Molecular detection and antibiogram of Shiga toxin-producing Escherichia coli (STEC) from raw milk in and around Bahir Dar town dairy farms, Ethiopia

Illnesses associated with consuming infected milk and milk products are a widespread problem in low and middle-income countries. Shiga toxin-producing Escherichia coli (STEC) is a bacterium commonly found in raw milk and causes foodborne diseases ranging from mild diarrhea to severe hemorrhagic colitis and hemolytic uremic syndrome. This study aimed to investigate the virulence gene and antimicrobial resistance profiles of Shiga toxin-producing E. coli strains isolated from raw milk in dairy farms in and around Bahir Dar town. Raw milk samples (n = 128) collected from December 2021 to July 2022 were cultured, and E. coli strains were isolated using standard methods. Shiga toxin-producing E. coli strains were identified genotypically by the presence of the virulence markers using a single-plex polymerase chain reaction. The antibiotic susceptibility testing of Shiga toxin-producing E. coli isolates was done by the agar disk diffusion method. In total, 32 E. coli isolates were recovered from milk samples from lactating animals. PCR screening of these isolates resulted in 19 (59.3%) positives for Shiga toxin-producing E. coli. The stx2 gene was detected in 53% of cases, followed by stx1 (31%) and eae (16%. The STEC isolates were highly sensitive to ciprofloxacin (94.7%) and kanamycin (89.5%), while exhibiting significant resistance to amoxicillin (89.5%) and streptomycin (73.7%). The present study points out the occurrence of virulent and antibiotic-resistant Shiga toxin-producing E. coli strains in raw milk that could pose a potential risk to public health. Further analysis by whole genome sequencing is necessary for an in-depth assessment and understanding of their virulence and resistance factors. Moreover, large-scale studies are needed to identify the prevalence and potential risk factors and to prevent the spread of antibiotic-resistant STEC strains in the milk production chain.

Occurrence and antimicrobial susceptibility patterns of Escherichia coli and Escherichia coli O157 isolated from cow milk and milk products, Ethiopia

Escherichia coli is a major foodborne pathogen worldwide. This study was conducted to assess the prevalence, risk factors, and antimicrobial susceptibility of E. coli and E. coli O157 in milk and milk products and hygienic practices in West Shoa, Oromia, Ethiopia. Five hundred fifty-six milk samples comprising 421 udder milk, 57 bulk tank milk, and 78 milk products were investigated. Moreover, a questionnaire was administered to 145 participants to assess hygienic practices. A standard microbiological procedure was used to detect E. coli and E. coli O157. The Kirby Bauer disc diffusion method was used to test the antimicrobial susceptibility of the isolates. Petri film plates were used to enumerate the coliform in raw bulk tank milk. Farm and animal-level E coli prevalence were estimated and association with risk factors was assessed. Escherichia coli was detected in 33.8% (95% confidence interval (CI) 29.9-37.9%) of the samples, of which only one isolate (0.2%) was E. coli O157. Escherichia coli contamination was higher in bulk tank samples (47.4%; 95% CI 34.0-61.0%) than in udder milk (34.7%; CI 30.1-39.4%), cottage cheese (27.0%; 95% CI 14.6-43.9%), and yoghurt 10.5% (95% CI 2.9-24.8%). For the animal-level E. coli contamination, only the study area was identified as a risk factor. Risk factors such as types of milk containers, udder washing practices, hygiene, and management systems were associated with both farm-level and milk products E. coli contamination. Most (59.0%) of the farmers practice udder washing only before milking and the remaining did not practice udder washing at all. The mean coliform count in raw bulk tank milk was higher than the international standard (4.09 log10 CFU/ml). All the 42 E. coli isolates tested were multidrug resistant. The occurrence of E. coli is high, while that of E. coli O157 is too low. The milk-handling practices are poor in the study areas. The high prevalence of E. coli, as well as the high coliform count and higher multi-drug resistance may pose risk to public health and food safety. Therefore, proper hygienic practices throughout the milk chain as well as rational drug use are advised.

