摘要
      抗生素耐药性是对人类健康和福祉的主要威胁。抗生素抗性细菌（ARB）和抗生素抗性基因（ARGs）是在人类、动物和环境中循环的环境污染物。在城市地区，污水处理厂是这些污染物的主要接收地。尽管在处理过程中部分消除，但最终的废水，即使在消毒后，也含有高剂量的ARB和ARG。由此产生的这些废水的持续排放具有重要的不利影响，在脆弱和恶化的接收环境中尤其严重（例如，由于污染、干旱或洪水、生物多样性减少）。ARB和ARGs是一种能够自我复制和水平基因转移的生物污染物，由于污染引起的选择性压力效应或缺乏竞争，这种能力可以在恶化的环境中增强。此外，与其他污染物一样，ARB和ARGs可以主要通过水进行运输，增加了作为人类接触源循环返回的风险。目前关于抗生素耐药性对环境污染和人类健康风险的影响的知识，以及废水处理技术和抗生素耐药性量化方法的进步，支持实施定期废水监测系统的必要性和及时性。由于没有单一的化学或微生物参数可以用来推断抗生素耐药性负荷，因此其具体监测应作为评估废水质量的参数的一部分。最低要求的定义和综合监测对于在时间和空间尺度上绘制抗生素耐药性图以及设计和实施纠正措施至关重要。这些目标在技术和经济上都是可行的，应纳入废水质量指令。
Abstract
Antibiotic resistance is a major threat to human-health and wellbeing. Antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) are environmental contaminants that circulate among humans, animals and the environment. In urban areas, wastewater treatment plants are the major recipients of these contaminants. Despite the partial elimination during treatment, final effluents, even after disinfection, contain high doses of ARB&ARG. The consequent continuous discharge of these effluents has important adverse impacts, which are particularly intense in vulnerable and deteriorated receiving environments (e.g., due to pollution, droughts or floods, reduced biodiversity). ARB&ARGs are biological contaminants capable of self-replication and horizontal gene-transfer, capabilities that due to pollution-induced selective pressure effects or absence of competition can be enhanced in deteriorated environments. Moreover, as other contaminants, ARB&ARGs can be transported, mainly through water, increasing the risks of circling back as a source of exposure to humans. The current knowledge about antibiotic resistance implications in terms of environmental contamination and risks to human-health, as well as the advances on wastewater treatment technology and antibiotic resistance quantification methods, support the need and timeliness of implementing regular wastewater monitoring systems. Because no single chemical or microbiological parameter can be used to infer the antibiotic resistance load, its specific monitoring should be part of the parameters used to assess wastewater quality. The definition of minimal requirements and integrated monitoring are essential to map antibiotic resistance at time- and space scales, and to design and implement corrective measures. These goals are technically and economically feasible and should be incorporated into wastewater quality directives.

https://www.tandfonline.com/doi/full/10.1080/10643389.2022.2085956