Antimicrobial Resistance Information for Water Professionals

Over the last two decades, numerous projects investigated the occurrence of antimicrobial resistance (AMR), especially antibiotic resistance, in wastewater. In 2023, several papers (e.g., Berglund et al., 2023; Wang & Smith, 2023; Zhao et al., 2023) reported the detection of antibiotic-resistant genes (ARGs) and mobile genetic elements (MGEs) in wastewater, resulting in negative news stories and media inquiries at water resource recovery facilities (WRRFs) about AMR and potential risks from wastewater or biosolids (Wigglesworth, 2023). In addition, the Centers for Disease Control and Prevention (CDC) has expressed interest in including wastewater-based surveillance (WBS) of AMR targets in its National Wastewater Surveillance System, which will lead to continued focus on AMR. This document is intended to help inform the water sector as attention to this complex topic grows. It provides a summary of concepts related to antimicrobial and antibiotic resistance and the current state of the science related to antibiotic resistance at WRRFs.