Standardized One Health surveillance of antibiotic residues and antibiotic and heavy metal resistance in Baltic water environments and wild birds

To face the serious threat of antimicrobial resistance (AMR), we need to perform standardized and holistic approaches that combine efforts in the three major One Health disciplines: human, animal, and environmental health. While it is well-known that AMR bacteria and AMR genes occur in each of these dimensions, it remains to be fully elucidated how exactly the environment and wildlife contribute to the contamination of clinical and non-clinical settings, how they are connected, and which methodologies and indicators to use. Here, we plan to establish a rational surveillance strategy that includes different member states around the Baltic Sea to investigate (waste)water and wild bird fecal samples for the occurrence and detailed characteristics of AMR bacteria, AMR genes, AMR in water-borne pathogens and antimicrobial and heavy metal residues. By also leveraging wild bird tracking data and available bird surveillance infrastructure as well as developing a rapid AMR detection method for water-borne pathogens, we aim at prospectively informing on suitable wild bird indicator species and water sampling/analysis procedures for a standardized and reliable AMR surveillance in the One Health context.