Track resistance trends at the community level
Identify emerging resistance
genes
Establish correlations with antibiotic misuse and overuse patterns
Monitor hospital and urban hotspots
Map spatial and temporal resistance trends
Wastewater
Surveillance
for AMR
This is the process of monitoring wastewater released by human societies to track pathogens and associated antimicrobial resistance. The goal is to generate a knowledge base and inform policy
What is Wastewater Surveillance?
Wastewater surveillance is the systematic monitoring of wastewater generated by human populations to gather actionable public health data. Wastewater contains biological and chemical signals shed by communities, including microorganisms, antibiotic residues, antimicrobial resistance genes, pathogens, and environmental indicators. By analysing these signals, wastewater surveillance provides a population-level snapshot of public health risks without requiring individual testing.
This approach complements clinical surveillance by capturing information from both symptomatic and asymptomatic individuals. It also enables monitoring of entire communities, healthcare settings, and environmental reservoirs in near real time.
Why studyWastewater?
Wastewater represents a pooled sample from communities, institutions, and environmental sources. This makes it uniquely suited for population-level monitoring. Unlike clinical sampling, which samples only the subset of people who are sick and also report to hospitals, wastewater surveillance captures community-level patterns. It also examines bacteria and associated genes in their natural setting, i.e, as a microbial community. This allows identification of context-specific resistance and potential for horizontal gene transfer, in turn, an index for the dissemination of existing AMR. Finally, surveillance of AMR serves as a non-invasive, cost-effective tool to assess local resistance and one that is scalable across geographic regions.
Key advantages include:
- Community-level monitoring without individual testing
- Early detection of emerging resistance threats
- Inclusion of environmental reservoirs of AMR
- Ability to monitor multiple pathogens simultaneously
- Reduced sampling bias compared to hospital-based surveillance
- Real-time tracking of resistance trends
- Scalable and cost-effective monitoring
Wastewater samples can also be analysed for multiple parameters simultaneously, including pathogens, antibiotic residues, resistance genes, and environmental factors. This enables integrated “One Health” surveillance linking human, animal, and environmental health.
Who We Are
Why Study Antimicrobial Resistance (AMR) in Wastewater?
While COVID-19 surveillance through wastewater sampling was adopted widely and served as an important resource, AMR can also be monitored via a similar route. The strains of bacteria that circulate in humans and their environments are released into their wastewater through various activities, with specific locations being hotspots (e.g., hospitals, wastewater treatment plants). If we can monitor these wastewater hotspots for bacteria (alive or only their genetic material) that have developed resistance towards certain antibiotics, we can study local patterns of antibiotic use, which will help us formulate local policies in real time. Additionally, it is possible that we might be able to establish threshold concentrations of AMR in wastewater beyond which we would sound local alarms and implement stricter policies for antibiotic use.
The “One Health” approach treats the health of humans, animals, and their environments as a unified whole. By monitoring wastewater for AMR, we implement this approach to monitor “One Health”, as AMR has the potential to impact the health of humans, animals, and their surrounding environment, with high levels of AMR leading to mortality in susceptible human and animal populations.
By monitoring wastewater, researchers and policymakers can:
-
Track
Track resistance trends at the community level -
Potential
Identify the potential for AMR dissemination
-
Identify
Identify emerging resistance
genes -
Establish
Establish correlations with antibiotic misuse and overuse patterns
-
Monitor
Monitor hospital and urban hotspots -
Develop
Develop early warning systems for AMR outbreaks
-
Evaluate
Evaluate stewardship interventions -
Map
Map spatial and temporal resistance trends
What We Do
Our work focuses on building comprehensive wastewater-based AMR surveillance systems that connect environmental data with clinical outcomes and policy action.
Our core activities include:
Using wastewater sampling as a tool to understand environmental AMR
Identification of novel AMR and bacteria-AMR associations
Tracking resistant bacterial strains and communities
Building/employing novel experimental and informatics tools for in-depth analysis of AMR
Quantification of antibiotic resistance genes
Linking environmental and clinical AMR data
Developing genomic surveillance pipelines
Policy translation and stakeholder engagement
Real solutions, tangible resultsGlobal
Landscape
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Many thanks again for your invaluable advice and assistance
Many thanks again for your invaluable advice and assistance
Many thanks again for your invaluable advice and assistance