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Viana GGF, Cardozo MV, Pereira JG, Rossi GAM. Antimicrobial Resistant Staphylococcus spp., Escherichia coli, and Salmonella spp. in Food Handlers: A Global Review of Persistence, Transmission, and Mitigation Challenges. Pathogens 2025; 14:496. [PMID: 40430816 PMCID: PMC12114568 DOI: 10.3390/pathogens14050496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2025] [Revised: 05/14/2025] [Accepted: 05/16/2025] [Indexed: 05/29/2025] Open
Abstract
Antimicrobial resistance in foodborne pathogens represents a critical global health challenge, with food handlers serving as key contributors in their transmission. This comprehensive review synthesizes evidence on the prevalence, transmission dynamics, and antimicrobial resistance patterns of three major pathogens, Staphylococcus spp., Escherichia coli, and Salmonella spp., among food handlers worldwide. Analysis of studies across diverse geographical regions reveals considerable variation in colonization rates, with Staphylococcus spp. prevalence ranging from 19.5% to 95.0%, Escherichia coli from 2.8% to 89.3%, and Salmonella spp. from 0.07% to 9.1%. Resistance profiles demonstrate alarming trends, including widespread β-lactam resistance and emerging resistance to last-resort antibiotics like carbapenems. Particularly concerning is the high occurrence of multidrug resistant (MDR) strains and extended spectrum β-lactamase (ESBL) producers in low- and middle-income countries. This review identified inadequate handwashing, poor hygiene infrastructure, and asymptomatic carriage as critical factors facilitating the transmission of antimicrobial resistant strains. These findings underscore the urgent need for enhanced surveillance systems, targeted decolonization strategies, improved hygiene protocols, and food handler education to mitigate the spread of resistant pathogens through the food chain.
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Affiliation(s)
- Gustavo Guimarães Fernandes Viana
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu 18618-681, SP, Brazil; (G.G.F.V.); (J.G.P.)
| | - Marita Vedovelli Cardozo
- Department of Pathology, Reproduction and One Health, Faculty of Agricultural and Veterinary Sciences, São Paulo State University (UNESP), Jaboticabal 14884-900, SP, Brazil;
| | - Juliano Gonçalves Pereira
- Department of Animal Production and Preventive Veterinary Medicine, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu 18618-681, SP, Brazil; (G.G.F.V.); (J.G.P.)
| | - Gabriel Augusto Marques Rossi
- Department of Veterinary Medicine, University Vila Velha (UVV), Av. Comissário José Dantas de Melo, n.21, Vila Velha 29102-920, ES, Brazil
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Ahmed HA, El-Tahlawy AS, El Bayomi RM, Ahmed MA, Abd Elazeem MA, Alahmad W, Hafez AESE. Prevalence, antimicrobial resistance, and genetic profile of Escherichia coli in retail chicken parts in Zagazig City, Egypt. Int J Food Microbiol 2025; 436:111211. [PMID: 40253952 DOI: 10.1016/j.ijfoodmicro.2025.111211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2024] [Revised: 04/09/2025] [Accepted: 04/14/2025] [Indexed: 04/22/2025]
Abstract
In recent times, chicken-based food items have seen a surge in demand due to their high-quality protein and essential nutrients. However, poultry products remain vulnerable to contamination by Escherichia coli (E. coli), including pathogenic strains that pose significant food safety challenges. This study investigates bacterial contamination in various chicken parts (thigh, breast, skin, gizzard, and liver) collected from five retail outlets and markets with different sanitation standards in Zagazig city, Sharkia Governorate, Egypt. The total Enterobacteriales count ranged from 5.38 to 5.55 log10 CFU/g, with gizzard samples showing the highest bacterial count of 5.55 ± 0.08 log10 CFU/g. Coliform levels were highest in gizzard samples with an average of 5.74 ± 0.10 log10 MPN/g. E. coli was detected in 33 % of the samples, with the highest prevalence in gizzard (12/20; 60 %) and liver (10/20; 50 %). Additionally, 11 out of 33 E. coli isolates (33.3 %) were Extended-Spectrum Beta-Lactamase (ESBL) producers, with liver samples showing the highest incidence (5/33; 15.15 %). E. coli serotyping revealed diverse strains, particularly in gizzard samples. All 25 E. coli isolates carried the phoA and blaTEM genes, while none tested positive for blaSHV. Of the 33 E. coli isolates, 25 were tested for antimicrobial resistance. All tested isolates (100 %) were resistant to ampicillin, while cefotaxime and cefoxitin exhibited complete sensitivity.
