Targeted removal of ARGs and facultative pathogenic bacteria (FPB) in wastewater from AMR hotspots using modular advanced treatment solutions (HOTMATS)

The objective of the project HOTMATS is to design and demonstrate effective and compact solutions for the source-treatment of wastewater emitted from AMR hotspots.

The goal is to stop the spreading of antimicrobial resistant bacteria (ARB), antibiotic resistance genes (ARG), and other health-critical microorganisms from hotspots to the public sewage network, which currently is one of the major AMR transmission links between the three pillars of One-Health. This intervention will unburden the sewage network including wastewater treatment plants from the load of AMR, and hence reduces their release to the environment.

The capability of different treatment principles will be investigated, novel treatment units will be designed, and the destruction of ARB/ARGs in contaminated wastewater will be demonstrated. Ozone, AOP, MF, and UV-C based pilot-reactors will be developed and their effectiveness to destroy ARB/ARGs in concentrated wastewater streams will be assessed at a hospital, nursery homes, and animal facilities.

Compared to existing methods, the investigated treatment solutions are more effective, have a lower footprint, and consume less energy and resources, making them attractive options for treatment at AMR hotspots, as retrofits at old building infrastructures, and where space is limited. The socio-economy assessment including the transfer from HIC to LMIC is part of the HOTMATS project by integration partners from LMICs.

Project partners

  • Thomas Schwartz, Karlsruhe Institute of Technology, Germany (Coordinator)
  • Carsten Schwermer, Norwegian Institute for Water Research, Norway
  • Jaqphet Opintan, University of Ghana, Ghana
  • Richard Wulwa, University of Nairobi, Kenya


Ionophore coccidiostats: risk of CO-selectioN of antImicrobial resistance – Clinical impact and intervention strategies (ICONIC)

Today’s intensive broiler production is highly dependent on in-feed ionophore coccidiostats. Because these ionophores are not used in humans, it is widely assumed that their use in poultry is not a risk for human health.

Recent evidence, however, suggests that they may cause co-selection of medically important antimicrobial resistance. This means that the use of ionophores can cause the spread of bacteria which, when they cause infections in humans, cannot be treated with certain antibiotics.

The ICONIC project aims to gain more insight into the magnitude of this problem by a analyzing and comparing bacteria from poultry, environment and humans. The results will yield a better understanding of the human health impact of ionophore use in poultry industry. In parallel, the project will investigate the effects of alternatives to the use of ionophores, providing leads for reducing the risk of resistant bacteria transmitting from the poultry chain to humans.

Project partners

  • Mariel Pikkemaat, Stichting Wageningen Research, Netherlands (Coordinator)
  • Anne Margrete Urdahl, Norwegian Veterinary Institute, Norway
  • Roger Simm, University of Oslo, Norway
  • Daniela Maria Cirillo, San Raffaele Scientific Institute, Italy
  • Isabelle Kempf, Anses, laboratoire de Ploufragan, France
  • Jowita Niczyporuk, National Veterinary Research Institute PIWet, Poland


FARM interventions to Control Antimicrobial ResistancE (FARM-CARE)

The aim of FARM-CARE is to control development and spread of antibiotic resistance in pig farming through four complementary interventions that reduce antibiotic use in pigs and prevent transfer of resistant bacteria to people.

The four interventions include a farm practice that reduces stress and antibiotic use in pigs (intervention A); a strategy based on hygiene and disinfection that minimizes the risk of transfer of resistant bacteria to farm workers and their families (intervention B); and two sophisticated computer programs enabling farmers and veterinarians to identify stressed piglets predisposed to disease and antibiotic treatment based on their behavior and bacterial content in faeces, respectively (interventions C and D). We will evaluate the efficacy of these interventions using DNA sequencing methods that allow quantification of antibiotic resistance genes in pig faeces, human faeces, and slurry intended for agricultural use. Additionally, costs and benefits to the farmers and to the society as a whole will be assessed for each intervention.

FARM-CARE is a project that requires knowledge and expertise from different disciplines and sectors. This is why the consortium brings together scientists and professionals with different backgrounds. Altogether the consortium comprises 3 universities, 3 public organizations (1 hospital, 1 research institute and 1 national agriculture and food authority) and 1 large non-profit company in representation of 5 countries (Denmark, Germany, Ireland, United Kingdom and Colombia).

