Metagenomics analysis of sewage for surveillance of antimicrobial resistance in South Africa

A study in Gauteng Province, South Africa, used metagenomics to analyze antimicrobial resistance (AMR) in raw sewage from wastewater treatment works. Results showed similar trends across all AMR classes, with aminoglycoside, beta-lactam, sulfonamide, and tetracycline resistance being the most abundant. Tshwane Metropolitan Municipality had higher AMR abundance compared to Ekurhuleni. Within each municipality, certain AMR classes were more abundant in urban high-income areas and less in semi-urban low-income areas. The study also found seasonal variability in six AMR genes, with higher abundances observed in colder seasons. Further research is needed to provide a comprehensive profile of AMR abundance across South Africa.