14 Antibiotic Resistance, Its Health Impacts and Advancements …
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resistant strains to non-resistant microorganism (Berendonk et al. 2015; BengtssonPalme et al. 2018). Another study by Qamar et al. (2018) report traced the cause of
typhoid fever as result of E. coli and Salmonella enterica ser. Typhi (ceftriaxoneresistant) due to contaminated drinking water. Prior to that in the year 2015, an
azithromycin and nalidixic acid resistance Shigella outbreak in a lower primary
school in China was reported due to poor quality of drinking water and food (Ma
et al. 2017). Yet in another report by Finley et al. (2013), intake of multi-drugresistant (MDR) Salmonella typhi contamination present in the treated water caused
~100 deaths. A Cholera outbreak case was investigated, and it was found that the
stool samples of the patients contained cotrimoxazole and ampicillin resistance in
Cholera vibrio (Gupta et al. 2016). ARB such as carbapenem resistance Klebsiella
pneumoniae are the supreme reasons for worldwide reason for urinary tract infections
(UTIs), lower respiratory tract infections and infections of blood.
Once bacteria evolve resistance to customary primary antibiotics (first line drugs),
treatment of human bacterial invasions and diseases becomes intricate and expensive, as it will demand doses of last antibiotics available or even require the discovery
of new drugs (World Health Organization (WHO) 2017). Although, AR is a worldwide issue, risks on human health remain more conspicuous in developing countries
and seem higher than that in developed ones. The reason behind this may be that
developing countries lack better healthcare facilities and are deprived of basic technology, medications and equipment. Also, tropical environments aid more diseases,
which in turn demand incessant use of antibiotics. In Asian and African countries
with underdeveloped conditions, impoverished sanitization and unreliable drinking
water quality, Shigella spp. with ciprofloxacin resistance may persists, causing conditions like dysentery and diarrhea, which is oftentimes malignant in children. In
2017, WHO listed couple of medium that serves list of critical priority pathogenic
ARBs possessing serious threat to human health and endorsed worldwide scrutiny
of these pathogenic ARBs (Barancheshme and Munir 2018).
14.3 Trending Treatment Techniques for ARB/G Removal
14.3.1 Efficient Physical Treatment
From last few decades, a large variety of technologies such as, filtration, oxidation
(both simple and advanced oxidation techniques), adsorption and improved membrane technologies are employed in the treatment of wastewater in WWTPs for
the removal of antibiotics. Adsorption process uses permeable solid adsorbent such
as silica gels, activated carbon, artificial pumice to adsorb pollutants and nutrients
from waste to eliminate contaminants or regain nutrients, thereby edulcorating the
media. Various studies have analyzed many substances, viz., activated carbon, carbon nanotubes, iron, permeable resins, etc., immobilized on alumina for the removal
of norfloxacin (NOR) (Liu et al. 2011; Yang et al. 2012a, b). Similarly, adsorption
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resistant strains to non-resistant microorganism (Berendonk et al. 2015; BengtssonPalme et al. 2018). Another study by Qamar et al. (2018) report traced the cause of
typhoid fever as result of E. coli and Salmonella enterica ser. Typhi (ceftriaxoneresistant) due to contaminated drinking water. Prior to that in the year 2015, an
azithromycin and nalidixic acid resistance Shigella outbreak in a lower primary
school in China was reported due to poor quality of drinking water and food (Ma
et al. 2017). Yet in another report by Finley et al. (2013), intake of multi-drugresistant (MDR) Salmonella typhi contamination present in the treated water caused
~100 deaths. A Cholera outbreak case was investigated, and it was found that the
stool samples of the patients contained cotrimoxazole and ampicillin resistance in
Cholera vibrio (Gupta et al. 2016). ARB such as carbapenem resistance Klebsiella
pneumoniae are the supreme reasons for worldwide reason for urinary tract infections
(UTIs), lower respiratory tract infections and infections of blood.
Once bacteria evolve resistance to customary primary antibiotics (first line drugs),
treatment of human bacterial invasions and diseases becomes intricate and expensive, as it will demand doses of last antibiotics available or even require the discovery
of new drugs (World Health Organization (WHO) 2017). Although, AR is a worldwide issue, risks on human health remain more conspicuous in developing countries
and seem higher than that in developed ones. The reason behind this may be that
developing countries lack better healthcare facilities and are deprived of basic technology, medications and equipment. Also, tropical environments aid more diseases,
which in turn demand incessant use of antibiotics. In Asian and African countries
with underdeveloped conditions, impoverished sanitization and unreliable drinking
water quality, Shigella spp. with ciprofloxacin resistance may persists, causing conditions like dysentery and diarrhea, which is oftentimes malignant in children. In
2017, WHO listed couple of medium that serves list of critical priority pathogenic
ARBs possessing serious threat to human health and endorsed worldwide scrutiny
of these pathogenic ARBs (Barancheshme and Munir 2018).
14.3 Trending Treatment Techniques for ARB/G Removal
14.3.1 Efficient Physical Treatment
From last few decades, a large variety of technologies such as, filtration, oxidation
(both simple and advanced oxidation techniques), adsorption and improved membrane technologies are employed in the treatment of wastewater in WWTPs for
the removal of antibiotics. Adsorption process uses permeable solid adsorbent such
as silica gels, activated carbon, artificial pumice to adsorb pollutants and nutrients
from waste to eliminate contaminants or regain nutrients, thereby edulcorating the
media. Various studies have analyzed many substances, viz., activated carbon, carbon nanotubes, iron, permeable resins, etc., immobilized on alumina for the removal
of norfloxacin (NOR) (Liu et al. 2011; Yang et al. 2012a, b). Similarly, adsorption