Abstract
Here, in this Perspective, we discuss how the detailed measurements of microbial hazards generated by wastewater surveillance remain fundamentally underdetermined: they quantify variation without resolving the biological states they represent. This limitation is particularly evident for antimicrobial resistance, where large-scale monitoring is advancing in the absence of parameters that link wastewater concentrations to population-level burden and environmental risk.
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Acknowledgements
We acknowledge the scientific discussions and interdisciplinary exchanges developed through the SPORE-MED project (PRIMA Programme, grant agreement no. 2322) and Joint Action EU-WISH (European Union Wastewater Integrated Surveillance for Public Health), which contributed to the development of the perspectives presented in this work.
Funding
S.C. was funded from the European Union’s Horizon 2020 research and innovation programme under Marie Sklodowska-Curie grant agreement no. 101034403.
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This Perspective was jointly conceptualized through collaborative development of the proposed framework and iterative discussion of the supporting evidence. The manuscript was refined through repeated critical review by all authors. All authors approved the final version and accept responsibility for its content.
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Naziri, Α., Chatzimichail, S., Karaolia, P. et al. Calibrating antimicrobial resistance influent and effluent signals in wastewater systems.
Nat Water (2026). https://doi.org/10.1038/s44221-026-00701-1
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DOI: https://doi.org/10.1038/s44221-026-00701-1
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