Standardization in global environmental antibiotic resistance genes (ARGs) surveillance

Abstract

Antimicrobial resistance (AMR) poses an increasing threat to global health. To deliberate the distribution and transmission of environmental resistance in a wide geographic and longitudinal scope, standardization of the analytical methods is desperately required for the extensive implementation of large-scale environmental antibiotic resistance gene (ARGs) surveillance. In this review, a standardized surveillance method using metagenomic analysis, coupled with proper quantification tools and environmental reference materials as technical benchmarks, was established to facilitate the generation of comparable and informative resistome datasets. As global and long-term ARGs surveillance has recently been performed in various environmental compartments, increasing efforts are also needed for assessing the health risks of ARGs. The development of risk assessment schemes that incorporate factors including transfer potential, host species, viability, and absolute quantification is essential to the regulatory guidelines for high-risk priority ARGs. This review provides guidance to ARGs surveillance regarding the level and the risk of ARG exposure, especially to identify and address critical hotspots.