Effect of disinfectant exposure and starvation treatment on the detachment of simulated drinking water biofilms

Mechanistic modeling of Legionella in building water systems: A critical review on the essential factors

Modeling Legionella exposure from building water systems is valuable to inform water management plans, but accurate risk estimates require accounting for spatiotemporal variations in concentrations. This comprehensive literature review covers existing mathematical approaches for predicting Legionella fate and transport in building water systems and proposes a framework for advanced modeling considering all mechanisms influencing its presence in water and biofilm during different life-stages (e.g., within protozoan hosts). Current models include persistence of culturable cells in a heater, growth and decay throughout simplified hot water systems, concentrations linked to water age using fitted growth rates, and a calibrated model for a highly-monitored system. The challenges of modeling influencing factors are also discussed, including water demand, hydraulics, nutrient availability, pipe materials, temperature, and chemical disinfection. By contrasting laboratory and field observations with existing models, this review highlights knowledge gaps and data needs for integrating Legionella growth and persistence into hydraulics, water quality and, ultimately, exposure models to define minimal-risk design and operational practices.

Controlling iron release and pathogenic bacterial growth in distribution pipes through nanofiltration followed by different disinfection methods

There is increasing concern about discoloration problems and microbial risks in drinking water. Until recently, how to control iron release and pathogenic bacterial growth in distribution pipes has been a knowledge gap. In our study, nanofiltration removed 13.3 % of lignins, 33.1 % of tannins and 17.7 % of proteins from dissolved organic matter (DOM). These DOM components were closely related to enzymes involved in the tricarboxylic acid (TCA) cycle. Therefore, nanofiltration followed by chlorine or chloramine disinfection inhibited the TCA cycle and induced lower adenosine triphosphate (ATP) and extracellular polymeric substance (EPS) production, resulting in reduced pathogenic bacterial growth. The number of Pseudomonas aeruginosa decreased to 7.43 × 105 and 2.43 × 105 gene copies/mL, respectively. Moreover, lower DOM concentrations increased the abundance of iron-reducing bacteria (IRBs) in the biofilm. IRBs can convert Fe(III) into Fe(II) through cellular c-type cytochromes, including CymA, MtrA, Cytc3, MacA, PpcA, and OcmB. The higher abundance of IRB and their cytochromes led to more Fe3O4 formation on the surface of the distribution pipes, resulting in lower iron release. The total iron concentration was 16.9 μg/L in the effluent of pipes treated with nanofiltration and chloramine disinfection. Therefore, nanofiltration followed by different disinfection methods, especially chloramine disinfection, effectively controlled iron release and pathogenic bacterial growth in distribution pipes. This study strongly contributes to maintaining the drinking water quality in distribution pipes.

The perfluorooctanoic acid accumulation and release from pipelines promoted growth of bacterial communities and opportunistic pathogens with different antibiotic resistance genes in drinking water

The spread of opportunistic pathogens (OPs) and antibiotic resistance genes (ARGs) through drinking water has already caused serious human health issues. There is also an urgent need to know the effects of perfluorooctanoic acid (PFOA) on OPs with different ARGs in drinking water. Our results suggested that PFOA accumulation and release from the pipelines induced its concentration in pipelines effluents increase from 0.03 ± 0.01 μg/L to 0.70 ± 0.01 μg/L after 6 months accumulation. The PFOA also promoted the growth of Hyphomicrobium, Microbacterium, and Bradyrhizobium. In addition, PFOA accumulation and release from the pipelines enhanced the metabolism and tricarboxylic acid (TCA) cycle processes, resulting in more extracellular polymeric substances (EPS) production. Due to EPS protection, Pseudomonas aeruginosa and Legionella pneumophila increased to (7.20 ± 0.09) × 104 gene copies/mL, and (8.85 ± 0.11) × 102 gene copies/mL, respectively. Moreover, PFOA also enhanced the transfer potential of different ARGs, including emrB, mdtB, mdtC, mexF, and macB. The main bacterial community composition and the main OPs positively correlated with the main ARGs and mobile genetic elements (MGE)-ARGs significantly. Therefore, PFOA promoted the propagation of OPs with different ARGs. These results are meaningful for controlling the microbial risk caused by the OPs with ARGs and MGE-ARGs in drinking water.

