Antibiotic resistance: hospitals and veterinary clinics under surveillance
To combat antibiotic resistance, we must address human, animal and environmental health together, as well as the challenges facing human and veterinary medicine. Coordinated monitoring of this resistance may be needed.
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About this article
Antibiotic resistance is a major global public health challenge. It occurs when certain bacteria can withstand the effects of one or more antibiotics. To better understand how this resistance can spread between bacteria, researchers1 have adopted a “One Health” approach, which recognizes the close links between environmental health and human and animal health. Microorganisms, including certain bacteria, are part of our everyday lives: some studies have shown that, in some cases, tap water or shower water can carry pathogens, that clouds can carry antibiotic resistance genes, and that our gut microbiota can help combat resistance.
An integrated, unifying approach that aims to sustainably maintain and optimize the health of human populations, animals and ecosystems associated with both humans and animals. It recognizes that the health of humans, domestic and wild animals, plants and the wider environment (including ecosystems) is closely linked and interdependent.
This approach applies to the design and implementation of programs, policies, legislation and research that bring sectors of human and veterinary medicine together to communicate and collaborate on improving public health outcomes. It is particularly useful for tackling antimicrobial resistance (the emergence of microorganisms resistant to antibiotic treatments). It also helps ensure food and water safety, improve nutrition, control zoonoses (diseases that can be transmitted between animals and humans) and manage pollution.2,3
Different microbial communities
Researchers have therefore examined the microorganisms (particularly bacteria) and antibiotic resistance genes present in the environment (wastewater, surfaces) of a hospital and a veterinary clinic in London. How? Using metagenomic sequencing, a method that directly analyzes all the genetic material in a sample and, therefore, every gene it contains. It is a little like putting the entire contents of a sample into a blender and deciphering all the DNA and the genes associated with resistance.
The results show that the microbial communities in the two facilities are very different. A greater variety of species was found in the hospital, along with a few dominant bacteria (each bacterium contributing to the composition of the microbial community). By contrast, microorganisms were more evenly distributed in the veterinary (animal-related) environment, which harbored not only bacteria but also fungi and viruses. … Of all the dangerous bacteria monitored that could potentially cause an infection, only the bacteria responsible for salmonellosis (Salmonella spp.) and campylobacteriosis (Campylobacter spp.)—two foodborne illnesses—were found in both facilities. Researchers detected these bacteria through their DNA, though they could not establish whether the bacteria were alive.
8,7 % According to a World Health Organization (WHO) report covering 55 hospitals in 14 countries, 8.7% of hospitalized patients had a hospital-acquired infection (nosocomial infection).⁴
2,9 % - 40 % The prevalence of nosocomial infections is estimated at between 2.9% and 5% in Europe and at 5% in North America, while it reached around 40% in some countries in Asia, Latin America and Africa.⁵
Resistance genes… and their “carriers”
Another finding: antibiotic resistance genes were found in both facilities, but with distinct signatures. At the hospital, antibiotic resistance genes considered to pose a high risk to human health were prevalent; in the veterinary setting, genes conferring resistance to common surface disinfectants were ubiquitous.
The researchers also examined plasmids, small pieces of DNA capable of moving from one bacterium to another and carrying one or more genes, particularly antibiotic resistance genes. Once again, the profiles differed: hospital samples contained more types of plasmids associated with bacteria involved in nosocomial infections and capable of carrying antibiotic resistance genes (responsible for antibiotic resistance). Veterinary samples contained more types of plasmids associated with Gram-positive bacteria.
Nosocomial infections or hospital-acquired infections
A significant category of infections in human medicine that are not present in patients before their admission to hospital.
The need for environmental monitoring
The researchers believe that systematic metagenomic sequencing could help identify reservoirs of antibiotic resistance and improve understanding of the risks of its spread between humans, animals and the environment. This is at the very heart of the One Health approach.
1. Elton L, Lutimba S, Mateos AD et al. Comparison of Environmental Microbiomes, Resistomes and Plasmidomes from a Human Tertiary Hospital and Companion Animal Veterinary Hospital in London, UK. Antibiotics (Basel). 2026 Jun 2;15(6):568.
2. https://www.who.int/health-topics/one-health#tab=tab_1
3. https://www.who.int/news-room/questions-and-answers/item/one-health
4. https://iris.who.int/server/api/core/bitstreams/2187e4e5-819d-46e0-a981-61fbd041470a/content
5. Raoofi S, Pashazadeh Kan F, Rafiei S et al. Global prevalence of nosocomial infection: A systematic review and meta-analysis. PLoS One. 2023 Jan 27;18(1):e0274248.
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