Unaccounted risk factors for the mobilization and transfer of antibiotic resistance genes from the environmental reservoir to human pathogens

Current strategies for antibiotic resistance stewardship are largely optimized to limit transmission of resistant bacteria, not to limit the emergence of new antibiotic resistance genes in pathogens. A fundamental knowledge gap is that we do not know where the critical evolutionary steps involved take place.

The overarching purpose of this project is to better understand the role of the external environment in the evolution of antibiotic resistance, particularly the mobilization and subsequent transfer of novel antibiotic resistance genes to pathogens.

The rapid increase in bacterial genomic and metagenomic data, together with new ultra-deep long-read sequencing technologies, opens new opportunities to address this key question.

An increased knowledge of how factors that directly drive risks for mobilization and transfer come together in humans, animals and the environment is necessary to direct measures that more effectively address the antibiotic resistance challenge.

To improve our understanding of selection pressures in antibiotic-polluted environments, we will also investigate which interactions that are prevailing in real, complex mixtures, such as human sewage. This could help us identify what the main drivers are, and at the end, inform risk-reducing actions.

The ultimate goal is to delay future emergence of new resistance genes in the clinics, and thereby benefit long-term, public health.