Antimicrobial resistance (AMR) is a public health crisis that is predicted to cause 10 million deaths per year by 2050. The environment has been implicated as a reservoir of AMR and is suggested to play a role in the dissemination of antibiotic resistance genes (ARGs). Currently, most research has focused on measuring concentrations of antibiotics and characterising the abundance and diversity of ARGs and antibiotic resistant bacteria (ARB) in the environment. To date, there has been limited empirical research on whether humans are exposed to this, and whether exposure can lead to measureable impacts on human health. Therefore, the objective of this work is to produce two linked systematic maps to investigate previous research on exposure and transmission of AMR to humans from the environment. The first map will investigate the available research relating to exposure and transmission of ARB/ARGs from the environment to humans on a global scale and the second will investigate the prevalence of ARB/ARGs in various environments in the UK. These two maps will be useful for policy makers and research funders to identify where there are significant gluts and gaps in the current research, and where more primary and synthesis research needs to be undertaken. Separate search strategies will be developed for the two maps. Searches will be run in 13 databases, and grey literature will be sought from key websites and engagement with experts. Hits will be managed in EndNote and screened in two stages (title/abstract then full text) against predefined inclusion criteria. A minimum of 10% will be double screened with ongoing consistency checking. All included studies will have data extracted into a bespoke form designed and piloted for each map. Data to be extracted will include bibliographic details, study design, location, exposure source, exposure route, health outcome (Map 1); and prevalence/percentage of ARB/ARG (Map 2). No validity appraisal will be undertaken. Results will be tabulated and presented narratively, together with graphics showing the types and areas of research that has been undertaken and heatmaps for key exposure-health outcomes (Map 1) and exposure-prevalence (Map 2).

中文翻译：

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抗生素耐药性暴露和环境传播给人类的研究证据是什么？系统地图协议。

抗菌素耐药性 (AMR) 是一场公共卫生危机，预计到 2050 年每年将导致 1000 万人死亡。环境已被认为是 AMR 的储存库，并被认为在抗生素耐药性基因 (ARG) 的传播中发挥作用. 目前，大多数研究都集中在测量抗生素浓度和表征环境中 ARGs 和抗生素耐药细菌 (ARB) 的丰度和多样性。迄今为止，关于人类是否接触到这种物质以及接触是否会对人类健康产生可衡量的影响的实证研究非常有限。因此，这项工作的目的是制作两个相关的系统地图，以调查先前关于 AMR 从环境中向人类暴露和传播的研究。第一张地图将调查与全球范围内 ARB/ARGs 从环境中向人类的暴露和传播相关的现有研究，第二张地图将调查 ARB/ARGs 在英国各种环境中的流行情况。这两张地图将有助于政策制定者和研究资助者确定当前研究中哪些地方存在严重的过剩和差距，以及哪些地方需要进行更多的初级和综合研究。将为这两个地图制定单独的搜索策略。将在 13 个数据库中进行搜索，并将从主要网站和与专家的接触中寻找灰色文献。命中将在 EndNote 中进行管理，并根据预定义的纳入标准分两个阶段（标题/摘要然后全文）进行筛选。至少 10% 将通过持续的一致性检查进行双重筛选。所有纳入的研究都将数据提取到为每张地图设计和试用的定制表格中。要提取的数据将包括书目细节、研究设计、位置、暴露源、暴露途径、健康结果（地图 1）；和 ARB/ARG 的流行率/百分比（图 2）。不进行有效性评估。结果将被制成表格并以叙述方式呈现，连同显示已进行的研究类型和领域的图表以及关键暴露-健康结果（地图 1）和暴露-流行率（地图 2）的热图。不进行有效性评估。结果将被制成表格并以叙述方式呈现，连同显示已进行的研究类型和领域的图表以及关键暴露-健康结果（地图 1）和暴露-流行率（地图 2）的热图。不进行有效性评估。结果将被制成表格并以叙述方式呈现，连同显示已进行的研究类型和领域的图表以及关键暴露-健康结果（地图 1）和暴露-流行率（地图 2）的热图。