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4.3 Monitoring
Robust monitoring procedures are key to ensuring the reliability and comparability of results between different workers and sites. The relative novelty of AMR in the environment means broadly applicable monitoring methods and strategies applicable have yet to be agreed.
Clarity of the monitoring purpose is essential. For AMR in the environment, there are different possibilities. To protect human and domestic animal health, monitoring could assess prevalence of the level of resistance, the use of antibiotics, or the transmission or evolution of resistance, for example. For environmental protection, some measure of ecological effect would be more appropriate. Selection of suitable sites follows the purpose. Monitoring programmes also need to consider costs, method robustness and skills required to implement the methods.
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Definition and harmonization of the monitoring purpose is essential. ..... Wastewater AMR monitoring should be framed within the One-Health perspective - humans, animals and the environment. Therefore, a dialogue among different players dealing with AMR issues is required.
However, the establishment of a monitoring system for the aquatic and terrestrial environment is most urgent as it exists already for humans and animals, but not for the avorementioned environments. Also monitoring techiques for the these environemnts may differ significantly due to technical reasons to the exsisting monitoring systems and a method bridge needs to be established. Monitoring data for the environment is paramount as at the moment there is no data for orientation - currently we cannot say how much AMR has increased in the envirtonment and if no monitoring data will be setup we will not be able to tell in the future either.