How effective are strategies to control the dissemination of antibiotic resistance in the environment? A systematic review

Table 9 Summary of results on wastewater treatment plant (WWTP) ability to reduce antibiotic-resistant bacteria (ARB), antibiotic resistance genes (ARG), mobile genetic elements (MGE) in studies with definitively/probably high validity level (n = 118/324). Numbers reported in each column are independent of each other

	Concentration or absolute abundance	Proportion or relative abundance
*ARB (measured in 54 studies)*
Decrease of all ATBR markers^a	n = 25	n = 11
Decrease of some ATBR markers	n = 2	n = 19
Increase of all ATBR markers or no variation^b	n = 1	n = 10
Not studied or not reported	n = 26	n = 14
*ARG (measured in 61 studies)*
Decrease of all ATBR markers^a	n = 33	n = 6
Decrease of some ATBR markers	n = 14	n = 18
Increase of all ATBR markers or no variation^b	n = 3	n = 3
Not studied or not reported	n = 11	n = 34
*MGE (measured in 43 studies)*
Decrease of all ATBR markers^a	n = 28	n = 9
Decrease of some ATBR markers	n = 3	n = 2
Increase of all ATBR markers or no variation^b	n = 4	n = 3
Not studied or not reported	n = 8	n = 29

^acorresponds to wished result, i.e., decrease of ATBR after WWTP
^bcorresponds to unwished outputs, i.e., increase and/or no variation of ATBR after WWTP

ISSN: 2047-2382