Deciphering Antimicrobial Resistance in Wastewater: Hospital vs. Community Data

A recent metagenomic analysis in Japan showed substantially higher diversity and abundance of antimicrobial resistance genes (ARGs) in the hospital wastewater resistome than in community effluent.

The study identified 825 unique ARGs in hospital effluent versus 333 in community wastewater.

Aminoglycoside and third-generation beta-lactam resistance genes were markedly enriched and showed high abundance by reads per kilobase per million mapped reads (RPKM), with aminoglycoside resistance signals particularly prominent. These patterns mirror antimicrobial selection pressures within inpatient care and point to concentrated selective pressure in hospital settings.

The finding raises concern that empirical regimens relying on aminoglycosides or third-generation beta-lactams may face higher local resistance rates. Resistome data complement culture-based surveillance and stewardship metrics by capturing non-cultivable gene pools and broader environmental signals, but translating resistome prevalence into specific susceptibility probabilities requires correlation with local clinical isolates.