Dennis Schmiege

Research themes
  • Water Resources
  • Health and sanitation
  • Land, water, food and energy
  • Health, nutrition and ecosystems
Research countries
  • Germany
  • India
Thesis title

Risk assessment of source and dissemination of multidrug-resistant Enterobacteriaceae in the catchment area of a wastewater system in the Ruhr Metropolis, Germany

Thesis abstract

The occurrence and development of multidrug-resistant Enterobacteriaceae in health care and community settings constitute a major public health challenge (Nordmann 2013; Giske et al. 2008). Adverse consequences of infections with multidrug-resistant Enterobacteriaceae are severe, ultimately even leading to higher mortality because of limited treatment options (Exner et al. 2017, Tängdén & Giske 2015). In Germany, around 11% of tested isolates of the species Escherichia coli show multidrug-resistant profiles, which is cause for concern (BVL & PEG 2016).

Multidrug-resistant Enterobacteriaceae can be spread in many ways whereby the environment occupies a pivotal role. In particular wastewater has been identified as a major source of antibiotic resistance elements (Berendonk et al. 2015; Berkner et al. 2014). Whereas current approaches often investigate the inlet and outlet of wastewater treatment plants thereby examining the treatment performance in regard to multidrug- resistant bacteria, this study will follow a different approach shifting the focus away from end-of-pipe approaches towards the catchment area.

The basis of this approach will be a risk assessment of the catchment area of the wastewater treatment plant in Dortmund-Deusen, Ruhr Metropolis, Germany, considering the source and dissemination of extended-spectrum beta-lactamase- producing Escherichia coli. The core will be the identification of physical structures and social hotspots using a mixed-method approach. Particularly potential social hotspots and their role are currently not well researched. In this study, the social determinants of health will function as a starting point for the investigation of this component.

Following this approach, it will be possible to characterize the catchment area and identify potential hotspots of the release of multidrug-resistant Enterobacteriaceae into the wastewater system. Eventually, this small-scale analysis allows for the identification of critical control points within the wastewater system of Dortmund, one of the four centres in the Ruhr Metropolis, Germany.


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Dennis Schmiege

Junior Researcher One Health


ZEF C: Department of Ecology and Natural Resources Management