Aircraft toilets could become a powerful early warning tool in the fight against antimicrobial resistant super-bugs, a growing health crisis that threatens to kill more people than cancer by 2050.
This is the conclusion of an international team of researchers who analyzed lavatory wastewater from 44 international flights arriving in Australia from nine different countries.
The findings are both alarming and promising. Using advanced molecular techniques, the researchers detected nine high-priority pathogens and super-bugs, including some that are acquired in hospitals and resistant to multiple drugs.
Five of the nine super-bugs were found in all 44 flight samples, and a gene conferring resistance to last-resort antibiotics was detected on 17 flights. This gene was absent in Australia’s urban wastewater during the same period, suggesting its was likely introduced via international travel.
Because it hosts so many pathogens, aircraft wastewater offers scientists a snapshot of emerging health risks before they reach local communities.
“Aircraft wastewater captures microbial signatures from passengers across different continents, offering a non-invasive, cost-effective way to monitor threats like AMR,” said paper author Warish Ahmed, a principal research scientist from the Commonwealth Scientific and Industrial Research Organisation (CSIRO), in a statement.
Significant Geographic Variations
The wastewater samples also revealed significant geographic variations, according to paper co-author and University of South Australia (UniSA) microbiologist professor Nicholas Ashbolt.
“Flights from Asia, particularly India, showed higher concentrations of antibiotic resistance genes, compared to flights from Europe and the UK,” Ashbolt said in a statement.
Of the 44 international flights sampled, 18 originated from India, 14 from the United Kingdom, six from Germany and the rest from France, UAE, Türkiye, South Africa, Japan and Indonesia.
According to study author Yawen Liu, a visiting scientist from Xiamen University in China, these disparities could reflect differences in antibiotic use, water sanitation, population density and public health policies across regions.
Do disinfectants affect genetic material?
The team also tested whether disinfectants used in aircraft toilets degrade genetic material. They found that nucleic acids remained stable for up to 24 hours, even when exposed to strong disinfectants—confirming the reliability of aircraft wastewater for surveillance purposes.
“International travel is one of the major drivers of AMR spread,” said Liu. “By monitoring aircraft wastewater, we can potentially detect and track antibiotic resistance genes before they become established in local environments.”
This study builds on previous CSIRO research carried out during the COVID-19 pandemic, which successfully detected the virus in wastewater from long-haul flights of returning Australians.
With AMR projected to cause more than 39 million deaths globally by 2050, Ashbolt emphasizes the urgency of developing innovative surveillance tools to contrast it.
“Aircraft wastewater monitoring could complement existing public health systems, providing early warnings of emerging super-bug threats”, he said.
Ahmed added: “This is a proof-of-concept with real-world potential. We now have the tools to turn aircraft toilets into an early-warning disease system to better manage public health.”
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Reference
Liu, Y., Smith, W. J. M., Gebrewold, M., Ashbolt, N. J., Keenum, I., Simpson, S. L., Wang, X., & Ahmed, W. (2025). Aircraft lavatory wastewater surveillance for movement of antimicrobial resistance genes: A proof-of-concept study. Microbiology Spectrum. https://doi.org/10.1128/spectrum.00569-25
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