{"id":"https://openalex.org/W7172404501","doi":"https://doi.org/10.1186/s12879-026-14138-0","title":"Environmental antimicrobial resistance and human infectious disease outcomes: a global one health systematic review and meta-analysis of observational studies","display_name":"Environmental antimicrobial resistance and human infectious disease outcomes: a global one health systematic review and meta-analysis of observational studies","publication_year":2026,"publication_date":"2026-08-04","ids":{"openalex":"https://openalex.org/W7172404501","doi":"https://doi.org/10.1186/s12879-026-14138-0","pmid":"https://pubmed.ncbi.nlm.nih.gov/42972506","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13729314"},"language":"en","primary_location":{"id":"doi:10.1186/s12879-026-14138-0","doi":"https://doi.org/10.1186/s12879-026-14138-0","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12879-026-14138-0","pdf_url":null,"source":{"id":"https://openalex.org/S171015910","display_name":"BMC Infectious Diseases","issn_l":"1471-2334","issn":["1471-2334"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Infectious Diseases","raw_type":"journal-article"},"volume":null,"type":"review","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1186/s12879-026-14138-0","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5029542238","display_name":"Gebre Ayanaw Alula","orcid":"https://orcid.org/0009-0000-4439-6279","observed_orcids":["https://orcid.org/0009-0000-4439-6279"]},"institutions":[{"id":"https://openalex.org/I4210124803","display_name":"Debark University","ror":"https://ror.org/034yc4v31","country_code":"ET","type":"education","lineage":["https://openalex.org/I4210124803"]}],"countries":["ET"],"is_corresponding":true,"raw_author_name":"Gebre Ayanaw Alula","raw_affiliation_strings":["Department of Biology, College of Natural and Computational Science, Debark University, Debark, Ethiopia. ayanawgebre@gmail.com"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Biology, College of Natural and Computational Science, Debark University, Debark, Ethiopia. ayanawgebre@gmail.com","institution_ids":["https://openalex.org/I4210124803"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5095737747","display_name":"Shegasew Tesema","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210124803","display_name":"Debark University","ror":"https://ror.org/034yc4v31","country_code":"ET","type":"education","lineage":["https://openalex.org/I4210124803"]}],"countries":["ET"],"is_corresponding":false,"raw_author_name":"Shegasew Tessema","raw_affiliation_strings":["Department of Sport Science, College of Natural and Computational Science, Debark University, Debark, Ethiopia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Sport Science, College of Natural and Computational Science, Debark University, Debark, Ethiopia","institution_ids":["https://openalex.org/I4210124803"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5029542238"],"corresponding_institution_ids":["https://openalex.org/I4210124803"],"apc_list":{"value":3090,"currency":"USD","value_usd":3090},"apc_paid":{"value":3090,"currency":"USD","value_usd":3090},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.225,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"26","issue":"1","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10419","display_name":"Pharmaceutical and Antibiotic Environmental Impacts","score":0.9312000274658203,"subfield":{"id":"https://openalex.org/subfields/2310","display_name":"Pollution"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T10419","display_name":"Pharmaceutical and Antibiotic Environmental Impacts","score":0.9312000274658203,"subfield":{"id":"https://openalex.org/subfields/2310","display_name":"Pollution"},"field":{"id":"https://openalex.org/fields/23","display_name":"Environmental Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T10897","display_name":"Antibiotic Use and Resistance","score":0.06669999659061432,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10147","display_name":"Antibiotic Resistance in Bacteria","score":0.0006000000284984708,"subfield":{"id":"https://openalex.org/subfields/2726","display_name":"Microbiology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/one-health","display_name":"One Health","score":0.9549999833106995},{"id":"https://openalex.org/keywords/environmental-contamination","display_name":"environmental contamination","score":0.675000011920929},{"id":"https://openalex.org/keywords/wastewater","display_name":"wastewater","score":0.8119999766349792},{"id":"https://openalex.org/keywords/low-and-middle-income-countries","display_name":"low- and middle-income countries","score":0.9430000185966492},{"id":"https://openalex.org/keywords/antimicrobial-resistance-control","display_name":"antimicrobial resistance control","score":0.8109999895095825}],"concepts":[{"id":"https://openalex.org/C23131810","wikidata":"https://www.wikidata.org/wiki/Q818574","display_name":"Observational study","level":2,"score":0.7702999711036682},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7360000014305115},{"id":"https://openalex.org/C190139176","wikidata":"https://www.wikidata.org/wiki/Q598976","display_name":"Medical