The Impact of Wastewater on Antimicrobial Resistance: A Scoping Review of Transmission Pathways and Contributing Factors

Background/Objectives: Antimicrobial resistance (AMR) is a global issue driven by the overuse of antibiotics in healthcare, agriculture, and veterinary settings. Wastewater and treatment plants (WWTPs) act as reservoirs for antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs)....

Full description

Saved in:
Bibliographic Details
Main Authors: Maria Clara La Rosa, Andrea Maugeri, Giuliana Favara, Claudia La Mastra, Roberta Magnano San Lio, Martina Barchitta, Antonella Agodi
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Antibiotics
Subjects:
Online Access:https://www.mdpi.com/2079-6382/14/2/131
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850080523351752704
author Maria Clara La Rosa
Andrea Maugeri
Giuliana Favara
Claudia La Mastra
Roberta Magnano San Lio
Martina Barchitta
Antonella Agodi
author_facet Maria Clara La Rosa
Andrea Maugeri
Giuliana Favara
Claudia La Mastra
Roberta Magnano San Lio
Martina Barchitta
Antonella Agodi
author_sort Maria Clara La Rosa
collection DOAJ
description Background/Objectives: Antimicrobial resistance (AMR) is a global issue driven by the overuse of antibiotics in healthcare, agriculture, and veterinary settings. Wastewater and treatment plants (WWTPs) act as reservoirs for antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs). The One Health approach emphasizes the interconnectedness of human, animal, and environmental health in addressing AMR. This scoping review analyzes wastewater’s role in the AMR spread, identifies influencing factors, and highlights research gaps to guide interventions. Methods: This scoping review followed the PRISMA-ScR guidelines. A comprehensive literature search was conducted across the PubMed and Web of Science databases for articles published up to June 2024, supplemented by manual reference checks. The review focused on wastewater as a source of AMR, including hospital effluents, industrial and urban sewage, and agricultural runoff. Screening and selection were independently performed by two reviewers, with conflicts resolved by a third. Results: Of 3367 studies identified, 70 met the inclusion criteria. The findings indicated that antibiotic residues, heavy metals, and microbial interactions in wastewater are key drivers of AMR development. Although WWTPs aim to reduce contaminants, they often create conditions conducive to horizontal gene transfer, amplifying resistance. Promising interventions, such as advanced treatment methods and regulatory measures, exist but require further research and implementation. Conclusions: Wastewater plays a pivotal role in AMR dissemination. Targeted interventions in wastewater management are essential to mitigate AMR risks. Future studies should prioritize understanding AMR dynamics in wastewater ecosystems and evaluating scalable mitigation strategies to support global health efforts.
format Article
id doaj-art-3a0b9c9bebaa493fa8042d331d47fb73
institution DOAJ
issn 2079-6382
language English
publishDate 2025-01-01
publisher MDPI AG
record_format Article
series Antibiotics
spelling doaj-art-3a0b9c9bebaa493fa8042d331d47fb732025-08-20T02:44:55ZengMDPI AGAntibiotics2079-63822025-01-0114213110.3390/antibiotics14020131The Impact of Wastewater on Antimicrobial Resistance: A Scoping Review of Transmission Pathways and Contributing FactorsMaria Clara La Rosa0Andrea Maugeri1Giuliana Favara2Claudia La Mastra3Roberta Magnano San Lio4Martina Barchitta5Antonella Agodi6Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, ItalyDepartment of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, ItalyDepartment of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, ItalyDepartment of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, ItalyDepartment of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, ItalyDepartment of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, ItalyDepartment of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95123 Catania, ItalyBackground/Objectives: Antimicrobial resistance (AMR) is a global issue driven by the overuse of antibiotics in healthcare, agriculture, and veterinary settings. Wastewater and treatment plants (WWTPs) act as reservoirs for antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs). The One Health approach emphasizes the interconnectedness of human, animal, and environmental health in addressing AMR. This scoping review analyzes wastewater’s role in the AMR spread, identifies influencing factors, and highlights research gaps to guide interventions. Methods: