the environment, highlighting their limited efficiency in removing ARB. Spatial analysis reveals regional variations in ARB rates, with vancomycin-resistant enterococci (VRE) more prevalent in the East and multi-drug resistant Gram-negative bacteria (3MRGN) evenly distributed across the Western and Eastern regions in Lower Saxony. Conclusion Overall, this study underscores the need for comprehensive One Health surveillance programs encompassing human health and the environment to address the complex challenge of antibiotic resistance effectively.