| Text | 477466 2022 10.1038/s41467 022 34312 7 Scopus 2 s2.0 85143185703 Antimicrobial Resistance Metagenomics Microbial Ecology Policy and public health in microbiology Genomic analysis of sewage from 101 countries reveals global landscape of antimicrobial resistance Munk P.; Brinch C.; Moller F.D.; Petersen T.N.; Hendriksen R.S.; Seyfarth A.M.; Kjeldgaard J.S.; Svendsen C.A.; van Bunnik B.; Berglund F.; Bego A.; Power P.; Rees C.; Lambrinidis D.; Neilson E.H.J.; Gibb K.; Coventry K.; Collignon P.; Cassar S.; Allerberger F.; Begum A.; Hossain Z.Z.; Worrell C.; Vandenberg O.; Pieters I.; Victorien D.T.; Gutierrez A.D.S.; Soria F.; Grujic V.R.; Mazalica N.; Rahube T.O.; Tagliati C.A.; Rodrigues D.; Oliveira G.; de Souza L.C.R.; Ivanov I.; Juste B.I.; Oumar T.; Sopheak T.; Vuthy Y.; Ngandijo A.; Nzouankeu A.; Olivier Z.A.A.J.; Yost C.K.; Kumar P.; Brar S.K.; Tabo D. A.; Adell A.D.; Paredes Osses E.; Martinez M.C.; Cuadros Orellana S.; Ke C.; Zheng H.; Baisheng L.; Lau L.T.; Chung T.; Jiao X.; Yu Y.; JiaYong Z.; Morales J.F.B.; Valencia M.F.; Donado Godoy P.; Coulibaly K.J.; Hrenovic J.; Jergovic M.; Karpiskova R.; Deogratias Z.N.; Elsborg B.; Hansen L.T.; Jensen P.E.; Abouelnaga M.; Salem M.F.; Koolmeister M.; Legesse M.; Eguale T.; Heikinheimo A.; Le Guyader S.; Schaeffer J.; Villacis J.E.; Sanneh B.; Malania L.; Nitsche A.; Brinkmann A.; Schubert S.; Hesse S.; Berendonk T.U.; Saba C.K.S.; Mohammed J.; Feglo P.K.; Banu R.A.; Kotzamanidis C.; Lytras E.; Lickes S.A.; Kocsis B.; Solymosi N.; Thorsteinsdottir T.R.; Hatha A.M.; Ballal M.; Bangera S.R.; Fani F.; Alebouyeh M.; Morris D.; O Connor L.; Cormican M.; Moran Gilad J.; Battisti A.; Diaconu E.L.; Corno G.; Di Cesare A.; Alba P.; Hisatsune J.; Yu L.; Kuroda M.; Sugai M.; Kayama S.; Shakenova Z.; Kiiyukia C.; Ng eno E.; Raka L.; Jamil K.; Fakhraldeen S.A.; Alaati T.; Berzins A.; Avsejenko J.; Kokina K.; Streikisa M.; Bartkevics V.; Matar G.M.; Daoud Z.; Pereckiene A.; Butrimaite Ambrozeviciene C.; Penny C.; Bastaraud A.; Rasolofoarison T.; Collard J. M.; Samison L.H.; Andrianarivelo M.R.; Banda D.L.; Amin A.; Rajandas H.; Parimannan S.; Spiteri D.; Haber M.V.; Santchurn S.J.; Vujacic A.; Djurovic D.; Bouchrif B.; Karraouan B.; Vubil D.C.; Pal P.; Schmitt H.; van Passel M.; Jeunen G. J.; Gemmell N.; Chambers S.T.; Mendoza F.P.; Huete Piotarez J.; Vilchez S.; Ahmed A.O.; Adisa I.R.; Odetokun I.A.; Fashae K.; Sorgaard A. M.; Wester A.L.; Ryrfors P.; Holmstad R.; Mohsin M.; Hasan R.; Shakoor S.; Gustafson N.W.; Schill C.H.; Rojas M.L.Z.; Velasquez J.E.; Magtibay B.B.; Catangcatang K.; Sibulo R.; Yauce F.C.; Wasyl D.; Manaia C.; Rocha J.; Martins J.; Alvaro P.; Di Yoong Wen D.; Shin H.; Hur H. G.; Yoon S.; Bosevska G.; Kochubovski M.; Cojocaru R.; Burduniuc O.; Hong P. Y.; Perry M.R.; Gassama A.; Radosavljevic V.; Tay M.Y.F.; Zuniga Montanez R.; Wuertz S.; Gavacova D.; Pastuchova K.; Truska P.; Trkov M.; Keddy K.; Esterhuyse K.; Song M.J.; Quintela Baluja M.; Lopez M.G.; Cerda Cuellar M.; Perera R.R.D.P.; Bandara N.K.B.K.R.G.W.; Premasiri H.I.; Pathirage S.; Charlemagne K.; Rutgersson C.; Norrgren L.; Orn S.; Boss R.; Van der Heijden T.; Hong Y. P.; Kumburu H.H.; Mdegela R.H.; Hounmanou Y.M.G.; Chonsin K.; Suthienkul O.; Thamlikitkul V.; de Roda Husman A.M.; Bidjada B.; Njanpop Lafourcade B. M.; Nikiema Pessinaba S.C.; Levent B.; Kurekci C.; Ejobi F.; Kalule J.B.; Thomsen J.; Obaidi O.; Jassim L.M.; Moore A.; Leonard A.; Graham D.W.; Bunce J.T.; Zhang L.; Gaze W.H.; Lefor B.; Capone D.; Sozzi E.; Brown J.; Meschke