scholarly journals Antimicrobial Resistance in ESBL-Producing Escherichia coli Isolated from Layer and Pig Farms in Thailand

2018 ◽  
Vol 46 (1) ◽  
pp. 8 ◽  
Author(s):  
Aniroot Nuangmek ◽  
Suvichai Rojanasthien ◽  
Suwit Chotinun ◽  
Panuwat Yamsakul ◽  
Pakpoom Tadee ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Function Analysis ◽  
Commensal Bacteria ◽  
Farm Worker ◽  
Stagnant Water ◽  
E Coli ◽  
Pig Farms ◽  
Resistance Patterns ◽  
Pig Farm

Background: Study of drug resistance of commensal bacteria in both humans and animals can determine the scale of the drug resistance problem. Usage of antimicrobials to treat infections in humans and animals has generated extensive antimicrobial pressure not only on targeted pathogens but also on commensal bacteria. Commensal Escherichia coli appears to be the major reservoir for resistant genes implicated in the transmission of genetic traits from one bacterium to another. Antimicrobial resistance in Enterobacteriaceae has increased dramatically worldwide in the last decade. An increasing number of community-onset extended-spectrum beta-lactamase (ESBL)-producing bacterial infections, especially those caused by ESBL-producing E. coli, have been reported in many countries, including Thailand. Moreover, ESBL-producing E. coli have been widely detected in food-producing animals and the environment. The increased use of ESBLs in food animals is a serious public health problem. The objective of the study was to determine the prevalence and antimicrobial resistance pattern of ESBL-producing E. coli isolated from pigs, layers, farm workers and stagnant water, in order to increase awareness about antimicrobial usage on farms and to minimize the expansion of the antimicrobial resistance phenomenon in farm settings.Materials, Methods & Results: A total of 588 samples were collected from 107 pig farms and 89 layer farms in Chiang Mai–Lamphun and Chon Buri provinces during May 2015-April 2016. Double-disk diffusion method according to EUCAST (European Committee on Antimicrobial Susceptibility Testing) guidelines was used for detection. The results demonstrated that 36.7% (216/588) of samples were ESBL-producing E. coli-positive, including rectal swabs 74.8% (80/107), pig farm worker stool swabs 57.0% (61/107), stagnant water on pig farms 21.5% (23/107), healthy layer rectal swabs 6.7% (6/89) and layer farm worker stool swabs 51.7% (46/89). Most of the isolates were resistant against ampicillin (99.5%), followed by erythromycin (98.6%) and ceftriaxone (96.3%). All of them were classified as multidrug-resistant strains. Moreover, AMP-CRO-E-TE-C-SXT-CN was the most frequent phenotype pattern detected in animals, humans and the environment, followed by AMP-CRO-E-TE-C-SXT-NA-CN.Discussion: The present study offers clear evidence that the prevalence of ESBL-producing E. coli in healthy pigs is higher than in layers. One possible explanation is that a large amount and variety of antimicrobials are used on pig farms, resulting in a common and significant source of drug-resistant ESBL-producing E. coli. The lower incidence of ESBL-producing E. coli in samples from a pig farm environment than in samples of animal origin indicate that pigs are a reservoir of a reservoir for resistant bacteria and a source of environmental contamination. Antimicrobial resistance patterns of ESBLproducing E. coli detected in all sample types and study locations were quite similar. In almost all ESBL-producing E. coli isolates, resistance was shown against ampicillin, erythromycin, ceftriaxone, tetracycline and chloramphenicol. Moreover, multidrug resistance was found in all isolates of ESBL-producing E. coli. The differences in antimicrobial agent resistance patterns can be used to differentiate sources by employing analytical tools such as discriminant function analysis. A molecular typing protocol is recommended for use in a discriminant function analysis for pattern determination of pathogen spreading. However, genetic fingerprinting techniques for microbial source tracking are more expensive, and facilities with appropriate equipment and expertise are required.

scholarly journals Genotyping and antimicrobial resistance in Escherichia coli from pig carcasses

