One Earth-One Health Concept to Combat Bacterial Resistance Having Dual Mutation Pattern, Based on the Self-Regulation of Ecosystems

Antibiotic resistance (ABR) has emerged as a grave threat to human health, and the One Earth-One Health (OE-OH) concept was proposed for addressing this challenge in 2024. To elucidate and refine this concept, a dual mutation pattern of bacterial resistance was put forward adhering to the principle of parsimony, involving the integration of Lamarckian and Darwinian evolutionary theories, and niche construction theory. Subsequently, the theoretical underpinnings of this concept were clarified based on the self-regulation and perpetual reconstruction of ecosystems, and a fundamental mathematical model was presented for the renewal of antibiotic resistance genes (ARGs) with the evolution of ecosystems. From this concept, it deduced that ABR and ARGs likely emerge 3.5 billion years ago and are now ubiquitous across the globe. Moreover, the self-regulation of the Earth's ecosystem on the generation, dissemination, and elimination of ABR and ARGs, involving various biotic and abiotic factors, was sorted out for enhancing an understanding of this concept. As an external intervention on this self-regulation, the use of antibiotic has been posed a concern transcending the self-regulatory capacity of ecosystems. Thereby, several crucial measures are proposed from the OE-OH concept, emphasizing the key role of utilizing the self-regulation of ecosystems in addressing ABR.