Dennis Schmiege

Research themes
  • Water resources (management)
  • Health and sanitation
  • Agriculture, land use, climate change
  • Health
Research countries
  • Germany
  • India

One Health, Antibiotic resistance, Water, sanitation and hygiene

Thesis title

Socio-spatial variation of antibiotic resistance in an urban sewershed 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.



Schmiege, D., N. Zacharias, E. Sib, S. Moebus, M. Evers and T. Kistemann, T.  2021.  Prevalence of multidrug-resistant and extended-spectrum beta-lactamase-producing Escherichia coli in urban community wastewater.  Science of The Total Environment, . Further Information


Schmiege, D.  2020.  Don’t waste water: wastewater surveillance, antimicrobial resistance and One Health.  WHO CC Newsletter Water & Risk Vol. 30 Further Information
Schmiege, D, Evers, M, Zügner, V, Rickert, B.  2020.  Comparing the German enabling environment for nationwide Water Safety Plan implementation with international experiences: Are we still thinking big or already scaling up?.  International Journal of Hygiene and Environmental Health, Volume 228   : 12   . (Open Access)   Further Information
Schmiege, D., Evers, M., Kistemann, T., Falkenberg, T..  2020.  What drives antibiotic use in the community? A systematic review of determinants in the human outpatient sector.  International Journal of Hygiene and Environmental Health, 226   : 11   . (Open Access)   Further Information

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Dennis Schmiege

Junior Researcher One Health

Department :
ZEF C: Department of Ecology and Natural Resources Management