Joint Programming Initiative on Antimicrobial Resistance

“Environmental Dimensions of AMR” workshop,

27-28 September 2017 in Gothenburg, Sweden.

The purpose of the workshop was to explore and identify critical research needs that relate to the environmental dimensions of AMR, both in the longer term for providing input to an updated JPIAMR Strategic Research Agenda, but also in the shorter term to provide guidance for specific calls.

The workshop was led by Professor Joakim Larsson, Sweden. The participants divided into three breakout groups focusing on the three thematic aspects (see Workshop concept), and reported back their work to the whole group.

Attendance was by invitation only.

Download the workshop report here



Evolution and selection in the environment

The environment hosts a vast diversity of bacteria and bacterial genes, and is believed to act as a source for resistance factors to pathogens. Selection pressures outside of the bodies of humans and animals may facilitate in this process. This may include direct selection pressures from antibiotics but also indirect selection via e.g. certain metals and antibacterial biocides. Understanding the environment´s involvement in the evolution and emergence of resistance in pathogens would fall under this theme, as well as the role human activities have on such processes. Understanding the relation between exposure level to selective agents and the development of resistance in different setting is one of the questions to address.

Proposed rapporteur: Joakim Larsson

Transmission of resistant bacteria via the environment

Many pathogens, including antibiotic resistant bacteria, spread via contaminated water and soils and may eventually lead to increased infection of humans and animals. Understanding the role of different environments, conditions and practices in the transmission of bacteria in the environment, particularly resistant bacteria, from the source all the way to humans/animals would fall under this theme. This also include approaches to quantify risks.

Proposed rapporteur: Ana-Maria de Roda Husman

Interventions related to the external environment

Interventions to reduce the spread of resistant bacteria and selective agents to environment and to prevent infection from environmental sources can be both technical and of a more social nature, i.e. measures to incentive change. The possibilities and need for interventions will differ not only between sectors (human, animal and industrial sources) but also between regions (low, middle and high-income countries) with radically different infrastructure for waste management. Identifying research gaps that address critical needs in all these sectors and regions will be within scope of this theme.

Proposed rapporteur: Ramanan Laxminarayan

It is acknowledged that there is some overlap between the three themes; i.e. selection may influence not only evolution but also transmission; investigating different levels of transmission under different practices has clear links to practical interventions, and so on. However, we feel this is unavoidable. Also, the environment priority topic has an overlap to several of the other priority topics of the SRA, not the least on the intervention side. Here, only interventions, aspects on selection and transmission that occur outside of the human/animal body will be covered.