show Abstracthide AbstractThe aim of the study was to investigate the genetic relationship between extended-spectrum beta-lactamase producing Escherichia coli isolated from humans and the aquatic environment during the same time period in a low-endemic setting.Bacterial lineages that were genetically similar to those causing infections in humans were found in treated wastewater and in the aquatic environment downstream of the wastewater treatment plant indicating that ESBL-producing E. coli are released into the environment through treated wastewater.