The Complex Interplay Between Antibiotic Resistance and Pharmaceutical and Personal Care Products in the Environment

Abstract

Antibiotic resistant bacteria and antibiotic resistance genes are important environmental contaminants. Nonetheless, what drives the evolution, spread and transmission of antibiotic resistance dissemination is still poorly understood. The abundance of antibiotic resistant bacteria and antibiotic resistance genes is often elevated in human impacted areas, especially in environments receiving faecal wastes, or in the presence of complex mixtures of chemical contaminants, such as pharmaceuticals and personal care products (PPCPs). Self-replication, mutation, horizontal gene transfer and adaptation to different environmental conditions contribute to the persistence and proliferation of antibiotic resistant bacteria in habitats under strong anthropogenic influence. This review will discuss the interplay between chemical contaminants and antibiotic resistant bacteria and respective genes, specifically in reference to co-occurrence, potential biostimulation and selective pressure effects, and will overview mitigation by existing man-made and natural barriers. Evidence and strategies to improve the assessment of human-health risks due to environmental antibiotic resistance are also debated