Surveillance of antimicrobial use and antimicrobial resistance

The chemical and biological constituents of wastewater are a valuable source of information on human health and behavior, and on the state of the environment. The concept of using this information for public health purposes has been referred to as wastewater-based epidemiology (WBE).

The main advantage of mining the information available in wastewater is that it provides a temporal and geographical dimension. Furthermore, it can give almost real-time surveillance data, which is hardly collectable with other means. This information can be used for tracking drug addiction and forensic purposes (e.g., monitoring drug use and tracing of illegal synthetic drugs waste disposal) or to track, for example, the spread of antibiotic resistance.


The objective of this project is to improve the assessment of human exposure to antibiotic resistance as well as monitor its spreading through wastewater-based epidemiology (WBE).

Influents, effluents of wastewater treatment plants as well as receiving waters will be analyzed for antibiotics (parent compounds and potentially metabolites) and antimicrobial resistance genes over a period of 6 months. Recent studies have shown the potential of using wastewater to monitor the occurrence and prevalence of antibiotic resistance, yet some fundamental questions regarding the behavior and fate of both antibiotics and antimicrobial resistance genes in sewers, wastewater treatment plants and receiving waters remain unanswered.

This exploratory research aims at improving our understanding of the underlying mechanisms. By combining chemical and microbiological analyses, the relationship between occurrence of antibiotics and potential metabolites and antimicrobial resistance genes in waste- and receiving waters will become clear. The objective of this project is to answer fundamental questions about the use of wastewater-based epidemiology (WBE) to monitor the spreading of antibiotic resistance.