Antimicrobial Resistance and Multiple Drug Resistance in Microorganisms: Source, Evolution, and Mitigation Approaches for Preventing Health Hazards

Abstract

The global public health threat posed by antibiotic resistance is expanding. Low-and middle-income nations are most impacted both in terms of the effect on public health and the associated financial burden. In metropolitan areas, wastewater is one of the major reservoirs of antibiotic resistance. Microorganisms from the environment, humans, and animals are all manifested in the wastewater microbiome. Several microbiomes present in wastewater carry genes for antibiotic resistance or some of the genes mutate over time due to evolutionary and environmental impact. Further, at wastewater treatment facilities, procedures frequently fall short in neutralizing antibiotic-resistant bacteria and mutant genes. These genes and bacteria are then released into the local environment and create havoc via entry into the food chain or direct contamination. This causes a rising incidence of antibiotic-resistant organisms via the spread of antibiotic resistance genes in the environment. The emergence and transmission of antibiotic resistance genes (ARG) that are leading to antimicrobial resistance (AMR) and multi-drug resistance (MDR) is a growing public health problem worldwide. Bacteria develop resistance to antibiotics through two different mechanisms, i.e. (a) chromosomal DNA mutations that result in changes to translated protein and/or (b) horizontal gene transfer (HGT), which enables the exchange of genetic material between unrelated bacteria (as parents or offspring). The accelerating prevalence of AMR renders even the most recent generation of antibiotics ineffective for treating common illnesses. As a result, there are now more fatalities, longer hospital stays, and higher healthcare expenses. Healthcare systems throughout the world are being challenged by untreatable symptomatic infections, which reduce the effectiveness of antibiotics. Thus, the menace of antibiotic resistance and multiple drug resistance created due to the creation of an evolutionary microbiome in wastewater needs to be addressed and mitigated. © 2025 selection and editorial matter, Arti Gupta and Ram Prasad.