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.

No abstract

Antibiotic resistant bacteria and antibiotic resistance genes have been of the emerging contaminant threatening human health. The overuse of antibiotics, both in human patients and, importantly, in livestock, has led to an explosion of antibiotic-resistant bacteria, both in the U.S. and around the world. The prediction from the World Health Organization (WHO) is that, if nothing changes, the future will look a lot like the pastwhere people die from minor injuries that become infected. One of the goals should be a long-term sustainable balance with everything in our environment, including bacteria to promote human health. Different microbial techniques have been employed to study the occurrence and spread of antibiotic resistance in the environment, preventing us from returning to a pre-antibiotic era. Dissemination of antibiotic resistance genes to the environment is an important factor causing an increased prevalence of resistant pathogens. Their spread to multidrug-resistant pathogens is one of the most emerging clinical challenges.