Antibiotic Resistance Genes in Urban Wastewater: Implications for Public Health

Abstract: Antibiotic resistance (AR) is a growing global health crisis, and urban wastewater is increasingly recognized as a significant source of antibiotic resistance genes (ARGs). Urban wastewater systems receive contributions from hospitals, industries, and households, making them hotspots for ARGs that can persist even after treatment. Wastewater treatment plants (WWTPs), while effective at reducing organic and pathogenic loads, are not always successful at eliminating ARGs, allowing resistant bacteria and genes to enter natural water bodies. This review explores the sources and mechanisms of ARG spread in urban wastewater, examines the role of WWTPs in mitigating this issue, and discusses the implications for public health. The article also outlines current challenges and future directions for research and policy to reduce ARG dissemination in the environment and safeguard public health.