Prevalence of β-lactam and fluoroquinolone resistance, and virulence factors in Escherichia coli isolated from chickens in Slovakia

Biologia ◽  
2013 ◽  
Vol 68 (1) ◽  
Author(s):  
Zuzana Drugdová ◽  
Vladimír Kmeť
Keyword(s):  
Escherichia Coli ◽  
Virulence Factors ◽  
Virulence Genes ◽  
Inhibitory Concentration ◽  
Fluoroquinolone Resistance ◽  
Food Markets ◽  
E Coli ◽  
Plasmid Replicon ◽  
Resistant Strains ◽  
Plasmid Replicons

AbstractThe incidence of infections due to organisms resistant to β-lactam antibiotics has increased sharply in recent years. The goal of this study was to investigate the β-lactam resistance in 151 Escherichia coli strains isolated from chickens over a two-year period. Extended spectrum β-lactamases (ESBLs) were present in 24 strains (16%), ESBL phenotype was identified by interpretative reading of minimal inhibitory concentration values of ceftriaxon (CRT ≥ 7.1 mg/L), ceftazidime (CAZ ≥ 3.4 mg/L) and ceftiofur (CFF ≥ 8.7 mg/L). PCR detection revealed the presence of the bla CMY-2 gene and CTX-M-1 group. We detected high resistance to ampicillin (92%), streptomycin (63%), tetracyclin (70%), ceftiofur (40%), floroquinolones (enrofloxacin 68%, ciprofloxacin 62%), florfenicol (18%), chloramphenicol (21%) and cotrimoxazol (43%). We also investigated the presence of virulence factors and mobile genetic elements, and performed plasmid replicon typing in 24 selected strains. The most prevalent integrase among the isolates was the integrase 1 with gene cassettes dfrA, aadA and genes sul1 and sul2. Plasmid mediated quinolone resistances (qnrS) were also detected in two strains. Plasmid typing showed that the Y and IncI1 were dominant plasmid replicons. The genes iss, kpsII, tsh, iutA were the most frequently detected virulence genes in ESBL-positive strains. These results demonstrate that broilers in Slovakian food markets and farms could be the source of ESBL-producing E. coli, as well as virulent and resistant strains representing a potential risk for the human population.

scholarly journals Synergism of the Combination of Traditional Antibiotics and Novel Phenolic Compounds against Escherichia coli

Pathogens ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 811
Author(s):  
Md. Akil Hossain ◽  
Hae-Chul Park ◽  
Sung-Won Park ◽  
Seung-Chun Park ◽  
Min-Goo Seo ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Rattus Norvegicus ◽  
Inhibitory Concentration ◽  
Epicatechin Gallate ◽  
Antibiotic Resistant ◽  
E Coli ◽  
Pathogenic Escherichia Coli ◽  
Resistant Strains ◽  
Novel Approaches ◽  
Rapid Emergence

Pathogenic Escherichia coli (E. coli)-associated infections are becoming difficult to treat because of the rapid emergence of antibiotic-resistant strains. Novel approaches are required to prevent the progression of resistance and to extend the lifespan of existing antibiotics. This study was designed to improve the effectiveness of traditional antibiotics against E. coli using a combination of the gallic acid (GA), hamamelitannin, epicatechin gallate, epigallocatechin, and epicatechin. The fractional inhibitory concentration index (FICI) of each of the phenolic compound-antibiotic combinations against E. coli was ascertained. Considering the clinical significance and FICI, two combinations (hamamelitannin-erythromycin and GA-ampicillin) were evaluated for their impact on certain virulence factors of E. coli. Finally, the effects of hamamelitannin and GA on Rattus norvegicus (IEC-6) cell viability were investigated. The FICIs of the antibacterial combinations against E. coli were 0.281–1.008. The GA-ampicillin and hamamelitannin-erythromycin combinations more effectively prohibited the growth, biofilm viability, and swim and swarm motilities of E. coli than individual antibiotics. The concentration of hamamelitannin and GA required to reduce viability by 50% (IC50) in IEC-6 cells was 988.54 μM and 564.55 μM, correspondingly. GA-ampicillin and hamamelitannin-erythromycin may be potent combinations and promising candidates for eradicating pathogenic E. coli in humans and animals.

scholarly journals Virulence and antibiotic resistance profile of avian Escherichia coli strains isolated from colibacillosis lesions in central of Algeria

