pp 1-28 | Cite as

Antibiotic Resistance, Sanitation, and Public Health

  • Juliana Calabria de AraújoEmail author
  • Silvana de Queiroz Silva
  • Sergio Francisco de Aquino
  • Deborah Leroy Freitas
  • Elayne Cristina Machado
  • Andressa Rezende Pereira
  • Aline Gomes de Oliveira Paranhos
  • Camila de Paula Dias
Part of the The Handbook of Environmental Chemistry book series


Antimicrobial resistance (AMR) poses a serious threat to global health. In countries with poor sanitation conditions, the situation is worrisome. In this chapter, worldwide data, particularly from Brazil, supports a discussion about the risks of sewage and livestock manure on spreading antibiotic resistance, calling attention to the relationship between poor sanitation conditions, water pollution, and public health. The role of wastewater treatment plants (WWTP) and different treatment technologies in reducing AMR from municipal and livestock wastewaters are discussed based on the information available. It has been observed that municipal WWTPs with tertiary treatment systems can be decisive in the prevention and control of AMR spread and thus contribute to the maintenance of environmental and public health. Considering the information provided, there is a potential for antibiotic-resistant bacteria and antibiotic resistance gene dissemination through conventional WWTP effluents and sludges, especially when the latter are used as biosolids. By reaching surrounding aquatic environments, antibiotic-resistant bacteria may arise as a threat for public health since WWTP and water treatment plants (WTP) are not normally designed to specifically remove AMR. In summary, globally and in particular, Brazil has a lot of challenges to monitor and control AMR not only in municipal WWTPs but also in clinical and natural environments. Accurate information provided by research and routine monitoring, political engagement, new policies, and multidisciplinary actions will be vital to tackle this problem. In the short term, the control of the antibiotic prescription and their use by the population and farmers (already in place) and the increase of sewage collection and treatment are strategic actions to reduce AMR and guarantee public health in the country.


Antibiotic resistance in Brazil Livestock wastes Tertiary treatment Wastewater treatment Water treatment 



Antimicrobial resistance


Antibiotic resistance


Antibiotic-resistant bacteria


Antibiotic resistance gene


Advanced oxidative processes


Biological oxygen demand


Chemical oxygen demand


Extended-spectrum β-lactamases


Horizontal gene transfer




Wastewater treatment plant


Water treatment plant


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Juliana Calabria de Araújo
    • 1
    Email author
  • Silvana de Queiroz Silva
    • 2
  • Sergio Francisco de Aquino
    • 3
  • Deborah Leroy Freitas
    • 1
  • Elayne Cristina Machado
    • 1
  • Andressa Rezende Pereira
    • 2
  • Aline Gomes de Oliveira Paranhos
    • 3
  • Camila de Paula Dias
    • 2
  1. 1.Department of Sanitary and Environmental EngineeringUniversidade Federal de Minas Gerais (UFMG)Belo HorizonteBrazil
  2. 2.Department of Biological SciencesUniversidade Federal de Ouro PretoOuro PretoBrazil
  3. 3.Department of ChemistryUniversidade Federal de Ouro PretoOuro PretoBrazil

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