Antimicrobial resistance (AMR) in rural Latin America is not fully understood. The transmission pathways are partially known since research predominantly focuses on the urban hospital setting. The contribution to AMR from environmental factors is usually only mentioned in large-scale animal production. To understand the state of the literature on AMR in rural LA, we carried out a scoping review using the One Health (OH) perspective. OH recognises the concomitant contributions and interconnectedness of humans, animal, and the environment, thus, we used the OH perspective to select those articles adopting a holistic view of the problem. We searched original articles in English, Spanish, and Portuguese in four peer-reviewed databases and included 21 publications in the analysis. We charted data on bibliometrics, design, data collection sources, and instruments. We identified the human, animal, and environmental contributions to AMR in rural locations, and information gaps on AMR transmission routes and AMR drivers. Intensive and non-intensive animal production systems and agricultural practices were the most frequently found human contributions to AMR. Poultry, swine, cattle, and fish were the most frequent livestock mentioned as sources of AMR bacteria. Animal carriage and/or transfer of AMR determinants or bacteria was recognised as the primary contribution of livestock to the problem, while water, soil, and farming were predominant environmental contributions. We found that only 1 article out of 21 considered the OH approach as a framework for their sampling scheme, whereas 5 out 21 discussed all the three OH components. There were hardly any descriptions of humans or human waste as reservoirs for AMR in rural locations, and rural health centres or hospitals and wildlife were not represented. No studies identified mining as an anthropogenic activity driving AMR. More OH-oriented studies, with emphasis on molecular approaches—for identification and comparison of AMR genes—are sorely needed to understand better the existence of a network of interconnected transmission routes in rural Latin America and provide efficient strategies to prevent further AMR emergence.

中文翻译：

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拉丁美洲农村环境中的抗菌素耐药性：一个健康视角的范围审查

拉丁美洲农村的抗微生物药物耐药性 (AMR) 尚未完全了解。由于研究主要集中在城市医院环境，因此传播途径部分已知。环境因素对 AMR 的贡献通常只在大规模动物生产中提及。为了了解洛杉矶农村 AMR 的文献状况，我们使用 One Health (OH) 视角进行了范围界定审查。OH 认识到人类、动物和环境的伴随贡献和相互联系，因此，我们使用 OH 视角来选择那些采用问题整体观点的文章。我们在四个同行评审数据库中检索了英语、西班牙语和葡萄牙语的原始文章，并在分析中纳入了 21 篇出版物。我们绘制了有关文献计量学、设计、数据收集来源、和仪器。我们确定了农村地区人类、动物和环境对 AMR 的贡献，以及 AMR 传播路线和 AMR 驱动程序的信息差距。集约化和非集约化动物生产系统和农业实践是人类对 AMR 最常见的贡献。家禽、猪、牛和鱼是最常见的作为 AMR 细菌来源的家畜。AMR 决定因素或细菌的动物携带和/或转移被认为是牲畜对该问题的主要贡献，而水、土壤和农业是主要的环境贡献。我们发现 21 篇文章中只有 1 篇将 OH 方法视为其抽样方案的框架，而 21 篇中有 5 篇讨论了所有三个 OH 组件。几乎没有任何关于人类或人类排泄物作为农村地区 AMR 储存库的描述，农村卫生中心或医院和野生动物也没有代表。没有研究将采矿确定为推动 AMR 的人为活动。迫切需要更多以 OH 为导向的研究，重点是分子方法——用于识别和比较 AMR 基因——以更好地了解拉丁美洲农村相互连接的传播路线网络的存在，并提供有效的策略来防止进一步出现 AMR。