The Surveillance of Antimicrobial Resistance in South African Wastewater Using Wastewater-Based Epidemiology Approaches

Antimicrobial resistance (AMR) has become one of the top ten global public health threats. Many countries have recognized the societal and economic burden of AMR. AMR has reduced the effectiveness of antimicrobial therapies, and this results in high mortality, morbidity, and health care expenditure. Like all the other developing countries, South Africa (SA) falls under the same ambiguous management system of antimicrobials. A lot of research focused on the global public health threat “AMR”. However, studies on AMR in wastewater are not yet enough, even though they are beginning to gain momentum. This paper highlights the imperatives of surveying AMR pathogens in wastewater since wastewaters are consecrated as hotspots for the dissemination and propagation of AMR genes. RNA was extracted from the untreated wastewater samples collected from the Tshwane district in Gauteng province, SA. Metatranscriptomics analysis was proposed for the analysis and profiling of AMR genes present in the wastewater. A total of 39 AMR gene families and 39 AMR drug classes were detected across 17 samples. The Metatranscriptomics approach discussed in this paper demonstrates the importance of wastewater surveillance, as it can be used as an early detecting system for communicable diseases and for monitoring wastewater.