Occurrence and Multidrug Resistance in Strains of Listeria monocytogenes Recovered from the Anaerobic Co-Digestion Sludge Contained in a Single Stage Steel Biodigester: Implications for Antimicrobial Stewardship

L. monocytogenes is a zoonotic foodborne pathogen with inherent adaptability to tolerate environmental and physiological stresses, thereby causing severe disease outbreaks. Antibiotic resistant foodborne pathogens are a challenge to the food industry. A total of 18 samples were pooled from a bio-digester co-digesting swine manure/pinewood sawdust, and evaluated for the occurrence of bacterium plus total viable counts using the spread plate method. The recovered bacterial isolates were presumptively identified by growth on selective medium and confirmed by biochemical characterisation, leading to the isolation of 43 L. monocytogenes. The isolates were characterized based on their susceptibility to antibiotics via the Kirby-Bauer disc diffusion technique against a panel of 14 antibiotics. Equally, the multiple antibiotic resistance (MAR) index was calculated, and MAR phenotypes generated. The bacterial counts were between 102 and104 cfu/mL. Complete susceptibility (100%) was demonstrated to ampicillin, gentamicin and sulfamethoxazole, which are the drugs of choice in the treatment of listeriosis. In addition, intermediate sensitivity occurred at 25.58% to cefotaxime, and the highest resistance (51.16%) was exhibited against nalidixic acid. The MAR index ranged from 0 to 0.71. Overall, 41.86% of the Listeria isolates displayed multidrug resistance, with 18 different MAR phenotypes, demonstrating CIP, E, C, TET, AUG, S, CTX, NA, AML, NI as the greatest MAR phenotype. It can be concluded that the isolates yielding MAR > 0.2 originated from the farm, where antibiotics had been in routine use. Therefore, strict monitoring of antibiotics use in the farm is crucial to mitigate further increase in antibiotic resistance amongst these bacterial isolates.

Occurrence and antimicrobial resistance pattern of E. coli O157:H7 isolated from foods of Bovine origin in Dessie and Kombolcha towns, Ethiopia

E. coli are frequently isolated food-borne pathogens from meat, milk, and their products. Moreover, there has been a significant rise in the antimicrobial resistance patterns of E. coli O157:H7 to commonly used antibiotics. A cross-sectional study was conducted from October 2019 to July 2021 to estimate prevalence and identify associated factors of E. coli and E. coli O157:H7 and to determine antibiotic resistance pattern of E. coli O157:H7 from foods of bovine origin in Dessie and Kombolcha towns. A total of 384 samples were collected. Systematic and simple random sampling techniques were employed for sampling carcasses and milking cows, respectively. E. coli and E. coli O157:H7 were detected according to recommended bacteriological protocols. E. coli O157:H7 strains were evaluated for in vitro antimicrobial susceptibility using agar disk diffusion method. Both descriptive and inferential statistical techniques were applied to analyze the data. Overall prevalence rates of E. coli and E. coli O157:H7 were 54.7% and 6.5%, respectively. Highest prevalence rates of E. coli (79.6%) and E. coli O157:H7 (16.7%) were obtained from carcass swabs and milk tank samples, respectively. Unlike E. coli O157:H7, a statistically significant difference in the E. coli prevalence (P<0.05) was observed among the different sample types. Multidrug resistance was observed among all isolates of E. coli O157:H7. All E. coli O157:H7 isolates (100.0%) were susceptible to Ampicillin, Sulfamethoxazole-trimethoprim, and Norfloxacin. On the contrary, all of the isolates (100%) were resistant to Penicillin G, Vancomycin, and Oxacillin. The current study indicated that different foods of bovine origin in the study area were unsafe for human consumption. Hence, good hygienic production methods should be employed to ensure the safety of foods of bovine origin.

Prevalence of Multidrug-Resistant Bacteria (Enteropathogens) Recovered from a Blend of Pig Manure and Pinewood Saw Dust during Anaerobic Co-Digestion in a Steel Biodigester

