Distribution, transmission, and control of antimicrobial resistance genes

Abstract

Introduction. Antimicrobial resistance (AMR) poses a growing global health threat, largely driven by the widespread presence and dissemination of antimicrobial resistance genes (ARGs). These genes are found across diverse settings from clinical, agricultural to natural ecosystems, enabling bacteria to survive antibiotic treatment. Their spread occurs through vertical inheritance and horizontal gene transfer, mediated by mobile genetic elements such as plasmids, transposons, and integrons. The complex dissemination of ARGs across environmental and biological networks presents a major challenge for containment. This review explores the distribution and transmission mechanisms of ARGs and examines current strategies for their monitoring and control. A thorough understanding of these mechanisms is essential for developing effective interventions against AMR and protecting public health. Purpose of the study. This study aimed to characterize the genes involved in antimicrobial resistance, analyze their transmission mechanisms, and describe control strategies for limiting their spread. Material and methods. This descriptive and analytical study reviewed recent English and Romanian publications on AMR genes, transmission, and control. Article selection from open-access databases was based on keywords like "genes", "antimicrobial resistance", "antibiotics" and "control strategies". Results. ARGs are detected across a wide range of ecosystems, including hospital environments, soils, aquatic systems, and animal products. The excessive use of antibiotics in human medicine and agriculture exerts a selective pressure that favors resistant strains and facilitates the horizontal transfer of resistance. Advances in molecular diagnostics and global surveillance have significantly improved the detection and monitoring of ARGs. However, substantial gaps remain, particularly in developing countries and non-human environments, highlighting the need for expanded surveillance and more inclusive strategies. Conclusions. A comprehensive understanding of ARG dissemination is critical for developing effective antimicrobial resistance control strategies. An integrated approach, involving enhanced surveillance, rational antibiotic use, and environmental management is essential to sustain antimicrobial efficacy and protect public health. This review highlights the cross-sectoral nature of AMR, reinforcing the need for an integrated One Health surveillance to track and control the spread of clinically relevant resistance genes.