2017 ◽  
Vol 37 (11) ◽  
pp. 1253-1260 ◽  
Author(s):  
Caroline Pissetti ◽  
Gabriela Orosco Werlang ◽  
Jalusa Deon Kich ◽  
Marisa Cardoso
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Antimicrobial Agents ◽  
Commensal Bacteria ◽  
Pfge Analysis ◽  
Gene Detection ◽  
E Coli ◽  
Antimicrobial Resistance Profile ◽  
Resistant Strains ◽  
Pig Carcasses

ABSTRACT: The increasing antimicrobial resistance observed worldwide in bacteria isolated from human and animals is a matter of extreme concern and has led to the monitoring of antimicrobial resistance in pathogenic and commensal bacteria. The aim of this study was to evaluate the antimicrobial resistance profile of Escherichia coli isolated from pig carcasses and to assess the occurrence of relevant resistance genes. A total of 319 E. coli isolates were tested for antimicrobial susceptibility against different antimicrobial agents. Moreover, the presence of extended-spectrum β-lactamase (ESBL) and inducible ampC-β-lactamase producers was investigated. Eighteen multi-resistant strains were chosen for resistance gene detection and PFGE characterization. The study showed that resistance to antimicrobials is widespread in E. coli isolated from pig carcasses, since 86.2% of the strains were resistant to at least one antimicrobial and 71.5% displayed multi-resistance profiles. No ampC-producing isolates were detected and only one ESBL-producing E. coli was identified. Genes strA (n=15), floR (n=14), aac(3)IVa (n=13), tetB (n=13), sul2 (n=12), tetA (n=11), aph(3)Ia (n=8) and sul3 (n=5) were detected by PCR. PFGE analysis of these multi-resistant E. coli strains showed less than 80% similarity among them. We conclude that antimicrobial multi-resistant E. coli strains are common on pig carcasses and present highly diverse genotypes and resistance phenotypes and genotypes.

scholarly journals Antimicrobial Resistance Patterns and ESBL of Uropathogens Isolated from Adult Females in Najran Region of Saudi Arabia

2021 ◽  
Vol 11 (3) ◽  
pp. 650-658
Author(s):  
Mohammed Yahia Alasmary
Keyword(s):  
Escherichia Coli ◽  
Saudi Arabia ◽  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Urine Samples ◽  
Klebsiella Species ◽  
E Coli ◽  
Government Hospitals ◽  
Resistance Patterns ◽  
Tract Infections

Background: To explore the prevalence of urinary tract infections (UTIs) among female patients in the Najran region of Saudi Arabia and determine their antimicrobial resistance pattern. Methods: This study was conducted on 136 urine samples collected from outpatient departments (OPDs) of the different government hospitals in the Najran region of Saudi Arabia. Over one year, the results of susceptibility testing reports of outpatient midstream urine samples from three government hospitals were prospectively evaluated. Results: Of 136 urine samples, only 123 (90.45%) were found to show significant growth for UTIs, from which 23 different uropathogens were identified. Escherichia coli (58.5%) was the most commonly isolated organism, followed by Klebsiella pneumoniae (8.1%). The isolated microorganism showed increased resistance patterns from 3.3% to 62.6%, with an overall resistance of 27.19%. Meropenem was the most effective antimicrobial, followed by amikacin and ertapenem (0.47%, 0.91%, and 1.5% resistance, respectively). At the same time, ampicillin and cephazolin were the least (62.6% and 59.5% resistance, respectively) effective. Overall, eleven (8.94%) uropathogens isolates were ESBLs, among which there were eight (6.5%) Escherichia coli, one (0.81%) Klebsiella pneumoniae, one (0.81%) Klebsiella oxytoca, and one (0.81%) Citrobacter amalonaticus. Conclusions: E. coli remains the most commonly isolated causative uropathogens, followed by Klebsiella species. The prevalence of pathogenic E. coli and Klebsiella species underscores the importance of developing cost-effective, precise, and rapid identification systems to minimize public exposure to uropathogens. Antibiotic susceptibility data revealed that most of the isolates were resistant to the majority of the antibiotics. The patients with UTIs in the Najran region of Saudi Arabia are at a high risk of antibiotic resistance, leading to significant problems in outpatient department (OPD) treatment outcomes and raising the alarm for the physician to change their empiric treatment.

