Resistance surveillance via analyses of hospital effluents

Sewage samples can be seen as pooled feces samples from a large number of individuals. As a complement to traditional patient-based screening, effluent-screening therefore has a potential to rapidly identify trends in the resistance situation to a low cost. Such information can provide input to changes in recommendations of antibiotics use as well as initiate measures to limit dissemination. In this project we will develop and evaluate methods (culturing, metagenomics, PCR, plasmid capture) to quantify selected resistant pathogens, resistance genes and resistance plasmids. Comparisons will be made with patient screening cultures and clinical isolates as well as local antibiotic use.