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Affiliation(s)
- Heba A Ahmed
- Department of Zoonoses, Faculty of Veterinary Medicine, Zagazig University, Zagazig City 44511, Sharkia Governorate, Egypt
| | - Ahmed S El-Tahlawy
- Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand; Food Hygiene, Safety, and Technology Department, Faculty of Veterinary Medicine, Zagazig University, Zagazig 44511, Egypt.
| | - Rasha M El Bayomi
- Food Hygiene, Safety, and Technology Department, Faculty of Veterinary Medicine, Zagazig University, Zagazig 44511, Egypt
| | - Marwa A Ahmed
- Department of Food Sciences and Nutrition, College of Sciences, University of Bisha, P.B. 551, Bisha 61922, Saudi Arabia
| | - Mona A Abd Elazeem
- Food Hygiene, Safety, and Technology Department, Faculty of Veterinary Medicine, Zagazig University, Zagazig 44511, Egypt
| | - Waleed Alahmad
- Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand.
| | - Abd El-Salam E Hafez
- Food Hygiene, Safety, and Technology Department, Faculty of Veterinary Medicine, Zagazig University, Zagazig 44511, Egypt
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Adenaya A, Adeniran AA, Ugwuoke CL, Saliu K, Raji MA, Rakshit A, Ribas-Ribas M, Könneke M. Environmental Risk Factors Contributing to the Spread of Antibiotic Resistance in West Africa. Microorganisms 2025; 13:951. [PMID: 40284787 PMCID: PMC12029926 DOI: 10.3390/microorganisms13040951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2025] [Revised: 04/11/2025] [Accepted: 04/16/2025] [Indexed: 04/29/2025] Open
Abstract
Antibiotic resistance is a well-documented global health challenge that disproportionately impacts low- and middle-income countries. In 2019, the number of deaths attributed to and associated with antibiotic resistance in Western Sub-Saharan Africa was approximately 27 and 115 per 100,000, respectively, higher than in other regions worldwide. Extensive research has consistently confirmed the persistent presence and spread of antibiotic resistance in hospitals, among livestock, within food supply chains, and across various environmental contexts. This review documents the environmental risk factors contributing to the spread of antibiotic resistance in West Africa. We collected studies from multiple West African countries using the Web of Science and PubMed databases. We screened them for factors associated with antibiotic-resistant bacteria and resistance genes between 2018 and 2024. Our findings indicate that antibiotic resistance remains a significant concern in West Africa, with environmental pollution and waste management identified as major factors in the proliferation of antibiotic-resistant bacteria and resistance genes between 2018 and 2024. Additional contributing factors include poor hygiene, the use of antibiotics in agriculture, aquaculture, and animal farming, and the transmission of antibiotic resistance within hospital settings. Unfortunately, the lack of comprehensive genetic characterization of antibiotic-resistant bacteria and resistance genes hinders a thorough understanding of this critical issue in the region. Since antibiotic resistance transcends national borders and can spread within and between countries, it is essential to understand the environmental risk factors driving its dissemination in West African countries. Such understanding will be instrumental in developing and recommending effective strategies nationally and internationally to combat antibiotic resistance.
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Affiliation(s)
- Adenike Adenaya
- Institute for Chemistry and Biology of the Marine Environment (ICBM), University of Oldenburg, Carl von Ossietzky Str. 9-11, 26129 Oldenburg, Germany; (A.R.); (M.K.)
| | - Adedapo Adedayo Adeniran
- Department of Pharmacognosy and Natural Medicine, Faculty of Pharmacy, University of Calabar, Calabar 540211, Nigeria;
| | - Chidera Linus Ugwuoke
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan 240281, Nigeria; (C.L.U.); (K.S.); (M.A.R.)
| | - Kaosara Saliu
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan 240281, Nigeria; (C.L.U.); (K.S.); (M.A.R.)
| | - Mariam Adewumi Raji
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan 240281, Nigeria; (C.L.U.); (K.S.); (M.A.R.)
| | - Amartya Rakshit
- Institute for Chemistry and Biology of the Marine Environment (ICBM), University of Oldenburg, Carl von Ossietzky Str. 9-11, 26129 Oldenburg, Germany; (A.R.); (M.K.)
| | - Mariana Ribas-Ribas
- Center for Marine Sensors (ZfMarS), Institute for Chemistry and Biology of the Marine Environment (ICBM), Carl von Ossietzky University of Oldenburg, 26380 Wilhelmshaven, Germany;
| | - Martin Könneke
- Institute for Chemistry and Biology of the Marine Environment (ICBM), University of Oldenburg, Carl von Ossietzky Str. 9-11, 26129 Oldenburg, Germany; (A.R.); (M.K.)
