Systematic Review on Monitoring Antibiotic-resistant Pathogens in Wastewater

Antimicrobial-resistance (AMR) is a top global health threat, potentially causing 10 million deaths annually by 2050. A systematic review of 156 articles found that wastewater surveillance and screening methods are crucial for understanding antibiotic-resistant bacteria. 52% of studies were conducted at the single-sewer level, followed by clinical settings and international studies. Most international studies used genomic screening, while regional and national-level studies used culture-based approaches. Advanced genomic approaches offer advantages but cannot overcome limitations like animal contamination. The Enterobacteriaceae family is highly evolving.