Environmental contribution to antimicrobial resistance: A largely ignored global health issue

Environmental contribution to the continued occurrence of antibiotic resistance has been largely unexplored. There has been much focus on clinical isolates for their resistant nature but non-clinical bacterial isolates in the environment have been considered as the chief contributing factors that facilitate the spread and dissemination of antibiotic-resistant bacteria (ABR) and antibiotic-resistant genes (ARGs). The natural environment acts as a reservoir for bacteria, providing them with a favourable condition for their emergence and breeding of resistance. One such environmental leverage is inter/intra-specie exchange of genes encoding resistance factors. It was argued that human activities aid immensely in the emergence of antibiotic resistance in the environment. The rationale for this review is to examine extensively the complex interplay of antibiotic resistance from the natural environmental perspective and factors that influence the occurrence and dissemination of such resistance. It also seeks to stress the biological factors that facilitate the emergence of resistance and link it to general biological processes. The review has been structured to capture the general threat posed by the circulation of antibiotic-resistant bacteria and their genes, as well as the influence of the environment in contributing to this global health threat. In addition, the review looked at the effective methods used to tackle the silent pandemic, by controlling the spread of resistance in the environment. Environmental stakeholders and policymakers are recommended to be included in tackling the development of antibiotic resistance.