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Emon AA, Hossain H, Chowdhury MSR, Rahman MA, Tanni FY, Asha MN, Akter H, Hossain MM, Islam MR, Rahman MM. Prevalence, antimicrobial susceptibility profiles and resistant gene identification of bovine subclinical mastitis pathogens in Bangladesh. Heliyon 2024; 10:e34567. [PMID: 39816335 PMCID: PMC11734078 DOI: 10.1016/j.heliyon.2024.e34567] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 07/11/2024] [Accepted: 07/11/2024] [Indexed: 01/18/2025] Open
Abstract
Subclinical mastitis (SCM), a silent threat in the dairy sector of Bangladesh poses a significant economic impact and serves as a potential source of infection for healthy cows, hindering efforts to achieve milk self-sufficiency. Despite the importance of this issue, limited research has been conducted on mastitis in Sylhet region of Bangladesh. This study aimed to investigate the molecular prevalence, antimicrobial susceptibility profile and resistant genes detection on pathogens (Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae) causing SCM. In a cross-sectional study utilizing convenience sampling, 325 milk samples were collected from apparently healthy dairy cows. Initially, SCM was detected using the modified Whiteside test (MWST) method. Suspected positive samples were then subjected to bacteriological culture and standard biochemical assays, followed by molecular identification through polymerase chain reaction (PCR). Finally, antimicrobial susceptibility testing was conducted on all PCR-positive samples using the Kirby-Bauer disk diffusion method on Mueller-Hinton agar. In the Sylhet district, the prevalence of SCM was 64.92 % (211 out of 325) at the individual animal level and 82.69 % (43 out of 52) at the herd level. Among the SCM-positive animals, S . aureus was found in 31.75 % (67 out of 211) of cases, E . coli in 81.99 % (173 out of 211), and K . pneumoniae in 66.82 % (141 out of 211). K . pneumoniae had the highest prevalence at 60 % in Zakiganj, S . aureus at 45 % in Zakiganj, and E . coli at 72 % in Bishwanath Upazila. Extended spectrum beta lactamase (ESBL) genes bla TEM , bla OXA, bla CTX-M1, bla CTX-M2, MultiCase DHA were identified. Additionally, antibiotic resistance genes tet(A), AAC (3)-iv, and Sul1 were also detected. The pathogens exhibited resistance to Penicillins (ampicillin, amoxicillin), Cephems (cefuroxime, ceftazidime), and Tetracyclines (tetracycline). However, all three bacteria were highly sensitive to meropenem, amikacin, gentamicin, ciprofloxacin, and sulfamethoxazole-trimethoprim. These findings highlight the critical need for targeted antimicrobial stewardship and effective control measures to mitigate the impact of SCM on dairy production and animal health in the Sylhet region of Bangladesh.
