Residues of antimicrobial drugs and their metabolites, antibiotic resistance genes (ARGs), and antibiotic resistant bacteria (ARBs), are continuously introduced into the aquatic environment from hospital wastewater discharges and municipal wastewater treatment plant (WWTP) effluents. However, current literature lacks an understanding of the role of antibiotic resistance (AR) elements from the environment on the proliferation and dissemination of AR in a human population that is directly impacted by these wastewater-contaminated waters.