Antimicrobial resistance landscape in a metropolitan city context using open drain wastewater-based metagenomic analysis

Antimicrobial resistance (AMR) is a major One Health concern, affecting human, animal, and plant health. A metagenomic analysis of open drains in a south Indian metropolitan city revealed that macrolide antibiotics contributed the highest resistance of 40.1% in January 2022. Mutations in the 23S rRNA gene conferring resistance to macrolide antibiotics were the most prevalent, with a prevalence of 39.7%. This resistance was present in multiple pathogens including Escherichia coli, Campylobacter jejuni, Acinetobacter baumannii, Streptococcus pneumoniae, Pseudomonas aeruginosa, Neisseria gonorrhoeae, Klebsiella pneumoniae, and Helicobacter pylori. The study’s findings are crucial for understanding the resistance landscape, identifying resistant drug classes, and developing new drugs targeting specific pathways. This surveillance protocol can be extended to other developing countries to assess and combat the problem of AMR.