Environmental antimicrobial contamination from terraccumulation and diffuse pollution pathways

The fate of antimicrobial pharmaceuticals entering the aquatic environment has become an increasing concern for researchers and regulators in the past decade, and recent research has focused on antimicrobial contamination from point sources, such as wastewater treatment facility outfalls. Terraccumulation is the concentration of pollutants in soils from land application of contaminated biosolids generated by agricultural practices and water and wastewater facilities. The terraccumulation of antimicrobials and mobility in diffuse pollution pathways should not be overlooked as a contributor to the spread of bacterial resistance and the resulting threat to human drug therapy. This review critically examines recent global trends of bacterial resistance, antimicrobial contaminant pathways from agriculture and water treatment processes, and the need to incorporate diffuse pathways into risk assessment and treatment system design. Alignment of environmental scientific and engineering research with strategies applied in clinical situations could contribute to continued efficacy of antimicrobial therapies necessary for human health and welfare.