Ranking the risk of antibiotic resistance genes by metagenomic and multifactorial analysis in hospital wastewater systems.

Antimicrobial resistance poses a serious threat to human health. Hospital wastewater system (HWS) is an important source of antibiotic resistance genes (ARGs). The risk of ARGs in HWS is still an under-researched area. In this study, we collected publicly metagenomic datasets of 71 hospital wastewater samples from 18 hospitals in 13 cities. A total of 9838 contigs were identified to carry 383 unique ARGs across all samples, of which 2946 contigs were plasmid-like sequences. Concurrently, the primary hosts of ARGs within HWS were found to be Escherichia coli and Klebsiella pneumoniae. To further evaluate the risk of each ARG subtype, we proposed a risk assessment framework based on the importance of corresponding antibiotics as defined by the WHO and three other indicators - ARG abundance (A), mobility (M), and host pathogenicity (P). Ninety ARGs were identified as R1 ARGs having high-risk scores, which meant having a high abundance, high mobility, and carried by pathogens in HWS. Furthermore, 25% to 49% of genomes from critically important pathogens accessed from NCBI carried R1 ARGs. A significantly higher number of R1 ARGs was carried by pathogens in the effluents of municipal wastewater treatment plants from NCBI, highlighting the role of R1 ARGS in accelerating health and environmental risks.

Antibiotic resistance genes alterations in murine guts microbiome are associated with different types of drinking water.

Antibiotic resistance genes (ARGs) are emerging contaminants threatening public health and commonly found in drinking water. However, the effect of different types of drinking water on ARG alterations in the gut microbiome is unclear. This study examines this issue in murine models in three phases (phase I: acclimation using ddH2O; phase II: treatment using different types of water, i.e. river water (RW), tap water (TW) and commercial bottled water (CBW); and phase III: recovery using ddH2O) using high-throughput qPCR and 16S rRNA amplicon sequencing. Results reveal that exposure to different types of drinking water could lead to significant changes in the gut microbiome, mobile genetic elements (MGEs), and ARGs. In phase II, treatment of RW and TW significantly increased the abundance of aminoglycoside and tetracycline resistance genes in mice guts (P < 0.01). In the recovery phase, consuming distilled water was found to restore ARG profiles to a certain extent in mice guts. Procrustes, network, redundancy and variation partitioning analysis indicated that ARG alterations in mice guts might relate to MGEs and bacterial communities. Our work suggests that the type of drinking water consumed may play a crucial role in shaping ARGs in gut microbiomes, emphasizing the urgent need for access to clean drinking water to mitigate the growing threat of antimicrobial resistance.

COVID-19: an opportunity to re-evaluate the implementation of a One Health approach to tackling emerging infections in Nigeria and other sub-Saharan African countries.

BACKGROUND: One Health (OH) has resurfaced in the light of the ravaging COVID-19 pandemic. It has been accepted by many local and global health authorities as a suitable approach for preventing and responding to infectious disease outbreaks including pandemics. MAIN BODY: One Health (OH) is a multisectoral and interdisciplinary framework for managing the animal, human, and ecosystem determinants of health. Globally, the majority of emerging infections in humans including SARS-Cov2-the causative agent of COVID-19-are transmitted from animals through environmental contacts in the last few decades. Yet, even when the biological and social interactions at the human, animal, and environmental interface that drive spillover of zoonotic diseases have been proven, OH strategies to address associated complex health challenges today are still rudimentary in many national health systems. Despite the disproportionate burden of infectious diseases in sub-Saharan Africa, OH is minimally incorporated into routine disease control and national health security programs. Challenges include poor policy support for OH in sub-Saharan Africa, and where some form of policy framework does exist, there are significant implementation bottlenecks. In this paper, we identified ideological, technical, operational, and economic barriers to OH implementation in Nigeria and sub-Saharan Africa, and highlighted possible recommendations across these domains. In order to yield sustainable benefits, a relevant OH policy approach in the sub-Saharan African health systems must derive from a buy-in of the critical mass of stakeholders in the society. CONCLUSION: The implementation of sustainable OH approaches as a countermeasure to recurring emerging infections is a developmental priority for sub-Saharan African countries. A deep understanding of the local context must be leveraged to develop integrative OH solutions that are bold, rooted in science, and proven to be compatible with the level of development in sub-Saharan Africa.

Operationalising One Health in Nigeria: Reflections From a High-Level Expert Panel Discussion Commemorating the 2020 World Antibiotics Awareness Week.

Antimicrobial resistance (AMR) poses an important One Health challenge for all countries of the world. As human, animal and environmental health are closely linked, it is essential that interventions targeted at reducing the spread of AMR and those promoting antimicrobial stewardship are conducted with all sectors in mind. Tackling this global slow-moving pandemic (AMR) also requires action and strong commitment from all countries of the world. Nigeria, like many other countries, have made considerable progress in implementing the National Action Plan on Antimicrobial Resistance. The accomplishments and ongoing work led by the National Technical Working Group on AMR is commendable. However, gaps still exist in terms of operationalising One Health interventions for AMR, especially regarding rational antimicrobial use and antimicrobial stewardship. The 2020 World Antimicrobial Awareness Week presented an opportunity to convene a multi-sectoral expert panel from national government agencies, research, academia and the World Health Organisation across the Nigerian One Health space. The panel discussion analysed the progress made so far and identified the barriers and the opportunities for operationalising One Health interventions on AMR. The discussion highlighted poor awareness and the fear phenomenon, driven by technical and socio-economic factors, as a common cross-sectoral denominator at the heart of inappropriate antibiotic use within the country. At the system level, suboptimal use of antimicrobials fuelled by the ease of purchase, poor regulations and insufficient enforcement of prescription-only access to antimicrobials, and limited infection prevention and biosecurity measures resonated as drivers of AMR across One Health sectors in Nigeria. Looking forward, the panel discussion identified substantial investment in the governance of the existing One Health component structures, inclusive bottom-up institutional antimicrobial stewardship that fosters community participation and multi-level cross-sectoral collaborations as the next level strategic imperatives. In this respect is the need for a strengthened One Health infrastructure, including an operational workforce, educational strategies to elevate AMR and rational antimicrobial use into public consciousness, and the use of improved data systems as countermeasures to the challenge of AMR.