The rise of antibiotic resistant infections is an imminent global public health threat, and Antibiotic resistance is a major health care concern worldwide. Wastewater (sewage) is considered an important source of dissemination of antibiotic resistant bacteria and resistance genes (ARB/ ARGs) to the environment.
Completed project
AWARE investigated whether people working at wastewater treatment plants (WWTP) and people living in the vicinity of WWTP have an increased risk of carriage of ARB/ARGs through exposure to contaminated water or air. This was studied in Germany, the Netherlands and Romania.
The main conclusion was that WWTP workers and nearby-residents may be at greater risk of carriage of ABR than the general population in some (as was shown for Romania) but not in other countries (as was shown for Germany and the Netherlands). Also, the results suggest that elevated carriage in Romanian nearby residents were not likely to be directly caused by the WWTP. Further analyses will quantify exposure risks and shed light on the role of WWTP in selection of antibiotic resistance.
Project partners
- Heike Schmitt, National Institute for Public Health and the Environment (RIVM), Netherlands (Coordinator)
- Carmen Chifiriuc, University of Bucharest, Romania
- Joakim Larsson, University of Gothenburg, Sweden
- Katja Radon, Ludwig-Maximilians-Universität, Germany
- Susan Pettersson, Water and Health, Australia
- Kate Medlicott, World Health Organization (WHO), Switzerland
- Peter Ulleryd, Västra Götaland och Regionala Strama Södra Älvsborgs Sjukhus, Sweden
Project resources
- AWARE project website
- AWARE project partner Katja Radon profile page (in German)
- Research in RIVM on antibiotic-resistant bacteria in relation to occupation and lifestyle
- Centre for Antibiotic Resistance Research, CARe (Gothenburg, Sweden)
Publications
- PlosOne, 2020. Whole genome sequencing snapshot of multi-drug resistant Klebsiella pneumoniae strains from hospitals and receiving wastewater treatment plants in Southern Romania
- MEDICHUB MEDIA, 2018. Review on methods for analyzing the antibiotic resistance in wastewater samples
- Environment International, 2018. Selective concentration for ciprofloxacin resistance in Escherichia coli grown in complex aquatic bacterial biofilms
- Journal of Environmental Protection, 2017. Physico-Chemical and Microbiological Assessment of Organic Pollution in Plain Salty Lakes from Protected Regions
- Front Microbiol. 2021. Multidrug Resistant Klebsiella pneumoniae ST101 Clone Survival Chain From Inpatients to Hospital Effluent After Chlorine Treatment.
- Syst Rev. 2019. Do wastewater treatment plants increase antibiotic resistant bacteria or genes in the environment? Protocol for a systematic review.
- Antibiotics (Basel). 2021. Antibiotic Resistance in Wastewater Treatment Plants and Transmission Risks for Employees and Residents: The Concept of the AWARE Study.
- Microb Genom. 2020. Comprehensive screening of genomic and metagenomic data reveals a large diversity of tetracycline resistance genes.
