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Open AccessReview

Antibiotic Resistance in Recreational Waters: State of the Science

1
U.S. Environmental Protection Agency, Office of Water, Office of Science and Technology, 1200 Pennsylvania Avenue, NW, Washington, DC 20460, USA
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ICF, LLC, 9300 Lee Highway, Fairfax, VA 22031, USA
3
1301 Michael Hooker Research Center, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(21), 8034; https://doi.org/10.3390/ijerph17218034
Received: 7 October 2020 / Revised: 27 October 2020 / Accepted: 28 October 2020 / Published: 31 October 2020
Ambient recreational waters can act as both recipients and natural reservoirs for antimicrobial resistant (AMR) bacteria and antimicrobial resistant genes (ARGs), where they may persist and replicate. Contact with AMR bacteria and ARGs potentially puts recreators at risk, which can thus decrease their ability to fight infections. A variety of point and nonpoint sources, including contaminated wastewater effluents, runoff from animal feeding operations, and sewer overflow events, can contribute to environmental loading of AMR bacteria and ARGs. The overall goal of this article is to provide the state of the science related to recreational exposure and AMR, which has been an area of increasing interest. Specific objectives of the review include (1) a description of potential sources of antibiotics, AMR bacteria, and ARGs in recreational waters, as documented in the available literature; (2) a discussion of what is known about human recreational exposures to AMR bacteria and ARGs, using findings from health studies and exposure assessments; and (3) identification of knowledge gaps and future research needs. To better understand the dynamics related to AMR and associated recreational water risks, future research should focus on source contribution, fate and transport—across treatment and in the environment; human health risk assessment; and standardized methods. View Full-Text
Keywords: antibiotic resistance; antimicrobial resistant bacteria; antimicrobial resistant genes; recreational exposures; aquatic microbial community; aquatic microbiome; wastewater; human health risk; ambient water; surface water antibiotic resistance; antimicrobial resistant bacteria; antimicrobial resistant genes; recreational exposures; aquatic microbial community; aquatic microbiome; wastewater; human health risk; ambient water; surface water
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MDPI and ACS Style

Nappier, S.P.; Liguori, K.; Ichida, A.M.; Stewart, J.R.; Jones, K.R. Antibiotic Resistance in Recreational Waters: State of the Science. Int. J. Environ. Res. Public Health 2020, 17, 8034. https://doi.org/10.3390/ijerph17218034

AMA Style

Nappier SP, Liguori K, Ichida AM, Stewart JR, Jones KR. Antibiotic Resistance in Recreational Waters: State of the Science. International Journal of Environmental Research and Public Health. 2020; 17(21):8034. https://doi.org/10.3390/ijerph17218034

Chicago/Turabian Style

Nappier, Sharon P.; Liguori, Krista; Ichida, Audrey M.; Stewart, Jill R.; Jones, Kaedra R. 2020. "Antibiotic Resistance in Recreational Waters: State of the Science" Int. J. Environ. Res. Public Health 17, no. 21: 8034. https://doi.org/10.3390/ijerph17218034

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