2019 ◽  
Vol 12 (11) ◽  
pp. 1840-1848 ◽  
Author(s):  
Nacima Meguenni ◽  
Nathalie Chanteloup ◽  
Angelina Tourtereau ◽  
Chafika Ali Ahmed ◽  
Saliha Bounar-Kechih ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Virulence Factors ◽  
Virulence Genes ◽  
Iron Acquisition ◽  
Virulence Gene ◽  
Resistance Profile ◽  
E Coli ◽  
Antibiotic Resistance Profile ◽  
Embryo Lethality

Background and Aim: Avian pathogenic Escherichia coli cause extensive mortality in poultry flocks, leading to extensive economic losses. To date, in Algeria, little information has been available on virulence potential and antibiotics resistance of avian E. coli isolates. Therefore, the aim of this study was the characterization of virulence genes and antibiotic resistance profile of Algerian E. coli strains isolated from diseased broilers. Materials and Methods: In this study, 43 avian E. coli strains isolated from chicken colibacillosis lesions at different years were analyzed to determine their contents in 10 virulence factors by polymerase chain reaction, antimicrobial susceptibility to 22 antibiotics belonging to six different chemical classes and genomic diversity by pulsed-field gel electrophoresis (PFGE). Results: Mainly E. coli isolates (58.1%) carried two at six virulence genes and the most frequent virulence gene association detected were ompT (protectin), hlyF (hemolysin) with 55.8% (p<0.001), and iroN, sitA (iron acquisition/uptake systems), and iss (protectin) with 41.8% (p<0.001). Some strains were diagnosed as virulent according to their virulence gene profile. Indeed, 23.25% of the isolates harbored iroN, ompT, hlyF, iss, and sitA combination, 14% ompT, hlyF, and frzorf4 (sugar metabolism), and 11,6% iroN, hlyF, ompT, iss, iutA (iron acquisition/uptake systems), and frzorf4. The chicken embryo lethality assay performed on five isolates confirmed the potential virulence of these strains. All isolates submitted to PFGE analysis yielded different genetic profiles, which revealed their diversity. Overall, 97.2% of the isolates were resistant to at least one antibiotic and 53.5% demonstrated multi-antimicrobial resistance to three different antimicrobial classes. The highest resistance levels were against nalidixic acid (83.4%), amoxicillin and ampicillin (83.3%), ticarcillin (80.5%), pipemidic acid (75%), and triméthoprim-sulfamethoxazole (66.6%). For beta-lactam class, the main phenotype observed belonged to broad-spectrum beta-lactamases. However, extended-spectrum beta-lactamase associated with three at six virulence factors was also detected in 13 isolates. Two of them were attested virulent as demonstrated in the embryo lethality test which constitutes a real public threat. Conclusion: It would be imperative in avian production to discourage misuse while maintaining constant vigilance guidelines and regulations, to limit and rationalize antimicrobial use.

scholarly journals Characterization of auto-agglutinating and non-typeable uropathogenic Escherichia coli strains

2019 ◽  
Vol 13 (06) ◽  
pp. 465-472
Author(s):  
Ulises Hernández-Chiñas ◽  
Alejandro Pérez-Ramos ◽  
Laura Belmont-Monroy ◽  
María E Chávez-Berrocal ◽  
Edgar González-Villalobos ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Virulence Genes ◽  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Uropathogenic Escherichia Coli ◽  
E Coli ◽  
Resistant Strains ◽  
Tract Infections ◽  
Disk Method

Introduction: Uropathogenic Escherichia coli (UPEC) are the main etiological agent of urinary tract infections (UTIs). Association between different serotypes and UTIs is known, however, some strains are incapable to be serotyped. The aim of this work was to study bthe phenotypical and genotypical characteristics of 113 non-typeable (NT) and auto-agglutinating (AA) E. coli strains, isolated from UTIs in children and adults. Methodology: The 113 UPEC strains were analyzed by PCR assays using specific primers to determine their serogroups, fimH, papC, iutA, sat, hlyCA and cnf1, virulence associated genes, and chuA, yjaA and TSPE4.C2 for phylogroup determination. Additionally, the diffusion disk method was performed to evaluate the antimicrobial resistance to 18 antimicrobial agents. Results: Using the PCR assay, 63% (71) of the strains were genotyped showing O25 and O75 as the most common serogroups. The virulence genes fimH (86%) and iutA (74%) were the most prevalent, in relation to the phylogroups the commensal (A and B1) and virulent (B2 and D) showed similar frequencies (P > 0.05). The antimicrobial susceptibility test showed a high percentage (73%) of multidrug-resistant strains. Conclusions: The genotyping allowed identifying the serogroup in many of the strains that could not be typed by traditional serology. The strains carried virulence genes and were multidrug-resistant in both, commensal and virulent phylogroups. Our findings revealed that, in addition to the classical UPEC serogroups, there are pathogenic serogroups not reported yet.

