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To analyse the evidence for increases in <jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content> in the natural environment associated with these point sources of <jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ARG<\/jats:styled-content>, we conducted a systematic review. We evaluated 5,247 records retrieved through database searches, including both studies that ascertained <jats:styled-content style=\"fixed-case\">ARG<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content> outcomes. All studies were subjected to a screening process to assess relevance to the question and methodology to address our review question. A risk of bias assessment was conducted upon the final pool of studies included in the review. This article summarizes the evidence only for those studies with <jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content> outcomes (<jats:italic>n<\/jats:italic>\u00a0=\u00a047). Thirty\u2010five studies were at high (<jats:italic>n<\/jats:italic>\u00a0=\u00a011) or at unclear (<jats:italic>n<\/jats:italic>\u00a0=\u00a024) risk of bias in the estimation of source effects due to lack of information and\/or failure to control for confounders. Statistical analysis was used in ten studies, of which one assessed the effect of multiple sources using modelling approaches; none reported effect measures. Most studies reported higher <jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content> prevalence or concentration downstream\/near the source. However, this evidence was primarily descriptive and it could not be concluded that there is a clear impact of point sources on increases in <jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content> in the environment. To quantify increases in <jats:styled-content style=\"fixed-case\">ARB<\/jats:styled-content> in the environment due to specific point sources, there is a need for studies that stress study design, control of biases and analytical tools to provide effect measure estimates.<\/jats:p>","DOI":"10.1111\/zph.12426","type":"journal-article","created":{"date-parts":[[2017,12,5]],"date-time":"2017-12-05T12:00:34Z","timestamp":1512475234000},"source":"Crossref","is-referenced-by-count":47,"title":["Systematic Review: Impact of point sources on antibiotic\u2010resistant bacteria in the natural environment"],"prefix":"10.1111","volume":"65","author":[{"given":"I.","family":"Bueno","sequence":"first","affiliation":[{"name":"Department of Veterinary Population Medicine University of Minnesota  St. Paul MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Williams\u2010Nguyen","sequence":"additional","affiliation":[{"name":"Department of Veterinary and Biomedical Sciences University of Minnesota  St. Paul MN USA"},{"name":"Department of Epidemiology University of Washington  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Division of Environmental Health Sciences School of Public Health University of Minnesota  Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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