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

Research output: Contribution to journalJournal articleResearchpeer-review

Rene S. Hendriksen, Patrick Munk, Patrick Njage, Bram van Bunnik, Luke McNally, Oksana Lukjancenko, Timo Röder, David Nieuwenhuijse, Susanne Karlsmose Pedersen, Jette Kjeldgaard, Rolf S. Kaas, Philip Thomas Lanken Conradsen Clausen, Josef Korbinian Vogt, Pimlapas Leekitcharoenphon, Milou G.M. van de Schans, Tina Zuidema, Ana Maria de Roda Husman, Simon Rasmussen, Bent Petersen, Artan Bego & 108 more Catherine Rees, Susan Cassar, Kris Coventry, Peter Collignon, Franz Allerberger, Teddie O. Rahube, Guilherme Oliveira, Ivan Ivanov, Yith Vuthy, Thet Sopheak, Christopher K. Yost, Changwen Ke, Huanying Zheng, Li Baisheng, Xiaoyang Jiao, Pilar Donado-Godoy, Kalpy Julien Coulibaly, Matijana Jergović, Jasna Hrenovic, Renáta Karpíšková, Jose Eduardo Villacis, Mengistu Legesse, Tadesse Eguale, Annamari Heikinheimo, Lile Malania, Andreas Nitsche, Annika Brinkmann, Courage Kosi Setsoafia Saba, Bela Kocsis, Norbert Solymosi, Thorunn R. Thorsteinsdottir, Abdulla Mohamed Hatha, Masoud Alebouyeh, Dearbhaile Morris, Martin Cormican, Louise O’Connor, Jacob Moran-Gilad, Patricia Alba, Antonio Battisti, Zeinegul Shakenova, Ciira Kiiyukia, Eric Ng’eno, Lul Raka, Jeļena Avsejenko, Aivars Bērziņš, Vadims Bartkevics, Christian Penny, Heraa Rajandas, Sivachandran Parimannan, Malcolm Vella Haber, Pushkar Pal, Gert Jan Jeunen, Neil Gemmell, Kayode Fashae, Rune Holmstad, Rumina Hasan, Sadia Shakoor, Maria Luz Zamudio Rojas, Dariusz Wasyl, Golubinka Bosevska, Mihail Kochubovski, Cojocaru Radu, Amy Gassama, Vladimir Radosavljevic, Stefan Wuertz, Rogelio Zuniga-Montanez, Moon Y.F. Tay, Dagmar Gavačová, Katarina Pastuchova, Peter Truska, Marija Trkov, Kerneels Esterhuyse, Karen Keddy, Marta Cerdà-Cuéllar, Sujatha Pathirage, Leif Norrgren, Stefan Örn, D. G.Joakim Larsson, Tanja Van der Heijden, Happiness Houka Kumburu, Bakary Sanneh, Pawou Bidjada, Berthe Marie Njanpop-Lafourcade, Somtinda Christelle Nikiema-Pessinaba, Belkis Levent, John Scott Meschke, Nicola Koren Beck, Chinh Dang Van, Nguyen Do Phuc, Doan Minh Nguyen Tran, Geoffrey Kwenda, Djim adjim Tabo, Astrid Louise Wester, Sara Cuadros-Orellana, Clara Amid, Guy Cochrane, Thomas Sicheritz-Ponten, Heike Schmitt, Jorge Raul Matheu Alvarez, Awa Aidara-Kane, Sünje J. Pamp, Ole Lund, Tine Hald, Mark Woolhouse, Marion P. Koopmans, Håkan Vigre, Thomas Nordahl Petersen, Frank M. Aarestrup

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.
Original languageEnglish
Article number1124
JournalNature Communications
Volume10
Issue number1
Number of pages12
ISSN2041-1723
DOIs
Publication statusPublished - 2019
Externally publishedYes

ID: 227841592