South Africa adopts intensive livestock farming, embracing the employment of huge quantities of antibiotics to meet the increased demand for meat. Therefore, bacteria occurring in the animal products and manure might develop antibiotic resistance, a scenario which threatens public health. The study investigated the occurrence of Gram-negative bacteria from eighteen pooled samples withdrawn from a single-stage steel biodigester co-digesting pig manure (75%) and pine wood saw dust (25%). The viable counts for each bacterium were determined using the spread plate technique. The bacterial isolates were characterised based on cultural, morphological and biochemical characteristics, using the Analytical Profile Index 20 e test kit. In addition, isolates were characterised based on susceptibility to 14 conventional antibiotics via the disc diffusion method. The MAR index was calculated for each bacterial isolate. The bacterial counts ranged from 104 to 106 cfu/mL, indicating manure as a potential source of contamination. Overall, 159 bacterial isolates were recovered, which displayed diverse susceptibility patterns with marked sensitivity to amoxicillin (100% E. coli), streptomycin (96.15% for Yersinia spp.; 93.33% for Salmonella spp.) and 75% Campylobacter spp. to nitrofurantoin. Varying resistance rates were equally observed, but a common resistance was demonstrated to erythromycin (100% of Salmonella and Yersinia spp.), 90.63% of E. coli and 78.57% of Campylobacter spp. A total of 91.19% of the bacterial isolates had a MAR index > 0.2, represented by 94 MAR phenotypes. The findings revealed multidrug resistance in bacteria from the piggery source, suggesting they can contribute immensely to the spread of multidrug resistance; thus, it serves as a pointer to the need for the enforcement of regulatory antibiotic use in piggery farms. Therefore, to curb the level of multidrug resistance, the piggery farm should implement control measures in the study area.

Prevalence and Antibiogram of Escherichia coli and Staphylococcus spp. Isolated from Cattle Milk Products Sold in Juja Sub-County, Kenya

Dairy ruminant milk provides a conducive environment for bacterial proliferation. In animals, these bacteria are exposed to antibiotics, whose overuse has led to increased cases of drug resistance. A cross-sectional study was conducted on milk and milk products vended in Juja Sub-County, Kenya to determine the prevalence of bacteria and antibiogram of Staphylococcus spp. and Escherichia coli. A total of 169 milk samples were obtained from various outlets in the study area. Milk samples were cultured and isolated bacteria were identified using standard bacteriological procedures. Various bacteria (15 species) were isolated in different proportions. Staphylococcus spp. and E. coli were isolated from 25.4% and 11.8% of the collected samples, respectively. The highest number of Staphylococcus spp. were isolated from raw milk (n = 34) while the highest number of E. coli where isolated from fermented milk (n = 15). Staphylococcus spp. and E. coli isolates were subjected to antimicrobial susceptibility tests using CLSI guidelines. The Staphylococcus spp. isolates were highly resistant to penicillin G (93%) but susceptible to norfloxacin (100%), gentamicin (90.6%), and chloramphenicol (86%). The E. coli isolates were highly resistant to cephalexin (85%) and ceftazidime (60%) but susceptible to chloramphenicol (100%), norfloxacin (95%), gentamicin (95%), azithromycin (95%) and cefepime (80%). Furthermore, 44.3% of Staphylococcus spp. and 50% of E. coli isolates had a Multiple Antibiotic Resistance (MAR) Index greater than 0.2. This implies that these bacteria were high-risk bacteria whose treatment with current antibiotics would be challenging. The high prevalence and multidrug resistance patterns shown by the Staphylococcus spp. and E. coli isolated from milk products in Juja Sub-county highlights the importance of proper handling and processing of milk from the farm to consumers. This will in turn reduce the possibility of zoonotic transfer of multidrug-resistant bacteria.

Isolation, characterization, and antimicrobial susceptibility pattern of Escherichia coli O157:H7 from foods of bovine origin in Mekelle, Tigray, Ethiopia

Escherichia coli O157:H7 is an emerging and major zoonotic foodborne pathogen. It has an increasing concern about the spread of antimicrobial-resistant strains. This study aimed to isolate and characterize Shiga toxin-producing E. coli O157:H7 from raw milk, yogurt, and meat of bovine origin and determine their antimicrobial susceptibility pattern. A cross-sectional study was conducted from December 2014 to June 2015, and a total of 284 milk and meat samples were collected from different sources in Mekelle. The collected samples were analyzed for the presence of E. coli and Shiga toxin-producing E. coli O157:H7 and the determination of their antimicrobial susceptibility pattern following the standard bacteriological and molecular techniques and procedures and antimicrobial sensitivity test. Out of the total 284 samples, 70 (24.6%) were bacteriologically positive for E. coli and 14.3% were found to be Shiga toxin-producing E. coli O157:H7. Of note, 100% of E. coli isolates carried the pal gene and 41.7% eaeA gene (EHEC). Of these EHEC isolates, 40% and 60% were positive for stx1 and stx2, respectively. E. coli isolates showed the highest level of susceptibility to gentamycin (91.7%) but the highest level of resistance to amoxicillin (95.8%). Of the tested isolates, 18 (75%) of E. coli showed multidrug-resistant. This study revealed the occurrence of Shiga toxin-producing E. coli O157:H7 in foods of bovine origin in the study area. In conclusion, a nationwide phenotypic and molecular characterization, in-depth typing, and drug-resistant gene identification of E. coli O157:H7 should be undertaken.