J.S.; Sobsey M.D.; Davis M.; Beck N.K.; Sukapanpatharam P.; Truong P.; Lilienthal R.; Kang S.; Wittum T.E.; Rigamonti N.; Baklayan P.; Van C.D.; Tran D.M.N.; Do Phuc N.; Kwenda G.; Larsson D.G.J.; Koopmans M.; Woolhouse M.; Aarestrup F.M. Research Group for Genomic Epidemiology, Technical University of Denmark, Kgs, Lyngby, Research Group for Genomic Epidemiology, Technical University of Denmark, Kgs, Lyngby, Denmark, , Denmark; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, UK, , United Kingdom; Centre for Antibiotic Resistance Research CARe , University of Gothenburg, Gothenburg, Centre for Antibiotic Resistance Research CARe , University of Gothenburg, Gothenburg, Sweden, , Sweden; Department of Viroscience, Erasmus MC, Rotterdam, Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands, , Netherlands; Institute of Public Health, Tirana, Institute of Public Health, Tirana, Albania, , Albania; Universidad de Buenos Aires, Buenos Aires, Universidad de Buenos Aires, Buenos Aires, Argentina, , Argentina; Melbourne Water Corporation, Melbourne, Melbourne Water Corporation, Melbourne, Australia, , Australia; Charles Darwin University, Darwin, Charles Darwin University, Darwin, Australia, , Australia; University of Copenhagen, Frederiksberg C, University of Copenhagen, Frederiksberg C, Denmark, , Denmark; Charles Darwin University, Darwin Northern Territory, Charles Darwin University, Darwin Northern Territory, Australia, , Australia; Canberra Hospital, ACT, Canberra Hospital, Canberra, Australia, , Australia; ALS Water, Scoresby, ALS Water, Scoresby, Australia, , Australia; Austrian Agency for Health and Food Safety AGES , Vienna, Austrian Agency for Health and Food Safety AGES , Vienna, Austria, , Austria; University of Dhaka, Dhaka, University of Dhaka, Dhaka, Bangladesh, , Bangladesh; Environmental Protection Department, Bridgetown, St. Michael, Environmental Protection Department, Bridgetown, St. Michael, Barbados, , Barbados; Laboratoire Hospitalier Universitaire de Bruxelles LHUB ULB , Brussels, Laboratoire Hospitalier Universitaire de Bruxelles LHUB ULB , Brussels, Belgium, , Belgium; AQUAFIN NV, Aartselaar, AQUAFIN NV, Aartselaar, Belgium, , Belgium; Polytechnic School of Abomey Calavi, Abomey Calavi, Polytechnic School of Abomey Calavi, Abomey Calavi, Benin, , Benin; Universidad Cat lica Boliviana San Pablo, La Paz, Universidad Cat lica Boliviana San Pablo, La Paz, Bolivia, , Bolivia; Public Health Institute of the Republic of Srpska, Faculty of Medicine University of Banja Luka, Banja Luka, Public Health Institute of the Republic of Srpska, Faculty of Medicine University of Banja Luka, Banja Luka, Bosnia and Herzegovina, , Bosnia and Herzegovina; Public Health Institute of the Republic of Srpska, Banja Luka, Public Health Institute of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina, , Bosnia and Herzegovina; Botswana International University of Science and Technology, Palapye, Botswana International University of Science and Technology, Palapye, Botswana, , Botswana; Universidade Federal de Minas Gerais, Belo Horizonte, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil, , Brazil; Oswaldo Cruz Institute, Rio de Janeiro, Oswaldo Cruz Institute, Rio de Janeiro, Brazil, , Brazil; Vale Institute of Technology, PA, Bel m, Vale Institute of Technology, Bel m, PA, Brazil, , Brazil; National Center of Infectious and Parasitic Diseases, Sofia, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria, , Bulgaria; University of