Antimicrobial Resistance Genes

Because BARNARDS-I was cross-sectional, it could not determine when ARGs were acquired, whether they persisted, or how early-life exposures shaped their trajectories. Metagenomic relatedness alone cannot prove transmission dynamics with certainty. BARNARDS-I found unexpectedly high carriage of ARGs, including ESBL and carbapenemase genes, in neonatal stool at sites in Nigeria and other low- and middle-income countries. Long-read shotgun metagenomic sequencing using Oxford Nanopore technology supports plasmid-level identification of ARGs. Planned longitudinal analyses will examine ARG stability and persistence across the first year, with particular focus on infants exposed to antibiotics early or repeatedly.