Strengthening Policy Relevance of Wastewater-Based Surveillance for Antimicrobial Resistance
Sheena Conforti (Eawag - Swiss Federal Institute of Aquatic Science and Technology)
Amy Pruden (Virginia Tech)
Nicole Acosta (University of Calgary)
Christopher Anderson (West Virginia University)
Helmut Buergmann (Eawag - Swiss Federal Institute of Aquatic Science and Technology)
Juliana Calabria De Araujo (Universidade Federal de Minas Gerais)
Judith R. Cristobal (State University of New York at Buffalo)
Barbara Drigo (University of South Australia)
H. Schmitt (TU Delft - BT/Environmental Biotechnology, Rijksinstituut voor Volksgezondheid en Milieu (RIVM))
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Abstract
Antimicrobial resistance (AMR) is among the top 10 public health threats, with nearly 5 million deaths in 2019 linked to AMR-related bacterial infections. (1) A One Health approach is needed to combat AMR.
Healthcare-based surveillance (HBS) of AMR provides incomplete information about the scope of the AMR threat. HBS screens only patients seeking medical attention, lacking community-level representativeness, and suffers from underreporting. (2) Consequently, researchers are turning to wastewater-based surveillance (WBS) to complement HBS. (3) WBS can provide information about AMR circulating within communities and hospitals, offering a comprehensive understanding of AMR prevalence. However, the surveillance targets and data obtained from WBS are distinct from those derived from HBS, creating uncertainty regarding their utility to the public health sector and ability to yield policy relevant information. In May 2024, participants in a workshop during the 7th Environmental Dimension of Antimicrobial Resistance (EDAR7) conference (Montréal, Canada) sought to answer four questions aimed at advancing the policy relevance of AMR data generated by WBS.
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