Phenotypic and genotypic profile of the antimicrobial resistance of bacterial isolates and evaluation of physical and chemical potability indicators in groundwater in Brazil.

References

• Aarestrup FM, Agerso Y, Gerner-Smidt P, Madsen M, Jensen LB. 2000. Comparison of antimicrobial resistance phenotypes and resistance genes in Enterococcus faecalis and Enterococcus faecium from humans in the community, broilers, and pigs in Denmark. Diagn Microbiol Infect Dis. 37(2):127–137.
   Web of Science ®Google Scholar
• Allen HK, Donato J, Wang HH, Cloud-Hansen KA, Davies J, Handelsman J. 2010. Call of the wild: antibiotic resistance genes in natural environments. Nat Rev Microbiol. 8:251–259. doi:10.1038/nrmicro2312
   PubMed Web of Science ®Google Scholar
• American Public Health Association (APHA). 2005. Standard methods for the examination of water and wastewater. 21st ed. Washington: APHA.
   Google Scholar
• American Public Health Association (APHA). 2012. Standard methods for the examination of water and wastewater. 22nd ed. Washington: APHA.
   Google Scholar
• Aminov RI, Mackie RI. 2007. Evolution and ecology of antibiotic resistance genes. FEMS Microbiol Lett. 271(2):147–161. doi:10.1111/j.1574-6968.2007.00757.x
   PubMed Web of Science ®Google Scholar
• Ammor MS, Gueimonde M, Danielsen M, Zagorec M, van Hoek AH, de Los Reyes-Gavilán CG, Mayo B, Margolles A. 2008. Two different tetracycline resistance mechanisms, plasmid-carried tet(L) and chromosomally located transposon-associated tet(M), coexist in Lactobacillus sakei rits 9. Appl Environ Microbiol. 74(5):1394–1401. doi:10.1128/AEM.01463-07
   PubMed Web of Science ®Google Scholar
• Andrade LN, Vitali L, Gaspar GG, Bellissimo-Rodrigues F, Martinez R, Darini AL. 2014. Expansion and evolution of a virulent, extensively drugresistant (polymyxin B-resistant), QnrS1-, CTX-M-2-, and KPC-2-producing Klebsiella pneumoniae ST11 international high-risk clone. J Clin Microbiol. 52(7):2530–2535. doi:10.1128/JCM.00088-14
   PubMed Web of Science ®Google Scholar
• Ashbolt NJ. 2015. Environmental (Saprozoic) pathogens of engineered water systems: understanding their ecology for risk assessment and management. Pathogens. 4(2):390–405. doi:10.3390/pathogens4020390
   PubMed Web of Science ®Google Scholar
• Ayach LR. 2012. Saúde, saneamento e percepção de riscos ambientais urbanos [Health, sanitation and the perception of urban environmental risks]. Caderno De Geografia. 22:37. Portuguese.
   Google Scholar
• Azizullah A, Khattak MNK, Richter P, Häder DP. 2011. Water pollution in Pakistan and its impact on public health a review. Environ Int. 37(2):479–497. doi:10.1016/j.envint.2010.10.007
   PubMed Web of Science ®Google Scholar
• Bauer AW, Kirby WM, Sherris JC, Turck M. 1966. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol. 45(4):493–496.
   PubMed Web of Science ®Google Scholar
• Bolon MK. 2011. The newer fluoroquinolones. Med Clin North Am. 95(4):793–817. doi:10.1016/j.mcna.2011.03.006
   PubMed Web of Science ®Google Scholar
• Bonomo RA, Szabo D. 2006. Mechanisms of multidrug resistance in Acinetobacter species and Pseudomonas aeruginosa. Clin Infect Dis. 43(2):49–56. doi:10.1086/504804
   PubMedGoogle Scholar
• Brasil. 2004. Ministério da Saúde. Portaria nº 518 de 25 de março de 2004. Estabelece os procedimentos e responsabilidades relativas ao controle e vigilância da qualidade da água para consumo humano e seu padrão de potabilidade e dão outras providências [It establishes the procedures and responsibilities related to the control and surveillance of the quality of water for human consumption and its standard of potability and provide other measures]. [accessed 2017 Aug 12]. http://bvsms.saude.gov.br/bvs/publicacoes/portaria_518_2004.pdf/. Portuguese.