Ouagadougou, Ouagadougou, University of Ouagadougou, Ouagadougou, Burkina Faso, , Burkina Faso; Institut Pasteur du Cambodge, Phnom Penh, Institut Pasteur du Cambodge, Phnom Penh, Cambodia, , Cambodia; Centre Pasteur du Cameroun, Yaound , Centre Pasteur du Cameroun, Yaound , Cameroon, , Cameroon; University of Regina, Regina, University of Regina, Regina, Canada, , Canada; Eau Terre Environnement Research Centre INRS ETE , Quebec City G1K 9A9, Canada and Indian Institute of Technology, Jammu, Eau Terre Environnement Research Centre INRS ETE , Quebec City G1K 9A9, Canada and Indian Institute of Technology, Jammu, India, , , India; Eau Terre Environnement Research Centre INRS ETE , Quebec City G1K 9A9, Canada and Indian Institute of Technology, Jammu, Eau Terre Environnement Research Centre INRS ETE , Quebec City G1K 9A9, Canada and Indian Institute of Technology, Jammu, India, , , India; Eau Terre Environnement Research Centre INRS ETE , Quebec City G1K 9A9, Canada and Lassonde School of Enginerring, York University, Toronto, Eau Terre Environnement Research Centre INRS ETE , Quebec City G1K 9A9, Canada and Lassonde School of Enginerring, York University, Toronto, Canada, , , Canada; Eau Terre Environnement Research Centre INRS ETE , Quebec City G1K 9A9, Canada and Lassonde School of Enginerring, York University, Toronto, Eau Terre Environnement Research Centre INRS ETE , Quebec City G1K 9A9, Canada and Lassonde School of Enginerring, York University, Toronto, Canada, , , Canada; University of N Djamena, N Djamena, University of N Djamena, N Djamena, Chad, , Chad; Escuela de Medicina Veterinaria, Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Escuela de Medicina Veterinaria, Facultad de Ciencias de la Vida, Universidad Andres Bello, Santiago, Chile, , Chile; Institute of Public Health, Santiago, Institute of Public Health, Santiago, Chile, , Chile; Centro de Biotecnolog a de los Recursos Naturales, Facultad de Ciencias Agrarias y Forestales, Talca, Centro de Biotecnolog a de los Recursos Naturales, Facultad de Ciencias Agrarias y Forestales, Talca, Chile, , Chile; Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China, , China; The Hong Kong Polytechnic University, The Hong Kong Polytechnic University, Hong Kong, China, , Hong Kong; Shantou University Medical College, Shantou, Shantou University Medical College, Shantou, China, , China; Nanjing University of Information Science and Technology, Nanjing, Nanjing University of Information Science and Technology, Nanjing, China, , China; Center for Disease Control and Prevention of Henan province, Zhengzhou, Center for Disease Control and Prevention of Henan province, Zhengzhou, China, , China; Colombian Integrated Program for Antimicrobial Resistance Surveillance Coipars, CI Tibaitat , Corporaci n Colombiana de Investigaci n Agropecuaria AGROSAVIA , Cundinamarca, Tibaitat Mosquera, Colombian Integrated Program for Antimicrobial Resistance Surveillance Coipars, CI Tibaitat , Corporaci n Colombiana de Investigaci n Agropecuaria AGROSAVIA , Tibaitat Mosquera, Cundinamarca, Colombia, , Colombia; Institut Pasteur de Cote d Ivoire, Abidjan, Institut Pasteur de Cote d Ivoire, Abidjan, Cote d Ivoire, , Cote d Ivoire; University of Zagreb, Zagreb, University of Zagreb, Zagreb, Croatia, , Croatia; Andrija Stampar Teaching Institute of Public Health, Zagreb, Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia, , Croatia; Veterinary Research Institute, Brno, Veterinary Research Institute, Brno, Czech Republic, , Czech