Project partners

  • Luca Guardabassi, University of Copenhagen, Denmark (Coordinator)
  • Jesper Larsen, Statens Serum Institut, Denmark
  • Edgar Garcia Manzanilla, The Irish Agriculture and Food Development, Ireland
  • Corina Zambrano, Colombian Association of Pork Farmers, Colombia
  • Melvyn Smith, University of the West England, United Kingdom
  • Emma Baxter, Scotland’s Rural College, United Kingdom
  • Chantal Morel, University Hospital Bonn, Germany


Interventions to control the dynamics of antimicrobial resistance from chickens through the environment (ENVIRE)

The overall objective of the project ENVIRE is to contribute to the reduction of antimicrobial resistance in broiler chickens and of the spread from chicken farms to the environment, and ultimately to humans.

We will carry out intervention studies, either as an experiment or in chicken farms. We will test, which interventions are most effective and feasible: i) Antibiotic-free raising of chickens, ii) Treatment with medicinal plants as alternative for antibiotics, iii) vaccination against the bacterium Escherichia coli, iv) Application of bacteriophages that infiltrate and destroy bacteria, v) Treatment or long storage of manure, vi) Treatment of farm effluents to remove antibiotics and their residues.

Focus will be laid on certain bacteria that are widely distributed, and on certain resistances that can harm human health (e.g. so-called ESBL). A mathematical risk assessment model will be developed and used to assess the effectiveness as well as potential synergistic effects of the interventions, to reduce human exposure via the foodborne, occupational and environmental pathways. Data already available for the participating countries will be included in the model, and new, essential data will be generated within the studies. As a result, specific as well as general interventions will be identified that have the potential to reduce AMR in chicken and in the environment of chicken farms for Europe and Tunisia. To achieve this, six working groups from Germany, France, Lithuania, Poland, and Tunisia, bundle their leading expertise for the respective issue.

Project partners

  • Roswitha Merle, Freie Universität Berlin, Germany (Coordinator)
  • Lucie Collineau, French Agency for Food, Environmental and Occupational Health & Safety, France
  • Mindaugas Malakauskas, Veterinary Academy of Lithuanian University of Health Sciences, Lithuania
  • Marta Kuzminska-Bajor, Wroclaw University of Environmental and Life Sciences, Poland
  • Wejdene Mansour, University of Sousse, Tunisia
  • Tina Kabelitz, Leibniz Institute for Agricultural Engineering and Bioeconomy, Germany


Designing One Health Governance for Antimicrobial Stewardship Interventions (DESIGN)

AMR is a problem of the global commons, whose resolution depends on coordination of collective global strategy. Addressing the challenges posed by AMR through a One Health approach relies on inter-sectoral policy coordination – across public health, agricultural, and environmental sectors – internationally, making stewardship complex, necessitating new approaches to policy development.

Our research seeks to address these issues through a comparative analysis that will identify innovative international policy, legal and regulatory approaches in high-, medium- and low-income case study countries. We will apply systems analysis to understand the complex contingencies inherent in local and international contexts in order to clarify the manner in which national systems could better support the coordinated efforts of public health, agricultural, environmental sectors, professional groups, public and private sectors, and civil society to secure their cooperation.

Design thinking workshops will leverage evidence emerging from the systems analysis by engaging governments and local stakeholders. Workshops will identify the incentives that foster a One Health approach to the governance of AB stewardship, including innovative governance approaches that support the development of regional and national policies, regulations and laws to improve the global commons. The findings will be used to advise government, industry, public health and environmental agencies on solutions that foster implementation of a One Health approach to reduce AMR.

Project partners

  • Mary E. Wiktorowicz, York University, Canada (Coordinator)
  • John Paget, Netherlands Institute for Health Care Research, Netherlands
  • Marion Bordier, Agricultural Research for Development, France
  • Alpha Amadou Diallo, Institut Sénégalais de Recherches Agricoles, Senegal
  • Marilen Balolong, University of the Philippines, Philippines
  • Ria Benko, University of Szeged, Hungary


COMplex Biofilms and AMR Transmission (COMBAT)

Antimicrobial resistant microorganisms are difficult to treat and lead to increased death and treatment costs.

Antibiotic resistance is recognised as a critical threat in both human and animal medicine. Addressing this threat can be challenging when bacteria exist in complicated communities called biofilms. Biofilms form naturally and allow bacteria to survive and persist in diverse environments. Surviving bacteria facilitates the spread of antibiotic resistance genes contributing to the spread of antimicrobial resistance.

The COMBAT (COMplex Biofilms and AMR Transmission) project will identify interventions that can actually control complex biofilms in three different environments, thereby decreasing the threat of antimicrobial resistance spreading. COMBAT’s approach is based on solid novel laboratory-based biofilm study but also on the application of interventions in the domestic, healthcare and animal environments, providing a direct application to control real “One Health” antibiotic resistance problem.

