Technologies to tackle antimicrobial resistance during treated wastewater reuse: current advances and future prospects

Wastewater reuse may serve as an important solution to the emerging issue of water scarcity. However, the potential public and ecological risks of antimicrobial resistance (AMR) may hinder the wide application of treated wastewater reclamation. Wastewater treatment plants have been recognized as hotspots of antibiotic resistance genes (ARGs) and key nodes of their spreading. Owing to their characterization of bioactive and penetrating ability from the treatment processes, it is important to design the tertiary treatment to enhance removal efficiencies of intracellular- and extracellular ARGs. Herein, we critically reviewed the available technologies classified into physicochemical, eco-biological, and integrated processes for reclaimed water generation and ARG removal from recently published articles. We summarized the performance, mechanisms, and bottlenecks of each process. For future prospects, we proposed a framework for multimode reuse to achieve the goal of sustainable social water cycle with low risk posed by AMR.