microbiology","level":2,"score":0.732200026512146},{"id":"https://openalex.org/C524204448","wikidata":"https://www.wikidata.org/wiki/Q788926","display_name":"Infectious disease (medical specialty)","level":3,"score":0.7045999765396118},{"id":"https://openalex.org/C94665300","wikidata":"https://www.wikidata.org/wiki/Q63391344","display_name":"Antibiotic resistance","level":3,"score":0.592199981212616},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.5317000150680542},{"id":"https://openalex.org/C189708586","wikidata":"https://www.wikidata.org/wiki/Q1504425","display_name":"Systematic review","level":3,"score":0.5077000260353088},{"id":"https://openalex.org/C185032368","wikidata":"https://www.wikidata.org/wiki/Q1365243","display_name":"Tropical medicine","level":2,"score":0.45019999146461487},{"id":"https://openalex.org/C4937899","wikidata":"https://www.wikidata.org/wiki/Q68541106","display_name":"Antimicrobial","level":2,"score":0.43950000405311584},{"id":"https://openalex.org/C190612196","wikidata":"https://www.wikidata.org/wiki/Q180502","display_name":"Parasitology","level":2,"score":0.41780000925064087},{"id":"https://openalex.org/C114851261","wikidata":"https://www.wikidata.org/wiki/Q12147416","display_name":"Drug resistance","level":2,"score":0.4156000018119812},{"id":"https://openalex.org/C2987857752","wikidata":"https://www.wikidata.org/wiki/Q12147","display_name":"Human health","level":2,"score":0.4043999910354614},{"id":"https://openalex.org/C2909960733","wikidata":"https://www.wikidata.org/wiki/Q68541106","display_name":"Antimicrobial drug","level":3,"score":0.4025000035762787},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.39899998903274536},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.36250001192092896},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.3513000011444092},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.3488999903202057},{"id":"https://openalex.org/C46578552","wikidata":"https://www.wikidata.org/wiki/Q2725393","display_name":"Global health","level":3,"score":0.34450000524520874},{"id":"https://openalex.org/C95190672","wikidata":"https://www.wikidata.org/wiki/Q815382","display_name":"Meta-analysis","level":2,"score":0.33230000734329224},{"id":"https://openalex.org/C2780120632","wikidata":"https://www.wikidata.org/wiki/Q7092706","display_name":"One Health","level":3,"score":0.3310000002384186},{"id":"https://openalex.org/C2988867146","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Human disease","level":3,"score":0.3206999897956848},{"id":"https://openalex.org/C2779973787","wikidata":"https://www.wikidata.org/wiki/Q609748","display_name":"Emerging infectious disease","level":3,"score":0.3172000050544739},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.2946999967098236},{"id":"https://openalex.org/C204787440","wikidata":"https://www.wikidata.org/wiki/Q188504","display_name":"Alternative medicine","level":2,"score":0.28369998931884766},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.2768000066280365},{"id":"https://openalex.org/C3018263421","wikidata":"https://www.wikidata.org/wiki/Q80083","display_name":"Human studies","level":2,"score":0.2581999897956848},{"id":"https://openalex.org/C2908569021","wikidata":"https://www.wikidata.org/wiki/Q2896740","display_name":"Anti-Infective Agents","level":3,"score":0.2535000145435333},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.2500999867916107}],"mesh":[{"descriptor_ui":"D000074823","descriptor_name":"One Health","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000900","descriptor_name":"Anti-Bacterial Agents","qualifier_ui":"Q000494","qualifier_name":"pharmacology","is_major_topic":true},{"descriptor_ui":"D003141","descriptor_name":"Communicable Diseases","qualifier_ui":"Q000382","qualifier_name":"microbiology","is_major_topic":true},{"descriptor_ui":"D003141","descriptor_name":"Communicable Diseases","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":true},{"descriptor_ui":"D004781","descriptor_name":"Environmental Exposure","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014943","descriptor_name":"Global Health","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D024881","descriptor_name":"Drug Resistance, Bacterial","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D064887","descriptor_name":"Observational Studies as Topic","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":3,"locations":[{"id":"doi:10.1186/s12879-026-14138-0","doi":"https://doi.org/10.1186/s12879-026-14138-0","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12879-026-14138-0","pdf_url":null,"source":{"id":"https://openalex.org/S171015910","display_name":"BMC Infectious Diseases","issn_l":"1471-2334","issn":["1471-2334"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Infectious Diseases","raw_type":"journal-article"},{"id":"pmid:42972506","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42972506","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC infectious diseases","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13729314","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13729314/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Infect