Mapping the evidence of the effects of environmental factors on the prevalence of antibiotic resistance in the non-built environment: Protocol for a systematic evidence map

Background: Human, animal, and environmental health are increasingly threatened by the emergence and spread of antibiotic resistance. Inappropriate use of antibiotic treatments commonly contributes to this threat, but it is also becoming apparent that multiple, interconnected environmental factors can play a significant role. Thus, a One Health approach is required for a comprehensive understanding of the environmental dimensions of antibiotic resistance and inform science-based decisions and actions. The broad and multidisciplinary nature of the problem poses several open questions drawing upon a wide heterogeneous range of studies. Objective: This study seeks to collect and catalogue the evidence of the potential effects of environmental factors on the abundance or detection of antibiotic resistance determinants in the outdoor environment, i.e., antibiotic resistant bacteria and mobile genetic elements carrying antibiotic resistance genes, and the effect on those caused by local environmental conditions of either natural or anthropogenic origin. Methods: Here, we describe the protocol for a systematic evidence map to address this, which will be performed in adherence to best practice guidelines. We will search the literature from 1990 to present, using the following electronic databases: MEDLINE, Embase, and the Web of Science Core Collection as well as the grey literature. We shall include full-text, scientific articles published in English. Reviewers will work in pairs to screen title, abstract and keywords first and then full-text documents. Data extraction will adhere to a code book purposely designed. Risk of bias assessment will not be conducted as part of this SEM. We will combine tables, graphs, and other suitable visualisation techniques to compile a database i) of studies investigating the factors associated with the prevalence of antibiotic resistance in the environment and ii) map the distribution, network, cross-disciplinarity, impact and trends in the literature.This work was supported by funding from the European Union’s Horizon 2020 Research and Innovation programme under grant agreement No 773830: One Health European Joint Programme. The funder had no role in the development of this protocol.info:eu-repo/semantics/publishedVersio

Factors associated with the prevalence of antibiotic resistance in the environment from a One Health perspective: Protocol for a systematic evidence map

This was developed within the FED-AMR project and is associated with WP6-T1 “Factors influencing the prevalence of antibiotic resistance in the environment”. It describes the protocol for a systematic evidence map of the scientific literature concerning factors associated with the prevalence of antibiotic resistance in the environment. This protocol adheres to the PRISMA-P statement: an established procedure for planning systematic evidence work. A key outcome of this systematic evidence map is to gather data items for future analysis work; potentially, this has application in identifying the main environmental risk factors associated with the presence and transmission of antibiotic resistance. This has important implications concerning risk mitigation for public and animal health