8.1 Determine trends of AMR in the environment or wastewater

Insights into temporal and spatial presence of AMR in an environmental compartment will emerge by following AMR trends like the ones shown in Figure 10. For example:

  • surveilling the presence of AMR in surface water over time to provide information on sources of emission of AMR into this surface water
  • surveilling the circulation of uncommon ARGs in human populations over time through raw wastewater measurements; this can be used as a proxy for human surveillance and is a cheaper and easier option – it is often called ‘wastewater-based surveillance’ or also occasionally ‘environmental surveillance’, although the goal is to provide information on AMR in the human population rather than in the environment.
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Figure 10 An illustrative example of ‘trends in AMR’ in surveillance, showing how this data could provide insights into temporal presence of AMR in an environmental compartment. ErmB, blaTEM and TetO are all ARGs. ErmB confers resistance to macrolide antimicrobials, blaTEM confers resistance to beta-lactam antimicrobials, TetO confers resistance to tetracycline
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A graph showing an example of the rise and fall (measured by gene copy number) of three ARGs between 2016 and 2025. ErmB confers resistance to macrolide antimicrobials, blaTEM confers resistance to beta-lactam antimicrobials and TetO confers resistance to tetracycline.

Figure 10 An illustrative example of ‘trends in AMR’ in surveillance, showing how this data could provide insights into temporal presence...

8 Why carry out environmental surveillance?

8.2 Determine emerging forms of AMR in environmental compartments and/or hotspots