scholarly journals Antimicrobial resistance pattern of extended-spectrum β-lactamase-producing Escherichia coli isolated from fecal samples of piglets and pig farm workers of selected organized farms of India

2020 ◽  
Vol 13 (2) ◽  
pp. 360-363
Author(s):  
Shikha Tamta ◽  
Obli Rajendran Vinodh Kumar ◽  
Shiv Varan Singh ◽  
Bommenahalli Siddaramiah Pruthvishree ◽  
Ravichandran Karthikeyan ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Susceptibility Testing ◽  
Farm Workers ◽  
Resistance Pattern ◽  
Antibiotic Susceptibility Testing ◽  
M Gene ◽  
Fecal Samples ◽  
E Coli ◽  
Pig Farm

Background and Aim: Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli are gradually increasing worldwide and carry a serious public threat. This study aimed to determine the antimicrobial resistance pattern of ESBL-producing E. coli isolated from fecal samples of piglets and pig farm workers. Materials and Methods: Fecal samples from <3-month-old piglets (n=156) and farm workers (n=21) were processed for the isolation of ESBL-producing E. coli in MacConkey agar added with 1 μg/mL of cefotaxime. E. coli (piglets=124; farm workers=21) were tested for ESBL production by combined disk method and ESBL E-strip test. Each of the ESBL-positive isolate was subjected to antibiotic susceptibility testing. The ESBL-producing E. coli were further processed for genotypic confirmation to CTX-M gene. Results: A total of 55 (44.4%, 55/124) and nine (42.9%, 9/21) ESBL-producing E. coli were isolated from piglets and farm workers, respectively. Antibiotic susceptibility testing of the ESBL-positive E. coli isolates from piglets and farm workers showed 100% resistance to ceftazidime, cefotaxime, cefotaxime/clavulanic acid, ceftazidime/clavulanic acid, and cefpodoxime. A proportion of 100% (55/55) and 88.9% (8/9) ESBL-positive E. coli were multidrug resistance (MDR) in piglets and farm workers, respectively. On genotypic screening of the ESBL E. coli isolated from piglets (n=55), 15 were positive for the blaCTX-M gene and of the nine ESBL E. coli from farm workers, none were positive for the blaCTX-M gene. Conclusion: Although there was no significant difference in isolation of ESBL-producing E. coli between piglets and farm workers, the ESBL-positive E. coli from piglets showed relatively higher MDR than farm workers.

Antimicrobial Resistance in Campylobacter, Salmonella, and Escherichia coli Isolated from Retail Grain-Fed Veal Meat from Southern Ontario, Canada

2011 ◽  
Vol 74 (8) ◽  
pp. 1245-1251 ◽  
Author(s):  
ANGELA COOK ◽  
RICHARD J. REID-SMITH ◽  
REBECCA J. IRWIN ◽  
SCOTT A. McEWEN ◽  
VIRGINIA YOUNG ◽  
...  
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Tetracycline Resistance ◽  
Antimicrobial Susceptibility Testing ◽  
E Coli ◽  
Testing Resistance ◽  
Resistance Patterns

This study estimated the prevalence of Salmonella, Campylobacter, and Escherichia coli isolates in fresh retail grain-fed veal obtained in Ontario, Canada. The prevalence and antimicrobial resistance patterns were examined for points of public health significance. Veal samples (n = 528) were collected from February 2003 through May 2004. Twenty-one Salmonella isolates were recovered from 18 (4%) of 438 samples and underwent antimicrobial susceptibility testing. Resistance to one or more antimicrobials was found in 6 (29%) of 21 Salmonella isolates; 5 (24%) of 21 isolates were resistant to five or more antimicrobials. No resistance to antimicrobials of very high human health importance was observed. Ampicillin-chloramphenicol-streptomycin-sulfamethoxazole-tetracycline resistance was found in 5 (3%) of 21 Salmonella isolates. Campylobacter isolates were recovered from 5 (1%) of 438 samples; 6 isolates underwent antimicrobial susceptibility testing. Resistance to one or more antimicrobials was documented in 3 (50%) of 6 Campylobacter isolates. No Campylobacter isolates were resistant to five or more antimicrobials or category I antimicrobials. E. coli isolates were recovered from 387 (88%) of 438 samples; 1,258 isolates underwent antimicrobial susceptibility testing. Resistance to one or more antimicrobials was found in 678 (54%) of 1,258 E. coli isolates; 128 (10%) of 1,258 were resistant to five or more antimicrobials. Five (0.4%) and 7 (0.6%) of 1,258 E. coli isolates were resistant to ceftiofur and ceftriaxone, respectively, while 34 (3%) of 1,258 were resistant to nalidixic acid. Ciprofloxacin resistance was not detected. There were 101 different resistance patterns observed among E. coli isolates; resistance to tetracycline alone (12.7%, 161 of 1,258) was most frequently observed. This study provides baseline prevalence and antimicrobial resistance data and highlights potential public health concerns.