Republic; Centre de Recherche en Sciences Naturelles de Lwiro CRSN LWIRO , Bukavu, Centre de Recherche en Sciences Naturelles de Lwiro CRSN LWIRO , Bukavu, Democratic Republic of Congo, , Democratic Republic Congo; BIOFOS A/S, Copenhagen K, BIOFOS A/S, Copenhagen K, Denmark, , Denmark; Technical University of Denmark, Kgs., Lyngby, Technical University of Denmark, Kgs., Lyngby, Denmark, , Denmark; Suez Canal University, Ismailia, Suez Canal University, Ismailia, Egypt, , Egypt; University of Sadat City, Sadat City, University of Sadat City, Sadat City, Egypt, , Egypt; Ministry of Health, Environmental Microbiology, Tallinn, Ministry of Health, Environmental Microbiology, Tallinn, Estonia, , Estonia; Addis Ababa University, Addis Ababa, Addis Ababa University, Addis Ababa, Ethiopia, , Ethiopia; University of Helsinki, Helsinki, University of Helsinki, Helsinki, Finland, , Finland; French Institute Search Pour L exploitation De La Mer Ifremer , Nantes, French Institute Search Pour L exploitation De La Mer Ifremer , Nantes, France, , France; Instituto Nacional de Investigaci n en Salud P blica INSPI CRNRAM , Gal pagos, Quito, Instituto Nacional de Investigaci n en Salud P blica INSPI CRNRAM , Gal pagos, Quito, Ecuador, , Ecuador; National Public Health Laboratories, Ministry of Health and Social Welfare, Kotu, National Public Health Laboratories, Ministry of Health and Social Welfare, Kotu, Gambia, , Gambia; National Center for Disease Control and Public Health, Tbilisi, National Center for Disease Control and Public Health, Tbilisi, Georgia, , Georgia; Robert Koch Institute, Berlin, Robert Koch Institute, Berlin, Germany, , Germany; Technische Universit t Dresden, Institute of Hydrobiology, Dresden, Technische Universit t Dresden, Institute of Hydrobiology, Dresden, Germany, , Germany; University for Development Studies, Tamale, University for Development Studies, Tamale, Ghana, , Ghana; University of Ghana, Accra, University of Ghana, Accra, Ghana, , Ghana; Kwame Nkrumah University of Science and Technology, PMB, Kumasi, Kwame Nkrumah University of Science and Technology, Kumasi, PMB, Ghana, , Ghana; Council for Scientific and Industrial Research Water Research Institute, Accra, Council for Scientific and Industrial Research Water Research Institute, Accra, Ghana, , Ghana; Veterinary Research Institute of Thessaloniki, Hellenic Agricultural Organisation DEMETER, Thermi, Veterinary Research Institute of Thessaloniki, Hellenic Agricultural Organisation DEMETER, Thermi, Greece, , Greece; Athens Water Supply and Sewerage Company EYDAP S.A. , Athens, Athens Water Supply and Sewerage Company EYDAP S.A. , Athens, Greece, , Greece; Universidad de San Carlos de Guatemala, Guatemala City, Universidad de San Carlos de Guatemala, Guatemala City, Guatemala, , Guatemala; Semmelweis University, Institute of Medical Microbiology, Budapest, Semmelweis University, Institute of Medical Microbiology, Budapest, Hungary, , , Hungary; Semmelweis University, Institute of Medical Microbiology, Budapest, Semmelweis University, Institute of Medical Microbiology, Budapest, Hungary, , , Hungary; University of Veterinary Medicine, Budapest, University of Veterinary Medicine, Budapest, Hungary, , Hungary; University of Iceland, Reykjav k, University of Iceland, Reykjav k, Iceland, , Iceland; Cochin University of Science and Technology, Cochin, Cochin University of Science and Technology, Cochin, India, , India; Kasturba Medical College, Manipal, Kasturba Medical College, Manipal, India, , India; Apollo