Global monitoring of antimicrobial resistance based on metagenomics analyses of urban sewage

By R. Hendriksen, P. Munk, P. Njage, Bram A. D. van Bunnik, L. McNally, O. Lukjancenko, Timo Röder, D. Nieuwenhuijse, S. Pedersen, J. Kjeldgaard and 23 more. Nature Communications, 2019

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Antimicrobial resistance (AMR) is a serious threat to global public health, but obtaining representative data on AMR for healthy human populations is difficult. Here, we use metagenomic analysis of untreated sewage to characterize the bacterial resistome from 79 sites in 60 countries. We find systematic differences in abundance and diversity of AMR genes between Europe/North-America/Oceania and Africa/Asia/South-America. Antimicrobial use data and bacterial taxonomy only explains a minor part of the AMR variation that we observe. We find no evidence for cross-selection between antimicrobial classes, or for effect of air travel between sites. However, AMR gene abundance strongly correlates with socio-economic, health and environmental factors, which we use to predict AMR gene abundances in all countries in the world. Our findings suggest that global AMR gene diversity and abundance vary by region, and that improving sanitation and health could potentially limit the global burden of AMR. We propose metagenomic analysis of sewage as an ethically acceptable and economically feasible approach for continuous global surveillance and prediction of AMR. Obtaining data on antimicrobial resistance (AMR) from healthy human populations is difficult. Here, Hendriksen et al. use metagenomic analysis to obtain AMR data from untreated sewage from 79 sites in 60 countries, finding correlations with socio-economic, health and environmental factors.

Subfields: Applied Microbiology and Biotechnology, Molecular Medicine, Pollution

View Paper: https://www.semanticscholar.org/paper/0d95983c96aea9f149474d197ad491139d1f4478

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• A review of the global climate change impacts, adaptation, and sustainable mitigation measures (2022, background): “This problem has been reported manifold in several countries (Hendriksen et al. 2019), where wastewater as a means of irrigated water is quite common.”