Strengthening Policy Relevance of Wastewater-Based Surveillance for Antimicrobial Resistance

Sheena Conforti¹, Amy Pruden², Nicole Acosta³, Christopher Anderson⁴, Helmut Buergmann⁵, Juliana Calabria De Araujo⁶, Judith R Cristobal⁷, Barbara Drigo⁸, Claire Ellison⁹, Zanah Francis¹⁰, Dominic Frigon¹¹, Markus Gaenzle¹², Julia Vierheilig¹³, Timothy R Julian¹, Uli Klümper¹⁴, Liping Ma¹⁵, Chand Mangat¹⁶, Maya Nadimpalli¹⁷, Manami Nakashita¹⁸, Gilbert Osena¹⁹, Sasikaladevi Rathinavelu⁵, Richard Reid-Smith²⁰, Michael Saldana²¹, Heike Schmitt^{22

23}, Shuxian Li²⁴, Andrew C Singer²⁵, Tam T Tran²⁶, Kadir Yanac²⁷, Gustavo Ybazeta²⁸, Monika Harnisz²⁹

Affiliations

¹ Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf 8600, Switzerland.
² Civil and Environmental Engineering, Virginia Polytechnic Institute and State University, 418 Durham Hall, Blacksburg, Virginia 24061, United States.
³ University of Calgary, Cumming School of Medicine, Calgary, AB T2N 1N4, Canada.
⁴ West Virginia University, Morgantown, West Virginia 26506-6201, United States.
⁵ Eawag, Swiss Federal Institute of Aquatic Science and Technology, Kastenienbaum 6047, Switzerland.
⁶ Federal University of Minas Gerais, Belo Horizonte, MG 31270-901, Brazil.
⁷ Department of Chemistry, University at Buffalo - The State University of New York, 633 Natural Science Complex, Buffalo, New York 14260, United States.
⁸ University of South Australia, Adelaide, SA 5001, Australia.
⁹ Queen's University, Beaty Water Research Center, Kingston, ON K7L 3N6, Canada.
¹⁰ U.S. Department of Health and Human Services, Washington, D.C. 20201-0004, United States.
¹¹ McGill University, Civil Engineering and Applied Mechanics, 817 Sherbrooke Street West, Montreal, QC H3A 0C3, Canada.
¹² University of Alberta, Edmonton, AB T6G 2R3, Canada.
¹³ TU Wien, Institute of Water Quality and Resource Management, ICC Water & Health, 1040 Wien, Austria.
¹⁴ Institute for Hydrobiology, TU Dresden, Dresden 01062, Germany.
¹⁵ East China Normal University, Dongchuan Road 500, Shanghai 200241, China.
¹⁶ Public Health Agency of Canada, Wastewater Surveillance Unit, National Microbiology Laboratory, Winnipeg, MB R3E 3R2, Canada.
¹⁷ Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia 30322, United States.
¹⁸ National Institute of Infectious Diseases, Shinjuku-ku, Tokyo 162-8640, Japan.
¹⁹ University of Gothenburg, Goteborg, Västra Götaland 405 30, Sweden.
²⁰ Public Health Agency of Canada Foodborne, Waterborne and Zoonotic Infections Division, Guelph, ON N1G 5B2, Canada.
²¹ Sonny Astani Civil and Environmental Engineering, University of Southern California, 920 Downey Way, BHE 201, Los Angeles, California 90089-0001, United States.
²² National Institute for Public Health and the Environment, Bilthoven 3720 BA, The Netherlands.
²³ Delft University of Technology, Delft, Zuid-Holland 2600 AA, Netherlands.
²⁴ Department of Civil Engineering, The University of Hong Kong, Hong Kong 999077, China.
²⁵ Centre for Ecology & Hydrology, Mansfield Road, Oxford OX1 3SR, United Kingdom.
²⁶ NORCE Norwegian Research Centre AS, Tromso, Troms og Finnmark 9019, Norway.
²⁷ University of Manitoba, Department of Civil Engineering, Winnipeg, MB CR3T 5V6, Canada.
²⁸ Health Sciences North Research Institute, Sudbury, ON P3E 2H2, Canada.
²⁹ University of Warmia and Mazury in Olsztyn, Department of Water Protection Engineering and Environmental Microbiology, Prawochenskiego 1, Olsztyn 10-790, Poland.

PMID: 39874274
PMCID: PMC11823445
DOI: 10.1021/acs.est.4c09663

Strengthening Policy Relevance of Wastewater-Based Surveillance for Antimicrobial Resistance

Sheena Conforti et al. Environ Sci Technol. 2025.

. 2025 Feb 11;59(5):2339-2343.

doi: 10.1021/acs.est.4c09663. Epub 2025 Jan 28.