Dis","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1186/s12879-026-14138-0","doi":"https://doi.org/10.1186/s12879-026-14138-0","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12879-026-14138-0","pdf_url":null,"source":{"id":"https://openalex.org/S171015910","display_name":"BMC Infectious Diseases","issn_l":"1471-2334","issn":["1471-2334"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","dongbi-d","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Infectious Diseases","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/systematic-review","display_name":"Systematic Review"},{"id":"https://openalex.org/study-designs/meta-analysis","display_name":"Meta-Analysis"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":30,"referenced_works":["https://openalex.org/W71228264","https://openalex.org/W1561012968","https://openalex.org/W1966542916","https://openalex.org/W1982479612","https://openalex.org/W1992332433","https://openalex.org/W2135417100","https://openalex.org/W2157823046","https://openalex.org/W2207760002","https://openalex.org/W2276210217","https://openalex.org/W2567362164","https://openalex.org/W2755850037","https://openalex.org/W2761178674","https://openalex.org/W3118615836","https://openalex.org/W3159187443","https://openalex.org/W3184260509","https://openalex.org/W4205349564","https://openalex.org/W4206677002","https://openalex.org/W4226089425","https://openalex.org/W4283065808","https://openalex.org/W4366183586","https://openalex.org/W4366827835","https://openalex.org/W4383273076","https://openalex.org/W4389484922","https://openalex.org/W4389623522","https://openalex.org/W4400953970","https://openalex.org/W4401795458","https://openalex.org/W4406270319","https://openalex.org/W4408744847","https://openalex.org/W4415138218","https://openalex.org/W7118129487"],"related_works":["https://openalex.org/W7212147773","https://openalex.org/W7220060416","https://openalex.org/W7214398161","https://openalex.org/W4220847553","https://openalex.org/W4313472307","https://openalex.org/W4376865323","https://openalex.org/W6963002827","https://openalex.org/W3034049132","https://openalex.org/W7221823450","https://openalex.org/W3213409332"],"abstract_inverted_index":{"Environmental":[0],"antimicrobial":[1,253],"resistance":[2,254],"(AMR)":[3],"is":[4],"increasingly":[5],"recognized":[6],"as":[7],"a":[8,66,214],"key":[9],"component":[10],"of":[11,36,88,167],"the":[12,31,54,104,138,150],"global":[13,67],"AMR":[14,58,119,159,211,244],"burden":[15],"and":[16,34,42,60,74,90,110,121,134,149,202,232,246],"may":[17],"be":[18],"associated":[19,163],"with":[20,164,188,206,218],"human":[21,61,122,168,219],"infectious":[22,62,123,169,220],"disease":[23,63,124,170,221],"outcomes":[24,64,125,171,222],"through":[25],"complex":[26],"ecological":[27],"exposure":[28,120,160,212],"pathways.":[29],"However,":[30,226],"overall":[32],"magnitude":[33],"consistency":[35],"this":[37],"relationship":[38],"across":[39,185,223],"environmental":[40,57,118,158,186,210,243,248],"compartments":[41,249],"regions":[43],"remain":[44],"insufficiently":[45],"quantified.":[46],"This":[47],"study":[48],"systematically":[49],"synthesized":[50],"observational":[51,230],"evidence":[52,144],"on":[53],"association":[55,217],"between":[56,108,117],"contamination":[59],"within":[65],"One":[68,251],"Health":[69,252],"framework.":[70],"A":[71],"systematic":[72],"review":[73,105],"meta-analysis":[75],"were":[76,92,106,126,132,197],"conducted":[77],"following":[78],"PRISMA":[79],"2020":[80],"guidelines.":[81],"Major":[82],"databases,":[83],"including":[84],"PubMed/MEDLINE,":[85],"Scopus,":[86],"Web":[87],"Science,":[89],"Embase,":[91],"searched":[93],"from":[94,145],"January":[95],"2000":[96],"to":[97],"March":[98],"2025.":[99,111],"Eligible":[100],"studies":[101,113,136],"included":[102],"in":[103,192,200],"published":[107],"2005":[109],"Observational":[112],"reporting":[114],"quantitative":[115],"associations":[116,196,231],"included.":[127],"In":[128],"total,":[129],"1,842":[130],"records":[131],"identified,":[133],"32":[135],"met":[137],"inclusion":[139],"criteria":[140],"for":[141],"meta-analysis,":[142],"covering":[143],"Asia,":[146],"Europe,":[147],"Africa,":[148],"Americas.":[151],"The":[152,239],"pooled":[153],"random-effects":[154],"analysis":[155],"showed":[156],"that":[157],"was":[161],"significantly":[162],"higher":[165,189],"odds":[166],"(OR":[172],"=":[173],"1.92,":[174],"95%":[175],"CI:":[176],"1.55-2.38;":[177],"p":[178],"<":[179],"0.001).":[180],"Subgroup":[181],"analyses":[182],"indicated":[183],"variation":[184],"compartments,":[187],"estimates":[190],"observed":[191,199],"wastewater-related":[193],"settings.":[194,225],"Stronger":[195],"also":[198],"low-":[201],"middle-income":[203],"countries":[204],"compared":[205],"high-income":[207],"countries.":[208],"Overall,":[209],"shows":[213],"consistent":[215],"positive":[216],"diverse":[224],"these":[227],"findings":[228],"represent":[229],"do":[233],"not":[234],"imply":[235],"direct":[236],"causal":[237],"transmission.":[238],"results":[240],"support":[241],"strengthening":[242],"surveillance":[245],"integrating":[247],"into":[250],"control":[255],"strategies.":[256]},"counts_by_year":[],"updated_date":"2026-11-06T12:05:46.655746","created_date":"2026-08-05T00:00:00"}