Epidemiology and Antimicrobial Susceptibility Pattern of E. coli O157:H7 Along Dairy Milk Supply Chain in Central Ethiopia

Background

Enterohemorrhagic Escherichia coli (O157:H7) is the primary cause of bloody diarrhea or hemorrhagic colitis. The study was carried out with to determine the epidemiology and antimicrobial resistance pattern of E. coli O157:H7 along the dairy supply chains in Akaki Kaliti sub-city of Addis Ababa, Bishoftu and Sululta towns of central Ethiopia.

Methods

A cross-sectional study design with random sampling methods was employed. Thus, a total of 450 raw cow milk (294), milker hand swab (65) and water (91) samples were collected from dairy farms, milk collection centers and Cafeterias and processed according to the standards to isolate and identify E. coli O157:H7. The samples were initially enriched in buffered peptone water, then plated onto Sorbitol MacConkey agar. Consequently, the suspected non-sorbitol fermenting colonies were confirmed as E. coli biochemically and serological test using latex agglutination tests.

Results

Out of the total 450 samples examined, 6.0% were found to be contaminated by E. coli O157:H7. Accordingly, 9.89% of water, 9.23% of milker hand swab and 4.08% of raw milk samples were contaminated by the pathogen. Furthermore, the prevalence of E. coli O157:H7 was 7.79%, 6.21% and 3.97% in Akaki kaliti sub-city, Sululta and Bishoftu towns, respectively. The result of Fisher exact analysis revealed a significant difference observed (p < 0.05) between the occurrence of the pathogen and the source of sample, sources of water used, sampled material and type of containers. The study also revealed that varying level of resistance of E. coli O157:H7 isolates against nine antimicrobial discs tested and 100% (n = 27) of the isolates showed multidrug-resistance comprising from two up to seven antimicrobial drugs.

Conclusion

In conclusion, this study has indicated the occurrence of E. coli O157:H7 and its multiple drug-resistant profiles in milk samples along the dairy supply chains and its risk to public health and food safety. Therefore, proper hygienic practices from dairy farms to fork and rational drug usage are recommended.

Isolation and Identification of Infection-Causing Bacteria in Dairy Animals and Determination of Their Antibiogram

Pathogens are always a threat to the livestock and domestic animals due to their exposure to the contaminated environments. The study was conducted to evaluation of the prevalence of Escherichia coli, Shigella spp., Salmonella spp., and S. aureus, in farm animals (cattle and buffalos). A total of 150 (n = 150) samples were collected from cattle and buffaloes, 60 samples from cows’ and buffalo’s teats milk, 30 of water samples, and 60 of fecal samples isolates from dairy farm animals, which may act as reservoir disseminating such pathogens. Farm hygiene, management, and milking procedure were listed through a questionnaire. The most common pathogens detected in this study was E. coli 88 (58%) and S. aureus 81 (54%), followed by Salmonella spp. 32 (21%), and Shigella spp. 44 (29%), respectively. During the antibiogram studies, the results revealed that the highest number of bacterial isolates showed resistance against ampicillin 50 (56.8%), followed by ciprofloxacin 23 (26.1%) and augmentin 22 (25%) of Escherichia coli and ampicillin 49 (60.4%), cefpodoxime 23 (28.3%), and augmentin 20 (24.6%) of S. aureus. In the case of Salmonella spp., the highest resistance was showed by amoxicillin 16 (50%). In Shigella spp., the highest resistance was shown by ampicillin 16 (36.3%), followed by cefpodoxime and ceftazidime 10 (22.7%). The high frequency of isolates in this investigation with multiple antibiotic resistance ranges from 15. MARI % value of S. aureus and E. coli 15 (12.5%), followed by Salmonella and Shigella spp. ranges from 12 (10%), suggesting the presence of various antibiotic-resistant bacteria as well as highly resistant bacteria. The mean ± SD zone areas for the greater resistance are for E. coli and S. aureus, already known to be multiresistant, followed by Salmonella spp. and Shigella spp., when the zone areas are for the low resistance, and the findings determined that there was a little difference between S. aureus and E. coli.

