Manipal, 19^th January 2023: Manipal Academy of Higher Education in collaboration with their research partners Denmark Technical University, Denmark, have successfully made it to the top journals in the world Nature Communications, December issue. Out of 101 participating countries around the world, only 2 centers from India had the honour of working with the team from which MAHE was one of them. One of the students from MAHE has got an opportunity to visit their lab in Denmark for a month.

Dr. Mamatha Ballal, Prof of Microbiology, KMC, MAHE, Manipal along with her team was associated with this global project that started from 2016 till 2022. During the COVID-19 pandemic, the entire world became aware of the value of using sewage analysis to monitor disease development in those areas. However, Denmark Technical university, at the National Food Institute, Denmark, where a group of researchers started sewage monitoring throughout the world since 2016 as an effective and inexpensive tool for monitoring infectious diseases and their antimicrobial resistance.

Speaking about the achievement, Vice-Chancellor, Lt. Gen (Dr.) M.D. Venkatesh of Manipal Academy of Higher Education, Manipal said, “MAHE has a legacy of collaborating with foreign universities in all fields of study. We have partnerships with over 250 Universities across the globe, such collaborations help in deepening the knowledge and development skills of both our students and faculty. We were always highly optimistic about this partnership, Kudos for the achievement team, can’t wait to celebrate more achievements like these.

Dr. Mamatha Ballal, Prof of Microbiology, KMC, MAHE, Manipal said, “We are thrilled to have made it this far and I feel elated and honoured to be a part of this prestigious project with my students we have worked hard to achieve this feat. It was a nice experience to work with a fabulous team for Genomic Analysis of Sewage. Once again, we managed to keep MAHE’s flag flying high. I must say the collaboration with Denmark university undoubtedly resulted in fruitful outcome.

Denmark Technical University, Denmark analysed 757 sewage samples from 243 cities across 101 countries from 2016 to 2019.  The researchers have now mapped where in the world the occurrence of resistance genes is highest and how the genes are located and in which type of bacteria they are found. Globally more than 2 billion people lack clean water with feces or sewage being the most common contaminant. The sewage reservoirs are missed by hospital surveillance highlighting the usefulness of sewage surveillance. There are many examples where antimicrobial resistance genes would have emerged clinically, (for instance, the New Delhi metallo beta-lactamase gene), and then swept globally through the environment and human and animal populations.

The results from this new metagenomics study which has been published in Nature Communications (December 2022) has surprised the scientists. In fact, the study shows that the genes have appeared in many different genetic contexts and bacterial types indicating greater transmission than expected. We have found similar resistance genes in highly different bacterial types. MAHE finds it worrying when genes can pass from a very broad group of bacteria to a completely different group with which there is no resemblance. As it is often found rare for these gene transmissions to occur in such long distances.

Genomic analysis of wastewater is fast and fairly inexpensive, relative to cover many people. It is a representation of different sources like hospitals, communities, and the environment. It is aiding that Genomic monitoring should not be reserved for acute pandemics only and should be applied continuously to endemic infections and silent epidemics like Antimicrobial Resistance which grows progressively and by some is predicted to result in an annual death rate of 10 million by 2050.  

A recent study found that bacterial AMR caused an additional 1.27 million deaths in 2019 in the world. Frank Aarestrup, the chief investigator of this global sewage project says a total of 1625 different AMR genes were detected in samples and their abundance varied across countries and continents. India, Brazil, and Vietnam had the highest diversity of AMR genes. Resistance to Macrolides, tetracyclines, aminoglycosides, beta-lactams and sulphonamides were most abundant.

Poor sanitation and health are linked to AMR levels, variables being life expectancy, childhood mortality and levels of investment in water and sanitation. The findings from this big global study suggest that improving sanitation and health as part of the UN’s sustainable developmental goals enables an effective way to help limit the global impact of antimicrobial resistance (AMR).