Strengthening Policy Relevance of Wastewater-Based Surveillance for Antimicrobial Resistance
Sheena Conforti, Amy Pruden, Nicole Acosta, Christopher W. N. Anderson, Helmut Bürgmann, Juliana Calábria de Araújo, Judith R. Cristobal, Barbara Drigo, Claire M. Ellison, Zanah Francis, Dominic Frigon, Markus Gaenzle, Julia Vierheilig, Timothy R. Julian, Uli Klümper, Liping Ma, Chand S. Mangat, Maya Nadimpalli, Manami Nakashita, Gilbert Osena, Sasikaladevi Rathinavelu, Richard J. Reid‐Smith, Michael A. Saldana, Heike Schmitt, Shuxian Li, Andrew C. Singer, Tam T. Tran, Kadir Yanaç, Gustavo Ybazeta, Monika Harnisz
Abstract
A ntimicrobial 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 7 th Environmental Dimension of Antimicrobial Resistance (EDAR7) conference (Montreál, Canada) sought to answer