Occurrence and fate of antibiotics, antibiotic resistant genes (ARGs) and antibiotic resistant bacteria (ARB) in municipal wastewater treatment plant: An overview

The occurrence and fate of antibiotics and antibiotic resistant genes (ARGs) and antibiotic resistant bacteria (ARB) in Municipal Wastewater Treatment Plants (WWTPs) worldwide were reviewed. The prevalence of antibiotics in WWTPs among different periods (1999-2009 and 2010-2019) and geographical areas (Europe, America, Asia and Africa) was summarized, analyzed and evaluated. The classes of macrolides (clarithromycin, erythromycin/erythromycin-H2O, azithromycin, roxithromycin), sulfonamides (sulfamethoxazole), trimethoprim, quinolones (ofloxacin, ciprofloxacin, norfloxacin) and tetracyclines (tetracycline) were the antibiotics most frequently detected, while bla (blaCTXM, blaTEM), sul (sul1, sul2), tet (tetO, tetQ, tetW) and ermB genes were the ARGs commonly reported in WWTPs. There was a positive correlation between antibiotics and ARGs commonly detected in WWTPs, except for β-lactam antibiotics and bla genes. The genes bla were found frequently, despite β-lactam antibiotics were seldom detected owing to the hydrolysis. Most of antibiotics had lower levels in the period 2010-2019 in Asian countries than that in period 1999-2009 in North American and European countries. In the effluent of secondary treatment, the concentration of trimethoprim was the highest (138 ng/L in median) and the concentration of other antibiotics remained at lower than 80 ng/L, while the relative abundance of ARGs ranged 2.9-4.6 logs (copies/mL, in median). Future researches on the development of effective antibiotic removal technologies, such as advanced oxidation processes, are suggested to focus on antibiotics frequently detected and their corresponding ARGs in WWTPs.