Escherichia coli O15 : H7 from Food of Animal Origin in Arsi: Occurrence at Catering Establishments and Antimicrobial Susceptibility Profile

Escherichia coli O157 : H7 (E. coli O157 : H7) has been found to be the major cause of food-borne diseases and a serious public health problem in the world, with an increasing concern for the emergence and spread of antimicrobial-resistant strains. Hitherto, little is known about the carriage of E. coli O157 : H7 and its antimicrobial susceptibility profile in the food of animal origin in Ethiopia. This study aimed to determine the occurrence and multidrug resistance profile of E. coli O157 : H7 from food of animal origin at different catering establishments in the selected study settings of Arsi Zone. One hundred ninety-two animal origin food items, namely, raw/minced meat (locally known as “Kitfo,” “Kurt,” and “Dulet”), raw milk, egg sandwich, and cream cake samples were collected and processed for microbiological detection of E. coli O157 : H7. Out of 192 samples, 2.1% (4/192) were positive for E. coli O157 : H7. Two E. coli O157 : H7 isolates were obtained from “Dulet” (6.3%) followed by “Kurt” (3.1%, 1/32) and raw milk (3.1%, 1/32), whereas no isolate was obtained from “Kitfo,” egg sandwich, and cream cake samples. Of the 4 E. coli O157 : H7 isolates subjected to 10 panels of antimicrobial discs, 3 (75%) were highly resistant to kanamycin, streptomycin, and nitrofurantoin. Besides, all the isolates displayed multidrug resistance phenotypes, 3 to 5 antimicrobial resistance, amid kanamycin, streptomycin, nitrofurantoin, tetracycline, and chloramphenicol. The occurrence of multidrug-resistant E. coli O157 : H7 isolates from foods of animal origin sampled from different catering establishments reveals that the general sanitary condition of the catering establishments, utensils used, and personnel hygienic practices did not comply with the recommended standards. Thus, this finding calls for urgent attention toward appropriate controls and good hygienic practices in different catering establishments dealing with consuming raw/undercooked foods of animal origin.

Characterisation and Antibiotic Resistance of Selected Bacterial Pathogens Recovered from Dairy Cattle Manure during Anaerobic Mono-Digestion in a Balloon-Type Digester

Dairy cattle manure serves as a potential source of contamination and infection of animals, humans and the environment. Manure samples withdrawn from a balloon-type digester during anaerobic digestion were evaluated for the presence of antibiotic-resistant bacterial pathogens. The bacterial load of the samples was determined via a viable plate count method and the recovered isolates were subjected to characterisation and identification. These isolates were employed in antibiotic susceptibility testing using a disc diffusion method against a suite of 10 conventional antibiotics. The multiple antibiotic resistance (MAR) index was calculated and MAR phenotypes were generated. Although all the bacterial pathogens showed a certain degree of resistance to the studied antibiotics, a marked resistance was demonstrated by Campylobacter sp. to co-trimoxazole (87.5%) and nalidixic acid (81.5%). Remarkably, a high resistance (82.42%) was demonstrated against the antibiotic class, macrolide, followed by beta-lactams (40.44%), suggesting that bacterial resistance depended on the chemical structure of the antibiotics. However, individual bacterial isolates varied in resistance to particular antibiotics. Of the 83 bacterial isolates, 40(48.19%) observed MAR > 0.2 and, thus, were described as multidrug-resistant isolates. A total of 28 MAR phenotypes were revealed with the highest frequency of MAR phenotypes (37.5%) expressed against 3 antibiotics. Results indicated a high risk of exposure to various antibiotics and wide diversity of antibiotic resistance.

