The Fate and Occurrence of Antibiotic-Resistant Bacteria and Antibiotic Resistance Genes during Advanced Wastewater Treatment and Disinfection: A Review

Abstract

Antimicrobial resistance (AMR) is a serious problem for modern society, not only associated with clinical environments, but also the natural environment. Conventional wastewater treatment plants (WWTPs) are important nodes for the dissemination of antibiotic resistance to the aquatic environment since they are reservoirs of antibiotic-resistant bacteria (ARB), antibiotic resistance genes (ARGs), and antibiotic residues. WWTPs are not designed to remove these antibiotic resistance determinants from wastewater, and as a result, they are present in treated effluent, leading to environmental and public health concerns regarding wastewater disposal and reuse. Additional treatments combined with conventional WWTPs can be barriers to the spread of AMR to the environment. In order to understand the effect of wastewater treatment methods on the removal of ARB and ARGs, an extensive bibliographic study was conducted. This review summarizes the efficiency of conventional disinfection methods, tertiary wastewater treatment, and advanced oxidation processes (AOPs) to remove ARB and ARGs from wastewater. In the context of the revised Urban Wastewater Treatment Directive 91/271/EEC, further studies are needed on the removal potential of AOPs on a full-scale, as they offer great potential for the removal of ARB and ARGs with a low formation of toxic by-products compared to conventional disinfection methods.

A microbial evolutionary approach for a sustainable future

“…Today, concerns have been raised about the influx of pharmaceuticals and persistent chemicals like poly‐ and perfluoroalkyl substances (PFAS) into wastewater (Sedlak, 2014). Antibiotics entering wastewater may select for tolerant bacteria and contribute to the spread of antibiotic resistance traits (Kalli et al, 2023).…”

The Impact of COVID-19 Pandemic on Hospital Waste Management: A Bibliometric Analysis

“…It is also important to understand that certain antibiotics we consume are not fully broken down by our bodies and are instead excreted as residual substances that ultimately end up in wastewater. Hospitals can mitigate the emergence of antibiotic resistance in wastewater by implementing advanced wastewater management techniques (19). Furthermore, several recommended wastewater treatment technologies have been proven effective in reducing antibiotic resistance in hospital wastewater treatment plants.…”

“…Furthermore, several recommended wastewater treatment technologies have been proven effective in reducing antibiotic resistance in hospital wastewater treatment plants. These include conventional processes such as chlorine disinfection, anaerobic digestion, ultraviolet radiation, membrane bioreactors, and up-flow anaerobic sludge blanket processes, all of which were found to be successful in removing SARS-CoV-2 RNA from wastewater (19). Additionally, tertiary processes such as membrane filtration, granular activated carbon, and sand filtration, along with disinfection techniques such as ozonation, chlorination, ultraviolet radiation, and peracetic acid, or advanced oxidation processes, can be utilized to control antimicrobial resistance in wastewater (19).…”

Rapid Antibiotic Adsorption from Water Using MCM-41-Based Material

“…Presently, there are more than 20 types of tetracyclines. However, tetracycline (TC), chlortetracycline, oxytetracycline, and doxycycline (DOX) are the most commonly used antibiotics in the poultry industry [3]. Tetracyclines are used for disease treatment and prevention and as growth promoters for entire populations.…”