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Affiliation(s)
- Ahsan Al Emon
- Department of Medicine, Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet, Bangladesh
- Faculty of Agricultural and Nutritional Sciences, Christian Albrechts University of Kiel, Kiel, Germany
| | - Hemayet Hossain
- Department of Anatomy and Histology, Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet, Bangladesh
| | - Md Shahidur Rahman Chowdhury
- Department of Medicine, Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet, Bangladesh
| | - Md Anisur Rahman
- Department of Medicine, Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet, Bangladesh
| | - Fatema Yeasmin Tanni
- Department of Medicine, Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet, Bangladesh
| | - Mashuka Nahida Asha
- Department of Medicine, Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet, Bangladesh
| | - Hafsa Akter
- Department of Biochemistry and Chemistry, Faculty of Biotechnology and Genetic Engineering, Sylhet Agricultural University, Sylhet, Bangladesh
| | - Md Mukter Hossain
- Department of Medicine, Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet, Bangladesh
| | - Md Rafiqul Islam
- Department of Medicine, Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet, Bangladesh
| | - Md Mahfujur Rahman
- Department of Medicine, Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet, Bangladesh
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Ibrahim D, Awad A, Younis G. Prevalence and characterization of quinolone-resistant Escherichia coli isolated from retail raw beef and poultry meat in Egypt. J Adv Vet Anim Res 2023; 10:490-499. [PMID: 37969807 PMCID: PMC10636088 DOI: 10.5455/javar.2023.j702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/04/2023] [Accepted: 03/05/2023] [Indexed: 11/17/2023] Open
Abstract
Objective The goal of this study was to look at quinolone-resistant (QR) Escherichia coli (E. coli) from retail beef and poultry meat in Egypt by looking at the QR mechanisms in the resistant strains. Materials and Methods In total, 120 samples of raw poultry meat (n = 60) and beef meat (n = 60) were purchased from Mansoura retail stores between January and March 2021, and evaluated microbiologically for E. coli. Then, an antimicrobial sensitivity test was applied to all isolates. The prevalence of QR E. coli with concern for the QR determinants, including quinolone resistance-determining regions (QRDRs) mutations, the plasmid-mediated quinolone resistance gene (PMQR), and the efflux pump activity were determined. Results The total prevalence of E. coli was 34.2% (41/120). Noticeably, the prevalence of E. coli in poultry meat (40%, 24/60) was higher than that of beef (28%, 17/60). All strains were assessed for their antimicrobial susceptibility using the disc diffusion technique; the highest rate of resistance (100%) was displayed to clindamycin and cefuroxime, followed by ampicillin (97.6%), doxycycline (92.7%), amoxicillin-clavulanate (92.7%), nalidixic acid (NA) (80.5%), sulfamethoxazole/trimethoprim (70.7%), chloramphenicol (63.4%), gentamicin, and azithromycin (58.5% each). Multiple antimicrobial resistance (strains resistant to three or more antimicrobial classes) was displayed by 97.6% of E. coli isolates. Regarding QR, 37 isolates could resist at least one of the examined quinolones. Regarding PMQR genes, qnrS was determined in 70% (7/10) of QR E. coli, while qnrA, qnrB, and qnrD were not identified. While the mutations determined regions of QR in the resistant E. coli isolates, S83L was the most prevalent in gyrase subunit A either alone or combined with D87N and D87Y, and three isolates of QR E. coli isolates revealed a topoisomerase IV subunit mutation harboring S80I. 20% of the isolates displayed efflux activity, as NA showed a considerable difference between its zones of inhibition. Conclusion The high prevalence of antimicrobial-resistant E. coli, with concern for QR strains harboring different resistance mechanisms in poultry meat and beef, threatens the public's health. Thus, standard manufacturing procedures and adequate hygiene conditions must be followed in all phases of meat preparation, production, and consumption, and public knowledge should be improved.
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Affiliation(s)
- Dina Ibrahim
- Department of Bacteriology, Mycology and Immunology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - Amal Awad
- Department of Bacteriology, Mycology and Immunology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - Gamal Younis
- Department of Bacteriology, Mycology and Immunology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
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Agatha TM, Wibawati PA, Izulhaq RI, Agustono B, Prastiya RA, Wardhana DK, Abdramanov A, Lokapirnasari WP, Lamid M. Antibiotic resistance of Escherichia coli from the milk of Ettawa crossbred dairy goats in Blitar Regency, East Java, Indonesia. Vet World 2023; 16:168-174. [PMID: 36855371 PMCID: PMC9967718 DOI: 10.14202/vetworld.2023.168-174] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/02/2022] [Indexed: 01/29/2023] Open
Abstract
Background and Aim Antimicrobial resistance, especially antibiotic resistance, is one of the most severe public health challenges. Antibiotic resistance occurs when bacteria avoid and fight the mechanism of action of antibiotic drugs. This study aimed to determine the resistance of Escherichia coli from the milk of Ettawa crossbreed dairy goat at Blitar Regency, East Java, Indonesia, with the antibiotics streptomycin, sulfonamides, and trimethoprim. Materials and Methods A total of 34 milk samples of Ettawa crossbreed dairy goats were used in this study. The initial stages of this research included tests of the physical properties, isolation, and identification of E. coli. Then, the E. coli isolates were tested for antibiotic resistance using the Kirby-Bauer method. Results The results showed that all samples were positive for E. coli. The physical properties of milk, namely, color, odor, flavor, and consistency, were normal. The results of the alcohol test showed normal acidity, and the specific gravity of goat milk met the criteria, with an average specific gravity of 1.0295 g/mL. The results of the antibiotic resistance test showed that 4 (12%) samples were resistant to streptomycin, 5 (15%) to sulfonamide, and 3% to trimethoprim. Conclusion The prevalence of E. coli from Ettawa crossbreed dairy goats in Blitar Regency, East Java, Indonesia, was 100%. Furthermore, this E. coli isolate exhibited resistance to antibiotics streptomycin, sulfonamides, and trimethoprim. The use of antibiotics in the dairy goat industry in Indonesia should be controlled to prevent the spread of resistant E. coli from animals to humans through the food chain and prevent the emergence of multidrug-resistant E. coli.
