Polski
Issue 3/2026, From the European Commission
Hospital wastewater and growing antimicrobial resistance
Mar
The European Commission reported that Norwegian scientists, using genetic techniques to analyze hospital wastewater, have shown that it contains both known and brand-new antibiotic resistance genes and, according to the researchers, is responsible for spreading further risks in the marine environment. Antimicrobial resistance is mainly caused by the improper use of antimicrobials in humans, animals and agriculture.
General background
Antimicrobial resistance is a serious health problem. Many diseases that were once treatable are now becoming untreatable, increasing the risk of severe illness and even death.
In light of the definition indicated in Directive 2024/3019 of November 27, 2024, concerning the treatment of municipal wastewater, antimicrobial resistance means the ability of microorganisms to survive or thrive at a concentration of antimicrobial agent that is usually sufficient to inhibit or kill microorganisms of the same species. It is introduced when bacteria, viruses, fungi or parasites evolve in such a way that they are no longer susceptible to antibiotics, antivirals and antifungals.
According to the WHO, municipal wastewater is considered a major source of antimicrobial agents and their metabolites, as well as resistant bacteria. Therefore, in order to increase knowledge of the main sources of antimicrobial resistance, it seems reasonable to make it mandatory to monitor the occurrence of antimicrobial resistance in municipal wastewater. This is to help develop knowledge as a basis for taking appropriate action now and in the future.
A study conducted in Norway, the results of which were published in 2025, shows how wastewater from hospitals affects antimicrobial resistance/drug resistance.
Key causes and consequences of antimicrobial resistance
The main causes of antimicrobial resistance include:
- Overuse of antibiotics in medicine, their use in viral infections, and discontinuation of therapy ahead of time;
- Misuse of antimicrobials in agriculture and animal husbandry and treatment;
- Self-medication – taking antibiotics on one‘s own, such as those left over from previous therapies, and overusing over-the-counter antimicrobial drugs;
- Use of antibiotics not in accordance with the doctor’s instructions – interruption of treatment or improper intervals between doses.
The consequences are difficulty in treating the infection, the need for stronger, more expensive drugs with more side effects, and in extreme cases, ineffective therapy.
Norwegian researchers’ study
A study by Norwegian researchers analyzes how untreated wastewater from hospitals can affect antimicrobial resistance. Norway has relatively low antibiotic use in both the EU and global contexts, a low prevalence of antimicrobial resistance and very limited use of one particular class of antibiotics. The country’s hospital wastewater is not treated on site, which has provided an opportunity to test it for the presence of microorganisms, antibiotics and genetic material that could contribute to microbial resistance to treatment.
The study found the presence of 40 antibiotic resistance genes (ARGs) in all types of samples tested – raw wastewater taken directly from the hospital (untreated), raw wastewater going to treatment plants (untreated) and treated wastewater. This suggests that the new ARGs -are introduced into the aquatic environment through hospital wastewater and remain there even after treatment. Independent of the Norwegian researchers’ study, French scientists from the Université d’Auvergne and Canadian researchers from Laval University have detected resistance genes even in clouds, studied for 2 years at an altitude of nearly 1,500. m. a.s.l., indicating their global transmission.The method adopted in the Norwegian researchers’ study provides an example that other countries and regions can use to monitor antimicrobial resistance (AMR).
In 2024, the updated EU Urban Wastewater Treatment Directive defined its role in the spread of AMR, indicating the need for monitoring to better understand and shape policy. It also emphasized the need to implement strategies to treat hospital wastewater on site or remove specific bacteria from it to limit further spread of AMR into the environment.
European Union action in the area of antimicrobial resistance problem
The European Union recognizes the importance of addressing antimicrobial resistance and has therefore adopted the European One Health Action Plan to combat antimicrobial resistance – a unified, integrated approach that takes into account the needs of humans, animals and ecosystems as a whole.
In 2022. The EC and member states listed AMR as one of the top three health risks, and a year later the European Council recommended intensifying European Union action to combat AMR as part of the One Health approach.
In 2024. It has been recognized that not only health, but also water is a basic asset that belongs to everyone and is meant to serve everyone, so Directive (EU) 2024/3019 of the European Parliament and of the Council of November 27, 2024 concerning the treatment of urban wastewater was published. Since this natural resource is crucial, irreplaceable and essential to life, an integrated approach was taken in three dimensions: social, economic and environmental, also addressing AMR. In 2025. The European Union has launched the 10-year AMR One Health Partnership (OHAMR), an initiative that aims to combat the global health threat through research and innovation.
In writing the article, I used:
https://environment.ec.europa.eu/news/norway-study-reveals-how-hospital-sewage-spreading-antimicrobial-resistance-2026-02-18_en
https://health.ec.europa.eu/document/download/353f40d1-f114-4c41-9755-c7e3f1da5378_en?filename=amr_2017_action-plan.pdf
https://eur-lex.europa.eu/eli/dir/2024/3019/oj
https://www.gov.pl/web/wsse-opole/lekoopornosc-drobnoustrojow–globalne-wyzwanie-zdrowia-publicznego
Victor, M.P., Radisic, V., Grevskott, D.H. & Marathe, N.P. (2025) Hospital effluent in a low-resistance setting is responsible for dissemination of novel antibiotic resistance genes into the marine environment. Ecotoxicology and Environmental Safety, Volume 301,118390., https://doi.org/10.1016/j.ecoenv.2025.118390
https://naukawpolsce.pl/aktualnosci/news%2C96422%2Cgeny-antybiotykoopornosci-znaleziono-w-chmurach.html
https://www.focus.pl/artykul/geny-opornosci-na-antybiotyki-w-chmurach
