Longitudinal monitoring of sewershed resistomes in socioeconomically diverse urban neighborhoods
Bibliographic record
Abstract
Understanding factors associated with antimicrobial resistance (AMR) distribution across populations is a necessary step in planning mitigation measures. While associations between AMR and socioeconomic-status (SES), including employment and education have been increasingly recognized in low- and middle-income settings, connections are less clear in high-income countries where SES remains an important influence on other health outcomes. We explored the relationship between SES and AMR in Calgary, Canada using spatially-resolved wastewater-based surveillance of resistomes detected by metagenomics across eight socio-economically diverse urban neighborhoods. Resistomes were established by shotgun-sequencing of wastewater pellets, and qPCR of targeted-AMR genes. SES status was established using 2021 Canadian census data. Conducting this comparison during the height of COVID-related international travel restrictions (Dec. 2020–Oct. 2021) allowed the hypotheses linking SES and AMR to be assessed with limited confounding. These were compared with sewage metagenomes from 244 cities around the world, linked with Human Development Index (HDI). Wastewater metagenomes from Calgary’s socioeconomically diverse neighborhoods exhibit highly similar resistomes, with no quantitative differences (p > 0.05), low Bray-Curtis dissimilarity, and no significant correlations with SES. By comparison, dissimilarity is observed between globally-sourced resistomes (p < 0.05), underscoring the homogeneity of resistomes in Calgary’s sub-populations. The analysis of globally-sourced resistomes alongside Calgary’s resistome further reveals lower AMR burden in Calgary relative to other cities around the world. This is particularly pronounced for the most clinically-relevant AMR genes (e.g., beta-lactamases, macrolide-lincosamide-streptogramin). This work showcases the effectiveness of inclusive and comprehensive wastewater-based surveillance for exploring the interplay between SES and AMR. Antimicrobial resistance (AMR) occurs when antimicrobial treatments fail to work and microbes continue to grow. This is a result of microbes acquiring AMR genes. Antimicrobial resistance (AMR) is an increasing public health threat. Some studies have suggested an association between AMR and socioeconomic factors. The amount of AMR can be monitored by investigating the presence of specific genes indicative of AMR in wastewater. To explore this within a high-income country with publicly funded health care, we collected wastewater from eight socioeconomically diverse neighborhoods across a large Canadian city. Conducted over eleven months during COVID-19-related travel restrictions, we did not observe an association between socioeconomic status of residents and the amount or types of AMR genes in wastewater. We also compared AMR genes from wastewater from cities across the globe, where we observed the presence of AMR genes significantly differed along established socio-economic parameters. Overall, our findings revealed the relationship between AMR genes and socioeconomic factors is dynamic, and context dependent. Lee et al. investigate whether the wastewater resistome of a large Canadian city associates with socioeconomic status (SES) of resident populations using a granular, neighborhood-based approach. No correlation is seen, in contrast with data from other cities around the world, where AMR genes disproportionately concentrate in cities with lower SES.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".