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How effective are strategies to control the dissemination of antibiotic resistance in the environment? A systematic review

Goulas A., Belhadi D., Descamps A., Andremont A., Benoit P., Courtois S., Dagot C., Grall N., Makowski D., Nazaret S., Nelieu S., Patureau D., Petit F., Roose-Amsaleg C., Vittecoq M., Livoreil B., Laouénan C.. 2020. Environmental Evidence, 9 : 32 p..

DOI: 10.1186/s13750-020-0187-x

Background: Antibiotic resistance is a major concern for public and environmental health. The role played by the environment in disseminating resistance is increasingly considered, as well as its capacity for mitigation. We reviewed the literature on strategies to control dissemination of antibiotic-resistant bacteria (ARB), antibiotic resistance genes (ARG) and mobile genetic elements (MGE) in the environment. Methods: This systematic review focused on three main strategies: (i) restriction of antibiotic use (S1), (ii) treatments of liquid/solid matrices (S2) and (iii) management of natural environment (S3). Articles were collected from seven scientific databases until July 2017 and from Web of Science until June 2018. Only studies reporting measurements of ARB, ARG or MGE in environmental samples were included. An evidence map was drawn from metadata extracted from all studies eligible for S1, S2 and S3. Subsets of studies were assessed for internal and external validity to perform narrative and quantitative syntheses. A meta-analysis was carried out to assess the effects of organic waste treatments (random-effect models). Review findings: Nine hundred and thirty-one articles representing 1316 individual studies (n) were eligible for S1 (n¿=¿59), S2 (n¿=¿781) and S3 (n¿=¿476) strategies, respectively. Effects of interventions to control the dissemination of antibiotic resistance in the environment were primarily studied in strategy S2. A partial efficiency of wastewater treatment plants (WWTPs) to reduce antibiotic resistance in treated effluent was reported in 118 high validity studies. In spite of the heterogeneity in published results, the meta-analysis showed that composting and drying were efficient treatments to reduce the relative abundance of ARG and MGE in organic waste, by 84% [65%; 93%] and 98% [80%; 100%], respectively. The effect of anaerobic digestion was not statistically significant (51% reduction [-¿2%; 77%]) when organic waste treatments were com

Mots-clés : traitement des déchets; résistance aux antibiotiques; antibiotique; déchet organique

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