Project partners

  • Jean-Yves Maillard, Cardiff University, United Kingdom (Coordinator)
  • Dirk Bockmühl, Rhein-Waal-University of Applied Sciences, Germany
  • Mark Fielder, Kingston University London, United Kingdom
  • Noora Perkola, Finnish Environment Institute SYKE, Finland
  • Veljo Kisand, University of Tartu, Estonia
  • Seamus Fanning, University College Dublin, Ireland


Optimising community antibiotic use and environmental infection control with behavioural interventions in rural Burkina Faso and DR Congo (CABU-EICO)

Incorrect use of antibiotics is a major cause of antibiotic resistance. In rural Africa, people often receive antibiotics without prescription from local pharmacy shops, increasing the risk of resistance.

Substandard sanitation and hygiene practices result in frequent exchange of bacteria between humans’ guts, and their environment. How important these different sources are for the acquisition of antimicrobial resistant (AMR) bacteria in humans is still unclear, but contacts between humans and animals, in particular rodents, are frequent in much of Africa.

We will develop and evaluate a behavioural intervention for community pharmacy staff and their communities, to improve antibiotic use and hygiene practices, to ultimately reduce AMR. The intervention will be implemented over 12 months in Burkina Faso and DR Congo. We’ll measure as primary result changes in the use of specific AMR-prone and clinically vital antibiotics at community pharmacies throughout the intervention period. We will compare antibiotic use in pharmacies and surrounding communities where the intervention was implemented, and where the intervention did not take place. Also, we will assess changes in hygiene practices by surveying members of the surrounding communities. Then, we will determine how frequent AMR bacteria are transmitted by repeatedly analysing stool samples of those populations, and of rodents living in the surroundings, for bacteria and specific AMR genes. Through mathematical modelling we will quantify how changes in antibiotic use and hygiene practices will impact AMR transmission.

Project partners

  • Marianne van der Sande, Institute of Tropical Medicine, Belgium (Coordinator)
  • Halidou Tinto, Institut de Recherche en Science de la Santé, Burkina Faso, Philippines
  • Delphin Phanzu Mavinga, Institut Médical Evangélique de Kimpese, The Democratic Republic Of The Congo
  • Edwin Wouters, University of Antwerp, Belgium
  • Tamara Giles-Vernick, Institut Pasteur, France
  • Stephen Baker, University of Cambridge, United Kingdom
  • Ben Cooper, University of Oxford, United Kingdom


Combating Antibiotic Resistance in Philippine Lakes: One Health upstream interventions to reduce the burden (ARPHILAKE)

Antimicrobial resistance (AMR) may lead to more deaths than cancer by 2050. Action is required now to avert this disaster.

This study aims to implement key interventions in Greater Manila, The Philippines to reduce AMR. Interventions will focus on hospitals, small farms, and the Laguna Lake, one of the largest freshwater lakes in Asia. Better antibiotic use, point of care testing in hospitals and farms, and novel solar-powered wastewater cleaning technologies will be implemented. Their impact will be assessed by state-of-the-art molecular surveillance for antibiotic resistance genes and bacteria in the water before and after interventions. The study will be the most comprehensive and systematic interventions to be introduced in Asia to reduce AMR in lakes.

Project partners

  • Dylan Pillai, University of Calgary, Canada (Coordinator)
  • Maria Pythias Espino, University of the Philippines Diliman, Philippines
  • Stefanos Giannakis, Polytechnic University of Madrid, Spain
  • Ana Pereira do Vale, University College Dublin, Ireland
  • Paul Wigley, University of Liverpool, United Kingdom


Impact of reducing colistin use on colistin resistance in humans and poultry in Indonesia (COINCIDE)

Antimicrobials are drugs that help cure people and animals from infections with bacteria. The slogan: ‘the more you use, the faster you lose’ is definitely applicable for antimicrobials. When you use antimicrobials, more bacteria become resistant, meaning that an infection can no longer be treated. This is a worldwide challenge for the treatment of diseases in animals and humans.

The World Health Organization (WHO), like many other organizations, are advocating for reduction of use of antimicrobials when they are not needed. The COINCIDE-project explores what will happen when the use of colistin in animals is banned in Indonesia. Colistin is a specific antimicrobial that is used as last resort in humans if nothing else works, resistance against this antimicrobial means that resistant disease causing bacteria will have free reign.

