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Modelling antimicrobial resistance spread in aquatic systems

The global increase of antimicrobial resistance (AMR) is one of the greatest threats to health. Based on current trends, AMR will cost up to 100 trillion USD and result in up to 10 million deaths every year by 2050.

Project leader

Prof David Graham



Project staff

Dr Greg O’Donnell

Dr Michaela Goodson, Newcastle Medical School, Malaysia


Faculty of Science, Agriculture & Engineering Singapore Scholarship


National University of Singapore

University Teknologi Malaysia

Chinese Academy of Science - Xiamen


The burden of AMR is greatest in emerging countries. In emerging countries, increasing economic wealth permits greater use of antibiotics. But poor waste management leads to wider spread.

We can observe the dramatic effect of AMR in emerging countries in their river systems. River systems are distributors of raw or inadequately treated sewage. The sewage includes antibiotics and antibiotic resistant bacteria and genes. But no AMR-focused, river quality model yet exists for predicting exposure risks in emerging countries. Our research will address this.

We will carry out extensive monitoring of water quality, resistant bacteria, genes, and antibiotics. We will then use the monitoring data in a paramaterised numerical model to guide policy.

We are underaking this research in Malaysia on the Skudai River, which passes from rural areas to highly polluted areas in urban Johor Bahru. Malaysia is an idea case study. It was one of the first regions where resistance to colistin was detected. It includes a range of pollutant sources and different levels of waste treatment. This allows for contrast of different sources and water quality consequences.