The European Environment Agency (EEA) highlights the urgent need for monitoring antimicrobial resistance (AMR) in surface waters to better assess health risks. While antibiotics and resistant bacteria occur naturally, human and veterinary antibiotic use, discharges from wastewater treatment, pharmaceuticals, and agricultural waste accelerate the spread of resistance into aquatic environments. Natural water bodies can act as reservoirs for resistant microorganisms, and human activities can enhance the transfer of antibiotic resistance genes, potentially endangering human and animal health.
The EEA emphasizes that monitoring AMR in surface waters would complement existing surveillance in food and animal sectors. Robust, Europe-wide monitoring requires clear objectives, harmonized sampling methods, quality control procedures, and centralized data reporting. Such monitoring can identify AMR hotspots, track trends and emerging genes, evaluate interventions, and improve understanding of associated risks.
EU action on AMR includes the One Health Action Plan and revised water legislation, such as the Urban Wastewater Treatment Directive, which mandates monitoring by 2030. Provisional revisions to the Water Framework Directive and other EU water laws are expected to integrate AMR indicators into surface and groundwater monitoring.
Antimicrobial resistance is a top global health threat, comparable to HIV or malaria, with forecasts predicting up to 1.9 million deaths directly attributable to AMR and 8.2 million associated deaths by 2050. The environment is increasingly recognized as a key reservoir for AMR, underlining the importance of Europe-wide monitoring to safeguard public health.
This briefing is based on a 2024 Eionet pilot study on AMR in surface waters involving experts from 14 European countries.
