A review of antibiotic resistance generation and control in wastewater and solid waste system

Abstract

The escalating prevalence and genetic diversity of antimicrobial resistance (AMR) pose significant threats to global ecosystems and public health, driven by their rapid dissemination across multiple environmental media. This review presents a comprehensive analysis of AMR transmission and surveillance approaches, while evaluating contemporary strategies for mitigating resistance spread within wastewater and solid waste treatment systems. Key interventions include source reduction through antibiotic stewardship programs and the development of alternative therapeutic approaches. At the cellular level, bacterial mutation rates can be suppressed through oxidative stress alleviation, efflux pump inhibition, and quorum sensing disruption. Horizontal gene transfer of AMR can be constrained through advanced oxidation processes for resistance gene degradation, physical immobilization techniques such as complexation, adsorption, precipitation, and ion exchange, as well as modulation of cell membrane permeability. Emerging biological control methods, particularly bacteriophage therapy and predatory bacterial applications, show considerable promise for AMR mitigation. By synthesizing these multidisciplinary strategies, this review offers critical insights for developing integrated approaches to combat the global spread of antibiotic resistance.