The Surveillance of Antimicrobial Resistance in South African Wastewater Using Wastewater-Based Epidemiology Approaches

This study highlights wastewater as a critical but underutilized surveillance source for antimicrobial resistance (AMR), particularly in settings like South Africa where AMR management remains complex. Using metatranscriptomic analysis of untreated wastewater samples from the Tshwane District, researchers identified 39 AMR gene families across 39 antimicrobial classes, confirming wastewater as a hotspot for the dissemination of resistance. The findings demonstrate that wastewater surveillance can serve as an early warning system for tracking AMR and communicable diseases at the population level, supporting more proactive public health monitoring and intervention strategies.