scholarly journals Antimicrobial Resistance Profiles and Characterization of Escherichia coli Strains from Cases of Neonatal Diarrhea in Spanish Pig Farms

2020 ◽  
Vol 7 (2) ◽  
pp. 48
Author(s):  
Anna Vidal ◽  
Laia Aguirre ◽  
Chiara Seminati ◽  
Montse Tello ◽  
Noelia Redondo ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Animal Health ◽  
Phenotypic Analysis ◽  
Low Frequencies ◽  
Neonatal Diarrhea ◽  
E Coli ◽  
Pig Farms ◽  
Diagnostic Approaches ◽  
Low Prevalence

Escherichia coli is considered one of the most common agents associated with neonatal diarrhea in piglets. The aim of this work was to characterize the pathogenic and antimicrobial resistance (AMR) profiles of 122 E. coli strains isolated from pigs suffering diarrhea (n = 94) and pigs without diarrhea (n = 28) of 24 farms in Spain. Virulence factors, toxins and AMR (ESBL and colistin) genes and AMR phenotypes of E. coli isolates were analyzed. Low prevalence of pathogenic E. coli strains (26%) was found in both groups. However, ETEC and VTEC strains were more frequently isolated from diarrheic piglets. Irrespectively of diarrhea occurrence, 97.5% of the strains showed a multidrug-resistance (MDR) profile to aminopenicillins, sulfonamides and tetracyclines. It was found that 22% of E. coli was CTX-M+, with CTX-M-14 being the principal allelic variant. Remarkably, 81.5% of CTX-M+ strains were isolated from diarrheic animals and presented an extended MDR profile to aminopenicillins, quinolones and aminoglycosides. Finally, low frequencies of colistin resistance genes mcr-1 (4/122) and mcr-4 (1/122) were found. MDR E. coli strains are circulating in pig farms of Spain, representing a serious threat to animal and public health. More appropriate diagnostic approaches (genetic and AMR phenotypic analysis) should be implemented in animal health to optimize antibiotic treatments.

scholarly journals Effect of Antimicrobial Dosage Regimen on Salmonella and Escherichia coli Isolates from Feeder Swine

2008 ◽  
Vol 74 (6) ◽  
pp. 1731-1739 ◽  
Author(s):  
Bruce A. Wagner ◽  
Barbara E. Straw ◽  
Paula J. Fedorka-Cray ◽  
David A. Dargatz
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Commensal Bacteria ◽  
Antimicrobial Use ◽  
Control Analysis ◽  
Fecal Samples ◽  
E Coli ◽  
The Impact ◽  
Susceptibility And Resistance ◽  
Continuous Pulse