Prevalence of antibiotic resistance genes in different drinking water treatment processes in a northwest Chinese city

Antibiotic resistance genes (ARGs) are an emerging issue which are receiving increasing concerns in drinking water safety. However, the factors (e.g. treatment processes and water quality) affecting the removal efficiency of ARGs in the drinking water treatment plants (DWTPs) is still unclear. This work investigated the ARG profiles in each treatment process of two DWTPs located in a northwest Chinese city. The results showed that tetracycline and sulfonamide resistance genes were predominant among the 14 targeted ARGs. After the treatment, the Z water treatment plant which demonstrated a higher removal rate of ARGs (ranging from 50 to 80%), compared to the S plant (50-75%). And the average removal rate of tetracycline resistance genes (tetA, tetG, tetQ, tetX) was about 49.18% (S plant) and 67.50% (Z plant), as well as the removal rate of 64.2% and 72.9% for sulfonamide resistance (sul1 and sul2) at S and Z water plants, respectively. It was found that the relative abundance of main microbial communities (such as Bacteroidota, Actinobacteria, Verrucomicrobiota, Roseomonas), α-diversity index, as well as the abundance of pathogenic bacteria were all significantly reduced after different treatment processes. Network co-occurrence analysis revealed that Methylocystis possibly was the potential host for most ARGs, and sul1 was found across a broad spectrum of microorganisms in the drinking water environment. Adonis analysis showed that heavy metals and microbial communities explain solely 44.1% and 35.7% of variances of ARGs within DWTPs. This study provides insights into the contamination status and removal efficiencies of ARGs in DWTPs, offering valuable references for future studies on ARG removal, propagation, and diffusion patterns in drinking water treatment.

Biofilm formation and microbial interactions in moving bed-biofilm reactors treating wastewater containing pharmaceuticals and personal care products: A review

The risk of pharmaceuticals and personal care products (PPCPs) has been paid more attention after the outbreak of COVID-19, threatening the ecology and human health resulted from the massive use of drugs and disinfectants. Wastewater treatment plants are considered the final stop to restrict PPCPs from wide spreading into the environment, but the performance of conventional treatment is limited due to their concentrations and characteristics. Previous studies have shown the unreplaceable capability of moving bed-biofilm reactor (MBBR) as a cost-effective method with layered microbial structure for treating wastewater even with toxic compounds. The biofilm community and microbial interactions are essential for the MBBR process in completely degrading or converting types of PPCPs to secondary metabolites, which still need further investigation. This review starts with discussing the initiation of MBBR formation and its influencing parameters according to the research on MBBRs in the recent years. Then the efficiency of MBBRs and the response of biofilm after exposure to PPCPs are further addressed, followed by the bottlenecks proposed in this field. Some critical approaches are also recommended for mitigating the deficiencies of MBBRs based on the recently published publications to reduce the environmental risk of PPCPs. Finally, this review provides fundamental information on PPCPs removal by MBBRs with the main focus on microbial interactions, promoting the MBBRs to practical application in the real world of wastewater treatment.

Nanocomposites against Pseudomonas aeruginosa biofilms: Recent advances, challenges, and future prospects

Pseudomonas aeruginosa is an opportunistic bacterial pathogen that causes life-threatening and persistent infections in immunocompromised patients. It is the culprit behind a variety of hospital-acquired infections owing to its multiple tolerance mechanisms against antibiotics and disinfectants. Biofilms are sessile microbial aggregates that are formed as a result of the cooperation and competition between microbial cells encased in a self-produced matrix comprised of extracellular polymeric constituents that trigger surface adhesion and microbial aggregation. Bacteria in biofilms exhibit unique features that are quite different from planktonic bacteria, such as high resistance to antibacterial agents and host immunity. Biofilms of P. aeruginosa are difficult to eradicate due to intrinsic, acquired, and adaptive resistance mechanisms. Consequently, innovative approaches to combat biofilms are the focus of the current research. Nanocomposites, composed of two or more different types of nanoparticles, have diverse therapeutic applications owing to their unique physicochemical properties. They are emerging multifunctional nanoformulations that combine the desired features of the different elements to obtain the highest functionality. This review assesses the recent advances of nanocomposites, including metal-, metal oxide-, polymer-, carbon-, hydrogel/cryogel-, and metal organic framework-based nanocomposites for the eradication of P. aeruginosa biofilms. The characteristics and virulence mechanisms of P. aeruginosa biofilms, as well as their devastating impact and economic burden are discussed. Future research addressing the potential use of nanocomposites as innovative anti-biofilm agents is emphasized. Utilization of nanocomposites safely and effectively should be further strengthened to confirm the safety aspects of their application.

