Prioritizing the One Health approach in hospitals and veterinary clinics
Hospitals and veterinary clinics harbor distinct microbial communities, so monitoring both is essential to better understand reservoirs of antibiotic resistance and how pathogenic bacteria may spread among humans, animals and their shared environment.
Lay public section
Find here your dedicated section
Sources
This article is based on scientific information
About this article
Antibiotic resistance (or antibiotic resistance) is a major challenge for global public health and human medicine. The “One Health” approach addresses it by bringing together human, animal and environmental health.To better understand the processes involved, researchers1 compared the microbial species, antibiotic resistance genes and plasmids detected in environmental samples—surfaces and wastewater—from a veterinary hospital for companion animals (48 samples) and a human hospital department (36 samples) in London.
One Health :
An integrated, unifying approach that aims to sustainably maintain and optimize the health of human populations, animals and ecosystems. 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 and bacteria 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
Greater richness and lower evenness in hospitals
The results? The two microbial communities prove to be very different. More species, particularly bacteria, were identified in the hospital samples (greater richness). Certain bacterial species dominated the hospital communities, whereas the veterinary samples showed a more uniform distribution (greater evenness). The veterinary microbiome was more diverse in terms of biological kingdoms (89.1% bacteria, 5.7% eukaryotes, 5.15% viruses, 0.1% archaea), whereas the classified sequences in the hospital samples were almost exclusively bacterial.
According to the authors, these differences are not so surprising: hospitals admit more people and use a wider variety of antimicrobials, including different classes of antibiotics, which sustain the dynamism and constant evolution of the bacterial pool and resistant bacteria, while veterinary facilities receive different species (animals and humans), maintaining greater evenness and a broader range of kingdoms.
Human microbiomes: reservoirs of antimicrobial peptides
Resistance genes…
Other differences: at the hospital, the total number of antibiotic resistance genes was higher; in the veterinary setting, genes conferring resistance to common surface disinfectants were ubiquitous. The resistomes of samples from both types of facilities frequently included genes conferring resistance to antibiotics in the β-lactam, aminoglycoside and sulfonamide classes. Hence the importance of strengthening infection prevention in both human and veterinary medicine (to reduce antibiotic use) and infection control when a dangerous resistant strain is detected (disinfection, wastewater management).
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.⁴
2,9 % - 40 % The prevalence of these 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
…and plasmids to spread them
Finally, hospital samples contained more plasmids associated with Enterobacterales, often linked to nosocomial infections and resistant bacteria. These plasmids associated with Enterobacterales are particularly concerning because they are highly mobile (transfer more easily from one bacterium to another) and more likely to carry high-risk antibiotic resistance genes (ARG), including extended-spectrum β-lactamases and carbapenemases.
Veterinary samples, in contrast, contained more plasmids associated with Gram-positive bacteria present in this animal environment. However, both types of plasmids promote the spread of antibiotic resistance in humans, animals or the environment.
The results highlight the importance of monitoring using metagenomic sequencing across different types of human and veterinary healthcare facilities. This integrated One Health approach would help identify reservoirs of antibiotic resistance and associated genes, track their evolution and better characterize potential pathways of spread between human and animal healthcare settings and their surrounding environment.
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.
See also
