摘要
      用于疾病监测的基于废水的监测（WBS）非常有前景，但需要包含预定目标、指标和指标的一致方法。在此，我们描述了一种基于宏基因组学的综合方法，用于全球监测污水中的抗生素耐药性，该方法能够评估1）哪些抗生素耐药性基因（ARGs）在不同地区/社区共享；2） 哪些ARG是歧视性的；以及3）与ARGs的总体趋势相关的因素，例如抗生素浓度。在使用集中、标准化方案收集的国际来源的污水样本横断面中，ARG相对丰度（16S rRNA基因正常化）在香港和印度最高，在瑞典和瑞士最低，这反映了国家政策、测定的抗生素浓度和金属抗性基因。亚洲和欧洲/美国的耐药性是不同的，大环内酯林可酰胺链脲菌素、氯霉素、喹诺酮类和四环素与多药耐药性ARGs分别是有区别的。测得的抗生素浓度的区域趋势与公共销售数据预期的趋势不同。这可能反映了未说明的用途，仅通过WBS方法获取。如果正确地进行基准测试，抗生素WBS可能会在未来补充公共销售和消费统计数据。本文定义的WBS方法证明了多站点的可比性和对当地/地区因素的敏感性。
Abstract
Wastewater-based surveillance (WBS) for disease monitoring is highly promising but requires consistent methodologies that incorporate predetermined objectives, targets, and metrics. Herein, we describe a comprehensive metagenomics-based approach for global surveillance of antibiotic resistance in sewage that enables assessment of 1) which antibiotic resistance genes (ARGs) are shared across regions/communities; 2) which ARGs are discriminatory; and 3) factors associated with overall trends in ARGs, such as antibiotic concentrations. Across an internationally sourced transect of sewage samples collected using a centralized, standardized protocol, ARG relative abundances (16S rRNA gene-normalized) were highest in Hong Kong and India and lowest in Sweden and Switzerland, reflecting national policy, measured antibiotic concentrations, and metal resistance genes. Asian versus European/US resistomes were distinct, with macrolide-lincosamide-streptogramin, phenicol, quinolone, and tetracycline versus multidrug resistance ARGs being discriminatory, respectively. Regional trends in measured antibiotic concentrations differed from trends expected from public sales data. This could reflect unaccounted uses, captured only by the WBS approach. If properly benchmarked, antibiotic WBS might complement public sales and consumption statistics in the future. The WBS approach defined herein demonstrates multisite comparability and sensitivity to local/regional factors.

https://pubs.acs.org/doi/full/10.1021/acs.est.1c08673