   Google Scholar
• Brasil. 2011. Ministério da Saúde. Portaria n° 2914, de 12 de dezembro de 2011. Dispõe sobre os procedimentos de controle e de vigilância da qualidade da água para consumo humano e seu padrão de potabilidade [Provides on the procedures for controlling and monitoring the quality of water for human consumption and its standard of potability]. [accessed 2017 Aug 12]. http://bvsms.saude.gov.br/bvs/saudelegis/gm/2011/prt2914_12_12_2011.html/. Portuguese.
   Google Scholar
• Bush K, Jacoby GA, Medeiros AA. 1995. A functional classification scheme for β-lactamases and its correlation with molecular structure. Antimicrob Agents Chemother. 39(6):1211–1233. doi:10.1128/aac.39.9.1920
   PubMed Web of Science ®Google Scholar
• Campos JADB, Farache Filho A, Faria JB. 2003. Qualidade da água armazenada em reservatórios domiciliares: Parâmetros Físico-Químicos e Microbiológicos [Quality of water stored in domestic reservoirs: physico-chemical and microbiological parameters]. Alimentos E Nutrição. 14(1):63–67. Portuguese.
   Google Scholar
• Cattoir V, Poirel L, Rotimi V, Soussy CJ, Nordmann P. 2007. Multiplex PCR for detection of plasmid-mediated quinolone resistance qnr genes in ESBL-producing enterobacterial isolates. J Antimicrob Chemother. 60:394–397. doi:10.1093/jac/dkm204
   PubMed Web of Science ®Google Scholar
• Chang FY, Siu LK, Fung CP, Huang MH, Ho M. 2001. Diversity of SHV and TEM beta-lactamases in Klebsiella pneumoniae: gene evolution in Northern Taiwan and two novel beta-lactamases, SHV-25 and SHV-26. Antimicrob Agents Chemother. 45(9):2407–2413. doi:10.1128/aac.45.9.2407-2413.2001
   PubMed Web of Science ®Google Scholar
• Chen B, Liang X, Huang X, Zhang T, Li X. 2013. Differentiating anthropogenic impacts on ARGs in the pearl river estuary by using suitable gene indicators. Water Res. 47:2811–2820. doi:10.1016/j.watres.2013.02.042
   PubMed Web of Science ®Google Scholar
• Clinical and Laboratory Standards Institute (CLSI). 2011. Performance standards for antimicrobial susceptibility testing; twentieth informational supplement. M100-S20. 30 (1). Wayne (PA): Clinical and Laboratory Standards Institute.
   Google Scholar
• Companhia de Tecnologia de Saneamento Ambiental (CETESB). 2010. Relatório de qualidade das águas subterrâneas do estado de São Paulo 2007–2009 [Report on the quality of groundwater in the state of São Paulo 2007–2009]. São Paulo: CETESB. Portuguese.
   Google Scholar
• Coque TM, Baquero F, Canton R. 2008. Increasing prevalence of ESBL-producing Enterobacteriaceae in Europe. Euro Surveill. 13(47):19044.
   PubMedGoogle Scholar
• Dallenne C, Da Costa A, Decré D, Favier C, Arlet G. 2010. Development of a set of multiplex PCR assays for the detection of genes encoding important β-lactamases in Enterobacteriaceae. J Antimicrob Chemother. 65:490–495. doi:10.1093/jac/dkp498
   PubMed Web of Science ®Google Scholar
• Dropa M, Lincopan N, Balsalobre LC, Oliveira DE, Moura RA, Fernandes MR, Da Silva QM, Matté GR, Sato MI, Matté MH. 2016. Genetic background of novel sequence types of CTX-M-8- and CTX-M-15-producing Escherichia coli and Klebsiella pneumoniae from public wastewater treatment plants in São Paulo, Brazil. Environ Sci Pollut Res Int. 23(5):4953–4958. doi:10.1007/s11356-016-6079-5
   PubMed Web of Science ®Google Scholar
• Dzidic S, Suskovic J, Kos B. 2008. Antibiotic resistance mechanisms in bacteria: biochemical and genetic aspects. Food Technol Biotechnol. 46(11):11–21.
