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Environ Int. 2021 Dec 16;159:107047. doi: 10.1016/j.envint.2021.107047. Epub 2021 Dec 16.

Environmental contamination in a high-income country (France) by antibiotics, antibiotic-resistant bacteria, and antibiotic resistance genes: Status and possible causes.

Environment international

Marisa Haenni, Christophe Dagot, Olivier Chesneau, Delphine Bibbal, Jérôme Labanowski, Michèle Vialette, Damien Bouchard, Fabrice Martin-Laurent, Louisiane Calsat, Sylvie Nazaret, Fabienne Petit, Anne-Marie Pourcher, Anne Togola, Morgane Bachelot, Edward Topp, Didier Hocquet


  1. Unité Antibiorésistance et Virulence Bactériennes, ANSES (French Agency for Food, Environmental and Occupational Health & Safety) - Université de Lyon, Lyon, France.
  2. Université of Limoges, RESINFIT, UMR INSERM 1092, CHU, F-87000 Limoges, France.
  3. Collection de l'Institut Pasteur (CIP), Microbiology Department, Institut Pasteur, Paris, France.
  4. INTHERES, Université de Toulouse, INRAE, ENVT, Toulouse, France.
  5. Université de Poitiers, UMR CNRS 7285 IC2MP, ENSI Poitiers, Poitiers, France.
  6. Institut Pasteur de Lille, Lille, France.
  7. National Agency for Veterinary Medicinal Products, ANSES, Fougères, France.
  8. AgroSup Dijon, INRAE, Université Bourgogne Franche-Comté, Agroécologie, Dijon, France.
  9. Risk Assessment Department (DER), ANSES (French Agency for Food, Environmental and Occupational Health & Safety), Maisons-Alfort, France.
  10. Université de Lyon, Université Claude Bernard Lyon 1, UMR CNRS 5557, UMR INRAE 1418, VetAgro Sup, Ecologie Microbienne, F-69622 Villeurbanne, France.
  11. UNIROUEN, UNICAEN, CNRS, M2C, Normandie Université Rouen, France; Sorbonne Université, CNRS, EPHE, PSL, UMR METIS, Paris F-75005, France.
  12. INRAE, OPAALE Research Unit, CS 64427, F-35044 Rennes, France.
  13. BRGM, F-45060 Orléans, France.
  14. ANSES (French Agency for Food, Environmental and Occupational Health & Safety), Maisons-Alfort, France.
  15. Agriculture and Agri-Food Canada, and University of Western Ontario, London, ON, Canada.
  16. UMR Chronoenvironnement CNRS 6249, Université de Bourgogne Franche-Comté, Besançon, France; Hygiène Hospitalière, Centre Hospitalier Universitaire, 25030 Besançon, France. Electronic address: [email protected].

PMID: 34923370 DOI: 10.1016/j.envint.2021.107047


Antimicrobial resistance (AMR) is a major global public health concern, shared by a large number of human and animal health actors. Within the framework of a One Health approach, actions should be implemented in the environmental realm, as well as the human and animal realms. The Government of France commissioned a report to provide policy and decision makers with an evidential basis for recommending or taking future actions to mitigate AMR in the environment. We first examined the mechanisms that underlie the emergence and persistence of antimicrobial resistance in the environment. This report drew up an inventory of the contamination of aquatic and terrestrial environments by AMR and antibiotics, anticipating that the findings will be representative of some other high-income countries. Effluents of wastewater treatment plants were identified as the major source of contamination on French territory, with spreading of organic waste products as a more diffuse and incidental contamination of aquatic environments. A limitation of this review is the heterogeneity of available data in space and time, as well as the lack of data for certain sources. Comparing the French Measured Environmental Concentrations (MECs) with predicted no effect concentrations (PNECs), fluoroquinolones and trimethoprim were identified as representing high and medium risk of favoring the selection of resistant bacteria in treated wastewater and in the most contaminated rivers. All other antibiotic molecules analyzed (erythromycin, clarithromycin, azithromycin, tetracycline) were at low risk of resistance selection in those environments. However, the heterogeneity of the data available impairs their full exploitation. Consequently, we listed indicators to survey AMR and antibiotics in the environment and recommended the harmonization of sampling strategies and endpoints for analyses. Finally, the objectives and methods used for the present work could comprise a useful example for how national authorities of countries sharing common socio-geographic characteristics with France could seek to better understand and define the environmental dimension of AMR in their particular settings.

Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

Keywords: Antibiotic resistance; Aquatic environment; Environmental antibiotic concentrations; One Health; Organic waste product; Terrestrial environment; Wastewater

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