Evidence map›Paper›PMID 36409546›Full record

ArticleJMIR research protocols2022

Prevalence of Antibiotic-Resistant Bacteria and Antibiotic-Resistant Genes and the Quantification of Antibiotics in Drinking Water Treatment Plants of Malaysia: Protocol for a Cross-sectional Study.

Zuraifah Asrah Mohamad, Sophia Karen Bakon, Mohd Azerulazree Jamilan Jamilan, Norhafizan Daud, Lena Ciric, Norazah Ahmad, Nor Asiah Muhamad

Abstract read
In one paragraph

Article in JMIR research protocols, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. City or Suburb, Resistance Flows: Wastewater-BorneAntibiotics (Basel, Switzerland) · 2025
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Zuraifah Asrah Mohamad *Health Risk Assessment Unit, Environmental Health Research Centre, Institute For Medical Research, National Institutes of Health, Ministry of Health of Malaysia, Shah Alam, Malaysia.ORCID https://orcid.org/0000-0003-1450-0260
Sophia Karen Bakon *Health Risk Assessment Unit, Environmental Health Research Centre, Institute For Medical Research, National Institutes of Health, Ministry of Health of Malaysia, Shah Alam, Malaysia.ORCID https://orcid.org/0000-0002-5088-3310
Mohd Azerulazree Jamilan Jamilan *Nutrition, Metabolic, and Cardiovascular Research Centre, Institute For Medical Research, National Institutes of Health, Ministry of Health of Malaysia, Shah Alam, Malaysia.ORCID https://orcid.org/0000-0003-3776-4365
Norhafizan Daud *Engineering Services Division, Ministry of Health of Malaysia, Putrajaya, Malaysia.ORCID https://orcid.org/0000-0001-7667-6777
Lena Ciric *Department of Civil, Environmental and Geomatic Engineering, University College London, London, United Kingdom.ORCID https://orcid.org/0000-0003-1476-6595
Norazah Ahmad *Infectious Disease Research Centre, Institute For Medical Research, National Institutes of Health, Ministry of Health of Malaysia, Shah Alam, Malaysia.ORCID https://orcid.org/0000-0002-8727-4172
Nor Asiah Muhamad *Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health of Malaysia, Shah Alam, Malaysia.ORCID https://orcid.org/0000-0002-7772-2103

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntimicrobial resistance is a known global public health threat. In addition, it brings serious economic consequences to agriculture. Antibiotic resistance in humans, animals, and environment is interconnected, as proposed in the tricycle surveillance by the World Health Organization. In Malaysia, research and surveillance of antimicrobial resistance are mainly performed in clinical samples, agricultural settings, and surface waters, but no surveillance of the drinking water systems has been performed yet. Hence, this policy-driven study is a combined effort of microbiologists and engineers to provide baseline data on the magnitude of antimicrobial resistance in the drinking water systems of Malaysia.

objectiveThe aim of this study was to study the baseline level of antibiotic-resistant bacteria in the drinking water distribution systems of Malaysia by collecting samples from the pretreatment and posttreatment outlets of water treatment plants in a selected state of Malaysia. We aimed to determine the prevalence of antibiotic-resistant bacteria, the occurrence of antibiotic-resistant genes, and the level of antibiotics present in the drinking water systems.

methodsThis is a laboratory-based, cross-sectional study in a selected state of Malaysia. Water samples from 6 drinking water treatment plants were collected. Samples were collected at 3 sampling points, that is, the intake sampling station, service reservoir outlet station, and the distribution system sampling station. These were tested against 7 types of antibiotics in triplicates. Samples were screened for antibiotic-resistant bacteria and antibiotic-resistant genes and quantified for the level of antibiotics present in the drinking water treatment plants.

resultsWe will show the descriptive statistics of the number of bacterial colonies harvested from water samples grown on Reasoner's 2A agar with or without antibiotics, the occurrence of antibiotic-resistant genes, and the level of antibiotics detected in the water samples. The sampling frame was scheduled to start from November 2021 and continue until December 2022. Data analysis is expected to be completed by early 2023, and the results are expected to be published in mid-2023.

conclusionsThis study provides baseline information on the status of the antimicrobial-resistant bacteria, the presence of resistance genes as contaminants, and the level of antibiotics present in the drinking water systems of Malaysia, with the aim of demonstrating to policymakers the need to consider antimicrobial resistance as a parameter in drinking water surveillance. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/37663.

Indexed as

antibioticantimicrobialAsiabacteriadrinking waterMalaysiaresistantriversafesanitation

Identifiers

PMID36409546
PMCPMC9723977

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.