   Google Scholar
• Edelstein M, Pimkin M, Palagin I, Edelstein I, Stratchounski L. 2003. Prevalence and molecular epidemiology of CTX-M extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in Russian hospitals. Antimicrob Agents Chemother. 47(12):3724–3732. doi:10.1128/aac.47.12.3724-3732.2003
   PubMed Web of Science ®Google Scholar
• Fernando DM, Tun HM, Poole J, Patidar R, Li R, Mi R, Amarawansha GEA, Fernando WGD, Khafipour E, Farenhorst A, et al. 2016. Detection of antibiotic resistance genes in source and drinking water samples from a first nations community in Canada. Appl Environ Microbiol. 82(15):4767–4775. doi:10.1128/AEM.00798-16
   PubMed Web of Science ®Google Scholar
• Fernicola NGG, Azevedo FA. 1981. Metemoglobinemia e nitrato nas águas. Rev Saúde Pública. 15(2):242–248. doi:10.1590/s0034-89101981000200009
   PubMedGoogle Scholar
• Francisco GR, Bueno MFC, Cedeira L, Lincopan N, Lenne S, Souza TA, Garcia DO. 2019. Draft genome sequences of KPC-2- and CTX-M-15-producing Klebsiella pneumoniae ST437 isolated from a clinical sample and urban rivers in Sao Paulo, Brazil. J Glob Antimicrob Resist. 16:74–75. doi:10.1016/j.jgar.2018.12.003
   PubMed Web of Science ®Google Scholar
• Freitas JC. 2000. Loteamentos Clandestinos: uma proposta de prevenção e repressão [Clandestine allotments: a proposal for prevention and repression]. In: Freitas JC (Coordenador), editor, Temas de direito urbanístico 2 (pp. 331–352). São Paulo: Imprensa Oficial do Estado - Ministério Público do Estado de São Paulo. Portuguese.
   Google Scholar
• Guillard T, Cambau E, Chau F, Massias L, de Champs C, Fantin B. 2013. Ciprofloxacin treatment failure in a murine model of pyelonephritis due to an AAC(6ʹ)-Ib-cr-producing Escherichia coli strain susceptible to ciprofloxacin in vitro. Antimicrob Agents Chemother. 57(12):5830–5835. doi:10.1128/AAC.01489-13
   PubMed Web of Science ®Google Scholar
• Huang S, Dai W, Sun S, Zhang X, Zhang L. 2012. Prevalence of plasmid-mediated quinolone resistance and aminoglycoside resistance determinants among carbapeneme non-susceptible Enterobacter cloacae. PLoS One. 7(10):e47636. doi:10.1371/journal.pone.0047636
   PubMed Web of Science ®Google Scholar
• Hudson CM, Bent ZW, Meagher RJ, Williams KP. 2014. Resistance determinants and mobile genetic elements of an NDM-1-encoding Klebsiella pneumoniae strain. PLoS One. 9(6):e99209. doi:10.1371/journal.pone.0099209
   PubMed Web of Science ®Google Scholar
• Hynds P, Misstear BD, Gill LW, Murphy HM. 2014. Groundwater source contamination mechanisms: physicochemical profile clustering, risk factor analysis and multivariate modelling. J Contam Hydrol. 159:47–56. doi:10.1016/j.jconhyd.2014.02.001
   PubMed Web of Science ®Google Scholar
• Instituto Adolfo Lutz. 2008. Métodos físico-químicos para análise de alimentos [Physical-chemical methods for food analysis]. 4th ed. São Paulo: Instituto Adolfo Lutz; [accessed 2017 June 1]. http://www.ial.sp.gov.br/resources/editorinplace/ial/2016_3_19/analisedealimentosial_2008.pdf?attach=true/. Portuguese.
   Google Scholar
• Jacoby GA. 2005. Mechanisms of resistance to quinolones. Clin Infect Dis. 41(Suppl2):S120–S126. doi:10.1086/444499
   PubMedGoogle Scholar
• Jacoby GA, Griffin CM, Hooper DC. 2011. Citrobacter spp. as a source of qnrB alleles. Antimicrob Agents Chemother. 55(11):4979–4984. doi:10.1128/AAC.05187-11
   PubMed Web of Science ®Google Scholar
• Laroche E, Pawlak B, Berthe T, Skurnik D, Petit F. 2009. Occurrence of antibiotic resistance and class 1, 2 and 3 integrons in Escherichia coli isolated from a densely populated estuary (Seine, France). FEMS Microbiol Ecol. 68(1):118–130. doi:10.1111/j.1574-6941.2009.00655.x
   PubMed Web of Science ®Google Scholar
• Lee GC, Burgess DS. 2012. Treatment of Klebsiella pneumoniae carbapenemase (KPC) infections: a review of published case series and case reports. Ann Clin Microbiol Antimicrob. 11:32. doi:10.1186/1476-0711-11-32
   PubMed Web of Science ®Google Scholar
• Lin M, Wu X, Yan Q, Ma Y, Huang L, Qin Y, Xu X. 2016. Incidence of antimicrobial-resistance genes and integrons in antibiotic-resistant bacteria isolated from eels and aquaculture ponds. Dis Aquat Organ. 120(2):115–123. doi:10.3354/dao03013
   PubMed Web of Science ®Google Scholar
• Lindberg F, Normark S. 1987. Common mechanism of ampC beta-lactamase induction in enterobacteria: regulation of the cloned Enterobacter cloacae P99 beta-lactamase gene. J Bacteriol. 169(2):758–763. doi:10.1128/jb.169.2.758-763.1987
   PubMed Web of Science ®Google Scholar
• Livermore DM. 2009. Has the era of untreatable infections arrived? JAC. 64(1):29–36.
