101 One Health with Natacha Couto and Ed Feil

The hosts of the MicroBinfie podcast invite Dr Natacha Couto (University of Oxford) and Professor Ed Feil (University of Bath) as special guests to discuss the concept of "One Health". One Health is a comprehensive approach that seeks to manage the problem of antimicrobial resistance (AMR) by addressing the use of antibiotics in healthcare, agriculture, and the environment. It aims to improve health outcomes across all sectors to create a better planet. However, the diagrams often used to represent One Health are misleading as they do not take into account the complexity of the transmission of AMR. Therefore, there is a need for a quantitative study to understand and identify the ecological and biological barriers to AMR transmission. Visual aids such as these diagrams are not always accurate and should be approached with caution; scientists should be mindful of the implicit confirmation bias in visually-appealing graphics. AMR determinants are found in various settings, including animals, the environment, and humans, due to the derived nature of most antibiotics from natural compounds on Earth. Studies have shown that the presence of AMR determinants is not limited to hospitals; they can be found in the environment and surroundings of hospitals. However, they caution that sampling methods can skew results, and it is essential to use a quantitative approach to understand the transmission of AMR across different sectors. The One Health approach requires understanding the drivers of resistance and virulence and looking beyond human pathogens. Plants, insects, and animals form part of the broader virome and represent systems that are harder to study. There is no clear answer on where to focus resources as both resistant and commensal strains can be important to study. Context is essential when it comes to virulence as the consensual bacteria can become dangerous pathogens in certain situations. They note that environmental factors play a significant role in disease outbreaks, and understanding the habits of hosts like deer or pheasants, on whom ticks feed on, is crucial. Approaches like outbreak analysis that work in hospitals cannot be used in environmental settings. Disease cannot be studied as if it occurs in a vacuum. Covid-19 has shown how host switches can have severe consequences, but spillover events usually fizzle out before causing any harm. Understanding environmental factors like habitat changes may help tackle disease outbreaks better in the future. While tools like sequencing and analysis may be equivalent, questions investigated in different settings are vastly different. It is essential to comprehensively understand social science factors such as people's compliance level and risk perception when studying transmission in human communities. In conclusion, the issue of antimicrobial resistance is complex and requires a multidimensional approach involving different perspectives and fields of study.