Mohamad Zuraifah Asrah, Bakon Sophia Karen, Jamilan Mohd Azerulazree Jamilan, Daud Norhafizan, Ciric Lena, Ahmad Norazah, Muhamad Nor Asiah
Health Risk Assessment Unit, Environmental Health Research Centre, Institute For Medical Research, National Institutes of Health, Ministry of Health of Malaysia, Shah Alam, Malaysia.
Nutrition, Metabolic, and Cardiovascular Research Centre, Institute For Medical Research, National Institutes of Health, Ministry of Health of Malaysia, Shah Alam, Malaysia.
JMIR Res Protoc. 2022 Nov 21;11(11):e37663. doi: 10.2196/37663.
Antimicrobial 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.
The 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.
This 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.
We 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.
This 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.
抗菌药物耐药性是一个已知的全球公共卫生威胁。此外，它还给农业带来了严重的经济后果。正如世界卫生组织提出的三轮监测所表明的那样，人类、动物和环境中的抗生素耐药性是相互关联的。在马来西亚，对抗菌药物耐药性的研究和监测主要在临床样本、农业环境和地表水中进行，但尚未对饮用水系统进行监测。因此，这项由政策驱动的研究是微生物学家和工程师的共同努力，旨在提供马来西亚饮用水系统中抗菌药物耐药性程度的基线数据。
本研究的目的是通过从马来西亚某选定州的水处理厂预处理和后处理出水口采集样本，研究马来西亚饮用水分配系统中抗生素耐药菌的基线水平。我们旨在确定抗生素耐药菌的流行情况、抗生素耐药基因的存在情况以及饮用水系统中抗生素的含量水平。
这是一项在马来西亚某选定州开展的基于实验室的横断面研究。收集了来自6家饮用水处理厂的水样。在3个采样点采集样本，即进水采样站、服务水库出水口站和分配系统采样站。对这些样本针对7种抗生素进行了一式三份的检测。对样本进行抗生素耐药菌和抗生素耐药基因筛查，并对饮用水处理厂中存在的抗生素水平进行定量分析。
我们将展示在添加或未添加抗生素的Reasoner's 2A琼脂上培养的水样中收获的细菌菌落数量、抗生素耐药基因的存在情况以及水样中检测到的抗生素水平的描述性统计数据。抽样计划于2021年11月开始，持续至2022年12月。数据分析预计在2023年初完成，结果预计在2023年年中发表。
本研究提供了关于马来西亚饮用水系统中抗生素耐药菌状况、作为污染物的耐药基因的存在情况以及抗生素含量水平的基线信息，目的是向政策制定者证明有必要将抗菌药物耐药性作为饮用水监测的一个参数加以考虑。
国际注册报告标识符（IRRID）：DERR1-10.2196/37663。