Diagnostics, Mangalore, Apollo Diagnostics, Mangalore, India, , India; Shiraz University of Medical Sciences, Shiraz, Shiraz University of Medical Sciences, Shiraz, Iran, , Iran; Shahid Beheshti University of Medical Sciences, Tehran, Shahid Beheshti University of Medical Sciences, Tehran, Iran, , Iran; National University of Ireland Galway, Galway, National University of Ireland Galway, Galway, Ireland, , Ireland; Ben Gurion University of the Negev and Ministry of Health, Beer Sheva, Ben Gurion University of the Negev and Ministry of Health, Beer Sheva, Israel, , , Israel; Ben Gurion University of the Negev and Ministry of Health, Beer Sheva, Ben Gurion University of the Negev and Ministry of Health, Beer Sheva, Israel, , , Israel; Istituto Zooprofilattico Sperimentale del Lazio e della Toscana, Rome, Istituto Zooprofilattico Sperimentale del Lazio e della Toscana, Rome, Italy, , Italy; CNR Water Research Institute, Verbania, CNR Water Research Institute, Verbania, Italy, , Italy; National Institute of Infectious Diseases, Tokyo, National Institute of Infectious Diseases, Tokyo, Japan, , Japan; National Center of Expertise, Taldykorgan, National Center of Expertise, Taldykorgan, Kazakhstan, , Kazakhstan; Mount Kenya University, Thika, Mount Kenya University, Thika, Kenya, , Kenya; Kenya Medical Research Institute, Nairobi, Kenya Medical Research Institute, Nairobi, Kenya, , Kenya; University of Prishtina Hasan Prishtina amp; National Institute of Public Health of Kosovo, Pristina, Kosovo, University of Prishtina Hasan Prishtina amp; National Institute of Public Health of Kosovo, Pristina, Kosovo, , ; University of Prishtina Hasan Prishtina amp; National Institute of Public Health of Kosovo, Pristina, Kosovo, University of Prishtina Hasan Prishtina amp; National Institute of Public Health of Kosovo, Pristina, Kosovo, , ; Kuwait Institute for Scientific Research, Kuwait City, Kuwait Institute for Scientific Research, Kuwait City, Kuwait, , Kuwait; Institute of Food Safety, Riga, Institute of Food Safety, Riga, Latvia, , Latvia; American University of Beirut, Beirut, American University of Beirut, Beirut, Lebanon, , Lebanon; Central Michigan University amp; Michigan Health Clinics, Saginaw, MI, Central Michigan University amp; Michigan Health Clinics, Saginaw, MI, USA, , United States; National Food and Veterinary Risk Assessment Institute, Vilnius, National Food and Veterinary Risk Assessment Institute, Vilnius, Lithuania, , Lithuania; Luxembourg Institute of Science and Technology, Belvaux, Luxembourg Institute of Science and Technology, Belvaux, Luxembourg, , Luxembourg; Institut Pasteur de Madagascar, Antananarivo, Institut Pasteur de Madagascar, Antananarivo, Madagascar, , Madagascar; University of Antananarivo, Centre d Infectiologie Charles M rieux, Antananarivo, University of Antananarivo, Centre d Infectiologie Charles M rieux, Antananarivo, Madagascar, , Madagascar; University of Malawi, Blantyre, University of Malawi, Blantyre, Malawi, , Malawi; Malaysian Genomics Resource Centre Berhad, Kuala Lumpur, Malaysian Genomics Resource Centre Berhad, Kuala Lumpur, Malaysia, , Malaysia; AIMST University, COMBio, Kedah, AIMST University, COMBio, Kedah, Malaysia, , Malaysia; Water Services Corporation, Luqa, Water Services Corporation, Luqa, Malta, , Malta; Environmental Health Directorate, St. Venera, Environmental Health Directorate, St. Venera, Malta, , Malta; University of Mauritius, Reduit, University of Mauritius, Reduit, Mauritius, , Mauritius; Institute