Antimicrobial resistance (AMR) is directly linked to sanitary conditions and the population’s general state of health, suggest results from a large EU-funded investigation utilising state-of-the-art DNA analysis of sewage around the globe.
The COMPARE project uses molecular technology to improve identification and mitigation of emerging infectious diseases and foodborne outbreaks.
Researchers used metagenomic analysis of untreated sewage to characterise the bacterial resistome from 79 sites in 60 countries.
This comparable data enabled the creation of the first-ever world map showing levels of AMR in predominantly healthy populations, with the results now published in Nature Communications.
Western Europe, North America, Australia, and New Zealand - generally regions with better sanitary conditions - have the lowest levels of antimicrobial resistance, while Asia, Africa, and South America have the highest levels.
Furthermore, Brazil, India, and Vietnam have the greatest diversity in resistant genes, while Australia and New Zealand have the lowest.
The researchers propose metagenomic analysis of sewage as an ethically acceptable and economically feasible approach for continuous global surveillance and prediction of AMR.
They now aim to develop a system to exchange and interpret information in real time, to help manage diseases that threaten to spread across borders and develop into pandemics, eg, Ebola, polio, or cholera.