Antibiotic resistance

Antibiotic resistance is arguably the most important threat to human health and medical care globally. The resistance crisis has been compared to the climate change issue, in that mitigation strategies to prevent disastrous consequences must be implemented immediately to avoid a potential disaster in the (relatively near) future. However, although resistance development and spread in clinics and society are relatively well understood, we still lack knowledge on how the environment outside the human body contributes to this situation and how that affects future resistance scenarios. This means that knowledge of dissemination routes, selective concentrations, co-selection of antibiotic resistance by other chemicals, and environments of particular concern remains scarce.

My previous research in this area has been applying metagenomic approaches to quantify resistance gene abundances, potential for genetic mobility, and assess the taxonomic composition of communities in different environments. This way, we have started to shed light on which environments that could be considered high-risk environments for antibiotic resistance development and spread to human pathogens.

Currently, I am mainly interested in the consequences of resistance development in the environment, including how increasing resistance affects other processes (such as invasion ability, virulence and dispersal ability) and microbial interactions. I also want to figure out which conditions and concentrations of selective agents that drive resistance development. Finally, I want to understand the routes through which resistant bacteria (and the genes conferring resistance) take from where they originally emerged to human pathogens. Together, these pieces of knowledge can be used to provide quantitative data for risk assessment.

Open questions of interest

  1. Which environments constitute particular high-risk settings for resistance development?
  2. How does the environment contribute to the emergence of novel resistance determinants?
  3. Which are the important dispersal routes for antibiotic resistance genes and resistant microbes to the human microbiome?
  4. What are the minimal selective concentrations of antibiotics (and other chemicals) in complex communities?
  5. What are the secondary (indirect) effects of antibiotic exposure and increasing antibiotic resistance in microbial communities?

Key publications

  • Bengtsson-Palme J, Kristiansson E, Larsson DGJ: Environmental factors influencing the development and spread of antibiotic resistance. FEMS Microbiology Reviews, 42, 1, 68–80 (2018). doi: 10.1093/femsre/fux053 [Paper link] (Editor’s choice)
  • Bahram M°, Hildebrand F°, Forslund SK, Anderson JL, Soudzilovskaia NA, Bodegom PM, Bengtsson-Palme J, Anslan S, Coelho LP, Harend H, Huerta-Cepas J, Medema MH, Maltz MR, Mundra S, Olsson PA, Pent M, Põlme S, Sunagawa S, Ryberg M, Tedersoo L, Bork P: Structure and function of the global topsoil microbiome. Nature, 560, 7717, 233–237 (2018). doi: 10.1038/s41586-018-0386-6 [Paper link]
  • Bengtsson-Palme J: The diversity of uncharacterized antibiotic resistance genes can be predicted from known gene variants – but not always. Microbiome, 6, 125 (2018). doi: 10.1186/s40168-018-0508-2 [Paper link]
  • Bengtsson-Palme J, Larsson DGJ, Kristiansson E: Using metagenomics to investigate human and environmental resistomes. Journal of Antimicrobial Chemotherapy, 72, 2690–2703 (2017). doi: 10.1093/jac/dkx199 [Paper link]
  • Bengtsson-Palme J, Larsson DGJ: Antibiotic resistance genes in the environment: prioritizing risks. Nature Reviews Microbiology, 13, 369 (2015). doi: 10.1038/nrmicro3399-c1 [Paper link]
  • Bengtsson-Palme J, Boulund F, Fick J, Kristiansson E, Larsson DGJ: Shotgun metagenomics reveals a wide array of antibiotic resistance genes and mobile elements in a polluted lake in India. Frontiers in Microbiology, 5, 648 (2014). doi: 10.3389/fmicb.2014.00648 [Paper link]
  • Bengtsson-Palme J, Angelin M, Huss M, Kjellqvist S, Kristiansson E, Palmgren H, Larsson DGJ, Johansson A: The human gut microbiome as a transporter of antibiotic resistance genes between continents. Antimicrobial Agents and Chemotherapy, 59, 10, 6551-6560 (2015). doi: 10.1128/AAC.00933-15 [Paper link]
  • Bengtsson-Palme J, Hammarén R, Pal C, Östman M, Björlenius B, Flach C-F, Kristiansson E, Fick J, Tysklind M, Larsson DGJ: Elucidating selection processes for antibiotic resistance in sewage treatment plants using metagenomics. Science of the Total Environment, 572, 697–712 (2016). doi: 10.1016/j.scitotenv.2016.06.228 [Paper link]
  • Bengtsson-Palme J, Larsson DGJ: Concentrations of antibiotics predicted to select for resistant bacteria: Proposed limits for environmental regulation. Environment International, 86, 140-149 (2016). doi: 10.1016/j.envint.2015.10.015 [Paper link]
  • Pal C, Bengtsson-Palme J, Kristiansson E, Larsson DGJ: The structure and diversity of human, animal and environmental resistomes. Microbiome, 4, 54 (2016). doi: 10.1186/s40168-016-0199-5 [Paper link]

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