Wastewater treatment plants (WWTPs) are being debated for being the hot spots for the development of antibiotic resistance in pathogenic microbial communities. We observed the prevalence of antibiotic-resistant bacteria (ARB), antibiotic resistance genes (ARG), and multidrug resistance (MDR) in two municipal WWTPs and one hospital WWTP in Western and Southern Sri Lanka, and compared the results with particular reference to Indian and the World scenario to trace the imprints of treatment on ARB and ARG. Result suggests that although wastewater treatment resulted in higher than 1.06 log Escherichia coli (E. coli) reduction at all WWTPs, yet the percent of E. coli resistant to most of the antibiotics increased from influent to effluent. Higher prevalence of ARB, ARG, and MDR were noted in hospital WWTP owing to the higher antibiotic concentrations used and excreted by the patients. With reference to India, the WWTPs in Sri Lanka showed more ARB and a consistent increase in its percentages after the treatment but were less resistant to Fluoroquinolone (FQ). E. coli strains isolated from each location of both countries showed multidrug resistance, which has increased after the treatment and was strongly correlated with FQ in every WWTP. Resistant genes for Fluoroquinolone (FQ) (aac-(6′)-1b-cr, qnrB, qnrS), β-lactams (ampC), and sulphonamides (sul1) were common in all the wastewaters except additional parC gene in the hospital effluent of Sri Lanka, implying much higher resistance for quinolones, especially for Ciprofloxacin. Multivariate statistical treatments suggest that effluent showed higher loadings and association for MDR/ARB, where pH change and more extensive interaction with metals during the treatment processes seem to have profound effects.