ABSTRACT A body of evidence exists that suggests that antimicrobial use in food animals leads to resistance in both pathogenic and commensal bacteria. This study focused on the impact of three different antimicrobial regimes (low-level continuous, pulse, and no antimicrobial) for two antimicrobials (chlortetracycline and tylosin) on the presence of Salmonella spp. and on the prevalence of antimicrobial resistance of both Salmonella spp. and nonspecific Escherichia coli in fecal samples from feeder swine. The prevalence of fecal samples positive for Salmonella spp. significantly decreased between the samples taken at feeder placement compared to samples taken when the animals were close to market weight. Differences in resistance of Salmonella spp. did not appear to be influenced by dosing treatment including the control. Analysis of antimicrobial resistance examining both susceptibility and resistance, as well as MIC outcomes, demonstrated that only resistance to cephalothin increased in E. coli under the pulse chlortetracycline treatment. These results suggest that the dosing regimes examined in this study did not lead to an increase in either the prevalence of Salmonella spp. or the prevalence of antimicrobial resistance in isolates of Salmonella spp. or E. coli.

scholarly journals Antimicrobial resistance of non-clinical Escherichia coli strains from chicken in Nsukka, South-east Nigeria.

2021 ◽  
Vol 30 (1) ◽  
pp. 101-106
Author(s):  
K. F. Chah ◽  
S. C. Okafor ◽  
S. I. Oboegbulem
Keyword(s):  
Escherichia Coli ◽  
Drug Resistance ◽  
Antimicrobial Resistance ◽  
Antimicrobial Agents ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Disc Diffusion Method ◽  
E Coli ◽  
Sensitivity Tests ◽  
Resistance Patterns

This study was carried out to determine resistance profiles of Escherichia coli strains isolated from clinically healthy chickens in Nsukka, southeast Nigeria. A total of 324 E. coli strains isolated from cloaca swabs from 390 chickens were tested against 16 antimicrobial agents using the disc diffusion method. The antibiotics used in the study were: ampicillin (25µg), amoxycillin-clavulanic acid (30µg), gentamicin (10µg), Streptomycin (30µg). cefuroxime (20µg), cephalexin (10µg), nalidixic acid (30µg), ciprofloxacin (5µg), norfloxacin (10µg), ofloxacin (5µg), pefloxacin (5µg), tetracycline (30µg), chloramphenicol (10µg), cotrimoxazole (50µg), colistin (25µg) and nitrofurantoin (100µg).The strains demonstrated high rates of resistance (34.6%  66.1%) to ampicillin, tetracycline, nitrofurantoin, cefuroxime and cotrimoxazole. None of the isolates was resistant to colistin, ofloxacin and pefloxacin. For each antimicrobial agent (except cephalexin), strains from the intensively reared chickens (layers and broilers) displayed higher resistance frequencies than those from the local birds. A total of 49 resistant patterns were recorded for the 228 strains resistant to at least one antimicrobial drug, with AmTeCoS and AmTeCfN being the predominant patterns. Because of the great variation in the drug resistance patterns of the Escherichia coli strains, use of antimicrobial agents in the management of E. coli infections in the study area should be based on results of sensitivity tests.

scholarly journals RESISTANCE TO FLUOROQUINOLONES IN ESCHERICHIA COLI FROM PIGS

2016 ◽  
Vol 8 (2) ◽  
pp. 103-112 ◽  
Author(s):  
Dalibor Todorović ◽  
Maja Velhner ◽  
Dragana Ljubojević ◽  
Marko Pajić ◽  
Dubravka Milanov
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
General Population ◽  
Digestive Tract ◽  
Food Production ◽  
Antimicrobial Agents ◽  
E Coli ◽  
Nearby Region ◽  
Pig Farms ◽  
Resistant Strains

The resistance of Escherichia coli (E. coli) to fluoroquinolones has become a serious issue on large pig farms worldwide, since these antimicrobial agents are widely used in the control of various diseases such as neonatal diarrhea, post weaning diarrhea, the edema disease as well as others. Being a frequent inhabitant of the digestive tract, E.coli is oft en exposed to antimicrobial agents, which are used to treat various infections. Uncontrolled application of fluoroquinolones has led to the emergence of resistant pathogenic strains as well as commensals. The spread of resistant strains is mostly found in animal and human food production chains, which are potentially huge threat for the general population. The resistance to fluoroquinolones may very oft en be combined with the resistance to other classes of antibiotics. Therefore, the use of fluoroquinolones for treating uncomplicated infections in pigs must be under strict control or completely banned. In this paper, we compared the results from available literature addressing the prevalence of antimicrobial resistance to fl uoroquinolones in E. coli strains both worldwide and in countries from the nearby region.

