在同一卫生领域减少抗菌素耐药性的挑战：关于抗菌素耐药性风险及其在水槽、排水沟和废水中的缓解的不同观点

IF 8 1区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Science of the Total Environment Pub Date : 2025-06-24 DOI:10.1016/j.scitotenv.2025.179935

Hillary A. Craddock , Aoife Kearney , Fidelma Fitzpatrick , Caoimhe Finn , Mary T. Pryce , Deirdre Fitzgerald-Hughes

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引用次数: 0

摘要

多部门控制来自水/废水的抗菌素耐药性对于实现联合国到2030年将抗菌素耐药性死亡人数减少10%的目标至关重要。支持针对抗生素耐药性的公共卫生保护的政策和实践适应的复杂性需要协调一致的“同一个健康”方法。为了为统一解决方案的实施提供信息，我们使用混合方法，在医疗保健、农业和环境部门的“同一个健康”利益相关者中探索了AMR缓解实践、动机和机会。通过在线调查（n = 55）和半结构化访谈（n = 26）收集定量和定性反馈。受访者被细分为；医疗保健、设施/地产、农业/兽医。使用NVivo进行专题分析。在21名受访者中，与废水接触的抗菌剂、抗菌素耐药性细菌和持久性病原体是所有人类和动物保健受访者（分别为60%和80%）优先考虑的问题，而地产/设施工人（分别为37.5%和44%）优先考虑的问题。在受访者中，62%的人报告了废水监测不足和控制挑战，包括过时的基础设施（73%）、资源（68%）和AMR水库的持续定殖（77%）。技术干预对大多数利益相关者来说很重要（92%），但监管需求（28%）、概念验证（22%）、成本和能源使用（12%）以及维护（10%）是技术采用的驱动因素或考虑因素。不同部门之间出现了不同的观点，包括；可行的技术，来源控制，筛选/监视。关于汇/废水风险和综合抗菌素耐药性政策需求的共识更加明确。以健康为导向的抗菌素耐药性缓解需要加强实践和可实施的政策。这项研究强调了同一健康环境中变化的竞争和互补驱动因素。随着新技术的出现，必须考虑它们的性能和集成，以满足医疗保健、社会和经济需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

The challenge of reducing antimicrobial resistance (AMR) across the one health landscape: Diverse perspectives on AMR risks and their mitigation in sinks, drains, and wastewater

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The challenge of reducing antimicrobial resistance (AMR) across the one health landscape: Diverse perspectives on AMR risks and their mitigation in sinks, drains, and wastewater

Multisectoral control of antimicrobial resistance (AMR) from water/wastewater is critical to meet United Nations targets of 10 % reduced AMR deaths by 2030. The complexity of policy and practice adaptations underpinning public health protection against AMR, requires coordinated One Health approaches. To inform harmonized solution implementation, we explored AMR mitigation practices, motivations, and opportunities among One Health stakeholders across healthcare, agricultural and environmental sectors, using mixed methods. Quantitative and qualitative responses were collected via online survey (n = 55), followed by semi-structured interviews (n = 26). Respondents were subdivided into; healthcare, facilities/estates, agriculture/veterinary. Thematic analysis was carried out using NVivo. Among 21 survey respondents interfacing with wastewater, antimicrobials, AMR bacteria and persistent pathogens were high priority for all human and animal healthcare respondents (60 % and 80 % respectively) compared to estates/facilities workers (37.5 % and 44 % respectively). Among respondents, 62 % reported wastewater monitoring deficits and containment challenges, including outdated infrastructure (73 %), resourcing (68 %) and persistent colonization of AMR reservoirs (77 %). Technology interventions were important to most stakeholders (92 %) but regulatory needs (28 %), proof-of-concept (22 %), cost and energy use (12 %) and maintenance (10 %) were drivers or considerations for technology adoption. Divergent perspectives emerged between sectors, including; feasible technology, source control, screening/surveillance. Consensus was clearer regarding sink/wastewater risks and comprehensive AMR policy needs. One Health oriented, AMR mitigation requires enhanced practices and implementable policies. This research highlights competing and complementary drivers for change across One Health settings. As new technologies emerge, their performance and integration to meet healthcare, societal and economics needs must be considered.

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来源期刊

Science of the Total Environment 环境科学-环境科学

CiteScore

17.60

自引率

10.20%

发文量

8726

审稿时长

2.4 months

期刊介绍： The Science of the Total Environment is an international journal dedicated to scientific research on the environment and its interaction with humanity. It covers a wide range of disciplines and seeks to publish innovative, hypothesis-driven, and impactful research that explores the entire environment, including the atmosphere, lithosphere, hydrosphere, biosphere, and anthroposphere. The journal's updated Aims & Scope emphasizes the importance of interdisciplinary environmental research with broad impact. Priority is given to studies that advance fundamental understanding and explore the interconnectedness of multiple environmental spheres. Field studies are preferred, while laboratory experiments must demonstrate significant methodological advancements or mechanistic insights with direct relevance to the environment.