   Google Scholar
• Machado A, Bordalo AA. 2014. Analysis of the bacterial community composition in acidic well water used for drinking in Guinea-Bissau. West Africa J Environ Sci (China). 26(8):1605–1614. doi:10.1016/j.jes.2014.05.027
   PubMed Web of Science ®Google Scholar
• Maran NH, Crispim BD, Iahnn SR, Araújo RP, Grisolia AB, Oliveira KM. 2016. Depth and well type related to groundwater microbiological contamination. Int J Environ Res Public Health. 21:13(10).
   Google Scholar
• Minarini LA, Darini AL. 2012. Mutations in the quinolone resistance-determining regions of gyrA and parC in Enterobacteriaceae isolates from Brazil. Braz J Microbiol. 43(4):1309–1314. doi:10.1590/S1517-838220120004000010
   PubMed Web of Science ®Google Scholar
• Moura AC, Assumpção RAB, Bischoff J. 2009. Monitoramento físico-químico e microbiológico da água do rio cascavel durante o período de 2003 a 2006 [Physical chemical and microbiological monitoring of the water of the Cascavel river during the period from 2003 to 2006]. Arq Inst Biol. 76(1):17–22. Portuguese.
   Google Scholar
• Ng LK, Martin I, Alfa M, Mulvey M. 2001. Multiplex PCR for the detection of tetracycline resistance genes. Mol Cell Probes. 15:209–215. doi:10.1006/mcpr.2001.0363
   PubMed Web of Science ®Google Scholar
• Nordmann P, Mammeri H. 2007. Extended-spectrum cephalosporinases: structure, detection and epidemiology. Future Microbiol. 2:297–307. doi:10.2217/17460913.2.3.297
   PubMed Web of Science ®Google Scholar
• Nunes LGP, Oliveira MV, Souza AA, Lopes LF, Dias PCS, Nogueira GB, Souza MAA. 2018. Water quality comparison between a supply network and household reservoirs in one of the oldest cities in Brazil. Int J Environ Health Res. 29(2):173–180. doi:10.1080/09603123.2018.1531114
   PubMed Web of Science ®Google Scholar
• Odeleye FO, Idowu AO. 2015. Bacterial pathogens associated with hand-dug wells in Ibadan city, Nigeria. Afr J Microbiol Res. 9:701–707. doi:10.5897/AJMR
   Google Scholar
• Odeyemi AT, Oluyege JO, Adebayo AA. 2012. Antibiogram of isolated bacteria from Omisanjana hand-dug well water and flowing stream. Sci J Microbiol. 1(3):82–90.
   Google Scholar
• Oliveira MMM, Brugnera DF, Piccoli RH. 2010. Biofilme microbianos na indústria de alimentos: uma revisão [Microbial biofilms in the food industry: a review]. Rev Inst Adolfo Lutz. 69(3):277–284. Portuguese.
   Google Scholar
• Oliveira S, Moura RA, Silva KC, Pavez M, McCulloch JA, Dropa M, Matté MH, Mamizuka EM, Sato MI, Pestana de Castro AF, et al. 2014. Isolation of KPC-2-producing Klebsiella pneumoniae strains belonging to the high-risk multiresistant clonal complex 11 (ST437 and ST340) in urban rivers. J Antimicrob Chemother. 69(3):849–852. doi:10.1093/jac/dkt431
   PubMed Web of Science ®Google Scholar
• Paschoal RP, Campana EH, Corrêa LL, Montezzi LF, Barrueto LRL, Da Silva IR, Bonelli RR, Castro LS, Picão RC. 2017. Concentration and variety of carbapenemase producers in recreational coastal waters showing distinct levels of pollution. Antimicrob Agents Chemother. 61:12. doi:10.1128/AAC.01963-17
   Web of Science ®Google Scholar
• Pérez-Pérez FJ, Hanson ND. 2002. Detection of plasmid-mediated AmpC beta-lactamase genes in clinical isolates by using multiplex PCR. J Clin Microbiol. 40(6):2153–2162. doi:10.1128/jcm.40.6.2153-2162.2002
   PubMed Web of Science ®Google Scholar
• Policontrol scribd. 2007. Determinação de Cloro: DPD x OTA [Determination of Chlorine: DPD x OTA]. [accessed 2017 June 1]. http://pt.scribd.com/doc/59885131/artigo-tecnico-cloro. Portuguese.