scholarly journals Antibiotic resistance patterns of intestinal Escherichia coli isolates from Nicaraguan children

2011 ◽  
Vol 60 (2) ◽  
pp. 216-222 ◽  
Author(s):  
Erick Amaya ◽  
Daniel Reyes ◽  
Samuel Vilchez ◽  
Margarita Paniagua ◽  
Roland Möllby ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Causes Of Death ◽  
Resistance Pattern ◽  
Aetiological Agent ◽  
Infantile Diarrhoea ◽  
E Coli ◽  
Resistance Patterns ◽  
Antibiotic Resistance Patterns ◽  
Children Under 5

In developing countries, diarrhoeal diseases are one of the major causes of death in children under 5 years of age. It is known that diarrhoeagenic Escherichia coli (DEC) is an important aetiological agent of infantile diarrhoea in Nicaragua. However, there are no recent studies on antimicrobial resistance among intestinal E. coli isolates in Nicaraguan children. The aim of the present study was to determine the antimicrobial resistance pattern in a collection of 727 intestinal E. coli isolates from the faeces of children in León, Nicaragua, between March 2005 and September 2006. All samples had been screened previously for the presence of DEC by multiplex PCR. Three hundred and ninety-five non-DEC isolates (270 from children with diarrhoea and 125 from children without diarrhoea) and 332 DEC isolates (241 from children with diarrhoea and 91 from children without diarrhoea) were analysed in this study. In general, antimicrobial resistance among the 727 intestinal E. coli isolates was high for ampicillin (60 %), trimethoprim–sulfamethoxazole (64 %) and chloramphenicol (11 %). Among individual E. coli categories, enteroaggregative E. coli isolates from children with and without diarrhoea exhibited significantly higher levels of resistance (P<0.05) to ampicillin and trimethoprim–sulfamethoxazole compared to the other E. coli categories. Resistance to ceftazidime and/or ceftriaxone and a pattern of multi-resistance was related to CTX-M-5- or CTX-M-15-producing E. coli isolates. The results suggest that E. coli isolates from Nicaraguan children have not reached the high levels of resistance to the most common antibiotics used for diarrhoea treatment as in other countries.

scholarly journals Virulence factors, antimicrobial resistance, and plasmid content of Escherichia coli isolated in swine commercial farms

2010 ◽  
Vol 62 (1) ◽  
pp. 30-36 ◽  
Author(s):  
M.M. Costa ◽  
G. Drescher ◽  
F Maboni ◽  
S.S. Weber ◽  
A. Schrank ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Virulence Factors ◽  
Intestinal Content ◽  
Specific Pattern ◽  
Clinical Isolates ◽  
Clinical Samples ◽  
Plasmid Content ◽  
E Coli ◽  
Resistance Patterns

Virulence factors and antimicrobial resistance patterns of Escherichia coli isolates were evaluated. A total of 80 E. coli isolates were evaluated, being 64 from clinical samples (intestinal content and fragments of organs from diarrheic piglets), seven from feces of clinically healthy piglets and sows, and nine environmental samples (five from facilities, two from feed, one from insect, and one from waste). Molecular characterization was performed by PCR detection of fimbriae and toxin genes and plasmid content determination. The isolates were also characterized according to their resistance or sensitivity to the following drugs: ampicillin, trimethoprim:sulfamethoxazole, tetracycline, amikacine, colistin, norfloxacin, florfenicol, enrofloxacin, cefalexin, trimethoprim, neomycin, chloramphenicol, and gentamicin. From 80 E. coli isolates, 53.8% were classified as enterotoxigenic E. coli (ETEC), 2.5% were shiga toxin-producing E. coli (STEC), and 43.8% showed a non specific pattern and were unclassified. One fecal isolate from non-diarrheic piglet was classified as ETEC by PCR. Clinical isolates showed resistance mainly for tetracycline and trimethoprim:sulfamethoxazole. Plasmidial DNA was observed in 70 isolates, being 78.5% of clinical isolates, 8.57% of non-diarrheic feces, and 12.8% of environment.

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