WASTEWATER MICROBIOLOGY AND PUBLIC HEALTH: PATHOGENS, ANTIMICROBIAL RESISTANCE, DETECTION, AND SUSTAINABLE TREATMENT STRATEGIES

Abstract

Background: Wastewater is an environment of complex microbes, including pathogenic microorganisms, antimicrobial-resistant bacteria, antibiotic-resistance genes, and other biological contaminants, with potential implications on human and environmental health.

Objective: This review aims to highlight the recent advancements in wastewater microbiology with emphasis on pathogenic microorganisms, antimicrobial resistance (AMR), wastewater microbial detection and surveillance methods, and sustainable wastewater treatment.

Methods: Recent peer-reviewed studies on bacterial, viral and protozoan pathogens associated with wastewater, AMR bacteria and resistance genes, wastewater-based epidemiology, molecular detection, metagenomics, and conventional and advanced treatment technologies were critically synthesized. Studies published between the years of 2022 and 2025 were given special attention.

Results: This study shows that wastewater contains many different types of microbial pathogens and AMR determinants from domestic, healthcare, agricultural and industrial sources. While culture-based methods are the gold standard for viable organism recovery and antimicrobial susceptibility testing, quantitative PCR, digital PCR, and metagenomic sequencing offer highly sensitive and comprehensive methods of detecting pathogens and resistance determinants. Wastewater based epidemiology has become an important population-level surveillance method. While conventional treatment can significantly decrease the amount of microbial contamination, it is essential to support the use of advanced or nature-based treatment technologies, as resistant organisms and ARGs can remain.

Conclusion: One Health approach of wastewater surveillance and multi-barrier treatment can enhance surveillance for infectious diseases, minimize environmental spread of AMR, and enhance public-health protection. Standardization of sampling, molecular techniques, treatment optimization and sustainable wastewater management should be considered in future research.