Sewage surveillance of antibiotic resistance holds both opportunities and challenges

A proposed European Union-directive requests that member states monitor antibiotic resistance at all sewage treatment plants serving >100,000 people. Sewage surveillance could provide information on the resistance situation in the underlying population and on environmental transmission risks. There are opportunities to make such surveillance data more informative and actionable, but there are also challenges. Sewage surveillance could provide information on the resistance situation in the underlying population and on environmental transmission risks. There are opportunities to make such surveillance data more informative and actionable, but there are also challenges.