Abundance changes and transfer mechanism of antibiotic resistance genes in water under sub-lethal disinfection

Antibiotic resistance genes (ARGs) have become a global challenge due to their widespread resistance to multiple classes of antibiotics. The emergence of antibiotic resistance represents a significant obstacle to the effective treatment of bacterial infections in clinical settings. Furthermore, it poses a grave threat to public health, serving as a primary reason for epidemic outbreaks and high mortality rates. Disinfection has been demonstrated to have a good inactivation effect on antibiotic resistant bacteria (ARB) and a certain removal effect on resistant genes compared to the traditional treatment process. However, sub-lethal disinfection effects are inevitable. To improve the study and enhancement of ARGs removal, the abundance and transfer of ARGs across various disinfection techniques under sub-lethal conditions were summarized in the review. Additionally, possible mechanisms of transfer of ARGs under these conditions were also explored. Sub-lethal disinfection has been shown to accelerate the horizontal gene transfer (HGT) of ARGs, thereby increasing potential health risks. This review centers on the current status and mechanism of ARGs diffusion under sub-lethal disinfection conditions, aiming to provide a theoretical basis and research foundation for cost-effective degradation of ARGs.