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 Murigu Kamau
AU - van Bunnik, Bram
AU - McNally, Luke
AU - Lukjancenko, Oksana
AU - Röder, Timo
AU - Nieuwenhuijse, David
AU - Karlsmose Pedersen, Susanne
AU - Kjeldgaard, Jette Sejer
AU - Kaas, Rolf Sommer
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 - Global, Sewage Surveillance project consortium
AU - Amid, Clara
AU - Cochrane, Guy
AU - Sicheritz-Pontén, Thomas
AU - Schmitt, Heike
AU - Alvarez, Jorge Raul Matheu
AU - Aidara-Kane, Awa
AU - Pamp, Sünje Johanna
AU - Lund, Ole
AU - Hald, Tine
AU - Woolhouse, Mark
AU - Koopmans, Marion P
AU - Vigre, Håkan
AU - Petersen, Thomas Nordahl
AU - Aarestrup, Frank Møller
PY - 2019
Y1 - 2019
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 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.
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 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.
KW - Antimicrobial resistance
KW - Ecological epidemiology
KW - Metagenomics
KW - Water microbiology
U2 - 10.1038/s41467-019-08853-3
DO - 10.1038/s41467-019-08853-3
M3 - Journal article
C2 - 30850636
SN - 2041-1723
VL - 10
JO - Nature Communications
JF - Nature Communications
M1 - 1124
ER -