scholarly journals Serogroups and virulence genes of Escherichia coli isolated from psittacine birds

2011 ◽  
Vol 31 (10) ◽  
pp. 916-921 ◽  
Author(s):  
Terezinha Knöbl ◽  
André B.S Saidenberg ◽  
Andrea M Moreno ◽  
Tânia A.T Gomes ◽  
Mônica A.M Vieira ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Virulence Factors ◽  
Virulence Genes ◽  
Serum Resistance ◽  
Temperature Sensitive ◽  
E Coli ◽  
Cytotoxic Necrotizing Factor ◽  
Heat Stable ◽  
Genes Encoding ◽  
Cytotoxic Necrotizing Factor 1

Escherichia coli isolates from 24 sick psittacine birds were serogrouped and investigated for the presence of genes encoding the following virulence factors: attaching and effacing (eae), enteropathogenic E. coli EAF plasmid (EAF), pili associated with pyelonephritis (pap), S fimbriae (sfa), afimbrial adhesin (afa), capsule K1 (neu), curli (crl, csgA), temperature-sensitive hemagglutinin (tsh), enteroaggregative heat-stable enterotoxin-1 (astA), heat-stable enterotoxin -1 heat labile (LT) and heat stable (STa and STb) enterotoxins, Shiga-like toxins (stx1 and stx2), cytotoxic necrotizing factor 1 (cnf1), haemolysin (hly), aerobactin production (iuc) and serum resistance (iss). The results showed that the isolates belonged to 12 serogroups: O7; O15; O21; O23; O54; O64; O76; O84; O88; O128; O152 and O166. The virulence genes found were: crl in all isolates, pap in 10 isolates, iss in seven isolates, csgA in five isolates, iuc and tsh in three isolates and eae in two isolates. The combination of virulence genes revealed 11 different genotypic patterns. All strains were negative for genes encoding for EAF, EAEC, K1, sfa, afa, hly, cnf, LT, STa, STb, stx1 and stx2. Our findings showed that some E. coli isolated from psittacine birds present the same virulence factors as avian pathogenic E. coli (APEC), uropathogenic E. coli (UPEC) and Enteropathogenic E. coli (EPEC) pathotypes.

scholarly journals Virulence genes and phylogenetic groups of uropathogenic Escherichia coli isolates from patients with urinary tract infection and uninfected control subjects: a case-control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Seyedeh Elham Rezatofighi ◽  
Mahsa Mirzarazi ◽  
Mansour Salehi
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Virulence Factors ◽  
Virulence Genes ◽  
Strong Association ◽  
Phylogenetic Groups ◽  
E Coli ◽  
Healthy Humans

Abstract Background Urinary Tract Infection (UTI) is one of the most common bacterial infectious diseases which causes considerable morbidity and costly health problems. Uropathogenic Escherichia coli (UPEC), the most common pathogen causing UTI, is a highly heterogeneous group of extraintestinal pathogenic E. coli (ExPEC) which may carry a variety of virulence factors and belonging to different phylogenetic backgrounds. The current study aimed to investigate the frequency and association between various virulence factors (VFs) and phylogenetic groups of UPEC and commensal isolates. Methods UPEC and commensal E. coli strains isolated from UTI and feces of healthy humans were compared for the presence of VFs and phylogenetic groups. Association between virulence genes was investigated and cluster analysis was employed. Results According to the results, among a 30 virulence markers tested, the pathogenicity-associated island (PAI), papAH, papEF, fimH, fyuA, and traT genes prevalence were statistically significant in UPEC isolates. A strong association was found between the B2 and D phylogenetic groups and clinical isolates of UPEC; while, commensal isolates were mostly associated with phylogenetic group A. The aggregated VFs scores were more than twice higher in the UPEC isolates in comparison with the commensal isolates. Interestingly, the B2 group in both UPEC and commensal isolates had the highest VF scores. A strong positive association was found between several virulence genes. The clustering results demonstrated that UPEC or commensal E. coli isolates were highly heterogeneous due to different composition of their virulence gene pool and pathogenicity islands. Conclusion Genetic structure and VFs of UPEC strains vary from region to region; therefore, to control the UTI, the epidemiological aspects and characterization of the UPEC isolates need to be investigated in different regions. Since UPEC isolates are generally originate from the commensal strains, it may be feasible to reduce the UTI burden by interfering the intestinal colonization, particularly in the highly pathogenic clonal lineages such as B2.

