The increase in infections from antibiotic-resistant bacteria is a danger to public health. Clinically relevant antibiotic-resistant bacteria of human origin are present in municipal wastewater treatment plants where they can spread to the surrounding environment. In order to investigate the occupational and environmental transmission of antibiotic resistance from wastewater treatment plants, 100 workers and 400 local residents at each of several municipal treatment plants in Germany, the Netherlands and Romania will be interviewed and examined for antibiotic-resistant bacteria (ESBL, CPE and resistance genes). A control group of 400 people who live further away from the treatment plants will be surveyed in each country. In order to document the dissemination of relevant bacteria from the treatment plants, water samples will be examined at different stages of the treatment process in the plants. Air samples will also be taken both in the plant and its vicinity. Air and water samples will also be analysed for antibiotic-resistant bacteria (ESBL, CPE and resistance genes). The results will be used to model the geospatial exposure and thus to identify the possible risks for workers and local residents from inhalation and ingestion of antibiotic-resistant bacteria from municipal wastewater treatment plants. This will enable the development of prevention strategies to reduce the dissemination of bacteria from municipal wastewater treatment plants.

The project is part of a transnational research collaboration under the Joint Programming Initiative on Antimicrobial Resistance (JPIAMR). The collaboration involves scientists from Germany, Romania, Sweden and the Netherlands working together on a solution to this research question. The funding measure pursues the aim of bringing together relevant research groups with complementary expertise and resources from the participating countries. Cooperative research approaches will achieve progress in preventing, monitoring and combating antibiotic resistance which could not be achieved on a national level.