title: Aquatic systems: maintaining, mixing and mobilising antimicrobial resistance?
abstract: Bacteria showing antimicrobial resistance (AMR) pose a significant global healthcare problem. Although many mechanisms conferring AMR are understood, the ecological processes facilitating its persistence and spread are less well characterised. Aquatic systems represent an important milieu for the environmental release, mixing, persistence and spread of AMR bacteria and resistance genes associated with horizontally transferable genetic elements. Additionally, owing to the use and discharge of antimicrobials and biocides, and the accumulation and abundance of other pollutants, mechanisms that confer AMR might evolve in aquatic systems. In this review, we hypothesise that aquatic systems have an important ecological and evolutionary role in driving the persistence, emergence and spread of AMR, which could have consequences when attempting to reduce its occurrence in clinical settings.
authors: Centre for Environment, Fisheries and Aquaculture Science, Barrack Road, Weymouth, Dorset, DT4 8UB, UK. nick.taylor@cefas.co.uk
authors: Nick G H
authors: NG
authors: Taylor
authors: David W
authors: DW
authors: Verner-Jeffreys
authors: Craig
authors: C
authors: Baker-Austin
mesh_terms: D001419:Bacteria / Q000378:metabolism*; D005075:Biological Evolution; D004352:Drug Resistance, Microbial / Q000235:genetics / Q000502:physiology*; D017753:Ecosystem; D022761:Gene Transfer, Horizontal / Q000235:genetics*; D019450:Genes, MDR / Q000235:genetics*; D056127:Hydrobiology / Q000379:methods*; D014871:Water Microbiology; D014874:Water Pollutants, Chemical / Q000378:metabolism
chemical_list: D014874:Water Pollutants, Chemical