Antimicrobial resistance (AMR) is a serious threat to global public health, but obtaining representative data on AMR for healthy human populations is difficult. Here, we use metagenomic analysis of untreated sewage to characterize the bacterial resistome from 79 sites in 60 countries. We find systematic differences in abundance and diversity of AMR genes between Europe/North-America/Oceania and Africa/Asia/South-America. Antimicrobial use data and bacterial taxonomy only explains a minor part of the AMR variation that we observe. We find no evidence for cross-selection between antimicrobial classes, or for effect of air travel between sites. However, AMR gene abundance strongly correlates with socio-economic, health and environmental factors, which we use to predict AMR gene abundances in all countries in the world. Our findings suggest that global AMR gene diversity and abundance vary by region, and that improving sanitation and health could potentially limit the global burden of AMR. We propose metagenomic analysis of sewage as an ethically acceptable and economically feasible approach for continuous global surveillance and prediction of AMR.

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There are few studies on the presence of extended-spectrum β-lactamases and AmpC β-lactamases (ESBL/AmpC) in bacteria that contaminate vegetables. The role of the production environment in ESBL/AmpC gene transmission is poorly understood. The occurrence of ESBL/AmpC in Escherichia coli (n = 46) from lettuce and irrigation water and the role of irrigation water in the transmission of resistant E. coli were studied. The presence of ESBL/AmpC, genetic similarity and phylogeny were typed using genotypic and phenotypic techniques. The frequency of β-lactamase gene transfer was studied in vitro. ESBLs/AmpC were detected in 35 isolates (76%). Fourteen isolates (30%) produced both ESBLs/AmpC. Prevalence was highest in E. coli from lettuce (90%). Twenty-two isolates (48%) were multi-resistant with between two and five ESBL/AmpC genes. The major ESBL determinant was the CTX-M type (34 isolates). DHA (33% of isolates) were the dominant AmpC β lactamases. There was a high conjugation efficiency among the isolates, ranging from 3.5 × 10−2 to 1 × 10−2 ± 1.4 × 10−1 transconjugants per recipient. Water isolates showed a significantly higher conjugation frequency than those from lettuce. A high degree of genetic relatedness between E. coli from irrigation water and lettuce indicated possible common ancestry and pathway of transmission.

Indigenous fermented milk products contain microbiota composed of technologically important species and strains which are gradually getting lost with new technologies. We investigated the microbial diversity inamabere amaruranu, a traditionally fermented milk product from Kenya. Sixteen samples of the product from different containers were obtained. One hundred and twenty isolates of lactic acid bacteria (LAB) and 67 strains of yeasts were identified using API 50 CH and API 20 C AUX identification kits, respectively. The average pH of all the traditional fermented samples was 4.00 ± 0.93. Lactobacilli, yeasts, and molds as well asEnterobacteriaceae counts from the plastic containers were significantly higher (P < 0.05) than those from gourd.Enterobacteriaceae were below 1.00 ± 1.11 log10 cfu/mL in products from the gourds and 2.17 ± 1.92 log10 cfu/mL from the plastic containers. The LAB species were identified asStreptococcus thermophilus (25%),Lactobacillus plantarum (20%), andLeuconostoc mesenteroides (20%). The predominant yeasts wereSaccharomyces cerevisiae (25%),Trichosporum mucoides (15%),Candida famata (10%), andCandida albicans (10%). The type of vessel used for fermentation had no significant influence on the type of isolated and identified species. The diverse mixture of LAB and yeasts microflora forms a potential consortium for further product innovation inamabere amaruranu and other fermented milk products.