{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:39:01Z","timestamp":1791617941223,"version":"4.3.4"},"reference-count":47,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2016,3,1]],"date-time":"2016-03-01T00:00:00Z","timestamp":1456790400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:p>\n                    This study is aimed to assess if hospital effluents represent an important supplier of multidrug-resistant (MDR) Gram-negative bacteria that, being discharged in the municipal collector, may be disseminated in the environment and bypassed in water quality control systems. From a set of 101 non-\n                    <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                    Gram-negative bacteria with reduced susceptibility to quinolones, was selected a group of isolates comprised by those with the highest indices of MDR (defined as nonsusceptibility to at least one agent in six or more antimicrobial categories, MDR \u22656) or resistance to meropenem or ceftazidime (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200925). The isolates were identified and characterized for antibiotic resistance phenotype, plasmid-mediated quinolone resistance (PMQR) genes, and other genetic elements and conjugative capacity. The isolates with highest MDR indices were mainly from hospital effluent and comprised ubiquitous bacterial groups of the class\n                    <jats:italic toggle=\"yes\">Gammaproteobacteria,<\/jats:italic>\n                    of the genera\n                    <jats:italic toggle=\"yes\">Aeromonas<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Acinetobacter<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Citrobacter<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Enterobacter<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Klebsiella<\/jats:italic>\n                    , and\n                    <jats:italic toggle=\"yes\">Pseudomonas<\/jats:italic>\n                    , and of the class\n                    <jats:italic toggle=\"yes\">Flavobacteriia<\/jats:italic>\n                    , of the genera\n                    <jats:italic toggle=\"yes\">Chryseobacterium<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">Myroides<\/jats:italic>\n                    . In this group of 25 strains, 19 identified as\n                    <jats:italic toggle=\"yes\">Gammaproteobacteria<\/jats:italic>\n                    harbored at least one PMQR gene (\n                    <jats:italic toggle=\"yes\">aac(6\u2032)-Ib-cr<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">qnrB<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">qnrS<\/jats:italic>\n                    , or\n                    <jats:italic toggle=\"yes\">oqxAB<\/jats:italic>\n                    ) or a class 1 integron gene cassette encoding aminoglycoside, sulfonamide, or carbapenem resistance. Most of the\n                    <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                    J53 transconjugants with acquired antibiotic resistance resulted from conjugation with\n                    <jats:italic toggle=\"yes\">Enterobacteriaceae<\/jats:italic>\n                    . These transconjugants demonstrated acquired resistance to a maximum of five classes of antibiotics, one or more PMQR genes and\/or a class 1 integron gene cassette. This study shows that ubiquitous bacteria, other than those monitored in water quality controls, are important vectors of antibiotic resistance and can be disseminated from hospital effluent to aquatic environments. This information is relevant to support management options aiming at the control of this public health problem.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2015.0118","type":"journal-article","created":{"date-parts":[[2015,10,15]],"date-time":"2015-10-15T15:16:24Z","timestamp":1444922184000},"page":"155-163","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":55,"title":["Multidrug Resistance in Quinolone-Resistant Gram-Negative Bacteria Isolated from Hospital Effluent and the Municipal Wastewater Treatment Plant"],"prefix":"10.1177","volume":"22","author":[{"given":"Ivone","family":"Vaz-Moreira","sequence":"first","affiliation":[{"name":"Universidade Cat\u00f3lica Portuguesa\/Porto","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Rita","family":"Varela","sequence":"additional","affiliation":[{"name":"Universidade Cat\u00f3lica Portuguesa\/Porto","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thamiris V.","family":"Pereira","sequence":"additional","affiliation":[{"name":"Universidade Cat\u00f3lica Portuguesa\/Porto","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rom\u00e1rio C.","family":"Fochat","sequence":"additional","affiliation":[{"name":"Universidade Cat\u00f3lica Portuguesa\/Porto","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9lia M.","family":"Manaia","sequence":"additional","affiliation":[{"name":"Universidade Cat\u00f3lica Portuguesa\/Porto","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,3]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.copbio.2008.05.006"},{"key":"e_1_3_3_3_2","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.watres.2013.11.047","article-title":"Impact of wastewater treatment processes on antimicrobial resistance genes and their co-occurrence with virulence genes in Escherichia coli","volume":"50","author":"Biswal B.K.","year":"2014","unstructured":"Biswal B.K., , Mazza A., , Masson L., , Gehr R., , and Frigon D. 2014. 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