Pathogens and antimicrobial resistance (AMR) are emerging as major global threats to public health. Wastewater, as the unique interface between environments and humans receiving and spreading pathogens and AMR, is playing a more important role than ever before for monitoring of public health. Here, by pinpointing pathogens and AMR, we reviewed the most recent technological advancements in Raman biosensors (single-cell Raman, Raman-stable isotope probing, surface-enhanced Raman, statistical analysis) and molecular methods (polymerase chain reaction, metagenomics and single-cell genomics) for phenotypic and genotypic surveillance, respectively. In particular, the importance of integrating phenotypic and genotypic analysis via targeted single-cell sorting for a complementary and holistic surveillance and understanding of health risk was highlighted. We further suggest technological requirements to enhance wastewater surveillance and better inform tackling strategy against pathogens and AMR.

病原体和抗微生物药物耐药性 (AMR) 正在成为全球公共卫生的主要威胁。废水作为环境与人类接收和传播病原体和 AMR 之间的独特界面，在监测公共卫生方面发挥着比以往任何时候都更重要的作用。在这里，通过精确定位病原体和 AMR，我们回顾了拉曼生物传感器（单细胞拉曼、拉曼稳定同位素探测、表面增强拉曼、统计分析）和分子方法（聚合酶链反应、宏基因组学和单-细胞基因组学）分别用于表型和基因型监测。特别强调了通过有针对性的单细胞分选整合表型和基因型分析对健康风险进行补充和整体监测和了解的重要性。