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Exploiting genomics to mitigate the public health impact of antimicrobial resistance.

Published version
Peer-reviewed

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Authors

Waddington, Claire 
Carey, Megan E 
Boinett, Christine J 
Higginson, Ellen 
Veeraraghavan, Balaji 

Abstract

Antimicrobial resistance (AMR) is a major global public health threat, which has been largely driven by the excessive use of antimicrobials. Control measures are urgently needed to slow the trajectory of AMR but are hampered by an incomplete understanding of the interplay between pathogens, AMR encoding genes, and mobile genetic elements at a microbial level. These factors, combined with the human, animal, and environmental interactions that underlie AMR dissemination at a population level, make for a highly complex landscape. Whole-genome sequencing (WGS) and, more recently, metagenomic analyses have greatly enhanced our understanding of these processes, and these approaches are informing mitigation strategies for how we better understand and control AMR. This review explores how WGS techniques have advanced global, national, and local AMR surveillance, and how this improved understanding is being applied to inform solutions, such as novel diagnostic methods that allow antimicrobial use to be optimised and vaccination strategies for better controlling AMR. We highlight some future opportunities for AMR control informed by genomic sequencing, along with the remaining challenges that must be overcome to fully realise the potential of WGS approaches for international AMR control.

Description

Keywords

Review, The impact of genomics on precision public health, Antimicrobial resistance, Public health, Genomics, Surveillance, Vaccines, Diagnostics

Journal Title

Genome Med

Conference Name

Journal ISSN

1756-994X
1756-994X

Volume Title

14

Publisher

Springer Science and Business Media LLC
Sponsorship
Wellcome Trust (215515/Z/19/Z)