7 Environmental AMR surveillance

Environmental surveillance of AMR refers to ongoing collection, analysis, interpretation and dissemination of data related to AMR in various environmental compartments.

Globally, AMR surveillance in animals and humans provides early warning about the spread of new resistant strains of bacteria, revealing trends and outbreaks of infection.

AMR surveillance is critical to tackling AMR because the data it yields:

  • can help to inform the best treatment and care (the right drug at the right dosage for the right amount of time) for humans or animals at a local level, even where it is not possible to test individually
  • informs intervention priorities and helps to identify gaps in service delivery at regional and national levels
  • guides planning and resource allocation at a national level, and informs policies and responses to patterns and trends.

As you are hopefully realising by studying this course, the environment plays an important role in the introduction and transmission of AMR in humans and animals, but there is limited data to quantify this role. Environmental surveillance can provide essential information to further understand the role of the environment in AMR.

Some aspects of environmental surveillance are similar to surveillance in humans and animals; some are a little different. Environmental surveillance of AMR has not been taking place for as long as human and animal surveillance: although it is growing in importance, it is still in its early stages, with few formalised systems or large-scale implementation projects. Environmental surveillance activities are often still limited to certain locations or specific research studies rather than continuous monitoring across regions.

Activity 6: Where should environmental surveillance be carried out?

Timing: Allow 5 minutes

Use the space below to make a list of specific places (compartments) in the environment where you think it might be useful to monitor for antimicrobials, resistant bacteria or ARGs.

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Discussion

The authors of this course thought of the following environmental compartments that could be monitored – you may have thought of others depending on your own setting:

  • raw sewage/untreated wastewater
  • treated wastewater
  • agricultural soil (e.g. after fertilisation)
  • drinking water
  • bathing water
  • river water
  • irrigation water
  • air.

Scientific studies on AMR in the environment have so far been performed in all types of surface water, coastal water, (manured) soil, wastewater and air. All these pilot studies and smaller initiatives are important to collect necessary information on AMR in the environment.

In the following sections you will look at surveillance in these compartments in more detail.

6 Introduction of new resistance combinations from environmental reservoirs

7.1 Wastewater surveillance