StARE - Stopping Antibiotic Resistance Evolution
StARE - Stopping Antibiotic Resistance Evolution

Program At A Glance

    Funding Agencies StARE is financed by the Cyprus Research Promotion Foundation (DESMI 2009-2010)
    Program Period 2014-2017
    Total Budget 1.970.093 €
    Nireas-IWRC Budget 99.998 €
    NIREAS Contact Dr. D. Fatta-Kassinos
    Project Acronym StARE
    Project Name Stopping Antibiotic Resistance Evolution
    Project Code ΚΟΙΝΑ/ΠΚΠ-WATER/1113/15
    Project Website
    Coordinating Beneficiary                                                     Universidade Católica Portuguesa (UCP)
    Cyprus Host Organisation                                   Nireas - International Water research Center, University of Cyprus
    Consortium University of Helsinki, Finland
Catalan Institute for Water Research (ICRA), Spain
Karlsruhe Institute of Technology (KIT), Germany
Agencia Estatal Consejo Superior de Investigaciones Científicas, Spain,
Norwegian School of Veterinary Science, Norway
Technische Universität Dresden (TUD), Germany
University of Aveiro, Portugal
NUI Maynooth, Ireland
Aquantec GmbH, Germany


       Project Description

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 (ARG) released into the environment, thus representing crucial control points for efficient technological interventions. ARB&G are well characterized clinically but the occurrence in aquatic environments, relation to regional antibiotic uses or temporal/geographical variations are poorly understood.


Project Objectives

  • 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 (WWTP) 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&Gs and determine the best combination.
  • Evaluate the potential of MBR coupled to AOPs and/or AC in removing antibiotics and ARB&Gs, 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 CEC 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.


        StARE involves five Work Packages (WPs):

  • WP1: Management
  • WP2: Antibiotics and resistance in European wastewater
  • WP3: Advanced treatment technologies for the removal of antibiotics, antibiotic resistant bacteria and resistance genes from wastewater
  • WP4: Effects of wastewater treatments on the microbiome and resistome
  • WP5: Communication, dissemination, and guideline development


WP1 will ensure that the management of the project is in compliance with the proposed activities, collaborative and mobility actions, and research objectives

WP2 aims at the characterization of treated wastewater (WW) in different European regions with respect to antibiotics and antibiotic-resistant bacteria and resistance genes (ARB&Gs). The methods and structure to be implemented are to be maintained beyond the project lifetime, allowing the continuous assessment of temporal and geographic antibiotic resistance (AR) evolution.

WP3 aims at  (i) maximizing the removal of bacteria, as this will reduce the overall loads of ARB&Gs released into the environment; (ii) producing a final effluent that has very low levels of antimicrobial residues if any, other CEC, ARGs, and pathogens (bacteria or viruses) and therefore is free of potential adverse biological effects; (iii) proposing the systems that are cost-effective for end-users in terms of implementation, operation and maintenance. These general objectives should be achieved simultaneously respecting the compliance with the limits set for the standard parameters for WW disposal or reuse (e.g. BOD, COD, etc.)

WP4 will use the cutting edge techniques in microbial ecology and evolution to unveil the effects of WW treatment on the microbiota at the community, cell and gene levels. This innovative approach will uncover not only the technological conditions that may be associated with AR proliferation but also the biology of AR evolution in anthropogenic environments at population, cell and genetic levels. WP4 will also have inferences on the impact of ARB&Gs on ecosystem services, such as nutrient metabolism or carbon flux. Armed with the fundamental research tools, WP4 will aim at achieving WW treatment operational conditions that minimize AR spread. This systematic approach to the problem is completely new in the current state-of-the-art and is only possible because the research consortium assembles WW engineers with microbiologists, molecular biologists, and bioinformatics and highly experienced researchers in AR evolution and ecology area.

WP5 aims at  the development of guidelines and recommendations based on the results of the project that will be delivered to the stakeholders, policy makers, scientific community and the general public through the most efficient and interactive channels of communication. The scientific outcomes of this project is expected to be of high interest to the scientific community, thus a scientific communication (research papers, conferences) will take place during the project implementation. A detailed relevant action plant has been formulated towards this objective.

Workshop invitation and agenda (in Greek)