Project 464452

When bacteria evolve, they can resist antibiotics, making infections harder to treat. As well, their risk of spreading, and causing severe illness and death increases. These antibiotic-resistant organisms are particularly common in hospitals. To maintain their licence to operate, hospitals must have programs to monitor antibiotic-resistant organisms, and limit their spread. However, existing programs track only those few patients who have confirmed infections or who are known to carry antibiotic-resistant organisms through infrequent and expensive surveillance swabs. New tools that can regularly monitor the entire hospital population are urgently needed to identify new pathogens and changes in their prevalence in real-time. Wastewater-based epidemiology is a new science that seeks to understand the health of a group of people by analyzing sewage. People who carry antibiotic-resistant organisms release them in their stool, as such we can count the genes of antibiotic-resistant organisms, and monitor for their presence and abundance in hospital wastewater. In this project, we will collect wastewater from four large hospitals, capturing entire facilities as well as smaller units (e.g., intensive care). We will identify the genes of antibiotic-resistant organisms using molecular and genomics tools. By tracking and comparing data on the genes of antibiotic-resistant organisms in wastewater with hospital-wide data on infection rates and antibiotic use, we will develop user-friendly tools that provide a day-to-day "snapshot" of antibiotic resistance. This information can be used to guide antibiotic therapy and evaluate strategies to limit and reduce spread. Our multi-disciplinary team, made up of specialists in engineering, chemistry, microbiology, and data analytics, will develop hospital-based wastewater monitoring systems so that the usable data can inform clinical care and save lives.