Harnessing Technology to Combat Antimicrobial Resistance: Insights from Wastewater Surveillance

Every day, wastewater samples were collected from 47 treatment plants, covering about two-thirds of the population. For this study, researchers combined daily samples into weekly composite samples for analysis. They also gathered daily samples from a large hospital for one month. The goal was to detect antibiotic resistance genes silently circulating in communities, understand their spread, and compare HT-qPCR and metagenomic sequencing as methods for monitoring nationwide antimicrobial resistance (AMR) profiles.

By analysing wastewater and turning it into data, researchers gain a powerful, non-invasive snapshot of public health. This national surveillance programme has provided real-time insights into population-wide health trends.

To do this, the team used two complementary technologies:

• High throughput quantitative PCR (HT-qPCR) to detect and quantify 73 specific resistance genes
• Metagenomic sequencing to identify a broad range of resistance genes and their potential bacterial hosts

Together, these methods revealed over 500 different antibiotic resistance genes. They also discovered that wastewater coming from hospitals contained a much larger and more diverse collection of these resistance genes compared to the wastewater entering treatment plants from the community, identifying hospitals as key resistance hotspots.

Rather than choosing one method over the other, the study demonstrated how combining targeted and broad approaches provides both depth and breadth crucial for effective AMR surveillance. 

Why Advanced Technology Matters in the Fight Against AMR:

• Early Warning System: Detect emerging resistance before it becomes widespread.
• Scalable Monitoring: Survey entire populations non-invasively.
• One Health Insights: Track AMR across humans, animals, and the environment.

Wastewater testing captures microbial signals from entire populations without the need for individual testing. It offers real-time insight into human, animal, and environmental health and directly supports public health decision-making worldwide. 

Antibiotic resistance is not a future threat, it's happening now. It makes common infections harder to treat and puts lives at risk. This kind of surveillance helps detect resistance early, guide healthcare responses, and protect the antibiotics we all depend on.

At Resistomap, we’re proud to contribute to this national effort by providing the SmartChip HT-qPCR system as a service, enabling high-resolution quantification of ARGs and mobile genetic elements (MGEs). Our technology delivers the precise, large-scale data needed to track resistance trends and inform public health strategies.

By advancing wastewater-based antimicrobial resistance surveillance with tools like SmartChip HT-qPCR, we aim to equip policymakers and researchers with actionable data. Together, we can strengthen public health, safeguard our environment and protect the power of antibiotics for the future generations.

Monitor 🧬 Detect 🧫 Protect 🛡️

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For more detailed insight, the full paper can be accessed through this link.

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