1 What is the environment and why is it important for AMR?

The environment is the space in which we live. It consists of different compartments – broadly speaking, water, soil and air – all harbouring and/or transmitting many microbes (Figure 1).

Bacteria are found everywhere in the natural environment: for example, it is estimated that there are more than 10,000 different bacterial species in 1 gram of soil (Torsvik, Øvreås and Thingstad, 2002). Bacteria are critical for life on Earth and, fortunately, the great majority of them are not pathogenic and not resistant to clinically relevant antibiotics.

When considering ‘the environment’, you can also think of the built environment, including objects such as furniture, fabrics, books and so on. These objects can transmit disease by harbouring bacteria deposited by an infected person and subsequently touched by an uninfected person who thereby becomes contaminated. Such objects are called fomites. (Although fomites are important in disease transmission, you won’t consider them further in this course, which focuses on the natural environment.)