A review of research advances on disinfection strategies for biofilm control in drinking water distribution systems

The presence of biofilms in drinking water distribution systems (DWDS) is responsible for water quality deterioration and a possible source of public health risks. Different factors impact the biological stability of drinking water (DW) in the distribution networks, such as the presence and concentration of nutrients, water temperature, pipe material composition, hydrodynamic conditions, and levels of disinfectant residual. This review aimed to evaluate the current state of knowledge on strategies for DW biofilm disinfection through a qualitative and quantitative analysis of the literature published over the last decade. A systematic review method was performed on the 562 journal articles identified through database searching on Web of Science and Scopus, with 85 studies selected for detailed analysis. A variety of disinfectants were identified for DW biofilm control such as chlorine, chloramine, UV irradiation, hydrogen peroxide, chlorine dioxide, ozone, and others at a lower frequency, namely, electrolyzed water, bacteriophages, silver ions, and nanoparticles. The disinfectants can impact the microbial communities within biofilms, reduce the number of culturable cells and biofilm biomass, as well as interfere with the biofilm matrix components. The maintenance of an effective residual concentration in the water guarantees long-term prevention of biofilm formation and improves the inactivation of detached biofilm-associated opportunistic pathogens. Additionally, strategies based on multi-barrier processes by optimization of primary and secondary disinfection combined with other water treatment methods improve the control of opportunistic pathogens, reduce the chlorine-tolerance of biofilm-embedded cells, as well as decrease the corrosion rate in metal-based pipelines. Most of the studies used benchtop laboratory devices for biofilm research. Even though these devices mimic the conditions found in real DWDS, future investigations on strategies for DW biofilm control should include the validity of the promising strategies against biofilms formed in real DW networks.

Effect of flow fluctuation on water pollution in drinking water distribution systems

The detachment of biofilm caused by changes in hydraulic conditions is an essential reason for the pollution of water in the drinking water distribution system (DWDS). In this research, the effect of flow fluctuation on bulk water quality was studied. The turbidity, iron concentration, manganese concentration, the total number of bacteria, biodegradable dissolved organic carbon (BDOC), bacterial community structure, and pathogenic genes in bacteria of bulk water were analyzed. The results indicate that the detachment of biofilm caused by fluctuant flow and reverse flow (especially instant reverse flow) can lead to the pollution of water. Throughout the entire experimental period, the turbidity under fluctuant flow velocity is 4.92%∼49.44% higher than that under other flow velocities. BDOC concentration is 5.68%∼53.99% higher than that under low and high flow velocities. The flow fluctuation increases bacterial regrowth potential (BRP) and reduces the biological stability of the bulk water. Low flow velocity is more conducive to the expression of pathogenic functional genes. In the short term, the water quality under low flow velocity is the best. Nevertheless, in a long-term operation (about seven days later), the water quality under high flow velocity is better than that under other flow velocities. This research brings new knowledge about the fluctuant hydraulic conditions on the bulk water quality within the DWDS and provides data support for stable drinking water distribution.

Occurrences and implications of pathogenic and antibiotic-resistant bacteria in different stages of drinking water treatment plants and distribution systems

Different stages of drinking water treatment plants (DWTPs) play specific roles in diverse contaminants' removal present in natural water sources. Although the stages are recorded to promote adequate treatment of water, the occurrence of pathogenic bacteria (PB) and antibiotic-resistant bacteria (ARB) in the treated water and the changes in their diversity and abundance as it passed down to the end users through the drinking water distribution systems (DWDSs), is a great concern, especially to human health. This could imply that the different stages and the distribution system provide a good microenvironment for their growth. Hence, it becomes pertinent to constantly monitor and document the diversity of PB and ARB present at each stage of the treatment and distribution system. This review aimed at documenting the occurrence of PB and ARB at different stages of treatment and distribution systems as well as the implication of their occurrence globally. An exhaustive literature search from Web of Science, Science-Direct database, Google Scholar, Academic Research Databases like the National Center for Biotechnology Information, Scopus, and SpringerLink was done. The obtained information showed that the different treatment stages and distribution systems influence the PB and ARB that proliferate. To minimize the human health risks associated with the occurrence of these PB, the present review, suggests the development of advanced technologies that can promote quick monitoring of PB/ARB at each treatment stage and distribution system as well as reduction of the cost of environomics analysis to promote better microbial analysis.

