Antimicrobial Resistance in Water: A One Health Perspective on Sources, Detection, Surveillance, and Public Health Implications

Antimicrobial resistance in aquatic environments is a major One Health issue impacting human, animal and environmental health. Antibiotic-resistant organisms and AMR genes are found in streams, rivers, lakes and oceans. Antimicrobial resistance in water is an increasing global concern, threatening ecosystems, food security and public health. The widespread use of antibiotics in human and veterinary medicine has led to the emergence of resistant bacteria, reducing therapeutic efficacy. The growing pollution of water with bacteria, genes and residues resistant to antibiotics is a vital threat to human health. The inconsistent monitoring of surface water, wastewater and recycled water increasingly affects environmental health, and hence, a coordinated approach is needed to minimize antimicrobial resistance hazards in these water sources. In the war against antimicrobial resistance in water, a broad-based approach by legislators, medical professionals, environmental scientists and the public is required. By understanding the inherent complexities of antimicrobial resistance in water, we can develop a targeted intervention program to better protect public health, animal health, and a sustainable environment from AMR in water. This review summarizes the current knowledge on AMR in water sources and detection, monitoring and surveillance plans and diseases related to AMR in One Health addressing this complex problem.