A One Health analysis of the Human Gut Resistome across 34 countries in relation to climate, geography, diet, and veterinary antimicrobial use
Abstract
Abstract Background Antimicrobial resistance (AMR) is a major global health threat, yet international comparisons of the human gut resistome remain limited, and the relative contributions of climatic, environmental, socioeconomic, and dietary drivers to resistome burden and composition are poorly resolved. Methods We characterised the gut resistome across 34 countries spanning four continents using shotgun metagenomic sequencing of pooled stool samples from 116 young adult medical students newly enrolled at the University of Debrecen, Hungary. This deliberately homogeneous sampling frame minimised within-country socioeconomic heterogeneity and allowed country-level differences to be more confidently attributed to country-of-origin exposures. Country-level environmental (temperature, PM2.5, precipitation), socioeconomic (Human Development Index), and dietary data (national dietary archetypes, Alternative Healthy Eating Index) were integrated with resistome profiles, alongside veterinary antibiotic use estimates (mg/PCU). Results Total resistance gene burden was primarily driven by climatic factors: temperature explained 15% of variance, corresponding to a 22% increase in total AMR abundance per 10°C, and this effect was independent of continent (Type II p = 0.030). In contrast, resistome composition was structured by continent, dietary pattern, and veterinary antibiotic use. Sub-Saharan African countries with low-diversity subsistence diets diverged significantly from the…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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