Human Movement and Transmission of Antimicrobial-Resistant Bacteria

Antimicrobial resistance (AMR) is a major issue that poses a serious threat to global health. Recent reports from the World Health Organization (WHO) highlighted the increased threat from continuously emerging AMR organisms, accompanied by the paucity of

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Contents 1 Introduction 2 Travel Promotes the Transmission of Infectious Diseases 3 Transmission Patterns of AMR Bacteria Associated with Planned International Traveling 4 Forcibly Displaced Populations: Figures at a Glance 5 The Global Distribution of the Refugee Population 6 Refugee Living Conditions and the Transmission of Infectious Diseases 6.1 Adequate and Proper Housing 6.2 Water and Sanitation 6.3 Food Safety and Nutrition 6.4 Access to Health Services 6.5 Environmental Factors 7 Natural Disasters and Transmission of Infectious Diseases 8 The Impact of Refugees on the Global Transmission of AMR 9 The Dynamics of AMR Transmission Associated with Refugee Migration 10 The Impact of Refugees on the Transmission of Drug-Resistant Tuberculosis 11 Refugees and Transmission of AMR Enterobacteriaceae Strains

M. Abd El Ghany (*) The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia The Marie Bashir Institute of Infectious Diseases and Biosecurity, The University of Sydney, Sydney, NSW, Australia Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia e-mail: [email protected]; [email protected] N. Fouz The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia G. A. Hill-Cawthorne School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia Celia M. Manaia, Erica Donner, Ivone Vaz-Moreira, and Peiying Hong (eds.), Antibiotic Resistance in the Environment: A Worldwide Overview, Hdb Env Chem, DOI 10.1007/698_2020_560, © Springer Nature Switzerland AG 2020

M. Abd El Ghany et al. 12 13 14

Knowledge Gaps on AMR Transmission Trend Associated with Refugee Migration Hajj-Associated AMR Enteric Infections Pose Serious Threats The Advantage of the Use of One Health Genomics to Tackle the AMR Dissemination Associated with the Refugees’ Displacement 15 Conclusion References

Abstract Antimicrobial resistance (AMR) is a major issue that poses a serious threat to global health. Recent reports from the World Health Organization (WHO) highlighted the increased threat from continuously emerging AMR organisms, accompanied by the paucity of development of new antimicrobial drugs. Low- and middle-income countries are likely to be the most affected, both in terms of the impact on public health and economic burden. Recently there has been increased evidence that the global transmission of AMR pathogens is fueled by AMR carriage associated with human movement, including international travel and forcible displacement. This is alarming, with the United Nations World Tourism Organization (UNWTO) reporting that 1.4 billion people, accounting for 19% of the world’s population, traveled across international borders in 2018. The number of tourists traveling to different destinations across the globe is predicted to increase to 1.8 billion by 2025. However, traveler population is not entirely formed of tourists, but it comprises different categories incl