Effects of disinfectant type and dosage on biofilm's activity, viability, microbiome and antibiotic resistome in bench-scale drinking water distribution systems

Drinking water distribution systems (DWDSs) are important for supplying high-quality water to consumers and disinfectant is widely used to control microbial regrowth in DWDSs. However, the disinfectant's influences on microbial community and antibiotic resistome in DWDS biofilms and the underlying mechanisms driving their dynamics remain elusive. The study investigated the effects of chlorine and chloramine disinfection on the microbiome and antibiotic resistome of biofilms in bench-scale DWDSs using metagenomics assembly. Additionally, the biofilm activity and viability were monitored based on adenosine triphosphate (ATP) and flow cytometer (FCM) staining. The results showed that both chlorine and chloramine disinfectants decreased biofilm ATP, although chloramine at a lower dosage (1 mg/L) could increase it. Chloramine caused a greater decrease in living cells than chlorine. Furthermore, the disinfectants significantly lowered the microbial community diversity and altered microbial community structure. Certain bacterial taxa were enriched, such as Mycobacterium, Sphingomonas, Sphingopyxis, Azospira, and Dechloromonas. Pseudomonas aeruginosa exhibited high resistance towards disinfectants. The disinfectants also decreased the complexity of microbial community networks. Some functional taxa (e.g., Nitrospira, Nitrobacter, Nitrosomonas) were identified as keystones in chloramine-treated DWDS microbial ecological networks. Stochasticity drove biofilm microbial community assembly, and disinfectants increased the contributions of stochastic processes. Chlorine had greater promotion effects on antibiotic resistance genes (ARGs), mobile genetic elements (MGEs) and ARG hosts than chloramine. The disinfectants also selected pathogens, such as Acinetobacter baumannii and Klebsiella pneumonia, and these pathogens also harbored ARGs and MGEs. Overall, this study provides new insights into the effects of disinfectants on biofilm microbiome and antibiotic resistome, highlighting the importance of monitoring and managing disinfection practices in DWDSs.

Responses of drinking water bulk and biofilm microbiota to elevated water age in bench-scale simulated distribution systems

Reductions in nonresidential water demand during the COVID-19 pandemic highlighted the importance of understanding how water age impacts drinking water quality and microbiota in piped distribution systems. Using benchtop model distribution systems, we aimed to characterize the impacts of elevated water age on microbiota in bulk water and pipe wall biofilms. Five replicate constant-flow reactors were fed with municipal chloraminated tap water for 6 months prior to building closures and 7 months after. After building closures, chloramine levels entering the reactors dropped; in the reactor bulk water and biofilms the mean cell counts and ATP concentrations increased over an order of magnitude while the detection of opportunistic pathogens remained low. Water age, and the corresponding physicochemical changes, strongly influenced microbial abundance and community composition. Differential initial microbial colonization also had a lasting influence on microbial communities in each reactor (i.e., historical contingency).

Decoupling the heterogeneity of sediment microbial communities along the urbanization gradients: A Bayesian-based approach

Comprehending the response of microbial communities in rivers along urbanization gradients to hydrologic characteristics and pollution sources is critical for effective watershed management. However, the effects of complex factors on riverine microbial communities remain poorly understood. Thus, we established a bacteria-based index of biotic integrity (Ba-IBI) to evaluate the microbial community heterogeneity of rivers along an urbanization gradient. To examine the response of Ba-IBI to multiple stressors, we employed a Bayesian network based on structural equation modeling (SEM-BN) and revealed the key control factors influencing Ba-IBI at different levels of urbanization. Our findings highlight that waterborne nutrients have the most significant direct impact on Ba-IBI (r = -0.563), with a particular emphasis on ammonia nitrogen, which emerged as the primary driver of microbial community heterogeneity in the Liuyang River basin. In addition, our study confirmed the substantial adverse effects of urbanization on river ecology, as urban land use had the greatest indirect effect on Ba-IBI (r = -0.460). Specifically, the discharge load from wastewater treatment plants (WWTP) was found to significantly negatively affect the Ba-IBI of the entire watershed. In the low urbanized watersheds, rice cultivation (RC) and concentrated animal feeding operations (CAFO) are key control factors, and an increase in their emissions can lead to a sharp decrease in Ba-IBI. In moderately urbanized watersheds, the Ba-IBI tended to decrease as the level of RC emissions increased, while in those with moderate RC emissions, an increase in point source emissions mitigated the negative impact of RC on Ba-IBI. In highly urbanized watersheds, Ba-IBI was not sensitive to changes in stressors. Overall, our study presents a novel approach by integrating Ba-IBI with multi-scenario analysis tools to assess the effects of multiple stressors on microbial communities in river sediments, providing valuable insights for more refined environmental decision-making.

