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Nordic researchers will study whether wastwater treatment plants can be a trusted source of antimicrobial resistance information. The project will focus on improving the analysis, transfer and archiving of data from municipal wastewater treatment plants in order to improve information transfer.
The TruSTme project at NORCE will investigate how public wastewater treatment plants can be a unique and reliable source of local information on antimicrobial resistance. In the future, wastewater treatment plants should be included as part of public preparedness strategies to notify of precursor events, for example increased occurrences of super bugs.
Antimicrobial resistance is an escalating global challenge, and the spread of resistance genes leads to an increase in multi-resistant bacteria that cannot be treated with antibiotics. During the Covid19 epidemic, other issues had to be prioritized, and the researchers therefore believe it is important that we now draw attention to measures that can limit the spread and impact of antimicrobial resistance.
- Municipal wastewater treatment plants can be seen as a large sinks. Most antimicrobial substances used as medicine are excreted through toilet visits and are collected through the sewage networks connected to the treatment plants. Wastewater treatment plants thus become hotspots for antimicrobial resistance genes, explains project manager Adriana Krolicka at NORCE.
At the facilities in Stavanger, Reykjavik and Mariehamn, samples will be taken over a specific period of time. Standard molecular-based laboratory methods will be used to track antimicrobial resistance in wastewater.
Anne Lise Norheim, IVAR IKS
IVAR's central wastewater treatment plant, Nord-Jæren, Norway
The project is based on two fundamental assumptions for health security governance in the Nordic region; that the role of the environment in the development and spread of disease cannot be overlooked, and that risk communication needs to be timely, consistent, transparent and from a reliable source. This is central to achieving the society’s acceptance and compliance.
Today, there is a big difference in how wastewater is treated in different countries. Even within Norway there are big differences. In Tromsø, wastewater is filtered through a grate, biological pollution is not removed. In larger cities such as Stavanger and Bergen, a cleaning process with several steps has been established.
The practices in the various parts of the Nordic region will now be mapped.
-Antimicrobial resistance is an issue that disregards geographical boundaries. It is influenced by local and regional factors, such as antibiotic use and practice, as well as population density. The goal is that the information collected can be used as part of public preparedness in the Nordic region, says NORCE scientist Odd-Gunnar Wikmark. He is leading one of the work packages in the project.
Samples from a wastewater treatment plant in Tromsø, Norway
The population in the Nordic countries generally have a high level of trust in the public health institutions, and in the Nordics there is an established practice for when one chooses to use different antibiotics. In addition, there are registers of prescriptions and drug use. This project is therefore tailored to Nordic conditions. The project will provide recommendations that specifically target the Nordic countries, either as individual countries or the region as a whole.
The TruSTme project is financed through NordForsk, and is a collaboration between researchers from leading Nordic research institutes: the University of Akureyri in Iceland, the Finnish Institute of Health and Welfare, Lund University in Sweden and NORCE in Norway.
The project will take a One-Health approach, where the health of people, animals and the environment all should be considered and representatives from other sectors, such as politics, regulatory bodies and research collaborate. This project will involve representatives from local and national authorities, as well as health and environmental agencies who will together discuss possible solutions, legislation and the implementation of new tools to ensure public security. The consortium has a strong focus on collaborative activities, access to infrastructure and will work in a transdiciplinary way across borders and sectors to solve complex issues:
- The consortium looks forward to finding Nordic solutions for open sharing and communication of antimicrobial resistance monitoring results. The proposed project is significant both nationally and internationally, and the first step towards better coordination and management that leads to a more appropriate handling of the resistence issue in the Nordics, concludes Adriana Krolicka.