Pandemic preparedness against antimicrobial resistance through wastewater monitoring
PI(s)/Head responsible for the resource:
The increasing spread of antimicrobial resistance (AMR) is a serious threat to human and animal health, and a OneHealth approach is needed to reduce the transmission of AMR microorganisms. AMR monitoring is considered essential to assess: (i) the overall AR status in a human population or community; (ii) the risks that AMR evolves and spread across One-Health compartments; (iii) the risk of AMR transmission to humans. The difficulties in global monitoring of AMR are many; ranging from ethical issues regarding human samples to lack of comparable methods available across nations. Recently, wastewater sampling has emerged as an excellent means of monitoring AMR as well as other pandemics. Clear benefits associated with wastewater sampling compared to clinical samples is that arising problems can be detected early and that it reduces bias as monitoring occurs on the whole population rather than a few individual patients. Here we suggest to set up a platform that will allow us to monitor prevalence of AMR in wastewater samples and by adapting computational modelling set up during the Covid-19 pandemic amongst others, we will develop models that will allow us to determine when the prevalence in wastewater reaches levels that indicates elevated risk for the spread of AMR in the clinic. This knowledge at regional and national levels will give the health care indications before the problem arises, allowing preparedness against potential epidemic outbreaks. In the long run, we hope to establish cheap and non-laborious techniques that can be used world-wide, allowing global awareness of upcoming potential problem clones and providing information for decision makers regarding protection of at-risk groups, changes in treatment regimens to avoid selection, increased screening in the clinic etc. The platform will also be an important tool to follow up the effects of interventions. Global AMR monitoring will require international cooperation and coordinated action and here we plan to use the channels of ReAct and Uppsala antibiotic center to implement the techniques in the world. The aim for this project is to set up a platform that will be integrated into the Microbial single cell sequencing platform at the end of the period. The techniques will be developed to increase pandemic preparedness against the silent AMR pandemic, but they will also be of use for many scientific projects regarding microbial evolution and epidemiology that struggle with the same type of problems to connect genes with species.