Abstract

The main objective of this review is to evaluate the performance of constructed wetlands (CWs) used to reduce antibiotic-resistant genes (ARGs) during sewage treatment. To accomplish this objective, statistical and correlation analyses were performed using published data to determine the influence of operational and design parameters on ARG reduction in CWs. The effects of design and operational parameters, such as different CW configurations, seasonality, monoculture and polyculture, support medium, and hydraulic retention time (HRT), on ARG removals, were analyzed. A comparison of ARG reduction under different CW configurations showed that the hybrid configuration of surface flow (SF)-vertical subsurface flow (VSSF) achieved the highest reductions, with values of 1.55 ulog. In this case, aeration is considered an important factor to reduce ARGs in CWs, and it should be considered in future studies. However, statistical analyses showed that the ARG reductions under different CW configurations were not significant (p > 0.05). The same behavior was observed when the effects of operational factors on ARG reductions were analyzed (p > 0.05). The results of this study show that CWs are not optimal technologies to reduce ARGs in sewage. The combination of CWs with advanced wastewater technologies can be a solution for enhancing ARG reduction and reducing the spread of antibiotic resistance.