for Public Health Montenegro, Podgorica, Institute for Public Health Montenegro, Podgorica, Montenegro, , Montenegro; Institut Pasteur du Maroc, Casablanca, Institut Pasteur du Maroc, Casablanca, Morocco, , Morocco; Centro de Investiga o em Sa de de Manhi a CISM , Maputo, Centro de Investiga o em Sa de de Manhi a CISM , Maputo, Mozambique, , Mozambique; Agriculture and Forestry University, Kathmandu, Agriculture and Forestry University, Kathmandu, Nepal, , Nepal; National Institute for Public, Health and the Environment RIVM , Bilthoven, National Institute for Public, Health and the Environment RIVM , Bilthoven, The Netherlands, , Netherlands; University of Otago, Dunedin, University of Otago, Dunedin, New Zealand, , New Zealand; University of Otago, Christchurch, University of Otago, Christchurch, New Zealand, , New Zealand; University of Central America, Managua, University of Central America, Managua, Nicaragua, , Nicaragua; Universidad Nacional Aut noma de Nicaragua Le n, Le n, Universidad Nacional Aut noma de Nicaragua Le n, Le n, Nicaragua, , Nicaragua; University of Ilorin, Ilorin, University of Ilorin, Ilorin, Nigeria, , Nigeria; University of Ibadan, Ibadan, University of Ibadan, Ibadan, Nigeria, , Nigeria; Norwegian Institute of Public Health, Oslo, Norwegian Institute of Public Health, Oslo, Norway, , Norway; VEAS, Slemmestad, VEAS, Slemmestad, Norway, , Norway; University of Agriculture, Faisalabad, University of Agriculture, Faisalabad, Pakistan, , Pakistan; Aga Khan University, Karachi, Aga Khan University, Karachi, Pakistan, , Pakistan; Laboratorio Central de Salud Publica, Asuncion, Laboratorio Central de Salud Publica, Asuncion, Paraguay, , Paraguay; Instituto Nacional de Salud, Lima, Instituto Nacional de Salud, Lima, Peru, , Peru; Universidad de Piura, Piura, Universidad de Piura, Piura, Peru, , Peru; WHO Environmental and Occupational Health, Manila, WHO Environmental and Occupational Health, Manila, Philippines, , Philippines; National Veterinary Research Institute, Pulawy, National Veterinary Research Institute, Pulawy, Poland, , Poland; Universidade Cat lica Portuguesa, CBQF Centro de Biotecnologia e Qu mica Fina Laborat rio Associado, Escola Superior de Biotecnologia, Porto, Universidade Cat lica Portuguesa, CBQF Centro de Biotecnologia e Qu mica Fina Laborat rio Associado, Escola Superior de Biotecnologia, Porto, Portugal, , Portugal; Aguas do Tejo Atlantico, Lisboa, Aguas do Tejo Atlantico, Lisboa, Portugal, , Portugal; Gwangju Institute of Science and Technology, Gwangju, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea, , South Korea; Korea Advanced Institute of Science and Technology, Daejeon, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea, , South Korea; Institute of Public Health of the Republic of North Macedonia, Skopje, Institute of Public Health of the Republic of North Macedonia, Skopje, Republic of North Macedonia, , North Macedonia; State Medical and Pharmaceutical University, Chi in u, State Medical and Pharmaceutical University, Chi in u, Republic of Moldova, , Moldova; National Agency for Public Health, Chi in u, National Agency for Public Health, Chi in u, Republic of Moldova, , Moldova; King Abdullah University of Science and Technology, Thuwal, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia, , Saudi Arabia; University of Edinburgh, Scotland, Edinburgh, University of Edinburgh, Edinburgh, Scotland, UK, , United Kingdom; Institut Pasteur de Dakar, Dakar, Institut Pasteur