Antimicrobial resistance in the environment – risk screening and prioritisation tool
Completed project (2023)
Background
Antimicrobial resistance (AMR) is a major One Health challenge. While the environment is a potential transmission route of AMR there is a paucity of information about its true impact on human health. For example, many uncertainties remain in terms of the exposure routes to be considered and their relative significance. The purpose of this study was to address this issue by developing a screening and prioritisation approach to assess the most likely routes of environmental exposure for humans to resistant organisms and their significance for human health.
Project description
The proposed framework focuses on direct human exposure to pathogenic antimicrobial resistant bacteria (pARB). It is based on a qualitative risk assessment approach and organized into 4 modules: Concentration of pARB in the environment, probability of human exposure via the environment, risk for population in contact with the environment, risk to public health beyond the population primarily exposed. Confidence is included and expressed in terms of degree of agreement between experts, and strength of evidence available. Detailed recommendations have been developed for supporting standard estimation of the variables along the risk pathways. The framework has been embedded within a graphical user interface to facilitate computation, visualization and ranking of the results.
Key findings
- One of the major strengths of the framework is its adaptability and flexibility to test a wide variety of scenarios incorporating new microorganisms and changes to the population and/or the environmental compartments of interest.
- Even if the modelling framework has been primarily developed for pARB and human health, its principles are broadly applicable to other resistant pathogens, including fungi and viruses, and other target species such as livestock or pets. Work should be undertaken to adjust the framework to any new purpose, but this study demonstrates that the impact of AMR present in the environment on human health can be effectively assessed in a standardised and qualitative way.
