A Nature Communications study traced how pharmaceutical contamination in Indian urban sewage correlates with accelerated antimicrobial resistance (AMR) emergence. Researchers combined chemical analysis of wastewater with genomic surveillance of resistomes and found hotspots where antibiotic concentrations select for resistant genes and mobile elements. The paper implicates inadequate wastewater treatment and unregulated antibiotic discharge as drivers, and recommends targeted interventions in urban sanitation and pharmaceutical stewardship. For readers: ‘resistome’ refers to the collection of resistance genes in a microbial community detectable by sequencing.