The Behavior of Polymeric Pipes in Drinking Water Distribution System-Comparison with Other Pipe Materials

The inner walls of the drinking water distribution system (DWDS) are expected to be clean to ensure a safe quality of drinking water. Complex physical, chemical, and biological processes take place when water comes into contact with the pipe surface. This paper describes the impact of leaching different compounds from the water supply pipes into drinking water and subsequent risks. Among these compounds, there are heavy metals. It is necessary to prevent these metals from getting into the DWDS. Those compounds are susceptible to impacting the quality of the water delivered to the population either by leaching dangerous chemicals into water or by enhancing the development of microorganism growth on the pipe surface. The corrosion process of different pipe materials, scale formation mechanisms, and the impact of bacteria formed in corrosion layers are discussed. Water treatment processes and the pipe materials also affect the water composition. Pipe materials act differently in the flowing and stagnation conditions. Moreover, they age differently (e.g., metal-based pipes are subjected to corrosion while polymer-based pipes have a decreased mechanical resistance) and are susceptible to enhanced bacterial film formation. Water distribution pipes are a dynamic environment, therefore, the models that are used must consider the changes that occur over time. Mathematical modeling of the leaching process is complex and includes the description of corrosion development over time, correlated with a model for the biofilm formation and the disinfectants-corrosion products and disinfectants-biofilm interactions. The models used for these processes range from simple longitudinal dispersion models to Monte Carlo simulations and 3D modeling. This review helps to clarify what are the possible sources of compounds responsible for drinking water quality degradation. Additionally, it gives guidance on the measures that are needed to maintain stable and safe drinking water quality.

Seasonality Determines the Variations of Biofilm Microbiome and Antibiotic Resistome in a Pilot-Scale Chlorinated Drinking Water Distribution System Deciphered by Metagenome Assembly

Understanding the biofilm microbiome and antibiotic resistome evolution in drinking water distribution systems (DWDSs) is crucial to ensure the safety of drinking water. We explored the 10 month evolution of the microbial community, antibiotic resistance genes (ARGs), mobile gene elements (MGEs) co-existing with ARGs and pathogenic ARG hosts, and the ARG driving factors in DWDS biofilms using metagenomics assembly. Sampling season was critical in determining the microbial community and antibiotic resistome shift. Pseudomonas was the primary biofilm colonizer, and biofilms diversified more as the formation time increased. Most genera tended to cooperate to adapt to an oligotrophic environment with disinfectant stress. Biofilm microbial community and antibiotic resistome assembly were mainly determined by stochastic processes and changed with season. Metagenome assembly provided the occurrence and fates of MGEs co-existing with ARGs and ARG hosts in DWDS biofilms. The abundance of ARG- and MGE-carrying pathogen Stenotrophomonas maltophilia was high in summer. It primarily harbored the aph(3)-IIb, multidrug transporter, smeD, and metallo-beta-lactamase ARGs, which were transferred via recombination. The microbial community was the most crucial factor driving the antibiotic resistance shift. We provide novel insights about the evolution of pathogens and ARGs and their correlations in DWDS biofilms to ensure the safety of drinking water.

Study on the distribution characteristics and metabolic mechanism of chlorine-resistant bacteria in indoor water supply networks

The presence and attachment of chlorine-resistant bacteria on the surface of water distribution network will deteriorate water quality and threaten human health. Chlorination is critical in drinking water treatment to ensure the biosafety of drinking water. However, how disinfectants affect the structures of dominant flora during biofilm development and whether the changes are consistent with the free flora remain unclear. Therefore, we investigated changes in species diversity and relative abundance of different bacterial communities in planktonic and biofilm samples at different chlorine residual concentrations (blank, 0.3 mg/L, 0.8 mg/L, 2.0 mg/L and 4.0 mg/L), and the main reasons for the development of chlorine resistance in bacteria was also discussed. The results showed that the richness of microbial species in the biofilm was higher than that in planktonic microbial samples. In the planktonic samples, Proteobacteria and Actinobacteria were the dominant groups regardless of the chlorine residual concentration. For biofilm samples, the dominant position of Proteobacteria bacteria was gradually replaced by actinobacteria bacteria with the increase of chlorine residual concentration. In addition, at higher chlorine residual concentration, Gram-positive bacteria were more concentrated to form biofilms. There are three main reasons for the generation of chlorine resistance of bacteria: enhanced function of efflux system, activated bacterial self-repair system, and enhanced nutrient uptake capacity.