In animals, colistin has been banned in 2020 and a group of human doctors, veterinarians, anthropologists and DNA researchers will look if less bacteria become resistant. We also want to reduce the colistin use in humans, as it is suspected to be used in humans without good reasons. We will work with farmers and their veterinarians, but also with people in the community and doctors and pharmacies to find out why they are still using colistin and if they can do without. The outcome of the project will help governments, farmers, veterinarians, human doctors, and everybody who really needs colistin, to safeguard this antimicrobial for use only when we cannot do without.

Project partners

  • Anis Karuniawati, Universitas Indonesia, Indonesia (Coordinator)
  • Juliëtte Severin, Erasmus MC University Medical Center Rotterdam, Netherlands
  • Jaap Wagenaar, Utrecht University, Faculty of Veterinary Medicine, Netherlands
  • Sunandar Sunandar, Center for Indonesian Veterinary Analytical Studies, Indonesia
  • Herman Barkema, University of Calgary, Canada
  • Koen Peeters, Institute of Tropical Medicine, Belgium
  • Imron Suandy, Directorate of Veterinary Public Health, DG of Livestock and Animal Health Services, MoA-Indonesia, Indonesia


Knowledge transfer strategies, networking and public engagement for a successful mitigation of risks induced by aquatic pollutants (AquaticPollutantsTransNet)

This transfer project is part of the AquaticPollutants projects’ family and accompany its research and innovation projects. It will support the funded projects in scientific communication and in the uptake of research results with the aim to increase their impact.

Ongoing project

Protecting all our water resources from pollutant inputs and the spread of pathogens is essential for a healthy environment, ecosystems, and our life! “Strengthen the European Research Area (ERA) in the field of clean and healthy aquatic ecosystems and to leverage untapped potential in the collaboration between the freshwater, marine and health research areas.” – That is the goal within the ERA-NET Cofund AquaticPollutants where the Joint Programming Initiatives (JPIs) on Water, Oceans and Antimicrobial Resistance (AMR) are working closely together. To support the achievement of this goal is in the focus of the upcoming transfer project AquaticPollutantsTransNet.


The project aims to:

  • Improve stakeholders’ & citizens’ perception through active involvement in the reduction of aquatic pollutants in the water cycle,
  • bring aquatic pollutants to the public’s attention and improve social impact awareness and understanding of the advantages in their reduction,
  • realise the above by using innovative tools and by implementing engagement activities around the AquaticPollutants projects to foster societal embedding.

Key objectives

To support knowledge transfer, scientific networking, and public engagement on aquatic pollutants,the key objectives are:

  • identification of key stakeholders and their knowledge gaps,
  • development of innovative approaches for enhanced knowledge transfer and exchange,
  • create synergies amongst the AquaticPollutants projects and strengthen stakeholder collaboration,
  • foster the knowledge transfer from the research projects to stakeholders and its uptake,
  • implementation of multiple dissemination and exploitation routes with thematic (non-scientific) groups, political fora, scientific networks and citizens.

Project phases

The transfer project consists of two interacting phases:

  • Phase one aims (a) to identify key stakeholders and knowledge demands relevant to aquatic pollutants (CEC, AMR and pathogens) and (b) to develop innovative methods/strategies/tools to improve the transfer of scientific knowledge on aquatic pollutants to policy makers, the public, the health, agricultural and industrial sectors.
  • The aim of phase two is (a) to create added value by cooperation among the AquaticPollutants projects, (b) to strengthen collaboration with stakeholders and (c) implement innovative methods and channels for strategic transfer exploitation and uptake of results by communication to reach the relevant identified stakeholder groups.

Thus, AquaticPollutantsTransNet will follow a tailored dissemination, exploitation and knowledge transfer strategy with multiple dissemination and exploitation routes integrating standardisation, thematic expert groups, political fora, scientific networks and the public.

Once the project has started, we will keep you updated on our website and communication channels. The entire AquaticPollutantsTransNet team looks forward to cooperate and interact with you as funded projects, stakeholders, interested parties or individuals!

Contact: Thomas Track, Head of Water Management, DECHEMA e.V., Frankfurt/Main, Germany, thomas.track[at]

Project partners

  • Dennis Becker, DECHEMA Gesellschaft fuer Chemische Technik und Biotechnologie e.V., Germany (Coordinator)
  • Gunnar Thorsén, IVL Swedish Evironmental Research Institute, Sweden
  • Nicole Baran, BRGM , the French geological survey, France
  • Pierre Strosser, ACTeon, France