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Abstract

The global rise of antimicrobial resistance (AMR) poses a significant threat to public health, driven in part by the proliferation of antimicrobial-resistant bacteria (ARB) and antimicrobial resistance genes (ARGs) in environmental systems. Wastewater treatment plants (WWTPs) are critical control points for limiting the spread of ARB and ARGs, yet conventional treatment methods often fall short in effectively eliminating these contaminants. This review provides a comprehensive analysis of current wastewater treatment methods, including physical, chemical, and biological approaches, in their capacity to mitigate ARB and ARGs. The mechanisms, advantages, and limitations of processes such as membrane filtration, advanced oxidation processes, and bioaugmentation are critically evaluated. Additionally, the role of novel and hybrid technologies in enhancing treatment efficacy is explored. By synthesizing recent research, this review highlights the need for optimized, multi-barrier approaches to effectively reduce the dissemination of ARB and ARGs from wastewater into the environment. The findings underscore the urgency for innovation and policy development in wastewater management to combat the escalating challenge of antimicrobial resistance.