Antibiotic Resistance in Waste Water and Surface Water and Human Health Implications

  • Célia M. ManaiaEmail author
  • Ivone Vaz-Moreira
  • Olga C. Nunes
Part of the The Handbook of Environmental Chemistry book series (HEC, volume 20)


The utilization of antibiotics to control infectious diseases is one of the biggest advances in human and veterinary health care. However, the generalized use of antibiotics has been accompanied by a worrisome increase in the prevalence of antibiotic-resistant bacteria. This evidence motivated numerous studies on the diversity and distribution of antibiotic-resistant bacteria and resistance genetic determinants not only in clinic but also in different environmental compartments. Given the particular importance that the anthropic water cycle (waste water/surface water/drinking water) may have in the development and dissemination of antibiotic-resistant organisms, this chapter aims at summarizing the recent advances in this area. Sections 1 and 2 are an Introduction to antibiotic resistance, summarizing some mechanisms and modes of resistance acquisition. In Sect. 3, the contribution of the environmental pollution and other anthropic pressures for antibiotic resistance evolution is discussed. The use of different methodologies and the limitations to achieve general conclusions on the characterization and quantification of antibiotic resistance in aquatic environments are examined in Sects. 4 and 7. Sections 5–7 summarize recent evidences on the widespread distribution of antibiotic resistance in different compartments of the anthropic water cycle. The scarcity of studies giving evidences on the direct effect of anthropic pressures on antibiotic resistance acquisition and maintenance in treated waste/drinking waters is highlighted. The contribution of bacterial community rearrangement, imposed by water treatment processes, on the increase of antibiotic resistance is discussed.


Resistance genes Resistome Selective pressure Water 


16S rRNA

16S small subunit ribosomal RNA


Small subunit of the 70S ribosome of prokaryotes


Large subunit of the 70S ribosome of prokaryotes




Genes encoding 3-N-aminoglycoside acetyltransferases; confer resistance to aminoglycosides


Gene encoding an aminoglycoside acetyltransferase; confers reduced susceptibility to ciprofloxacin and norfloxacin


Genes encoding aminoglycoside-3″-adenylyltransferases (AAD); confer resistance to streptomycin and spectinomycin


Antibiotic impregnated agar


Gene encoding chromosomal β-lactamase; confers resistance to β-lactams






Gene encoding acid phosphatase/phosphotransferase; confers resistance to aminoglycosides


Alliance for the Prudent Use of Antibiotics


Average values of n plants




Genes encoding extended spectrum β-lactamases; confer resistance to β-lactams


Gene encoding for the New Delhi metallo-β-lactamase-1; confers resistance to almost all β-lactams


British Society for Antimicrobial Chemotherapy




Antibiogram Committee of the French Society for Microbiology


Genes encoding chloramphenicol acetyltransferases; confer resistance to chloramphenicol


Centres for Disease Control and Prevention


Colony forming units


Clinical and Laboratory Standards Institute


Gene encoding a putative efflux pump; confers resistance to chloramphenicol


European Cooperation in Science and Technology


The Danish Integrated Antimicrobial Resistance Monitoring and Research programme


Detecting evolutionary hot spots of antibiotic resistance in Europe


Disc diffusion method


Genes encoding dihydrofolate reductases; confers resistance to trimethoprim


Denaturating gradient gel electrophoresis


Deoxyribonucleic acid


European Antimicrobial Resistance Surveillance Network


European Centre for Disease Prevention and Control


Epidemiological cut-off values


Genes encoding rRNA methylase; confers resistance to erythromycin


Genes encoding rRNA methylases; confer cross-resistance to macrolides, lincosamides and streptogramin B


European Surveillance of Antimicrobial Consumption


European Committee on Antimicrobial Susceptibility Testing


Final effluent


Gene encoding an exporter protein that specifically exports amphenicol antibiotics




Gene encoding DNA gyrase subunit A; gene mutation confers resistance to ciprofloxacin






Microdilution method


Gene encoding penicillin binding protein 2; confers resistance to penicillins


Modified most probable number


Gene encoding methionine sulfoxide reductase A; confers resistance to erythromycin


Not available


Nalidixic acid


National Antimicrobial Resistance Monitoring System (United States of America)


Gene encoding DNA topoisomerase IV subunit A; gene mutation confers resistance to quinolone


Polymerase chain reaction




Gene encoding multidrug transporters


Gene encoding an efflux pump; confers resistance to fluoroquinolone


Genes encoding Qnr proteins, capable of protecting DNA gyrase; confer resistance to quinolone


Quantitative real time polymerase chain reaction


Ribonucleic acid


Range values for n plants




Genes encoding a nourseothricin N-acetyltransferase; confer resistance to aminoglycosides


Genes encoding phosphotransferases; confer resistance to streptomycin


Genes encoding a drug-resistant dihydropteroate synthase enzyme required for folate biosynthesis; confer resistance to sulfonamide




Genes encoding efflux pumps; confer resistance to tetracyclines


Genes encoding proteins protecting the ribosome from the inhibiting effects of tetracycline


Gene encoding a repressor protein, which regulates the tetracycline efflux system genes




Tertiary treatment implemented


Genes encoding d-alanine:d-alanine ligases with a broad substrate specificity; confer inducible resistance to the glycopeptides antibiotics, as vancomycin


World Health Organization




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Copyright information

© Springer-Verlag Berlin Heidelberg 2011 2011

Authors and Affiliations

  • Célia M. Manaia
    • 1
    Email author
  • Ivone Vaz-Moreira
    • 1
  • Olga C. Nunes
    • 2
  1. 1.CBQF/Escola Superior de BiotecnologiaUniversidade Católica PortuguesaPortoPortugal
  2. 2.LEPAE – Departamento de Engenharia Química, Faculdade de EngenhariaUniversidade do PortoPortoPortugal

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