Control strategies to combat dissemination of antibiotic resistance in urban water systems

The intensive use of antibiotics for medical, veterinary, or agricultural purposes results in the continuous release of antibiotics into the environment, leading to the increasingly widespread occurrence of antibiotic resistance. Although antibiotic resistance has been recognized as a major threat to human health worldwide, the related phenomenon occurring in natural and engineered environments has so far been largely overlooked. The urban (including industrial) water cycle, which connects urban life, agriculture, and the environment, is potentially a hot spot for the spread of antibiotic resistance. Therefore, better understanding of the distribution and transportation of antibiotic-resistant bacteria (ARB) and acquisition of antibiotic resistance genes (ARGs) in the urban water cycle is critically important to improve the control of this emerging environmental and human health challenge. In this book chapter, we comprehensively review the occurrence, transfer, and acquisition mechanisms of ARGs in the urban water cycle. Various methods that are used to monitor ARB and ARGs are compared in terms of their strengths and limitations. Opportunities for the development of real-time monitoring methods are discussed, along with possible control strategies for ARB and ARGs in urban water environments. We recommend that three major barriers should be developed to minimize or halt the spread of ARGs in urban water systems, including more efficient water disinfection, advanced wastewater treatment, and optimized sludge treatment processes