Multidrug-resistant genes and pathogenic bacteria in hospital wastewater

Abstract The extensive and imprudent use of antimicrobials compounds leads to prevalence and proliferation of multidrug-resistant bacteria and genes. The intrinsic and acquired antibiotic-resistance mechanisms (mutation, chemical alteration of drug targets, enzyme hydrolysis, efflux system, genomic alteration) led their prevalence and dissemination in the environment. Wastewater treatment facilities are hotspots for the spread of antibiotic-resistance microbiome because it is the meeting point of biocontaminants from various sources. Thus the occurrences of antibiotic-resistance bacteria and their genes in the wastewater treatment plants and their effluents are increasing due to gene transfer mechanisms. This chapter provides an overview of the prevalence of multidrug-resistance bacteria and genes in different water environments and mechanisms governing their resistances. Furthermore, the most prevailed multidrug-resistance bacteria occurring in HWW are briefly discussed. The presence of antibiotic-resistance gene in human gut, natural water bodies, wastewater effluent, and biosolids is addressed. The requirement of the detailed investigations on “environmental reservoirs of resistance” is provided as a future direction.