Abstract
The main goal of this manuscript is to review different treatment strategies and mechanisms for combating the antibiotic resistant bacteria (ARB) and antibiotic resistant genes (ARGs) in the wastewater environment. The high amount of antibiotics is released into the wastewater that may promote selection of ARB and ARGs which find their way into natural environments. Emerging microbial pathogens and increasing antibiotic resistance among them is a global public health issue. The propagation and spread of ARB and ARGs in the environment may result in an increase of antibiotic resistant microbial pathogens which is a worldwide environmental and public health concern. A proper treatment of wastewater is essential before its discharge into rivers, lake, or sewage system to prevent the spread of ARB and ARGs into the environment. This review discusses various treatment options applied for combating the spread of ARB and ARGs in wastewater treatment plants (WWTPs). It was reported that low-energy anaerobic–aerobic treatment reactors, constructed wetlands, and disinfection processes have shown good removal efficiencies. Nanomaterials and biochar combined with other treatment methods and coagulation process are very recent strategies regarding ARB and ARGs removal and need more investigation and research. Based on current studies a wide-ranging removal efficiency of ARGs can be achieved depending on the type of genes present and treatment processes used, still, there are gaps that need to be further investigated. In order to find solutions to control dissemination of antibiotic resistance in the environment, it is important to (1) study innovative strategies in large scale and over a long time to reach an actual evaluation, (2) develop risk assessment studies to precisely understand occurrence and abundance of ARB/ARGs so that their potential risks to human health can be determined, and (3) consider operating and environmental factors that affect the efficiency of each treatment mechanism.
Highlights
Environmental ImpactRecently, World Health Organization (WHO) announced that antibiotic resistance is growing, and we are fast running out of treatment options (Lawe-Davies and Bennett, 2017)
It was observed that the concentration of tetracycline in the downstream of river was equal to the effluent of wastewater treatment plants (WWTPs) and the concentration of total sulfonamides in the effluent was around 2-fold higher than in the receiving river water suggesting that the effluent containing antibiotics are contaminating the natural water bodies (Table 1; Xu et al, 2015)
It has been observed that Low-energy anaerobic–aerobic treatment reactors reduce high concentrations of various antibiotic resistant genes (ARGs) from domestic wastewater
Summary
Environmental ImpactRecently, World Health Organization (WHO) announced that antibiotic resistance is growing, and we are fast running out of treatment options (Lawe-Davies and Bennett, 2017). Increasing levels of ARB carrying antibiotic resistance genes (ARGs) in the environment, especially in water and wastewater is a human health issue (Rizzo et al, 2013; Devarajan et al, 2015; Sharma et al, 2016; Li H. et al, 2017).
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