Citation:

Franklin, A., J. Garland, P. McDermott, AND K. Cook. Developing a National Scale Monitoring Program for Antimicrobial Resistance in Surface Waters. SETAC North America 44th Annual Meeting, Louisville, KY, November 12 - 16, 2023.

Impact/Purpose:

Antimicrobial resistance (AMR) is a rising public and environmental health issue. Surface waters offer a conduit for AMR to spread through the environment as well as impact human and animal populations. The National Antimicrobial Resistance Monitoring System (NARMS) started a pilot study in 2020 to monitor AMR in surface waters at a watershed and national scale. The yearlong watershed scale study was completed in May of 2023. The data from this study will help develop robust surface water monitoring programs with the goal of assessing risks associated with AMR pathogens in surface water, provide a fuller picture of how resistant strains are related spatially and temporally within a watershed, and help assess how anthropogenic drivers and intervention strategies impact the transmission of AMR within human, animal, and environmental systems.

Description:

Antimicrobial resistance (AMR) is a major public health threat that is projected to lead to 10 million deaths annually by 2030. The AMR public health issue has led to the development of action plans to combat AMR, including improved antimicrobial stewardship, development of new antimicrobials, and advanced surveillance. The National Antimicrobial Resistance Monitoring System (NARMS) led by the Food and Drug Administration along with the Centers for Disease Control and U.S. Department of Agriculture monitors antimicrobial resistant bacteria (ARB) in food animals, retail meats, and humans.  NARMS is exploring an integrated One Health surveillance model recognizing that human and animal health are linked to environmental health. Since 2020, the Environmental Protection Agency (EPA) has led an interagency NARMS effort to implement an environmental AMR monitoring program at watershed and national scales. The East Fork Watershed (SE Ohio) was selected since it is impacted by anthropogenic and agricultural inputs, including wastewater effluent and surface runoff from nearby farms. The watershed effort included collection of 35 surface water sites from August of 2022 until May of 2023 with most sites sampled every three weeks and four sites sampled weekly. Samples were analyzed for culture targets (Escherichia coli, extended spectrum beta-lactamase producing E. coli (ESBL E. coli), Enterococcus, vancomycin-resistant Enterococcus (VRE), and Salmonella) and will be analyzed for molecular targets (metagenomics and targeted ARG analysis). Counts of total E. coli and Enterococcus (CFU/100 mL) ranged from no detection to 30,000 and 3 to 7,450, respectively. About 25% of the sites had counts of E. coli above recreational water quality criteria limits, while about 50% of the sites had Enterococcus counts above these limits. Percent of total E. coli and Enterococcus that were ESBL E. coli and VRE ranged from 0 to 25% and 0 to 5%, respectively. Quantifiable ESBL E. coli and VRE were detected in 34% and 23% of the samples, respectively, while Salmonella was detected in 37%. This data will help develop robust surface water monitoring programs with the goal of assessing risks associated with AMR pathogens in surface water, provide a fuller picture of how resistant strains are related spatially and temporally within a watershed, and help assess how anthropogenic drivers and intervention strategies impact the transmission of AMR within human, animal, and environmental systems.

URLs/Downloads:

Record Details: