Variability in responses of antimicrobial resistance genes to lifting COVID-19-related measures among different population groups : A comparative study of the general public, university campus community, and marginalized groups

COVID-19 pandemic posed a serious threat to the public health, resulting in an unprecedented level of travel restrictions across our societies. As a result, in Alberta, both domestic and international travel decreased significantly during the travel restriction compared to the previous years, then gradually recovered upon lifting the restriction from 2022-March. Such changes in the governmental measure might have had an impact on the public antimicrobial resistance (AMR), as evidenced by other studies reporting association between travel and AMR (Heß et al., 2019 Env Sci Tech; Ricotta et al., 2014 Am J Public Health), but the impact has not comprehensively been studied. For the first time, our team monitored occurrences of AMR genes in different population groups in Calgary, including the general public, university campus community, and marginalized groups, during the transition period (Oct 2021 - Oct 2022), leveraging multi-disciplinary efforts spanning wastewater-based surveillance (WBS), geography, genomics, computer and statistical sciences. We first (1) sequenced genomic DNAs in wastewaters obtained from wastewater treatment plants (WWTPs; covering > 1M serving population), a university residence hall, and a homeless facility in Calgary during the monitoring period, (2) identified AMR genes from the samples using bioinformatics, and (3) correlated those genes with domestic and international passengers. Many genes of clinical concern (for beta-lactamases, MLS, and fluoroquinolones) increased significantly after lifting travel restriction. Consequently, those genes correlated positively with either domestic or international passengers, depending on the population group (p < 0.05). Our approach emphasizes the significance of travel as a key factor influencing public AMR. Additionally, it highlights that AMR transmission or carriage routes differ among population groups, underscoring the importance of customizing resource allocation for equitable health outcomes.