The analysis of sewage collected in 74 cities in 60 countries has yielded the first, comparable global data on antimicrobial resistance has now been published in Nature Communications.
From a surveillance point of view, urban sewage is attractive because it provides sampling material from a large and mostly healthy population, which otherwise would not be feasible to monitor.
In this study, the metagenomic analysis of untreated sewage to characterize the bacterial resistome from 79 sites in 60 countries.
The 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. The authors propose metagenomic analysis of sewage as an ethically acceptable and economically feasible approach for continuous global surveillance and prediction of AMR.
"Analysing sewage can quickly and relatively cheaply show exactly which bacteria abound in an area—and collecting and analysing sewage doesn’t require ethical approval, as the material cannot be traced back to individuals. Both parameters help to make a surveillance system via sewage a viable option—also in developing countries,” Professor Frank Aarestrup explains.
The study is described in further detail in an article in the scientific journal Nature Communications (http://www.nature.com/ncomms/, DOI 10.1038/s41467-019-08853-3): Global monitoring of antimicrobial resistance based on metagenomics analyses of urban sewage.