Journal article
Global monitoring of antimicrobial resistance based on metagenomics analyses of urban sewage
Research Group for Genomic Epidemiology, National Food Institute, Technical University of Denmark1
World Health Organization2
National Food Institute, Technical University of Denmark3
University of Edinburgh4
Erasmus University Medical Center5
Wageningen University & Research6
National Institute of Public Health and the Environment7
Department of Health Technology, Technical University of Denmark8
European Bioinformatics Institute9
AIMST University10
...and 0 moreAntimicrobial 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.
Language: | English |
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Publisher: | Nature Publishing Group UK |
Year: | 2019 |
Pages: | 1124 |
ISSN: | 20411723 |
Types: | Journal article |
DOI: | 10.1038/s41467-019-08853-3 |
ORCIDs: | Munk, Patrick , 0000-0003-2177-7073 , Rasmussen, Simon , Aarestrup, Frank Møller , Hendriksen, Rene S. , Njage, Patrick Murigu Kamau , Lukjancenko, Oksana , Röder, Timo , Karlsmose Pedersen, Susanne , Kjeldgaard, Jette Sejer , Kaas, Rolf Sommer , Clausen, Philip Thomas Lanken Conradsen , Leekitcharoenphon, Pimlapas , Petersen, Bent , Pamp, Sünje Johanna , Lund, Ole , Hald, Tine , Vigre, Håkan and Petersen, Thomas Nordahl |