Stopping antibiotic resistance evolution

Program at a glance

Funding Agencies

StARE is financed by the Cyprus Research Promotion Foundation (DESMI 2009-2010)

Program Period



Total Budget

1.970.093 €


Nireas-IWRC Budget

99.998 €


NIREAS Contact

Dr. D. Fatta-Kassinos


Project Acronym



Project Name

Stopping Antibiotic Resistance Evolution


Project Code



Project Website



The goal of StARE (Stopping Antibiotic Resistance Evolution) is to protect European citizens’ health and the environment via water quality research, aimed at minimizing the impact of discharges from urban wastewater treatment plants (UWTPs) and sustaining safe water cycles. According to WHO, antibiotic resistance is a global human health threat driven by many interconnected factors, where water plays a key role. UWTPs are a major source of antibiotic residues, antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) released into the environment, thus representing crucial control points for efficient technological interventions. ARB&ARGs are well characterized clinically but the occurrence in aquatic environments, relation to regional antibiotic uses or temporal/geographical variations are poorly understood.


  • Establish standardized procedures for antibiotic residues and resistance monitoring (to be used during the whole project and beyond).
  • Characterize the final effluents of urban wastewater treatment plants (UWTP) in different European regions (10 countries) in terms of antibiotic residues, antibiotic resistance genes and other physico-chemical parameters.
  • Implement a database for antibiotic resistance prevalence and patterns in wastewater in Europe.
  • Propose possible indicators of antibiotic resistance to be used for rapid and cost-effective routine monitoring.
  • Obtain statistically sound inferences about factors/conditions that may enhance antibiotic resistance spread during wastewater treatment.
  • Evaluate the potential of conventional activated sludge (CAS) treatment when combined with advanced chemical processes (AOPs) or ultrafiltration (UF) and/or Activated Carbon (AC) to remove antibiotics and ARB&ARGs and determine the best combination.
  • Evaluate the potential of MBR coupled to AOPs and/or AC in removing antibiotics and ARB&ARGs, and determine the most efficient combination.
  • Assess effluent microbiota modifications resulting from stress conditions imposed by different treatment processes (WP3) or by specific selectors or stressors hinted from WP2 and with a special emphasis on AR dissemination.
  • Characterize microbial community modifications imposed by treatment conditions.
  • Characterize the effect of advanced treatment regarding the emergence and spread of AR, in terms of mutation, gene transfer and occurrence of relevant markers.
  • Develop a conceptual model of bacterial response to CECs or other external stimuli.
  • Assess the effect of possible stressors and/or selectors on bacterial communities or bacteria.
  • Deliver guidelines and recommendations to the stakeholders, policy makers, scientific community and general public through the most efficient and targeted channels of communication available.
  • Serve as an interface between the parties aimed at public health protection.
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