Detection and removal methods of antibiotic-resistance genes in drinking water sources: a review

The natural evolutionary process of bacterial resistance has been catastrophically amplified into a planetary health crisis through anthropogenic antibiotic pollution. Antibiotic accumulation in the environment has become a key driver of antimicrobial resistance (AMR) proliferation. This is particularly critical in wastewater and drinking water systems (DWSs). The presence of antibiotics selects for resistant strains and facilitates horizontal gene transfer of antibiotic resistance genes (ARGs). This phenomenon arises from excessive antibiotic usage coupled with inefficient removal through conventional water treatments, which fail to eliminate residual antibiotics or impede ARG dissemination. This review systematically summarizes current knowledge on bacterial resistance mechanisms in DWSs and recent advancements in detection methodologies of ARGs. Furthermore, we discussed the efficiency of conventional water treatment processes against antimicrobial containment and the emerging solutions to help curb the menace of AMR effectively. Overall, this study aims to establish a theoretical foundation for accurately assessing health risks posed by ARGs in DWSs and implementing effective prevention and control measures. This review can serve as a foundational resource for guiding policy recommendations to protect drinking water sources and public health.