This scoping review followed the PRISMA-ScR guidelines. A comprehensive literature search was conducted across the PubMed and Web of Science databases for articles published up to June 2024, supplemented by manual reference checks. The review focused on wastewater as a source of AMR, including hospital effluents, industrial and urban sewage, and agricultural runoff. Screening and selection were independently performed by two reviewers, with conflicts resolved by a third. Results: Of 3367 studies identified, 70 met the inclusion criteria. The findings indicated that antibiotic residues, heavy metals, and microbial interactions in wastewater are key drivers of AMR development. Although WWTPs aim to reduce contaminants, they often create conditions conducive to horizontal gene transfer, amplifying resistance. Promising interventions, such as advanced treatment methods and regulatory measures, exist but require further research and implementation. Conclusions: Wastewater plays a pivotal role in AMR dissemination. Targeted interventions in wastewater management are essential to mitigate AMR risks. Future studies should prioritize understanding AMR dynamics in wastewater ecosystems and evaluating scalable mitigation strategies to support global health efforts.https://www.mdpi.com/2079-6382/14/2/131antibiotic-resistant bacteria (ARB)antibiotic resistance genes (ARGs)antimicrobial resistance (AMR)wastewater treatment plants (WWTPs)public health
spellingShingle Maria Clara La Rosa
Andrea Maugeri
Giuliana Favara
Claudia La Mastra
Roberta Magnano San Lio
Martina Barchitta
Antonella Agodi
The Impact of Wastewater on Antimicrobial Resistance: A Scoping Review of Transmission Pathways and Contributing Factors
Antibiotics
antibiotic-resistant bacteria (ARB)
antibiotic resistance genes (ARGs)
antimicrobial resistance (AMR)
wastewater treatment plants (WWTPs)
public health
title The Impact of Wastewater on Antimicrobial Resistance: A Scoping Review of Transmission Pathways and Contributing Factors
title_full The Impact of Wastewater on Antimicrobial Resistance: A Scoping Review of Transmission Pathways and Contributing Factors
title_fullStr The Impact of Wastewater on Antimicrobial Resistance: A Scoping Review of Transmission Pathways and Contributing Factors
title_full_unstemmed The Impact of Wastewater on Antimicrobial Resistance: A Scoping Review of Transmission Pathways and Contributing Factors
title_short The Impact of Wastewater on Antimicrobial Resistance: A Scoping Review of Transmission Pathways and Contributing Factors
title_sort impact of wastewater on antimicrobial resistance a scoping review of transmission pathways and contributing factors
topic antibiotic-resistant bacteria (ARB)
antibiotic resistance genes (ARGs)
antimicrobial resistance (AMR)
wastewater treatment plants (WWTPs)
public health
url https://www.mdpi.com/2079-6382/14/2/131
work_keys_str_mv AT mariaclaralarosa theimpactofwastewateronantimicrobialresistanceascopingreviewoftransmissionpathwaysandcontributingfactors
AT andreamaugeri theimpactofwastewateronantimicrobialresistanceascopingreviewoftransmissionpathwaysandcontributingfactors
AT giulianafavara theimpactofwastewateronantimicrobialresistanceascopingreviewoftransmissionpathwaysandcontributingfactors
AT claudialamastra theimpactofwastewateronantimicrobialresistanceascopingreviewoftransmissionpathwaysandcontributingfactors
AT robertamagnanosanlio theimpactofwastewateronantimicrobialresistanceascopingreviewoftransmissionpathwaysandcontributingfactors
AT martinabarchitta theimpactofwastewateronantimicrobialresistanceascopingreviewoftransmissionpathwaysandcontributingfactors
AT antonellaagodi theimpactofwastewateronantimicrobialresistanceascopingreviewoftransmissionpathwaysandcontributingfactors
AT mariaclaralarosa impactofwastewateronantimicrobialresistanceascopingreviewoftransmissionpathwaysandcontributingfactors
AT andreamaugeri impactofwastewateronantimicrobialresistanceascopingreviewoftransmissionpathwaysandcontributingfactors
AT giulianafavara impactofwastewateronantimicrobialresistanceascopingreviewoftransmissionpathwaysandcontributingfactors
AT claudialamastra impactofwastewateronantimicrobialresistanceascopingreviewoftransmissionpathwaysandcontributingfactors
AT robertamagnanosanlio impactofwastewateronantimicrobialresistanceascopingreviewoftransmissionpathwaysandcontributingfactors
AT martinabarchitta impactofwastewateronantimicrobialresistanceascopingreviewoftransmissionpathwaysandcontributingfactors
AT antonellaagodi impactofwastewateronantimicrobialresistanceascopingreviewoftransmissionpathwaysandcontributingfactors