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Article summary:

1. Antibiotic resistance is a global threat to human health, and surface water resources are environmental hotspots of antibiotic resistant gene (ARG) transfer.

2. Fecal pollution from both animal and human waste are important sources of ARB and ARGs to surface waters, with non-point source fecal contamination from aging wastewater infrastructure being a primary driver of antibiotic resistance in surface waters.

3. A novel analysis found strong correlations between ARGs and measures of sewer density, sewer length, and septic system age within sample watersheds, indicating the critical role of non-point sources of antimicrobial resistance to surface waters.

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