From what I understand, the prevalence of antibiotic resistance outside the clinic is likely due to two factors. One, that antibiotic usage is so widespread out side the clinical environment that the levels of antibiotics used in agriculture and home treatments leach into the environment. Thus environmental antibiotic resistance is a biproduct of massive human use. The second argument is that the evolution of antibiotics and resistance are common among the microbial world. Likely mechanisms for such evolution is a way of protecting or communicating biofilms of bacteria from other microbial challenges. Both arguments have their validity however scientists are only starting to understand the mechanisms behind ecological antibiotic resistance.
One of the coolest examples of antibiotic resistance (in my opinion) is the common trend among cave dwelling bacteria that are supposedly isolated from human antibiotic use: http://news.nationalgeographic.com/news/2012/04/120411-drug-resistance-bacteria-caves-diseases-human-health-science/
Hope this answers your question.
Thanks for the answer, but I was more thinking along the lines of environments such as soil and water and actual in vitro testing, like MICs and breakpoints.
based on my own study there are some ways
first of all, tons of hospital waste are being depleted in nature specially in rivers in vicinity,whereas in non-developed countries where people are deprived from hygiene and potable water, the resistant bacteria can easily enter their digestive system through drinking the contaminated water,as second factor, the over-use of Antibiotics can lead to intestinal bacteria resistance that could be transmitted through fecal way,in one of my studies in burnt patients care unit in Urmia hospital of Azerbaijan of Iran, I detected very high resistant bacteria which were resistant to more than 25 antibiotics, these bacteria were spread from the toilets to other units,I believe that the nosocomial infections increase from this way,but there should be more studies to confirm the route of spreading
hope this could be helpful
And I agree the Robert Brucker's answer
In hospital environment the resistance in the antibiotic is developed in the microorganisms due to their continuous exposure to the antibiotics due to which the microorganisms combat the antibiotic due to the production of certain enzymes to breakdown antibiotics to inactive form. Also certain bacteria which become or are antibiotic resistance is mainly due to the presence of plasmids/integrons or even transposons, and it is passed to the other bacteria in the same environment.
Therefore, continuous exposure to antibiotics can develop antibiotics resistance in the population also bacteria with plasmids can pass the plasmids to antibiotic sensitive bacteria and can also acquire multiple plasmids from other resistant bacteria to become resistance to other drugs/antibiotics. The same is in case of environment. like soil or water.
Very difficult one: antibiogram typing method may be usefull: wherein antibiogram of the environmental isolates are compared with that of hospital isolate: this is for epidemiological and for source finding. further specific markers are there for antibiotic group resistance like the beta lactamase, carbapenemase etc.,
Fiona, you asked the question a year ago. May be you are still interested in some more opinion. We have a good proof of accumulated resistance to tetracycline in Xanthomonas campestris population at South of Russia after its use (illegally) on cabbage. The second evidence came from Fitolavin-300 (non-purified dried Streptomyces sp. antibiotic mix) application against Agrobacteria. Resistant isolates were obtained after one season of rose plants treatment and they had resistance to 7 of 10 tested medic antibiotics comparing to 2-3 of 10 for strains obtained before plant protection.
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