Review of Antimicrobial Resistance in Wastewater in Japan: Current Challenges and Future Perspectives

Hiroaki Baba, Masateru Nishiyama, Toru Watanabe, Hajime Kanamori

研究成果: Review article査読

1 被引用数 (Scopus)


Antimicrobial resistance (AMR) circulates through humans, animals, and the environments, requiring a One Health approach. Recently, urban sewage has increasingly been suggested as a hotspot for AMR even in high-income countries (HICs), where the water sanitation and hygiene infrastructure are well-developed. To understand the current status of AMR in wastewater in a HIC, we reviewed the epidemiological studies on AMR in the sewage environment in Japan from the published literature. Our review showed that a wide variety of clinically important antibiotic-resistant bacteria (ARB), antibiotic resistance genes (ARGs), and antimicrobial residues are present in human wastewater in Japan. Their concentrations are lower than in low-and middle-income countries (LMICs) and are further reduced by sewage treatment plants (STPs) before discharge. Nevertheless, the remaining ARB and ARGs could be an important source of AMR contamination in river water. Furthermore, hospital effluence may be an important reservoir of clinically important ARB. The high concentration of antimicrobial agents commonly prescribed in Japan may contribute to the selection and dissemination of AMR within wastewater. Our review shows the importance of both monitoring for AMR and antimicrobials in human wastewater and efforts to reduce their contamination load in wastewater.

出版ステータスPublished - 2022 7月

ASJC Scopus subject areas

  • 微生物学
  • 生化学
  • 薬理学、毒性学および薬学(全般)
  • 微生物学(医療)
  • 感染症
  • 薬理学(医学)


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