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

抗菌素耐药性（AMR）是指微生物适应环境，不再对抗菌素药物产生反应，从而使感染更难治疗。这对医疗保健和社会都有重大影响。最近的证据表明，非人类宿主是普通人群中抗菌素耐药性的重要来源。地表水，特别是河流，受到各种来源的污染，游泳者可以与水生微生物密切接触。先前在沿海水域的研究发现，在沿海水域洗澡与AMR细菌暴露和定植的风险增加有关。这个研究项目非常及时，因为淡水游泳越来越受欢迎，河流正在被考虑作为洗澡的场所。然而，河水中的抗菌素耐药性对游泳者和公众健康构成的威胁却没有得到很好的描述。监督小组成员的工作为英国政府应对抗菌素耐药性的最新五年计划（2019-2024年）以及世卫组织对洗澡水的审查提供了信息。因此，这个拟议的博士项目的结果将在了解河流污染的来源和对人类健康的影响方面具有全球意义，并可以通过与环境署和英国卫生安全局（前身为英格兰公共卫生部）的接触，帮助为区域和国家一级的土地和水管理讨论提供信息。项目目的和方法本跨学科项目评估河水中抗菌素耐药性对人类健康的威胁。我们预期将通过以下方式实现这一目标：对在河水中洗澡对人体健康的影响进行系统审查；对英国一条河流进行微生物学研究，以了解抗菌素耐药性的重要来源，以及对沐浴者暴露的影响；一项调查在河水中游泳与具有公共卫生意义的健康结果之间关系的流行病学研究。学生在进行这些研究项目的方法上有创新的余地。该项目涉及埃克塞特大学，英国生态和水文中心（UK CEH）和英国卫生安全局（前身为英国公共卫生部（PHE））之间令人兴奋的合作，并得到了环境署（EA）的支持。该学生将在埃克塞特大学学习，那里有最先进的实验室和计算设施，以及一个充满活力的跨学科研究社区。英国CEH和EA的合作伙伴在了解淡水系统生态方面提供了经验。在英国卫生安全局实习期间，学生可能有机会发展自己的技能。

Project BackgroundAntimicrobial 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 MethodsThis 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.