   Google Scholar
• Queenan AM, Bush K. 2007. Carbapenemases: the versatile β-lactamases. Clin Microbiol Rev. 20(3):440–458. doi:10.1128/CMR.00001-07
   PubMed Web of Science ®Google Scholar
• Rasheed JK, Jay C, Metchock B, Berkowitz F, Weigel L, Crellin J, Steward C, Hill B, Medeiros AA, Tenover FC. 1997. Evolution of extend-spectrum β-lactam resistance (SHV-8) in a strain of Escherichia coli during multiple episodes of bacteremia. Antimicrob Agents Chemother. 41:647–653.
   PubMed Web of Science ®Google Scholar
• Rhodes G, Huys G, Swings J, McGann P, Hiney M, Smith P, Pickup RW. 2000. Distribution of oxytetracycline resistance plasmids between aeromonads in hospital and aquaculture environments: implication of Tn1721 in dissemination of the tetracycline resistance determinant TetA. Appl Environ Microbiol. 66:3883–3890. doi:10.1128/AEM.66.9.3883-3890.2000
   PubMed Web of Science ®Google Scholar
• Rocha LK, Dos Santos Neto RL, Da Costa Guimarães AC, Almeida AC, Vilela MA, de Morais MM. 2014. Plasmid-mediated qnrA1 in Klebsiella pneumoniae ST147 in Recife, Brazil. Int J Infect Dis. 26:49–50. doi:10.1016/j.ijid.2014.04.026
   PubMed Web of Science ®Google Scholar
• Rodrigues VR. 2004. Uma reflexão sobre dois importantes instrumentos de gestão de recursos hídricos subterrâneos: licença para perfuração de poços tubulares e outorga de direito de recursos hídricos [A reflection on two important instruments for the management of groundwater resources: license for drilling of tubular wells and granting of water resources rights]. Poster session presentation at the Congresso Brasileiro de Águas Subterrâneas; Cuiabá, MT. Portuguese.
   Google Scholar
• Rodríguez-Martínez JM, Cano ME, Velasco C, Martínez-Martínez L, Pascual A. 2011. Plasmid-mediated quinolone resistance: an update. J Infect Chemother. 17(2):149–182. doi:10.1007/s10156-010-0120-2
   PubMed Web of Science ®Google Scholar
• Rodriguez-Martinez JM, Poirel L, Nordmann P. 2009. Molecular epidemiology and mechanisms of carbapenem resistance in Pseudomonas aeruginosa. Antimicrob Agents Chemother. 53(11):4783–4788. doi:10.1128/AAC.00574-09
   PubMed Web of Science ®Google Scholar
• Ruiz J. 2003. Mechanisms of resistance to quinolones: target alterations, decreased accumulation and DNA gyrase protection. J Infect Chemother. 51:1109–1117.
   Google Scholar
• Santos CCM, Peresi JTM, Lima SI, Silveira PR, Brighetti JMP, Nascimento SC, Zenebon O. 2002. Qualidade da água de origem subterrânea oferecida à população na região de São José do Rio Preto (SP), no período de 1991 a 1999 [Quality of underground water supply to the population in the region of São José do Rio Preto (SP), from 1991 to 1999]. Hig Aliment. 82(15):47–51. Portuguese.
   Google Scholar
• Scorsafava MA, de Souza A, Stofer M, Nunes CA, Milanez TV. 2010. Avaliação físico-química da qualidade de água de poços e minas destinada ao consumo humano [Physico-chemical assessment of the water quality of wells and mines intended for human consumption]. Rev Inst Adolfo Lutz. 69:229–232. Portuguese.
