The European Union is now proposing that all large sewage treatment plants should be monitored for antibiotic resistance. This may provide information on the resistance situation in the population and on environmental transmission risks
–Adequate monitoring is simply the basis for giving the patient the right antibiotics says Professor Joakim Larsson, director of CARe when interviewed in Swedish Radio.
Although sewage surveillance for other purposes has been in place for decades, the COVID-19 pandemic gave this approach a new lease of life as a resource-efficient tool for monitoring the spread and evolution of SARS-CoV-2.
Adequate monitoring is simply the basis for giving the patient the right antibiotics
Early detection of potential outbreaks
Measurements of wastewater are an established method for monitoring the spread of microbes in society. The new directive emphasizes the role of sewage surveillance for preventive or early warning purposes, exemplified by the detection of specific viruses as a signal of the emergence of epidemics or pandemics.
In an article in Nature Microbiology, researchers from the Centre for Antibiotics in Gothenburg, (CARe) recognize emissions from sewage treatment plants as a major transmission pathway for antimicrobial agents and resistant bacteria. However, the specific motivation for sewage surveillance of antimicrobial resistance is primarily to increase knowledge of the main sources of resistant bacteria in the environment.
Monitoring needed in developing countries
In many countries, there is already good monitoring of antibiotic resistance but the new EU proposal will allow progress and calibration of methods that can be used in developing countries that currently have no monitoring at all. Tracking resistance there can be an important weapon in the war on resistant bacteria.
–It could help us to assess the resistance situation in different parts of the world if we implement a system like this, says Professor Joakim Larsson.
Swedish Radio News Ekot 14 April 2023
Larsson DGJ, Flach CF, Laxminarayan R. (2022). Sewage surveillance of antibiotic resistance holds both opportunities and challenges. Nature Reviews Microbiology 21:213-214.