Prevalence and Antimicrobial Susceptibility Pattern of E. coli O157:H7 Isolated from Traditionally Marketed Raw Cow Milk in and around Asosa Town, Western Ethiopia

A cross-sectional study was conducted from October 2014 to July 2015 to determine the prevalence and populations of E. coli as well as the prevalence and antimicrobial susceptibility of E. coli O157:H7 isolated from raw milk. Biochemical and serological tests methods were used to confirm E. coli and E. coli O157:H7 and isolates were subjected to antimicrobial susceptibility test using the agar disc diffusion method. Out of 380 raw milk samples examined, 129 (33.9%) and 11 (2.9%) were contaminated with E. coli and E. coli O157:H7, respectively. The highest prevalence was recorded in samples obtained from vendors (39.1%, 4.978 ± 0.180 log₁₀/ml) compared with samples from farmers (28.1%, 3.93 ± 0.01 log₁₀/ml) with significant differences (P = 0.02). The frequency of contamination was higher in the samples collected from milk that was stored and transported in plastic containers (39.4%) than in the containers made of stainless steel (23.0%) (P = 0.002). The antimicrobial susceptibility profile showed that E. coli O157:H7 were resistant to tetracycline (81.8%), streptomycin (81.8%), and kanamycin (63.6%). Milk samples were produced and handled under poor hygienic conditions, stored, and transported in inappropriate containers and under temperature abuse conditions leading to high health risk to the consumers. Additional studies would be needed to establish association between the occurrences of E. coli O157:H7 in raw milk and all the risk factors involved in and around Asosa town.

Antibiotic-Resistant Extended Spectrum ß-Lactamase- and Plasmid-Mediated AmpC-Producing Enterobacteriaceae Isolated from Retail Food Products and the Pearl River in Guangzhou, China

We conducted a survey in 2015 to evaluate the presence of extended spectrum β-lactamase (ESBL)- and plasmid-mediated AmpC-producing Enterobacteriaceae in retail food and water of the Pearl River in Guangzhou, China, as well as their antibiotic resistance profiles. Samples (88 fresh food samples and 43 water samples) from eight different districts were analyzed by direct plating and after enrichment. Multidrug-resistant strains were found in 41.7 and 43.4% of food and water samples, respectively. ESBLs were found in 3.4 and 11.6% of food and water samples, respectively, and AmpC producers were found in 13.6 and 16.3% of food and water samples, respectively. Molecular characterization revealed the domination of bla_CTX−Mgenes; plasmidic AmpC was of the type DHA-1 both in food and water samples. Thirteen of Fifty one β-lactamase-producing positive isolates were detected to be transconjugants, which readily received the β-lactamase genes conferring resistance to β-lactam antibiotics as well as some non-β-lactam antibiotics. These findings provide evidence that retail food and the river water may be considered as reservoirs for the dissemination of β-lactam antibiotics, and these resistance genes could readily be transmitted to humans through the food chain and water.

Effective Phages as Green Antimicrobial Agents Against Antibiotic-Resistant Hospital Escherichia coli

BACKGROUND

Bacteriophages are viruses that attack bacteria and lead to their lysis in an efficient and highly specific manner. These natural enemies of bacteria were used as therapeutic agents before the advent of antibiotics. Currently, with the rapid spread of multi-drug resistant bacteria, phage therapy can be an effective alternative treatment for antibiotic resistant bacteria.

OBJECTIVES

This study evaluated the effectiveness of bacteriophages in removing antibiotic-resistant clinical Escherichia coli strains in vitro and in vivo.

PATIENTS AND METHODS

Different samples were taken from bed sore and foot ulcers of patients with diabetes. E. coli strains were isolated and identified by standard methods. The antibiogram was ascertained using the Kirby Bauer disc diffusion method for ten antibiotics. The bacteriophages were isolated from environmental water samples. They were exposed to the host bacteria by the double-layer agar technique (DLA) to observe plaques. Cross reaction of the phages on test E. coli strains was performed to determine broader-spectrum phages. Phage TPR7 was selected for animal trials. Five groups of mice including a control group, bacterial group, phage group, antibiotic therapy group and phage therapy group, were examined.

RESULTS

Ten E. coli strains were isolated from hospital samples. They showed high resistance to the used antibiotics. An effective bacteriophage was isolated for each strain. The cross-reaction showed phages which affect more than six E. coli strains. They can be a good choice for clinical therapeutic use. In animal trials the group challenged with phages after being infected showed similar results as the group treated with gentamicin after being infected. In both groups infection was removed after 48 hours.

CONCLUSIONS

According to the results, six strains were resistant to six or seven antibiotics and all strains were at least resistant to two antibiotics. However, for each of these resistant bacteria one bacteriophage was isolated from environmental samples, which showed the effectiveness of bacteriophages to remove clinically resistant E. coli strains. Effective phages in vitro showed effective results in vivo as well.