de Dakar, Dakar, Senegal, , Senegal; Institute of Veterinary Medicine of Serbia, Belgrade, Institute of Veterinary Medicine of Serbia, Belgrade, Serbia, , Serbia; Nanyang Technological University, Singapore, Nanyang Technological University, Singapore, Singapore, , Singapore; Public Health Authority of the Slovak Republic, Bratislava, Public Health Authority of the Slovak Republic, Bratislava, Slovakia, , Slovakia; National Laboratory of Health, Environment and Food, Ljubljana, National Laboratory of Health, Environment and Food, Ljubljana, Slovenia, , Slovenia; Independent consultant, Johannesburg, Independent consultant, Johannesburg, South Africa, , South Africa; Daspoort Waste Water Treatment Works, Pretoria, Daspoort Waste Water Treatment Works, Pretoria, South Africa, , South Africa; Korea Advanced Institute of Science and Technology, Daejeon, Korea Advanced Institute of Science and Technology, Daejeon, South Korea, , South Korea; School of Veterinary Sciences, Lugo, School of Veterinary Sciences, Lugo, Spain, , Spain; Labaqua, Santiago de Compostela, Labaqua, Santiago de Compostela, Spain, , Spain; IRTA, Centre de Recerca en Sanitat Animal CReSA, IRTA UAB , Campus de la Universitat Autonoma de Barcelona, Bellaterra, IRTA, Centre de Recerca en Sanitat Animal CReSA, IRTA UAB , Campus de la Universitat Autonoma de Barcelona, Bellaterra, Spain, , , Spain; IRTA, Centre de Recerca en Sanitat Animal CReSA, IRTA UAB , Campus de la Universitat Autonoma de Barcelona, Bellaterra, IRTA, Centre de Recerca en Sanitat Animal CReSA, IRTA UAB , Campus de la Universitat Autonoma de Barcelona, Bellaterra, Spain, , , Spain; University of Kelaniya, Ragama, University of Kelaniya, Ragama, Sri Lanka, , Sri Lanka; Medical Research Institute, Colombo, Medical Research Institute, Colombo, Sri Lanka, , Sri Lanka; Caribbean Public Health Agency, Catries, Caribbean Public Health Agency, Catries, Saint Lucia, , Saint Lucia; The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden, , , Sweden; The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden, , , Sweden; Swedish University of Agricultural Sciences, Uppsala, Swedish University of Agricultural Sciences, Uppsala, Sweden, , Sweden; Federal Food Safety and Veterinary Office FSVO , Bern, Federal Food Safety and Veterinary Office FSVO , Bern, Switzerland, , Switzerland; Ara Region Bern AG, Herrenschwanden, Ara Region Bern AG, Herrenschwanden, Switzerland, , Switzerland; Centers for Disease Control, Taipei, Centers for Disease Control, Taipei, Taiwan, , Taiwan; Kilimanjaro Clinical Research Institute, Moshi, Kilimanjaro Clinical Research Institute, Moshi, Tanzania, , Tanzania; Sokoine University of Agriculture, Morogoro, Sokoine University of Agriculture, Morogoro, Tanzania, , Tanzania; Faculty of Science and Technology, Suratthani Rajabhat University, Surat Thani, Faculty of Science and Technology, Suratthani Rajabhat University, Surat Thani, Thailand, , Thailand; Faculty of Public Health, Mahidol University, Bangkok, Faculty of Public Health, Mahidol University, Bangkok, Thailand, , Thailand; Faculty of Medicine Siriraj Hospital, Bangkok, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand, , Thailand; National Institute for Public Health and the Environment RIVM , Bilthoven, National Institute for Public Health and the Environment RIVM , Bilthoven, Netherlands, , Netherlands; National Institute of Hygiene, Lom , National Institute of Hygiene, Lom , Togo, , Togo; Agence de M decine Pr ventive, Dapaong, Agence de