   Google Scholar
• Stange C, Sidhu JPS, Tiehm A, Toze S. 2016. Antibiotic resistance and virulence genes in coliform water isolates. Int J Hyg Environ Health. 219(8):823–831. doi:10.1016/j.ijheh.2016.07.015
   PubMed Web of Science ®Google Scholar
• Strand L, Jenkins A, Henriksen IH, Allum AG, Grude N, Kristiansen BE. 2014. High levels of multiresistance in quinolone resistant urinary tract isolates of Escherichia coli from Norway; a non clonal phenomen? BMC Res Notes. 7:376. doi:10.1186/1756-0500-7-376
   PubMedGoogle Scholar
• Strateva T, Yordanov D. 2009. Pseudomonas aeruginosa – a phenomenon of bacterial resistance. J Med Microbiol. 58:1133–1148. doi:10.1099/jmm.0.009142-0
   PubMed Web of Science ®Google Scholar
• Tollentino FM, Polotto M, Nogueira ML, Lincopan N, Neves P, Mamizuka EM, Remeli GA, de Almeida MT, Rúbio FG, Nogueira MC. 2011. High prevalence of blaCTX-M extended spectrum beta-lactamase genes in Klebsiella pneumoniae isolates from a tertiary care hospital: first report of blaSHV-12, blaSHV-31, blaSHV-38, and blaCTX-M-15 in Brazil. Microb Drug Resist. 17(1):7–16. doi:10.1089/mdr.2010.0055
   PubMed Web of Science ®Google Scholar
• Tripathi V, Cytryn E. 2017. Impact of anthropogenic activities on the dissemination of antibiotic resistance across ecological boundaries. Essays Biochem. 61(1):11–21. doi:10.1042/EBC20160054
   PubMed Web of Science ®Google Scholar
• Varela AR, Nunes OC, Manaia CM. 2016. Quinolone resistant Aeromonas spp. as carriers and potential tracers of acquired antibiotic resistance in hospital and municipal wastewater. Sci Total Environ. 542(Pt A):665–671. doi:10.1016/j.scitotenv.2015.10.124
   PubMedGoogle Scholar
• Vila J, Ruiz J, Marco F, Barcelo A, Goñi P, Giralt E, Jimenez de Anta T. 1994. Association between double mutation in gyrA gene of ciprofloxacin resistant clinical isolates of Escherichia coli and minimal inhibitory concentration. Antimicrob Agents Chemother. 38:2477–2479. doi:10.1128/aac.38.10.2477
   PubMed Web of Science ®Google Scholar
• Wang M, Guo Q, Xu X, Wang X, Ye X, Wu S, Hooper DC, Wang M. 2009. New plasmid-mediated quinolone resistance gene, qnrC, found in a clinical isolate of Proteus mirabilis. Antimicrob Agents Chemother. 53(5):1892–1897. doi:10.1128/AAC.01400-08
   PubMed Web of Science ®Google Scholar
• Wen Y, Pu X, Zheng W, Hu G. 2016. High prevalence of plasmid-mediated quinolone resistance and IncQ plasmids carrying qnrS2 gene in bacteria from rivers near hospitals and aquaculture in China. PLoS One. 11(7):e0159418. doi:10.1371/journal.pone.0159418
   PubMed Web of Science ®Google Scholar
• WHO. 2011. Guidelines for drinking-water quality. [accessed 2017 Apr 16]. http://apps.who.int/iris/bitstream/10665/44584/1/9789241548151_eng.pdf
   Google Scholar
• WHO. 2014. Preventing diarrhoea through better water, sanitation and hygiene: exposures and impacts in low- and middle-income countries. [Accessed 2017 Feb 17]. http://apps.who.int/iris/bitstream/10665/150112/1/9789241564823_eng.pdf
   Google Scholar
• Xia R, Ren Y, Xu H. 2013. Identification of plasmid-mediated quinolone resistance qnr genes in multidrugresistant gram-negative bacteria from hospital wastewaters and receiving waters in the Jinan area, China. Microb Drug Resist. 19(6):446–456. doi:10.1089/mdr.2012.0210
   PubMed Web of Science ®Google Scholar
• Zhang Y, Marrs CF, Simon C, Xi C. 2009. Wastewater treatment contributes to selective increase of antibiotic resistance among Acinetobacter spp. Sci Total Environ. 407:3702–3706. doi:10.1016/j.scitotenv.2009.02.013
   PubMed Web of Science ®Google Scholar
• Zhao X, Xu X, Zhu D, Ye X, Wang M. 2010. Decreased quinolone susceptibility in high percentage of Enterobacter cloacae clinical isolates caused only by qnr determinants. Diagn Microbiol Infect Dis. 67(1):110–113. doi:10.1016/j.diagmicrobio.2009.12.018
   PubMed Web of Science ®Google Scholar