Authors

Affiliations

¹ Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf 8600, Switzerland.
² Civil and Environmental Engineering, Virginia Polytechnic Institute and State University, 418 Durham Hall, Blacksburg, Virginia 24061, United States.
³ University of Calgary, Cumming School of Medicine, Calgary, AB T2N 1N4, Canada.
⁴ West Virginia University, Morgantown, West Virginia 26506-6201, United States.
⁵ Eawag, Swiss Federal Institute of Aquatic Science and Technology, Kastenienbaum 6047, Switzerland.
⁶ Federal University of Minas Gerais, Belo Horizonte, MG 31270-901, Brazil.
⁷ Department of Chemistry, University at Buffalo - The State University of New York, 633 Natural Science Complex, Buffalo, New York 14260, United States.
⁸ University of South Australia, Adelaide, SA 5001, Australia.
⁹ Queen's University, Beaty Water Research Center, Kingston, ON K7L 3N6, Canada.
¹⁰ U.S. Department of Health and Human Services, Washington, D.C. 20201-0004, United States.
¹¹ McGill University, Civil Engineering and Applied Mechanics, 817 Sherbrooke Street West, Montreal, QC H3A 0C3, Canada.
¹² University of Alberta, Edmonton, AB T6G 2R3, Canada.
¹³ TU Wien, Institute of Water Quality and Resource Management, ICC Water & Health, 1040 Wien, Austria.
¹⁴ Institute for Hydrobiology, TU Dresden, Dresden 01062, Germany.
¹⁵ East China Normal University, Dongchuan Road 500, Shanghai 200241, China.
¹⁶ Public Health Agency of Canada, Wastewater Surveillance Unit, National Microbiology Laboratory, Winnipeg, MB R3E 3R2, Canada.
¹⁷ Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia 30322, United States.
¹⁸ National Institute of Infectious Diseases, Shinjuku-ku, Tokyo 162-8640, Japan.
¹⁹ University of Gothenburg, Goteborg, Västra Götaland 405 30, Sweden.
²⁰ Public Health Agency of Canada Foodborne, Waterborne and Zoonotic Infections Division, Guelph, ON N1G 5B2, Canada.
²¹ Sonny Astani Civil and Environmental Engineering, University of Southern California, 920 Downey Way, BHE 201, Los Angeles, California 90089-0001, United States.
²² National Institute for Public Health and the Environment, Bilthoven 3720 BA, The Netherlands.
²³ Delft University of Technology, Delft, Zuid-Holland 2600 AA, Netherlands.
²⁴ Department of Civil Engineering, The University of Hong Kong, Hong Kong 999077, China.
²⁵ Centre for Ecology & Hydrology, Mansfield Road, Oxford OX1 3SR, United Kingdom.
²⁶ NORCE Norwegian Research Centre AS, Tromso, Troms og Finnmark 9019, Norway.
²⁷ University of Manitoba, Department of Civil Engineering, Winnipeg, MB CR3T 5V6, Canada.
²⁸ Health Sciences North Research Institute, Sudbury, ON P3E 2H2, Canada.
²⁹ University of Warmia and Mazury in Olsztyn, Department of Water Protection Engineering and Environmental Microbiology, Prawochenskiego 1, Olsztyn 10-790, Poland.

PMID: 39874274
PMCID: PMC11823445
DOI: 10.1021/acs.est.4c09663

No abstract available

Keywords: One Health; antimicrobial resistance; epidemiology; policy integration; public health; wastewater-based surveillance.

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Conflict of interest statement

The authors declare no competing financial interest.

Figures

**Figure 1**
Integration of data across One Health sectors to inform AMR policy and the potential role of WBS. Clinical settings, environmental studies, and agricultural surveillance can provide indicators used for antimicrobial stewardship and antimicrobial resistance (AMR) management. Indicators include prevalence of AMR and prescription patterns in clinical settings, geographic distribution and emerging threats in the environment to identify horizontal gene transfer (HGT) hot spots, and antibiotic/biocide residues and zoonotic pathways in agriculture. Wastewater-based surveillance (WBS) programs can be designed to integrate within and across all sectors.

See this image and copyright information in PMC

References

1. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet 2022, 399 (10325), 629–655. 10.1016/S0140-6736(21)02724-0. - DOI - PMC - PubMed
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1. von Wintersdorff C. J. H.; Wolffs P. F. G.; van Niekerk J. M.; Beuken E.; van Alphen L. B.; Stobberingh E. E.; Oude Lashof A. M. L.; Hoebe C. J. P. A.; Savelkoul P. H. M.; Penders J. Detection of the plasmid-mediated colistin-resistance gene mcr-1 in faecal metagenomes of Dutch travellers. J. Antimicrob. Chemother. 2016, 71 (12), 3416–3419. 10.1093/jac/dkw328. - DOI - PubMed

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Strengthening Policy Relevance of Wastewater-Based Surveillance for Antimicrobial Resistance

Affiliations

Strengthening Policy Relevance of Wastewater-Based Surveillance for Antimicrobial Resistance

Authors

Affiliations

Conflict of interest statement

Figures

References

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