Advances and solutions in biological treatment for antibiotic wastewater with resistance genes: A review

Biological treatment represents a fundamental component of wastewater treatment plants (WWTPs). The transmission of antibiotic resistance bacteria (ARB) and resistance genes (ARGs) occurred through the continuous migration and transformation, attributed to the residual presence of antibiotics in WWTPs effluent, posing a significant threat to the entire ecosystem. It is necessary to propose novel biological strategies to address the challenge of refractory contaminants, such as antibiotics, ARGs and ARB. This review summarizes the occurrence of antibiotics in wastewater, categorized by high and low concentrations. Additionally, current biological treatments used in WWTPs, such as aerobic activated sludge, anaerobic digestion, sequencing batch reactor (SBR), constructed wetland, membrane-related bioreactors and biological aerated filter (BAF) are introduced. In particular, because microorganisms are the key to those biological treatments, the effect of high and low concentration of antibiotics on microorganisms are thoroughly discussed. Finally, solutions involving functional bacteria, partial nitrification (PN)-Anammox and lysozyme embedding are suggested from the perspective of the entire biological treatment process. Overall, this review provides valuable insights for the simultaneous removal of antibiotics and ARGs in antibiotics wastewater.