Review: approaches to monitoring and surveillance of antimicrobial resistance in bathing waters - summary
Published 26 October 2023
Applies to England
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1. Chief Scientist’s Group report summary
This project aimed to improve our understanding of antimicrobial resistance in relation to human exposures via bathing waters and to identify options for any future surveillance at designated bathing water sites. As part of this we reviewed efforts in other countries to monitor antimicrobial resistance (AMR) in bathing waters.
1.1 Background
Antimicrobial resistance represents a major concern for humans, animals, plants, and the wider environment. The Government’s 20-year Vision for AMR and the 5-year National Action Plan outline how the UK will address the AMR challenge. Whilst studies have indicated that people can be infected by resistant bacteria through recreational use of coastal bathing waters, there is currently no statutory obligation to monitor AMR in bathing waters. Additionally, to date work on AMR in bathing waters has overwhelmingly focussed on antibiotic resistance in bacteria, with little information on resistant fungi. This project aimed to improve our understanding of AMR in bathing waters and provide options for any future surveillance including a potential approach to prioritise sites of greatest concern.
1.2 Approach
We reviewed how AMR is assessed in designated bathing waters, focusing on other jurisdictions in the UK and Europe. Topics of interest included sampling methods, laboratory analytical methods, antifungal resistance in bathing waters, and catchment prioritisation approaches.
A draft hazard assessment scheme was developed to distinguish sites within different land use settings. Factors for coastal bathing water catchments were scored based on the perceived impact on AMR (expert opinion) and grouped. Factors indicative of pollution for potential sources of AMR were considered such as the presence of diffuse (arable agriculture) and point (wastewater) discharges. Catchments which scored highly were deemed as potential ‘hotspots’ for AMR pollution related to that catchment use, we also identified a control group which had low scores overall.
1.3 Result
The only example of AMR surveillance included in national scale monitoring at designated bathing waters was found to take place in Scotland, although smaller efforts do occur elsewhere. Very few studies identified antifungal resistance in bathing waters even though many fungal species which carry antimicrobial resistance genes are also commonly found in coastal environments across the world.
Our hazard assessment based on likely source groupings could inform any surveillance of environmental AMR from different sources which may have different types of AMR.
1.4 Conclusion
This work has identified that very few other regulatory bodies are monitoring for AMR in bathing waters at a national scale at present. We have shown how bathing water sites which could be used to enable AMR surveillance in coastal bathing waters and how this could be targeted at higher risk sites based on an expert prioritisation model. However, follow-up work would be needed to incorporate additional data sources for a more robust decision-making.
1.5 Publication details
This summary relates to information from project SC220005, reported in detail in the following output:
- Report: SC220005
- Title: Review: approaches to monitoring and surveillance of antimicrobial resistance in bathing waters
- Project manager: Jono Warren, Chief Scientist’s Group
This project was commissioned by the Environment Agency’s Chief Scientist’s Group, which provides scientific knowledge, tools, and techniques to enable us to protect and manage the environment as effectively as possible. The project was carried out as part of the Environment Agency Chief Scientist’s Group research into AMR in the environment and has been funded by the PATH-SAFE programme which has been funded by HM Treasury through the Shared Outcomes Fund.
Enquiries: research@environment-agency.gov.uk.
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