M decine Pr ventive, Dapaong, Togo, , Togo; Division of Integrated Surveillance of Health Emergencies and Response, Lom , Division of Integrated Surveillance of Health Emergencies and Response, Lom , Togo, , Togo; Public Health Institution of Turkey, Ankara, Public Health Institution of Turkey, Ankara, Turkey, , Turkey; Hatay Mustafa Kemal University, Hatay, Hatay Mustafa Kemal University, Hatay, Turkey, , Turkey; Makerere University, Kampala, Makerere University, Kampala, Uganda, , Uganda; Abu Dhabi Public Health Center, Abu Dhai, Abu Dhabi Public Health Center, Abu Dhai, United Arab Emirates, , United Arab Emirates; Dubai municipality, WWTP Al Aweer, Dubai, Dubai municipality, WWTP Al Aweer, Dubai, UAE, , United Arab Emirates; Rashid Hospital, Dubai, Rashid Hospital, Dubai, UAE, , United Arab Emirates; Northumbrian Water, Northumbria House, Abbey Road, Pity Me, Durham, Northumbrian Water, Northumbria House, Abbey Road, Pity Me, Durham, UK, , United Kingdom; University of Exeter Medical School, Cornwall, University of Exeter Medical School, Cornwall, UK, , United Kingdom; Newcastle University, Newcastle upon Tyne, Newcastle University, Newcastle upon Tyne, UK, , United Kingdom; Brightwater Treatment Plant, Woodinville, WA, Brightwater Treatment Plant, Woodinville, WA, USA, , United States; Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, , United States; University of North Carolina, Chapel Hill, University of North Carolina, Chapel Hill, USA, , United States; University of Washington, Seattle, WA, University of Washington, Seattle, WA, USA, , United States; Baylor University, Waco, Baylor University, Waco, USA, , United States; Columbia Boulevard WWTP, Portland, Columbia Boulevard WWTP, Portland, USA, , United States; Eastern Illinois University, Charleston, Eastern Illinois University, Charleston, USA, , United States; The Ohio State University, Columbus, OH, The Ohio State University, Columbus Ohio, USA, , United States; Laboratorio Tecnol gico del Uruguay, Montevideo, Laboratorio Tecnol gico del Uruguay, Montevideo, Uruguay, , Uruguay; Institute of Public Health in Ho Chi Minh City, Ho Chi Minh, Institute of Public Health in Ho Chi Minh City, Ho Chi Minh, Vietnam, , Viet Nam; University of Zambia, Lusaka, University of Zambia, Lusaka, Zambia, , Zambia Antimicrobial resistance AMR is a major threat to global health. Understanding the emergence, evolution, and transmission of individual antibiotic resistance genes ARGs is essential to develop sustainable strategies combatting this threat. Here, we use metagenomic sequencing to analyse ARGs in 757 sewage samples from 243 cities in 101 countries, collected from 2016 to 2019. We find regional patterns in resistomes, and these differ between subsets corresponding to drug classes and are partly driven by taxonomic variation. The genetic environments of 49 common ARGs are highly diverse, with most common ARGs carried by multiple distinct genomic contexts globally and sometimes on plasmids. Analysis of flanking sequence revealed ARG specific patterns of dispersal limitation and global transmission. Our data furthermore suggest certain geographies are more prone to transmission events and should receive additional attention. 13 Published version http //www.scopus.com/record/display.url eid=2 s2.0 85143185703 origin=inward Articolo in rivista Nature Publishing Group. 2041 1723 Nature communications Nature communications Nature communications gianluca.corno CORNO GIANLUCA andrea.dicesare DI CESARE ANDREA |
