Genomic analysis of sewage from 101 countries reveals global landscape of antimicrobial resistance

Patrick Munk*, Christian Brinch, Frederik Duus Møller, Thomas N. Petersen, Rene S. Hendriksen, Anne Mette Seyfarth, Jette S. Kjeldgaard, Christina Aaby Svendsen, Bram van Bunnik, Fanny Berglund, Sewage Surveillance Consortium Global (Member of author collaboration), D. G. Joakim Larsson, Marion Koopmans, Mark Woolhouse, Frank M. Aarestrup

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Abstract

Antimicrobial resistance (AMR) is a major threat to global health. Understanding the emergence, evolution, and transmission of individual antibiotic resistance genes (ARGs) is essential to develop sustainable strategies combatting this threat. Here, we use metagenomic sequencing to analyse ARGs in 757 sewage samples from 243 cities in 101 countries, collected from 2016 to 2019. We find regional patterns in resistomes, and these differ between subsets corresponding to drug classes and are partly driven by taxonomic variation. The genetic environments of 49 common ARGs are highly diverse, with most common ARGs carried by multiple distinct genomic contexts globally and sometimes on plasmids. Analysis of flanking sequence revealed ARG-specific patterns of dispersal limitation and global transmission. Our data furthermore suggest certain geographies are more prone to transmission events and should receive additional attention.
Original languageEnglish
Article number7251
JournalNature Communications
Volume13
Issue number1
Number of pages16
ISSN2041-1723
DOIs
Publication statusPublished - 2022

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