National antibiotic consumption is strongly related to the prevalence of antibiotic resistance across bacterial clades

Abstract

The impact of societal antibiotic consumption on the prevalence of antibiotic resistance across microbial taxa in natural environments has not yet been assessed at global scales. Here, I examine the prevalence of 155 antibiotic resistance genes (ARGs) in 300,209 bacterial genomes, from non-clinical non-human-associated terrestrial environments at over 9,600 locations in 44 countries. I then compare ARG prevalences to nationwide antibiotic consumption rates, distinguishing between different ARG types. I find that depending on country and ARG type, ARG prevalences can be extremely high; for example, the probability that a given quinolone resistance gene is present in a given strain in Thailand was estimated at 42%. Further, I find strong positive correlations between nationwide antibiotic consumption rates and mean ARG prevalences for nearly all ARG types. Thus, national antibiotic consumption leaves a signal on the prevalence of ARGs across the bacterial tree, even in non-clinical environments.