Assessing Antimicrobial Resistance Connectivity Across One Health Sectors
A multinational research team led by Professor Tong Zhang from the Department of Civil Engineering, Faculty of Engineering at The University of Hong Kong (HKU Engineering), in collaboration with an international team, has developed a new framework to assess and track antimicrobial resistance (AMR) connectivity across human, animal, and environmental sectors. The study systematically examines the connectivity of AMR and proposes an assessment framework along with mitigation strategies.
Antimicrobial resistance (AMR), the ability of bacteria and other microbes to withstand antibiotics, is one of the most pressing global health challenges of this century, associated with an estimated 4.95 million deaths annually. If left unaddressed, AMR will reduce global life expectancy and impose immense healthcare and socioeconomic burdens.
Addressing AMR requires a One Health approach that integrates human, animal, and environmental health. World Health Organization (WHO), Food and Agriculture Organization (FAO), World Organisation for Animal Health (WOAH), and United Nations Environment Programme (UNEP), or called the Quadripartite, have established a research agenda covering transmission, integrated surveillance, interventions, behavioural change, and policy.
Understanding the Roots of AMR
The fundamental drivers of AMR are genes, which are called antimicrobial resistance genes (ARGs) that allow bacteria to survive antibiotics. Over decades, the widespread use of antibiotics has increased these genes, helping resistant bacteria to emerge and spread across different sectors.
While many countries agree that tackling AMR requires a One Health framework, implementing effective monitoring and control remains challenging, especially in low- and middle-income regions with limited resources.
A New Way to Measure AMR Spread
The study, published in the international journal Nature Water and led by Professor Zhang, represents a vital step toward more effective global efforts to combat antimicrobial resistance—a challenge that threatens health, food security, and sustainable development worldwide.
This study is the first to define "AMR connectivity" and establish a multi-level assessment framework covering ecological, microbial, and genetic dimensions. It examines transmission pathways and drivers across key habitats such as the gut, wastewater, soil, and air, emphasising that understanding cross-sector connectivity is essential for effective AMR management.
The research team compared various scientific methods to detect and analyse AMR. They highlighted metagenomics, a technique that studies all genetic material in a sample, as a cost-effective and mature tool for large-scale cross-sector monitoring. They also recommended using Escherichia coli (E. coli), a common bacteria, as an initial indicator for tracking AMR spread because it's well-studied and easy to test.
Implications for Global Action
This research provides a clear roadmap for scientists and policymakers to better understand and monitor how antimicrobial resistance moves across different environments and sectors. By establishing standardised methods and baseline measurements, it supports the development of integrated strategies to reduce AMR transmission worldwide.
Link to paper:
Assessing Antimicrobial Resistance Connectivity Across One Health Sectors
https://www.nature.com/articles/s44221-025-00514-8
About Professor Tong Zhang
Professor Tong Zhang leads the Environmental Microbiome Engineering and Biotechnology Laboratory at the Department of Civil Engineering of Faculty of Engineering at HKU. His research focuses on the "environmental microbiome." He has conducted pioneering work on the emerging topic of the "Environmental Dimension of Antibiotic Resistance" in the microbiome field and developed the COVID-19 sewage surveillance system in Hong Kong.
