Health Risk Indicators Resulting from The Spread of Antibiotic Resistance Genes in Rural Aquatic Environments in Babylon Governorate

Abstract

The main objective of this review was to examine the health risk indicators related to the dissemination of antibiotic resistance genes in the rural aquatic environment, focusing on the Babylon Governorate. The significance of this topic is derived from the fact that the problem of antibiotic resistance exists not only in the treatment pathway in healthcare but in an environment that is interconnected to humans, animals, and water because of the growing presence of wastewater, animal waste, agricultural runoff, and disposal of pharmaceuticals in water systems. A descriptive-analytical method was used to review the scientific literature that has explored the occurrence of resistant bacteria, resistance genes, and antibiotic residues in freshwater, wastewater, and water sources impacted by human activities. The analysis was conducted to identify the sources of the resistance factor that enters water, the genetic classes most linked to the most frequently used antibiotics, the mechanisms for gene survival and transfer, and factors that enhance the risk of human and animal exposure. There are indications that the aquatic environment can serve as a reservoir and a facilitator for the dissemination of resistance, notably in case of organic contamination, selection pressure, and transposable genetic elements. However, the presence of a resistance gene does not necessarily mean that pathogenic bacteria or that humans have been infected are present. Must be used in conjunction with water quality indicators, bacterial isolation, susceptibility testing and the nature of use of the source. The review recommends that risk assessment in Babylon Governorate needs to be done regularly and in a standardized manner, through local field studies, better management of waste water and sewage, rational use of antibiotics and institutional cooperation with One Health approach into consideration, and implementation of preventive measures taking into account the safety and living conditions of the population.

Keywords:

Health risk, Resistance genes, Aquatic environments, Rural water, Babylon Governorate

References

Danner, M.-C., Robertson, A., Behrends, V., & Reiss, J. (2019). Antibiotic pollution in surface fresh waters: Occurrence and effects. Science of the Total Environment, 664, 793–804. https://doi.org/10.1016/j.scitotenv.2019.01.406

Felis, E., Kalka, J., Sochacki, A., Kowalska, K., Bajkacz, S., Harnisz, M., & Korzeniewska, E. (2020). Antimicrobial pharmaceuticals in the aquatic environment—Occurrence and environmental implications. European Journal of Pharmacology, 866, 172813. https://doi.org/10.1016/j.ejphar.2019.172813

Kraemer, S. A., Ramachandran, A., & Perron, G. G. (2019). Antibiotic pollution in the environment: From microbial ecology to public policy. Microorganisms, 7(6), 180. https://doi.org/10.3390/microorganisms7060180

Nappier, S. P., Liguori, K., Ichida, A. M., Stewart, J. R., & Jones, K. R. (2020). Antibiotic resistance in recreational waters: State of the science. International Journal of Environmental Research and Public Health, 17(21), 8034. https://doi.org/10.3390/ijerph17218034

Nnadozie, C. F., & Odume, O. N. (2019). Freshwater environments as reservoirs of antibiotic-resistant bacteria and their role in the dissemination of antibiotic resistance genes. Environmental Pollution, 254, 113067. https://doi.org/10.1016/j.envpol.2019.113067

Sankhla, M. S., Negaa, Sharma, V., Kumar, R., Awasthi, G., Shukla, R., Yadav, B., & Awasthi, K. K. (2026). Antibiotic residues in aquatic environment: Ecological disruption and biotechnological solutions for environmental safety. Frontiers in Environmental Engineering, 5, 1872048. https://doi.org/10.3389/fenve.2026.1872048

Sلnchez-Baena, A. M., Caicedo Bejarano, L. D., & Chلvez-Vivas, M. (2021). Structure of bacterial community with resistance to antibiotics in aquatic environments: A systematic review. International Journal of Environmental Research and Public Health, 18(5), 2348. https://doi.org/10.3390/ijerph18052348

Zheng, D., Yin, G., Liu, M., Chen, C., Jiang, Y., Hou, L., et al. (2021). A systematic review of antibiotics and antibiotic resistance genes in estuarine and coastal environments. Science of the Total Environment, 777, 146009. https://doi.org/10.1016/j.scitotenv.2021.146009