With the rapid rise in antimicrobial drug resistance, having the ability to identify trends in antibiotic use and control antibiotic resistance on the global scale is an important step in halting and potentially reversing the spread of drug resistance. In 2014, the problem of drug resistance was named among serious threats to human health by the World Health Organization (WHO), with the assistant director-general for health, security, and environment Keiji Fukuda, M.D., stating, “because we are not taking any rapid and coordinated measures, the world is entering an age of diminished antibiotic efficiency, with common infections and minor injuries taking live—many decades after we learned to treat them successfully.”
Now, a group of Russian scientists from the Federal Research and Clinical Center of Physical-Chemical Medicine, the Moscow Institute of Physics and Technology, and Data Laboratory have created an interactive world map of human gut microbiota potential to resist antibiotics, which they have dubbed ResistoMap (from the Latin word resisto, “I resist”). The findings from this new study were published recently in Bioinformatics in an article entitled “ResistoMap—Online Visualization of Human Gut Microbiota Antibiotic Resistome.” Moreover, the tool is publicly available at resistomap.rcpcm.org.
“We created ResistoMap—a Web-based interactive visualization of the presence of genetic determinants conferring resistance to antibiotics, biocides and heavy metals in human gut microbiota,” the authors wrote. “ResistoMap displays the data on more than 1500 published gut metagenomes of world populations including both healthy subjects and patients.”
The human microbiome refers to the aggregate of all microorganisms residing in and on the human body. Compared to other organs, tissues, and biofluids, the gut flora has the largest number of bacteria. According to molecular genetics research, the composition of species in gut flora is stable but can be altered dramatically due to changes in diet or antibiotic treatment. The community of microorganisms in the gut is a complex ecosystem encompassing hundreds of species whose genomes collectively encode 100 times more genetic information than the human genome.
The aggregate of all genomes of gut microbiota includes a “behavioral code” that determines trophic connections and other interactions within the gut community and with the host (human). The stability, or health, of human gut microflora, is essential for normal metabolism, cardiovascular health, food digestion, and protection against infectious diseases (immunity).
During antibiotic treatment, the abundance of antibiotic resistance genes increases. When these genes are transmitted to a pathogen, this has dire consequences for both the individual patient and the society as a whole. An analysis of the functional composition of microbiota using metagenomic methods allows to investigators to assess the relative abundance of the antibiotic resistance genes in human microbiota and thus predict the capacity of an individual's microbiota to contribute to the onset of resistant pathogens.
The ResistoMap has two main interactive working fields: a geographic map and a heat map. Users can choose the antibiotic group or country of interest to be displayed on the heat map and obtain a resistome cross section. The data can be filtered by the country of origin, gender, age, and diagnosis. The current version of the interactive map developed by the authors draws on a dataset that includes over 1600 individuals from 12 studies covering 15 countries. However, the dataset can be expanded by additional input from users reflecting the findings of newly published studies in a unified format.
Using the ResistoMap, it is possible to estimate the global variation of the resistance to different groups of antibiotics and explore the associations between specific drugs and clinical factors or other metadata. For instance, the Danish gut metagenomes tend to demonstrate the lowest resistome among the European groups, whereas the French samples have the highest levels, particularly of the fluoroquinolones, a group of broad-spectrum antibacterial drugs. This is in agreement with the fact that France has the highest total antibiotic use across Western Europe, while the use of antimicrobial drugs in Denmark and Germany is moderate, both in health care and agriculture.
“We anticipate that the exploratory analysis of global gut resistome enabled by the ResistoMap will provide new insights into how the use of antibiotics in medicine and agriculture could be optimized,” concluded lead study investigator Konstantin Yarygin, a bioinformatic scientist Moscow Institute of Physics and Technology and one of the creators of the visualization tool.