A global analysis of community WASH access and antibiotic resistance in the human gut
Antibiotic resistance is a growing public health issue and is likely exacerbated in settings with limited access to water, sanitation, and hygiene (WASH) infrastructure. Understanding the role of community WASH access in the proliferation of antibiotic resistance across both rural and urban communities is needed to inform public policies beyond clinical settings (e.g. stewardship).
In this talk, Erica Fuhrmeister will present her work leveraging publicly available short-read sequencing data to determine the association between community levels of improved WASH coverage and abundance of antibiotic resistance genes in human guts around the world. In total, Erica and her team compiled 1600 human stool metagenomes from 27 countries and corresponding WASH data from geospatially tagged, nationally representative household surveys. Total antibiotic resistance gene (ARG) abundance varied significantly by WHO region with the highest abundance in Africa and lowest in the Americas. Increased access to both improved drinking water and sanitation was associated with a decrease in ARG abundance in unadjusted and adjusted analyses.
The results of Erica’s primary analysis, as well as her subgroup analyses by income, WHO region, antibiotic usage in humans and livestock, urbanicity, and age will be presented. Current approaches to controlling antibiotic resistance in humans rely on antibiotic stewardship; however, this approach is difficult in low- and middle-income countries where infectious illnesses are prevalent and unregulated antibiotic usage is common. The results of this work support improved WASH infrastructure as an additional strategy to curb the spread of antibiotic resistance around the world.
Dr Erica Fuhrmeister is currently a postdoctoral fellow in the Department of Civil and Environmental Engineering at Tufts University. She received her Bachelor of Science in environmental engineering from Johns Hopkins University and her Master of Science and PhD in environmental engineering from the University of California, Berkeley. Dr Fuhrmeister studies reservoirs and transmission of enteric pathogens and antimicrobial resistance to develop innovative interventions to prevent illnesses.
In her postdoctoral work, she is investigating the transmission of antimicrobial resistance between humans, poultry, and the environment in urban Kenya using metagenomics. In her PhD work, she studied the impact of improved sanitation on the occurrence of enteric pathogens in household reservoirs in rural Bangladesh.
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