How to establish a hospital wastewater surveillance program for antimicrobial resistance: Current experience and future knowledge gaps

Wastewater-based surveillance (WBS) is a promising tool for monitoring antimicrobial resistance (AMR) in healthcare settings. It can be cost-effective and efficient, as used in monitoring virus during the COVID-19 pandemic. However, the optimal approach for this purpose is yet to be established due to variability in sampling and processing methods. Knowledge gaps remain regarding the link between AMR detected in wastewater and hospitalized patients, influenced by factors like antibiotic residues and biofilm formation. New research is needed to refine WBS methods, understand the link between wastewater findings and AMR prevalence in hospitalized patients, and validate its effectiveness.