Antimicrobial resistance (AMR) is becoming increasingly more prevalent due to the use of antimicrobial agents within the healthcare industry, livestock production and elsewhere. Many of the antibiotic resistance genes (ARGs) found in human pathogens are of environmental origin. The processes within and the types of the ARG reservoirs outside the hospitals are not well described, even though horizontal gene transfer of environmental ARGs is an important contributor to the development of multidrug-resistant strains. AMR surveillance is challenged further by not knowing which bacterial taxa that are the major sources of ARG within the ARG reservoirs, making it difficult to track AMR across different ecotypes, i.e., humans, animals, and environments.
Access to unique samples from humans, the indoor environment and from wastewater in Norway, Denmark, Sweden, and Iceland, will help us to identify essential reservoirs and bacterial sources of ARGs. Time-series wastewater samples enable us to describe changes in ARG profiles over time, and with samples from different geographical sites this can help us to understand how much AMR has been affected by human activity, national prescription policies and changes in livestock production in the Nordic countries.
This project will apply cultivation-independent metagenomics and quantitative PCR to decipher the diversity and abundance of known and novel ARGs, combined with bioinformatics to assign the ARGs to specific bacterial taxa. The project aims to explain whether ARG types are differently distributed across the Nordic countries, and how this is linked to antibiotic prescription among humans and livestock in the studied countries. The results will contribute significantly to improving surveillance of AMR and increase the knowledge among health care professionals and policy makers involved in decision-making on AMR.