Disruption of Pseudomonas aeruginosa Adherent Cells by NaCl and NaOCl in Drinking Water

The aim of this study was to compare and explain the disruptive effect of sodium chloride and sodium hypochlorite on the adherent cells of P. aeruginosa on glass slides. To this end, the surface characteristics of glass slides and P. aeruginosa were estimated using the contact angle method. In addition, the effects of NaCl and NaOCl on the attachment of the adherent cells were revealed using optical microscopy. The contact angle data showed moderate effects of NaCl and NaOCl on the P. aeruginosa surface, which became faintly more hydrophilic (21.9 mJ/m², 51.1 mJ/m²) and a stronger electrons donor (53.4 mJ/m², 54.3 mJ/m²). NaCl reversed the hydrophobicity of glass, with its surface becoming very hydrophobic (- 31.7 mJ/m²) and a weak electrons donor (7.4 mJ/m²), whereas NaOCl enhanced the hydrophobicity of glass (49.3 mJ/m²) and its electrons donor character (62.7 mJ/m²). The optical microscopy showed that NaCl caused a clear and progressive disruption of the colonization, while NaOCl had no effect. Briefly, this study suggests that a combination of NaCl and NaOCl may solve the problem of P. aeruginosa installation in water tracks.

Metagenomics analysis of antibiotic resistance genes, the bacterial community and virulence factor genes of fouled filters and effluents from household water purifiers in drinking water

The aim of this study was to explore the influence and removal of household water purifiers (HWPs) on emerging contaminants in drinking water, and their distribution characteristics. The antibiotic resistance genes (ARGs), mobile genetic elements (MGEs), virulence factor genes (VFGs) and bacterial communities were profiled in the fouled filters, influents, and effluents from HWPs with five steps of filtration after 150 days operation, using metagenomics. The results showed that the diversity of dominant species in Poly Propylene 1 μm (PP1) and nanofiltration membrane (NM) was significantly higher than that in other filters. Post-activated carbon (AC) was used to detect low species richness or diversity, and the highest proportion of dominant species, which contributes to the greater microbial risk of HWPs effluents in drinking water. The number of dominant bacterial genera in the filters disinfected with chloramine was higher than that in the same group disinfected with chlorine. The bacterial species richness or diversity in water was reduced by the purification of HWPs because the filter elements effectively trapped a variety of microorganisms. The relative abundance of Antibiotic efflux in the effluents of chlorinated and chloraminated HWPs was 5.58 × 10-3 and 4.60 × 10-3, respectively, which was the main resistance mechanism. High abundance of VFGs was found in HWPs effluents and the relative abundance of aggressive VFGs was significantly higher than those of defensive VFGs. Based on the co-occurrence results, 243 subtypes of ARGs co-occurred with VFGs, and a variety of bacteria were thought to be possible ARGs hosts, which indicated that the host bacteria of VFGs in HWP effluents had a stronger attack ability. The effluent of HWPs with only filtration processes is exposed to the risk of ARGs and VFGs. This study helps to understand the actual purification effect of HWPs and provides a theoretical reference for the management and control of ARGs pollution in domestic drinking water.

Antibiotic Resistance in the Drinking Water: Old and New Strategies to Remove Antibiotics, Resistant Bacteria, and Resistance Genes

Bacterial resistance is a naturally occurring process. However, bacterial antibiotic resistance has emerged as a major public health problem in recent years. The accumulation of antibiotics in the environment, including in wastewaters and drinking water, has contributed to the development of antibiotic resistant bacteria and the dissemination of antibiotic resistance genes (ARGs). Such can be justified by the growing consumption of antibiotics and their inadequate elimination. The conventional water treatments are ineffective in promoting the complete elimination of antibiotics and bacteria, mainly in removing ARGs. Therefore, ARGs can be horizontally transferred to other microorganisms within the aquatic environment, thus promoting the dissemination of antibiotic resistance. In this review, we discuss the efficiency of conventional water treatment processes in removing agents that can spread/stimulate the development of antibiotic resistance and the promising strategies for water remediation, mainly those based on nanotechnology and microalgae. Despite the potential of some of these approaches, the elimination of ARGs remains a challenge that requires further research. Moreover, the development of new processes must avoid the release of new contaminants for the environment, such as the chemicals resulting from nanomaterials synthesis, and consider the utilization of green and eco-friendly alternatives such as biogenic nanomaterials and microalgae-based technologies.