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Affiliation(s)
- Tweedekharis Marlin Agatha
- Department of Veterinary Medicine, School of Health and Life Sciences (SIKIA), Universitas Airlangga, Surabaya 60115, Indonesia
| | - Prima Ayu Wibawati
- Department of Veterinary Medicine, School of Health and Life Sciences (SIKIA), Universitas Airlangga, Surabaya 60115, Indonesia,Corresponding author: Prima Ayu Wibawati, e-mail: Co-authors: TMA: , RII: , BA: , RAP: , DKW: , AA: , WPL: , ML:
| | - Reza Ikhza Izulhaq
- Department of Veterinary Medicine, School of Health and Life Sciences (SIKIA), Universitas Airlangga, Surabaya 60115, Indonesia
| | - Bodhi Agustono
- Department of Veterinary Medicine, School of Health and Life Sciences (SIKIA), Universitas Airlangga, Surabaya 60115, Indonesia
| | - Ragil Angga Prastiya
- Department of Veterinary Medicine, School of Health and Life Sciences (SIKIA), Universitas Airlangga, Surabaya 60115, Indonesia
| | - Dhandy Koesoemo Wardhana
- Department of Veterinary Science, Division of Veterinary Public Health, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Abzal Abdramanov
- Department of Veterinary Sanitary Expertise and Hygiene, Faculty of Veterinary medicine, Kazakh National Agrarian Research University, Almaty, Kazakhstan
| | - Widya Paramita Lokapirnasari
- Department of Veterinary Science, Division of Animal Husbandry, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Mirni Lamid
- Department of Veterinary Science, Division of Animal Husbandry, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya 60115, Indonesia
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Samy AA, Mansour AS, Khalaf DD, Khairy EA. Development of multidrug-resistant Escherichia coli in some Egyptian veterinary farms. Vet World 2022; 15:488-495. [PMID: 35400950 PMCID: PMC8980374 DOI: 10.14202/vetworld.2022.488-495] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/20/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: Food of animal origin is considered a major source of foodborne diseases. In this context, multidrug-resistant (MDR) Escherichia coli pose a serious hazard to public health due to the consumption of food contaminated with antibiotics that are used for the treatment of various bacterial infections in farm animals. Therefore, this study aimed to determine the effect of the excessive use of antibiotics on the development of MDR E. coli strains in Egyptian poultry, dairy, and meat farms.
Materials and Methods: A total of 1225 samples were randomly collected from poultry, dairy, and meat products intended for human consumption in different governorates. E. coli were isolated from the collected samples and subjected to biochemical identification and antibiotic sensitivity tests with antibiotics commonly used in human and veterinary medicine. Then, amoxicillin (AML)- and oxytetracycline (OT)-resistant E. coli isolates were subjected to a polymerase chain reaction test to detect the blaTEM and tetA genes, respectively.
Results: E. coli were isolated from 132 out of 350, 148 out of 350, 177 out of 350, and 35 out of 175 poultry, milk, meat, and human samples, respectively. Most of the isolates expressed multidrug resistance, and resistance genes (blaTEM and tetA) were detected in all the tested AML- and OT-resistant E. coli isolates.
Conclusion: Foods of animal origin may represent a source of MDR E. coli, which can be a major threat to public health.
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Affiliation(s)
- A. A. Samy
- Department of Microbiology and Immunology, National Research Center, Dokki, Cairo, Egypt
| | - Asmaa S. Mansour
- Department of Microbiology and Immunology, National Research Center, Dokki, Cairo, Egypt
| | - Doaa D. Khalaf
- Department of Microbiology and Immunology, National Research Center, Dokki, Cairo, Egypt
| | - Eman A. Khairy
- Department of Microbiology and Immunology, National Research Center, Dokki, Cairo, Egypt
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