Abstract

This review investigated the antimicrobial resistance (AMR) in the context of environmental waters of Pakistan. The literature was searched through databases via; google scholar, PubMed, science direct, research gate, some organization’s websites like UNEP, Pak-EPA and Government of Pakistan. This review details the AMR in the context of surface waters (glaciers, glaciated lakes and rivers), wastewaters (wastewater effluents, pharmaceutical wastes entering surface waters) and drinking waters (tap water, pumped water etc.) of Pakistan. The pharmaceutical industries, animal husbandry, agriculture and aquaculture practices in Pakistan as a source of AMR have also been discussed. It appeared that the waste effluents (industrial, hospital, domestic, animal farming) are harboring antibiotics resistant bacteria (ARBs), antibiotics resistant genes (ARGs) and antibiotics residues that are contaminating surface water sources of Pakistan including glaciated lakes, rivers, tributaries, streams, nullas culminating into the waters used for agriculture or domestic use. The wastewaters of Pakistan should be considered as reservoir of AMR for human where not merely the resistant bacteria/genes and antibiotics, but pollutants like biocides and heavy metals are also drivers of AMR. The Governance and legislations need to be strengthened for sustainable protection of waters from AMR menace.