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Review

Review of Antimicrobial Resistance in Wastewater in Japan: Current Challenges and Future Perspectives

1
Department of Infectious Diseases, Internal Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
2
Department of Food, Life and Environmental Sciences, Faculty of Agriculture, Yamagata University, Tsuruoka 997-8555, Japan
*
Authors to whom correspondence should be addressed.
Academic Editors: Jie Fu and Fernando Albericio
Antibiotics 2022, 11(7), 849; https://doi.org/10.3390/antibiotics11070849
Received: 20 May 2022 / Revised: 14 June 2022 / Accepted: 22 June 2022 / Published: 24 June 2022
(This article belongs to the Special Issue Antibiotic Resistance in the Water Environment)
Antimicrobial resistance (AMR) circulates through humans, animals, and the environments, requiring a One Health approach. Recently, urban sewage has increasingly been suggested as a hotspot for AMR even in high-income countries (HICs), where the water sanitation and hygiene infrastructure are well-developed. To understand the current status of AMR in wastewater in a HIC, we reviewed the epidemiological studies on AMR in the sewage environment in Japan from the published literature. Our review showed that a wide variety of clinically important antibiotic-resistant bacteria (ARB), antibiotic resistance genes (ARGs), and antimicrobial residues are present in human wastewater in Japan. Their concentrations are lower than in low- and middle-income countries (LMICs) and are further reduced by sewage treatment plants (STPs) before discharge. Nevertheless, the remaining ARB and ARGs could be an important source of AMR contamination in river water. Furthermore, hospital effluence may be an important reservoir of clinically important ARB. The high concentration of antimicrobial agents commonly prescribed in Japan may contribute to the selection and dissemination of AMR within wastewater. Our review shows the importance of both monitoring for AMR and antimicrobials in human wastewater and efforts to reduce their contamination load in wastewater. View Full-Text
Keywords: antibiotic-resistant bacteria; antibiotic resistance genes; water environment; wastewater; sewage treatment plant; residual antibiotics; one health approach; Japan antibiotic-resistant bacteria; antibiotic resistance genes; water environment; wastewater; sewage treatment plant; residual antibiotics; one health approach; Japan
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MDPI and ACS Style

Baba, H.; Nishiyama, M.; Watanabe, T.; Kanamori, H. Review of Antimicrobial Resistance in Wastewater in Japan: Current Challenges and Future Perspectives. Antibiotics 2022, 11, 849. https://doi.org/10.3390/antibiotics11070849

AMA Style

Baba H, Nishiyama M, Watanabe T, Kanamori H. Review of Antimicrobial Resistance in Wastewater in Japan: Current Challenges and Future Perspectives. Antibiotics. 2022; 11(7):849. https://doi.org/10.3390/antibiotics11070849

Chicago/Turabian Style

Baba, Hiroaki, Masateru Nishiyama, Toru Watanabe, and Hajime Kanamori. 2022. "Review of Antimicrobial Resistance in Wastewater in Japan: Current Challenges and Future Perspectives" Antibiotics 11, no. 7: 849. https://doi.org/10.3390/antibiotics11070849

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