Emergence of methicillin resistance predates the clinical use of antibiotics.

The discovery of antibiotics more than 80 years ago has led to considerable improvements in human and animal health. Although antibiotic resistance in environmental bacteria is ancient, resistance in human pathogens is thought to be a modern phenomenon that is driven by the clinical use of antibiotics . Here we show that particular lineages of methicillin-resistant —a notorious human pathogen—appeared in European hedgehogs in the pre-antibiotic era. Subsequently, these lineages spread within the local hedgehog populations and between hedgehogs and secondary hosts, including livestock and humans. We also demonstrate that the hedgehog dermatophyte produces two β-lactam antibiotics that provide a natural selective environment in which methicillin-resistant isolates have an advantage over susceptible isolates. Together, these results suggest that methicillin resistance emerged in the pre-antibiotic era as a co-evolutionary adaptation of to the colonization of dermatophyte-infected hedgehogs. The evolution of clinically relevant antibiotic-resistance genes in wild animals and the connectivity of natural, agricultural and human ecosystems demonstrate that the use of a One Health approach is critical for our understanding and management of antibiotic resistance, which is one of the biggest threats to global health, food security and development.

Funder

Funder name	Awards
Česká Zemědělská Univerzita v Praze, Czech Republic	No. IGA 20213106
National Institute for Health Research	Health Protection Research Unit in Genomics and Enabling Data (no. NIHR200892)
Medical Research Council, United Kingdom	No. G1001787/1 - No. MR/N002660/1 - No. MR/P007201/1
Economic and Social Research Council, United Kingdom	No. ES/S000186/1
UK Research and Innovation, United Kingdom	Fellowship no. MR/S00291X/1