Not a waste: Wastewater surveillance to enhance public health

Abstract

Domestic wastewater, when collected and evaluated appropriately, can provide valuable health-related information for a community. As a relatively unbiased and non-invasive approach, wastewater surveillance may complement current practices towards mitigating risks and protecting population health. Spurred by the COVID-19 pandemic, wastewater programs are now widely implemented to monitor viral infection trends in sewersheds and inform public health decision-making. This review summarizes recent developments in wastewater-based epidemiology for detecting and monitoring communicable infectious diseases, dissemination of antimicrobial resistance, and illicit drug consumption. Wastewater surveillance, a quickly advancing Frontier in environmental science, is becoming a new tool to enhance public health, improve disease prevention, and respond to future epidemics and pandemics.

Prevalence of antibiotic-resistant Gram-negative bacteria having extended-spectrum β-lactamase phenotypes in polluted irrigation-purpose wastewaters from Indian agro-ecosystems

“…Bacterial resistance to β-lactams has increased substantially in past few decades ( Jani et al, 2021 ; Zaatout et al, 2021 ; Mutuku et al, 2022 ; Tan et al, 2023 ). However, their irrational, injudicious, and excessive use is on steady rise which not only worsen the issue of antibiotic resistance but also resulted in their accumulation in the environment as micro-pollutant ( Du and Liu, 2012 ; Fazaludeen Koya et al, 2022 ; Gitter et al, 2023 ). The emergence of antibiotic resistance has threatened the effective treatment of microbial infections ( Sanz-García et al, 2023 ).…”

“…Wastewaters from municipal corporations, hospitals, pharmaceutical companies, animal husbandry, and poultry farms contain a diverse array of antibiotic residues, antibiotic-resistant bacteria (ARB) and antibiotic-resistant genes (ARGs) ( Leiva et al, 2021 ; Uluseker et al, 2021 ; Larsson and Flach, 2022 ; Gitter et al, 2023 ). The combination of all these factors in aquatic environments allows rapid genetic exchange of ARGs from pathogenic to non-pathogenic bacterial strains leading to their genetic evolution and subsequent dissemination to human communities and animals ( Liguori et al, 2022 ; Matthiessen et al, 2022 ; Muntean et al, 2022 ; Mutuku et al, 2022 ).…”

“…The combination of all these factors in aquatic environments allows rapid genetic exchange of ARGs from pathogenic to non-pathogenic bacterial strains leading to their genetic evolution and subsequent dissemination to human communities and animals ( Liguori et al, 2022 ; Matthiessen et al, 2022 ; Muntean et al, 2022 ; Mutuku et al, 2022 ). Overuse and misuse of antibiotics have resulted in the widespread occurrence of ARB in surface water of rivers, irrigation-wastewater, soil, meat products, vegetables, etc., which possess the risk of dissemination in vulnerable human populations such as children, elderly, and immunocompromised persons ( Uluseker et al, 2021 ; Zaatout et al, 2021 ; Gitter et al, 2023 ). The infections caused by multidrug-resistant bacteria can cause high morbidity and mortality, higher treatment costs and longer hospitalization duration.…”