A National Wastewater Surveillance Program for Antimicrobial Resistance

Antimicrobial resistance is the ability of micro-organisms (e.g. bacteria, fungi, parasites and viruses) to change over time, hence reducing the effectiveness of treatments such as antibiotics. The World Health Organisation declared it as one of the greatest human health challenges of the 21st century. Current surveillance of antimicrobial resistance is limited to the clinical setting and does not provide coverage of antimicrobial resistance in the general population. It was recently demonstrated that metagenomic analysis of SARS-CoV-2 gene fragments in a community’s wastewater is pivotal in how Australia and other countries respond to COVID19 outbreaks. It is a contemporary exemplar of the intersection between wastewater testing and health surveillance. This project aims to use wastewater analysis to provide a surveillance strategy for monitoring antimicrobial resistance in the general population and to develop a National Wastewater Antimicrobial Resistance and Antimicrobial Use Surveillance Method.

Outcomes

A direct injection LC-MS/MS method for the ultra-trace determination of ~100 antimicrobial compounds in wastewater influent and effluent has been developed on a state-of-the-art Sciex 7500 system and has been applied to samples collected across the country. 

Lecture Presentations

O,Brien, J. The Wastewater Analysis for Understanding Populations and New Tools for the Detection of Chemicals of Emerging Concern, Imperial College London, 31 October 2022.

O'Brien, J. The Role of Wastewater Analysis for Understanding Populations and New Tools for the Detection of Chemicals of Emering Concern, Vrije Universiteit Amsterdam, 27 October, 2023. 

O'Brien, J. The Role of Wastewater Analysis for Understanding Populations and New Tools for the Detection of Chemicals of Emerging Concern, Federal Institure for Materials Research and Testing (BAM), 18 October 2023.

Conference Abstracts

O’Brien, J., Samanipour, S., Rousis, N., Tscharke, B., Bade, R., Van Herwerden, D., Dewapriya, P., Mueller, J. & Thomas, K. Combining non-target screening, wastewater-based epidemiology and Census as a technique to identify population and demographic markers, International Conference on Non-Target Screening, Germany, 16-19 October 2023. 

Research Output

Clarke, L.M., O’Brien, J.W., Murray, A.K., Gaze, W.H. and Thomas, K.V., 2024. A review of wastewater-based epidemiology for antimicrobial resistance surveillance. Journal of Environmental Exposure Assessment, 3(1).

Li, J., Choi, P.M., Gao, J., Ren, J., O'Brien, J.W., Thomas, K.V., Mueller, J.F., Thai, P.K. and Jiang, G., 2024. In-sewer stability of 31 human health biomarkers and suitability for wastewater-based epidemiology. Water Research, 249, p.120978.

Research Impact

This project has been discussed with the Australian Department of Agriculture, Water and the Environment who are particularly interested in the analytical method developed to date, and would like to apply this method to effluent and biosolids. This method will also be applied for monitoring purposes for CRC-SAAFE, and there is discussion of a collaboration with Animal Industries Antimicrobial Stewarship Strategy. This project has also resulted in a relationship with the Interm Australian Centre for Disease Control Antimicrobial Resistance Policy section.