Does antimicrobial resistance in river water pose a risk to human health? (Ref: 4263)

Project Background

Antimicrobial resistance (AMR) occurs when microorganisms adapt, such that they no longer respond to antimicrobial drugs, making infections harder to treat. This has significant implications for healthcare and society. Recent evidence indicates that non-human reservoirs are important sources of AMR in the general population 1.

Surface waters, especially rivers, receive pollution from various sources, and bathers can come into close contact with water-borne microbes. Previous work in coastal waters found that bathing in coastal waters is associated with an increased risk of exposure to and colonisation by AMR bacteria 2. This research project is very timely as freshwater swimming increases in popularity, and rivers are being considered for bathing status.

However, the threat that AMR in river water poses to bathers' and public health is poorly characterised. Work by members of the supervisory team has informed the latest UK Government's 5-year plan to tackle antimicrobial resistance (2019-2024), as well as the WHO's review of bathing waters. Thus, the results of this proposed PhD project will have global significance in terms of understanding the sources and effects of pollution in rivers on human health and can help inform discussions on land and water management at regional and national levels through engagement with the Environment Agency and the UK Health Security Agency (formerly Public Health England).

Project Aims and Methods

This interdisciplinary project evaluates the threat that AMR in river water poses to human health. We anticipate that this will be achieved through: A systematic review on the effects of bathing in river water on human health; A microbiological study of a UK rivers to understand the important sources of AMR, and effects on bathers' exposure; An epidemiological study to investigate the link between swimming in river water and health outcomes of public health significance.

There will be scope for the student to be innovative in their approach to conducting these research projects. Project partners

This project involves an exciting collaboration between the University of Exeter, UK Centre for Ecology and Hydrology (UK CEH), and the UK Health Security Agency (formerly Public Health England (PHE), with support from the Environment Agency (EA). The student will be based at the University of Exeter with access to state-of-the-art laboratory and computing facilities and a vibrant, interdisciplinary community of researchers.

Partners at UK CEH and EA contribute experience in understanding the ecology of freshwater systems. There may be chances for the student to develop their skills while on placement at the UK Health Security Agency.