Vision: Towards a Nordic wastewater-based antimicrobial resistance surveillance network and an integrated digital platform

The consortium in the TruSTme project proposes to use existing knowledge and technological solutions to design robust operational routines and implement regulations at WWTPs in the Nordic countries.

This will require funding for the development of routine activities to build infrastructure at WWTPs, providing practical guidance for WWTP operators, and setting threshold values for discharges in terms of pathogens and AMR.

The infrastructure at WWTPs will result in:

1) Pandemic preparedness Nordic countries should agree on standardized guidelines. These should include sampling routines and methods, a list of monitoring targets (such as multidrug-resistant pathogens and population-level AMR determinants), testing protocols and data collection. Consistent and compatible data across the Nordic region for comparison and analysis will facilitate robust interpretation of temporal trends of AMR and will constitute a powerful tool for timely policy decisions.

2) Inclusion of the One Health approach by enabling control of the quality of WWTP discharges and limitation of AMR spreading. There is a need to provide practical guidance for WWTP operators to set threshold values for discharges in terms of pathogens and relevant genes.