Sustainable material platforms for multi-log removal of antibiotic-resistant bacteria and genes from wastewater: A review

Antibiotic-resistant bacteria (ARB) and the associated resistance genes (ARGs) are now recognized as emerging contaminants that can disseminate via wastewater streams, posing significant risks to both human and ecosystem health. Conventional physicochemical treatment approaches (e.g., chlorination, ozonation, advanced oxidation processes) typically suppress these contaminants but may also result in the formation of hazardous by-products. This critical review comprehensibly evaluates bio-based and other sustainable materials designed for the removal of ARB and ARGs from aqueous environments. The materials are systematically categorized into (i) biopolymers and their composites (chitosan, alginate, cellulose), (ii) carbon-rich adsorbents and (photo-)catalysts (biochar, activated carbon, graphene), (iii) metal- and semiconductor-based nanomaterials, and (iv) nature-based treatment solutions (constructed wetlands, soil-aquifer treatment, clay sorbents). Observed log-reduction value range from 2 to 7 for ARB with platforms such as zinc oxide/activated-carbon alginate beads, Fe/N-doped biochars, and graphene-supramolecular-porphyrin hybrids demonstrating high multifunctional efficacy. Mechanistic studies reveal that removal involves synergistic adsorption, photodynamic or Fenton-like oxidation, cell-membrane disruption, and inhibition of horizontal gene transfer. This review emphasizes the advancing potential of sustainable material solutions for mitigating antibiotic resistance and highlights the urgent need to develop scalable, environmentally sustainable treatment methods for protecting water resources and public health.