Chapter 2 - Development and spread of drug resistance through wastewater

Abstract

Antimicrobial drug resistance represents a serious and growing human health threat worldwide. The development and growth of drug-resistant organisms, leading to antimicrobial resistance, causes antibiotics and antimicrobials to become ineffective and makes disease treatment difficult. Resistance to drugs has been recognized as an emerging public health issue by several organizations such as the World Health Organization, US Center for Disease Control, the National Academy of Science Institute of Medicine, the Infectious Diseases Society of America, and numerous other worldwide public health authorities. The main factors contributing to the growth of drug resistance include its excessive use in humans and animals, overcrowding and increased rates of transmission between people in communities and hospitals, and the failure of executing proper hygiene and disinfection practices. Lack of proper sanitization leads to release of antimicrobials and antimicrobial-resistant pathogens into the water. Wastewater thus serves as a pool of antibiotics and origin of antibiotic resistance genes. Traditional wastewater treatment strategies are not directed at removing antibiotics or antimicrobial-resistant genes and their prolonged stay may give rise to antimicrobial resistance. In this chapter, the role of wastewater in the development and spread of drug resistance has been discussed. The chapter also considers the sources for development of drug resistance. The chapter concludes with the human exposure to drug resistance via water and its health impacts.