Characterization of CTX-M enzymes, quinolone resistance determinants, and antimicrobial residues from hospital sewage, wastewater treatment plant, and river water
β-lactamase-producing bacteria and quinolone resistance are found in both raw and treated water. CTX-M is the prevalent β-lactamase among isolated resistant bacteria. GES-5 carbapenemase is found in hospital effluent. Sewage treatment does not efficiently remove multidrug-resistant bacteria.