The emergence of multidrug resistance (MDR) has become
a global health threat due to the increasing unnecessary use
of antibiotics. Multidrug resistant bacteria occur mainly by
accumulating resistance genes on mobile genetic elements
(MGEs), made possible by horizontal gene transfer (HGT).
Humans and animal guts along with natural and engineered
environments such as wastewater treatment plants and manured
soils have proven to be the major reservoirs and hotspots
of spreading antibiotic resistance genes (ARGs). As those
environments support the dissemination of MGEs through
the complex interactions that take place at the human-animalenvironment
interfaces, a growing One Health challenge is
for multiple sectors to communicate and work together to
prevent the emergence and spread of MDR bacteria. However,
maintenance of ARGs in a bacterial chromosome and/or
plasmids in the environments might place energy burdens
on bacterial fitness in the absence of antibiotics, and those
unnecessary ARGs could eventually be lost. This review highlights
and summarizes the current investigations into the gain
and loss of ARG genes in MDR bacteria among human-animal-
environment interfaces. We also suggest alternative treatments
such as combinatory therapies or sequential use of different
classes of antibiotics/adjuvants, treatment with enzymeinhibitors,
and phage therapy with antibiotics to solve the
MDR problem from the perspective of One Health issues.
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