Abstract

The World Health Organization (WHO) has identified the spread of antibiotic resistance as one of themajor risks
to global public health. An important transfer route into the aquatic environment is the urban water cycle. In this
paper the occurrence and transport of antibiotic microbial resistance in the urban water cycle are critically
reviewed. The presence of antibiotic resistance in low impacted surface water is being discussed to determine
background antibiotic resistance levels, which might serve as a reference for treatment targets in the absence
of health-based threshold levels. Different biological, physical and disinfection/oxidation processes employed
in wastewater treatment and their efficacy regarding their removal of antibiotic resistant bacteria and antibiotic
resistance geness (ARGs)were evaluated. Amore efficient removal of antibiotic microbial resistance abundances
from wastewater effluents can be achieved by advanced treatment processes, including membrane filtration,
ozonation, UV-irradiation or chlorination, to levels typically observed in urban surface water or low impacted
surface water.

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