Wuijts Susanne, van den Berg Harold H J L, Miller Jennifer, Abebe Lydia, Sobsey Mark, Andremont Antoine, Medlicott Kate O, van Passel Mark W J, de Roda Husman Ana Maria
National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA Bilthoven, The Netherlands E-mail:
Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
J Water Health. 2017 Apr;15(2):175-184. doi: 10.2166/wh.2017.124.
Clinically relevant antimicrobial resistant bacteria, genetic resistance elements, and antibiotic residues (so-called AMR) from human and animal waste are abundantly present in environmental samples. This presence could lead to human exposure to AMR. In 2015, the World Health Organization (WHO) developed a Global Action Plan for Antimicrobial Resistance with one of its strategic objectives being to strengthen knowledge through surveillance and research. With respect to a strategic research agenda on water, sanitation and hygiene and AMR, WHO organized a workshop to solicit input by scientists and other stakeholders. The workshop resulted in three main conclusions. The first conclusion was that guidance is needed on how to reduce the spread of AMR to humans via the environment and to introduce effective intervention measures. Second, human exposure to AMR via water and its health impact should be investigated and quantified, in order to compare with other human exposure routes, such as direct transmission or via food consumption. Finally, a uniform and global surveillance strategy that complements existing strategies and includes analytical methods that can be used in low-income countries too, is needed to monitor the magnitude and dissemination of AMR.
环境样本中大量存在来自人类和动物粪便的具有临床相关性的抗菌耐药菌、耐药基因元件及抗生素残留（即所谓的抗菌药物耐药性）。这种情况可能导致人类接触抗菌药物耐药性。2015年，世界卫生组织（WHO）制定了《抗菌药物耐药性全球行动计划》，其战略目标之一是通过监测和研究加强相关知识。关于水、环境卫生和个人卫生与抗菌药物耐药性的战略研究议程，WHO组织了一次研讨会，征求科学家和其他利益相关方的意见。该研讨会得出了三个主要结论。第一个结论是，需要就如何减少抗菌药物耐药性通过环境向人类的传播以及引入有效的干预措施提供指导。第二，应调查并量化人类通过水接触抗菌药物耐药性及其对健康的影响，以便与其他人类接触途径（如直接传播或通过食物摄入）进行比较。最后，需要一个统一的全球监测战略，以补充现有战略，并包括也可在低收入国家使用的分析方法，来监测抗菌药物耐药性的规模和传播情况。
