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 a One Earth-One Health (OE-OH) concept was proposed for addressing this challenge in 2024. To elucidate and refine this concept, here a dual mutation pattern was put forward for bacterial resistance adhering to the principle of parsimony, integrating Lamarckian, Darwinian, and Niche construction theories. Subsequently, its theoretical foundation was clarified, together with a fundamental mathematical model for antibiotic resistance genes (ARGs) within ecosystems, based on the robust self-regulation and perpetual reconstruction of ecosystems. From this concept, it deduced that ABR and ARGs emerge 3.5 billion years ago and are ubiquitous across the globe prior to antibiotic use. For better understanding this concept, the self-regulation of the Earth's ecosystem on the generation, dissemination, and elimination of ABR and ARGs was sorted out and elucidated. Finally, several crucial measures are proposed for addressing the concern transcending this regulation due to antibiotic overuse, emphasizing the key role of utilizing the self-regulation of ecosystems.