1. Global monitoring of antimicrobial resistance based on metagenomics analyses of urban sewage
- Author
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Hendriksen, Rene S., Munk, Patrick, Njage, Patrick, van Bunnik, Bram, McNally, Luke, Lukjancenko, Oksana, Röder, Timo, Nieuwenhuijse, David, Pedersen, Susanne Karlsmose, Kjeldgaard, Jette, Kaas, Rolf S., Clausen, Philip Thomas Lanken Conradsen, Vogt, Josef Korbinian, Leekitcharoenphon, Pimlapas, van de Schans, Milou G.M., Zuidema, Tina, de Roda Husman, Ana Maria, Rasmussen, Simon, Petersen, Bent, Bego, Artan, Rees, Catherine, Cassar, Susan, Coventry, Kris, Collignon, Peter, Allerberger, Franz, Rahube, Teddie O., Oliveira, Guilherme, Ivanov, Ivan, Vuthy, Yith, Sopheak, Thet, Yost, Christopher K., Ke, Changwen, Zheng, Huanying, Baisheng, Li, Jiao, Xiaoyang, Donado-Godoy, Pilar, Coulibaly, Kalpy Julien, Jergović, Matijana, Hrenovic, Jasna, Karpíšková, Renáta, Villacis, Jose Eduardo, Legesse, Mengistu, Eguale, Tadesse, Heikinheimo, Annamari, Malania, Lile, Nitsche, Andreas, Brinkmann, Annika, Saba, Courage Kosi Setsoafia, Kocsis, Bela, Solymosi, Norbert, Thorsteinsdottir, Thorunn R., Hatha, Abdulla Mohamed, Alebouyeh, Masoud, Morris, Dearbhaile, Cormican, Martin, O’Connor, Louise, Moran-Gilad, Jacob, Alba, Patricia, Battisti, Antonio, Shakenova, Zeinegul, Kiiyukia, Ciira, Ng’eno, Eric, Raka, Lul, Avsejenko, Jeļena, Bērziņš, Aivars, Bartkevics, Vadims, Penny, Christian, Rajandas, Heraa, Parimannan, Sivachandran, Haber, Malcolm Vella, Pal, Pushkar, Jeunen, Gert Jan, Gemmell, Neil, Fashae, Kayode, Holmstad, Rune, Hasan, Rumina, Shakoor, Sadia, Rojas, Maria Luz Zamudio, Wasyl, Dariusz, Bosevska, Golubinka, Kochubovski, Mihail, Radu, Cojocaru, Gassama, Amy, Radosavljevic, Vladimir, Wuertz, Stefan, Zuniga-Montanez, Rogelio, Tay, Moon Y.F., Gavačová, Dagmar, Pastuchova, Katarina, Truska, Peter, Trkov, Marija, Esterhuyse, Kerneels, Keddy, Karen, Cerdà-Cuéllar, Marta, Pathirage, Sujatha, Norrgren, Leif, Örn, Stefan, Larsson, D. G.Joakim, Heijden, Tanja Van der, Kumburu, Happiness Houka, Sanneh, Bakary, Bidjada, Pawou, Njanpop-Lafourcade, Berthe Marie, Nikiema-Pessinaba, Somtinda Christelle, Levent, Belkis, Meschke, John Scott, Beck, Nicola Koren, Van, Chinh Dang, Tran, Doan Minh Nguyen, Kwenda, Geoffrey, Tabo, Djim adjim, Wester, Astrid Louise, Cuadros-Orellana, Sara, Amid, Clara, Cochrane, Guy, Sicheritz-Ponten, Thomas, Schmitt, Heike, Alvarez, Jorge Raul Matheu, Aidara-Kane, Awa, Pamp, Sünje J., Lund, Ole, Hald, Tine, Woolhouse, Mark, Koopmans, Marion P., Vigre, Håkan, Petersen, Thomas Nordahl, Aarestrup, Frank M., Sub RIVM, dIRAS RA-I&I RA, One Health Microbieel, dIRAS RA-I&I I&I, University of Helsinki, Food Hygiene and Environmental Health, Producció Animal, Sanitat Animal, Tilraunastöð í meinafræði að Keldum (HÍ), Institute for Experimental Pathology, Keldur (UI), Heilbrigðisvísindasvið (HÍ), School of Health Sciences (UI), Háskóli Íslands, University of Iceland, Food Hygiene and Environmental Health, Helsinki One Health (HOH), Zoonotic Antimicrobial Resistance, and Virology
- Subjects
0301 basic medicine ,Water microbiology ,global surveillance ,Sanitation ,Kwantitatieve Veterinaire Epidemiologie ,Drug Resistance ,General Physics and Astronomy ,Sewage ,02 engineering and technology ,Drug resistance ,Antimicrobial resistance ,413 Veterinary science ,BU Veterinary Drugs ,Abundance (ecology) ,Drug Resistance, Multiple, Bacterial ,Genamengi ,AMR ,lcsh:Science ,resistome ,Ónæmisfræði ,Multidisciplinary ,Population Health ,021001 nanoscience & nanotechnology ,3. Good health ,Europe ,machine learning ,Geography ,Epidemiological Monitoring ,0210 nano-technology ,Asia ,Science ,Microbial Consortia ,Oceania ,Article ,General Biochemistry, Genetics and Molecular Biology ,BU Dierbehandelingsmiddelen ,03 medical and health sciences ,Antibiotic resistance ,SDG 3 - Good Health and Well-being ,Environmental health ,Erfðafræði ,Life Science ,Humans ,ddc:610 ,wastewater ,Ecological epidemiology ,Bacteria ,business.industry ,Quantitative Veterinary Epidemiology ,prediction ,General Chemistry ,South America ,Resistome ,030104 developmental biology ,Genes ,Socioeconomic Factors ,416 Food Science ,Genes, Bacterial ,Metagenomics ,ENVIRONMENTAL SURVEILLANCE ,Africa ,North America ,Metagenome ,UPDATE ,lcsh:Q ,business ,610 Medizin und Gesundheit - Abstract
Publisher's version (útgefin grein), 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., We are grateful to Hanne Nørgaard Nielsen, Christina Aaby Svendsen, Jacob Dyring Jensen, Birthe S. Rosenqvist Lund, Kate Vina Vibefeldt, Inge Marianne Hansen, Gunhild Larsen, Hanne Mordhorst, and Carsten Bidstrup for technical assistance. We also thank Jeffrey Edward Skiby for internal review. This study has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 643476 (COMPARE), the World Health Organization, The Villum Foundation (VKR023052), and The Novo Nordisk Foundation (NNF16OC0021856: Global Surveillance of Antimicrobial Resistance).
- Published
- 2019
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