Fate of antibiotic resistance genes and antibiotic-resistant bacteria in water resource recovery facilities.

Many important diseases are showing resistance to commonly used antibiotics, and the resistance is potentially caused by widespread use of antibiotics for maintaining human health and improving food production. Antibiotic resistance genes (ARGs) and antibiotic-resistant bacteria (ARB) are associated with this increase, and their fate in water resource recovery facilities is an important, emerging area of research. This literature review summarizes current findings of worldwide research on the fate of ARB and ARGs in various types of treatment plants. Twenty-five published studies were reviewed which contained 215 observations in activated sludge, membrane bioreactors, anaerobic digestion, constructed wetlands, coagulation-filtration, and three types of disinfection. We found 70% decreased observations, 18% increased observations, and 12% unchanged observations of all observations in all treatment processes. Resistance genes to tetracycline were most often observed, but more studies are needed in other antibiotic resistance genes. The causes for increased abundance of ARGs and ARB are not well understood, and further studies are warranted. PRACTITIONER POINTS: Antibiotic resistance is increasing with concern that treatment plants may acclimate bacteria to antibiotics. A literature survey found 215 resistance observations with 70% decreased, 18% increased, 12% unchanged after treatment. The type of treatment process is important with activated sludge showing the greatest reductions.