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Environmental factors influencing the development and spread of antibiotic resistance

Review article
Authors Johan Bengtsson-Palme
Erik Kristiansson
D. G. Joakim Larsson
Published in FEMS microbiology reviews
Volume 42
Issue 1
Pages fux053
ISSN 1574-6976
Publication year 2018
Published at Department of Mathematical Sciences
Institute of Biomedicine, Department of Infectious Medicine
Centre for antibiotic resistance research, CARe
Pages fux053
Language en
Keywords Antimicrobial resistance; Dissemination; Fitness costs; Horizontal gene transfer; Human health risks; Microbial ecology
Subject categories Ecology, Microbiology, Evolutionary Biology, Microbiology


Antibiotic resistance and its wider implications present us with a growing healthcare crisis. Recent research points to the environment as an important component for the transmission of resistant bacteria and in the emergence of resistant pathogens. However, a deeper understanding of the evolutionary and ecological processes that lead to clinical appearance of resistance genes is still lacking, as is knowledge of environmental dispersal barriers. This calls for better models of how resistance genes evolve, are mobilized, transferred and disseminated in the environment. Here, we attempt to define the ecological and evolutionary environmental factors that contribute to resistance development and transmission. Although mobilization of resistance genes likely occurs continuously, the great majority of such genetic events do not lead to the establishment of novel resistance factors in bacterial populations, unless there is a selection pressure for maintaining them or their fitness costs are negligible. To enable preventative measures it is therefore critical to investigate under what conditions and to what extent environmental selection for resistance takes place. In addition, understanding dispersal barriers is not only key to evaluate risks, but also to prevent resistant pathogens, as well as novel resistance genes, from reaching humans.

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