NUI Galway participates in major international study showing sewage can reveal levels of antimicrobial resistance worldwide.
A comprehensive analysis of sewage collected in 74 cities in 60 countries worldwide has yielded the first comparable global data which show the levels and types of antimicrobial resistant bacteria that are present in mainly healthy people in these countries. The National Food Institute, Technical University of Denmark led the study, which was conducted by an international team of researchers, including Professor Martin Cormican, Dr. Dearbháile Morris, and Dr. Louise O’Connor from the Discipline of Bacteriology, School of Medicine at NUI Galway.
The World Health Organization describes antimicrobial resistance as the ability of a microorganism (like bacteria, viruses, and some parasites) to stop an antimicrobial (such as antibiotics) from working against it. As a result, standard treatments become ineffective, infections persist, and they may spread to others.
The key finding from the study showed that there were marked differences in the levels of antimicrobial resistance observed by region, and regions with poorer sanitation had higher levels. This suggests that improving the overall sanitation and health in these regions could limit the overall global burden of antimicrobial resistance. The study was published in the highly-regarded scientific journal Nature Communications.
In the study, the researchers mapped out all the DNA material in the sewage samples and found that according to antimicrobial resistance, the world’s countries fall within two groups. North America, Western Europe, Australia, and New Zealand generally have the lowest levels of antimicrobial resistance, while Asia, Africa, and South America have the highest levels. Brazil, India, and Vietnam have the greatest diversity in resistance genes, while Australia and New Zealand have the lowest.
Dr. Dearbháile Morris, from the School of Medicine at NUI Galway, said: “The approach taken in this study is an important first step toward the development of a global model for surveillance of all disease-causing organisms, not just antimicrobial resistance.”
The researchers’ findings show that most of the variables which are associated with the occurrence of antimicrobial resistance in a country, are related to the sanitary conditions in the country and the population’s general state of health.
The project lead, Professor Frank Aarestrup, Technical University of Denmark, says: “In the fight against antimicrobial resistance, our findings suggest that it would be a very effective strategy if concerted efforts were made to improve sanitary conditions in countries with high levels of antimicrobial resistance.”
The overall ambition of those participating in the study is to develop a worldwide surveillance system that can continuously monitor the occurrence and spread of disease-causing microorganisms and antimicrobial resistance. As such, it would be possible to use the global surveillance data, for example, to manage diseases that threaten to spread beyond a country’s borders and develop into pandemics, such as Ebola, measles, polio, or cholera.
Professor Aarestrup added: “Analyzing sewage can quickly and relatively cheaply show exactly which bacteria abound in an area, and collecting and analyzing sewage does not 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.” ♦