The scourge of antibiotic resistance: the important role of the environment

Clin Infect Dis. 2013 Sep;57(5):704-10. doi: 10.1093/cid/cit355. Epub 2013 May 30.


Antibiotic resistance and associated genes are ubiquitous and ancient, with most genes that encode resistance in human pathogens having originated in bacteria from the natural environment (eg, β-lactamases and fluoroquinolones resistance genes, such as qnr). The rapid evolution and spread of "new" antibiotic resistance genes has been enhanced by modern human activity and its influence on the environmental resistome. This highlights the importance of including the role of the environmental vectors, such as bacterial genetic diversity within soil and water, in resistance risk management. We need to take more steps to decrease the spread of resistance genes in environmental bacteria into human pathogens, to decrease the spread of resistant bacteria to people and animals via foodstuffs, wastes and water, and to minimize the levels of antibiotics and antibiotic-resistant bacteria introduced into the environment. Reducing this risk must include improved management of waste containing antibiotic residues and antibiotic-resistant microorganisms.

Keywords: antibiotic resistance; environment; human resistant infections.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anti-Bacterial Agents / pharmacology*
  • Bacteria / drug effects*
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / microbiology
  • Bacterial Infections / veterinary*
  • Drug Resistance, Bacterial*
  • Drug Utilization / standards
  • Gene Transfer, Horizontal
  • Humans
  • Selection, Genetic
  • Water Purification / methods


  • Anti-Bacterial Agents