TY - JOUR
T1 - Global monitoring of antimicrobial resistance based on metagenomics analyses of urban sewage
AU - Hendriksen, Rene S.
AU - Munk, Patrick
AU - Njage, Patrick
AU - Van Bunnik, Bram
AU - Mcnally, Luke
AU - Lukjancenko, Oksana
AU - Röder, Timo
AU - Nieuwenhuijse, David
AU - Pedersen, Susanne Karlsmose
AU - Kjeldgaard, Jette
AU - Kaas, Rolf S.
AU - Clausen, Philip Thomas Lanken Conradsen
AU - Vogt, Josef Korbinian
AU - Leekitcharoenphon, Pimlapas
AU - Van De Schans, Milou G.M.
AU - Zuidema, Tina
AU - De Roda Husman, Ana Maria
AU - Rasmussen, Simon
AU - Petersen, Bent
AU - Amid, Clara
AU - Cochrane, Guy
AU - Sicheritz-ponten, Thomas
AU - Schmitt, Heike
AU - Alvarez, Jorge Raul Matheu
AU - Aidara-kane, Awa
AU - Pamp, Sünje J.
AU - Lund, Ole
AU - Hald, Tine
AU - Woolhouse, Mark
AU - Koopmans, Marion P.
AU - Vigre, Håkan
AU - Petersen, Thomas Nordahl
AU - Aarestrup, Frank M.
PY - 2019/3/8
Y1 - 2019/3/8
N2 - 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 meta-genomic 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.
AB - 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 meta-genomic 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.
U2 - 10.1038/s41467-019-08853-3
DO - 10.1038/s41467-019-08853-3
M3 - Article
SN - 2041-1723
VL - 10
JO - Nature Communications
JF - Nature Communications
IS - 1
M1 - 1124
ER -