Gain and loss of antibiotic resistant genes in multidrug resistant bacteria: One Health perspective

Misung Kim, Jaeeun Park, Mingyeong Kang, Jihye Yang, Woojun Park

Research output: Contribution to journalReview articlepeer-review

24 Citations (Scopus)


The emergence of multidrug resistance (MDR) has become a global health threat due to the increasing unnecessary use of antibiotics. Multidrug resistant bacteria occur mainly by accumulating resistance genes on mobile genetic elements (MGEs), made possible by horizontal gene transfer (HGT). Humans and animal guts along with natural and engineered environments such as wastewater treatment plants and manured soils have proven to be the major reservoirs and hotspots of spreading antibiotic resistance genes (ARGs). As those environments support the dissemination of MGEs through the complex interactions that take place at the human-animal-environment interfaces, a growing One Health challenge is for multiple sectors to communicate and work together to prevent the emergence and spread of MDR bacteria. However, maintenance of ARGs in a bacterial chromosome and/or plasmids in the environments might place energy burdens on bacterial fitness in the absence of antibiotics, and those unnecessary ARGs could eventually be lost. This review highlights and summarizes the current investigations into the gain and loss of ARG genes in MDR bacteria among human-animal-environment interfaces. We also suggest alternative treatments such as combinatory therapies or sequential use of different classes of antibiotics/adjuvants, treatment with enzyme-inhibitors, and phage therapy with antibiotics to solve the MDR problem from the perspective of One Health issues.

Original languageEnglish
Pages (from-to)535-545
Number of pages11
JournalJournal of Microbiology
Issue number6
Publication statusPublished - 2021 Jun

Bibliographical note

Funding Information:
This work was supported by the National Research Foundation of Korea (NRF) Grant (NRF-2020M3A9H5104237).

Publisher Copyright:
© 2021, The Microbiological Society of Korea.


  • antibiotic resistance genes
  • co-selection
  • cross resistance
  • horizontal gene transfer
  • multidrug resistance

ASJC Scopus subject areas

  • Microbiology
  • Applied Microbiology and Biotechnology


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