Antimicrobial resistance from the One Health perspective. The environment in the equation.

Antimicrobial resistance (AMR) is a global problem that causes great concern to health and scientific authorities and compromises the use of antimicrobial agents in the treatment of infectious diseases. This problem needs to be addressed from the One Health perspective in which human, animal and environmental health are interconnected. Information about the relevance of the environment in this context has been increasingly reported in the last years. The group of Antimicrobial Resistance from de One Health perspective (OneHealth-UR) has analyzed AMR in different environmental niches as is the case of wastewater-treatment plants (WWTP) and wildlife animals, as storks and wild rabbits, among others. Two WWTPs of La Rioja have been followed (influent, effluent, sludges and receiving river at upstream and downstream points) using different technologies, with special emphasis in the dissemination of Extended-Spectrum-beta-Lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae isolates (ESBL-Ec/Kp) and carbapenemase-producing Enterobacterales (CP-E), and results will be shown as well as the comparative analysis with clinical isolates in the surrounding hospital. Moreover, the occurrence of critical mechanisms of resistance linked to ESBL-Ec/Kp and CP-E in wild birds or mecC-mediated methicillin-resistant Staphylococcus aureus in wild rabbits will be also reported through results obtained in our group in comparison with those of other groups. All these data will allow to increase our knowledge about the relevance of the environment as a crucial link in the study of AMR at global level, to adopt the adequate decisions to manage and control the AMR crisis.