scholarly journals Carbapenem Resistance Profiles of Pathogenic Escherichia coli in Uganda

2021 ◽  
Vol 2 (2) ◽  
pp. 63-73
Author(s):  
Kenneth Ssekatawa ◽  
Denis K. Byarugaba ◽  
Jesca L. Nakavuma ◽  
Charles D. Kato ◽  
Francis Ejobi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Virulence Factors ◽  
Virulence Genes ◽  
Carbapenem Resistance ◽  
Phylogenetic Group ◽  
Clinical Isolates ◽  
Phylogenetic Groups ◽  
Phenotypic Resistance ◽  
E Coli ◽  
Tract Infections

Escherichia coli has been implicated as one of the main etiological agents of diarrhea, urinary tract infections, meningitis and septicemia worldwide. The ability to cause diseases is potentiated by presence of virulence factors. The virulence factors influence the capacity of E. coli to infect and colonize different body systems. Thus, pathogenic E. coli are grouped into DEC strains that are mainly clustered in phylogenetic group B1 and A; ExPEC belonging to A, B2 and D. Coexistence of virulence and beta-lactamase encoding genes complicates treatment outcomes. Therefore, this study aimed at presenting the carbapenem resistance (CR) profiles among pathogenic E. coli. This was a retrospective cross-sectional study involving use of 421 archived E. coli clinical isolates collected in 2019 from four Uganda tertiary hospitals. The isolates were subjected to antibiotics sensitivity assays to determine phenotypic resistance. Four sets of multiplex PCR were performed to detect CR genes, DEC pathotypes virulence genes, ExPEC PAI and the E. coli phylogenetic groups. Antibiotic susceptibility revealed that all the 421 E. coli isolates used were MDR as they exhibited 100% resistance to more than one of the first-line antibiotics. The study registered phenotypic and genotypic CR prevalence of 22.8% and 33.0% respectively. The most predominant gene was blaOXA-48 with genotypic frequency of 33.0%, then blaVIM (21.0%), blaIMP (16.5%), blaKPC (14.8%) and blaNDM (14.8%). Spearman’s correlation revealed that presence of CR genes was highly associated with phenotypic resistance. Furthermore, of 421 MDR E. coli isolates, 19.7% harboured DEC virulence genes, where EPEC recorded significantly higher prevalence (10.8%) followed by S-ETEC (3.1%), STEC (2.9%), EIEC (2.0%) and L-ETEC (2.0%). Genetic analysis characterized 46.1% of the isolates as ExPEC and only PAI IV536 (33.0%) and PAI IICFT073 (13.1%) were detected. Phylogenetic group B2 was predominantly detected (41.1%), followed by A (30.2%), B1(21.6%), and D (7.1%). Furthermore, 38.6% and 23.1% of the DEC and ExPEC respectively expressed phenotypic resistance. Our results exhibited significant level of CR carriage among the MDR DEC and ExPEC clinical isolates belonging to phylogenetic groups B1 and B2 respectively. Virulence and CR genetic factors are mainly located on mobile elements. Thus, constitutes a great threat to the healthcare system as this promotes horizontal gene transfer.

scholarly journals Virulence Genes in Expanded-Spectrum-Cephalosporin-Resistant and -Susceptible Escherichia coli Isolates from Treated and Untreated Chickens

2015 ◽  
Vol 60 (3) ◽  
pp. 1874-1877 ◽  
Author(s):  
S. Baron ◽  
S. Delannoy ◽  
S. Bougeard ◽  
E. Larvor ◽  
E. Jouy ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Virulence Factors ◽  
Shiga Toxin ◽  
Virulence Genes ◽  
Phylogenetic Groups ◽  
Content Type ◽  
E Coli ◽  
Heat Stable ◽  
Intestinal Infections

This study investigated antimicrobial resistance, screened for the presence of virulence genes involved in intestinal infections, and determined phylogenetic groups ofEscherichia coliisolates from untreated poultry and poultry treated with ceftiofur, an expanded-spectrum cephalosporin. Results show that none of the 76 isolates appeared to be Shiga toxin-producingE. colior enteropathogenicE. coli. All isolates were negative for the major virulence factors/toxins tested (ehxA,cdt, heat-stable enterotoxin [ST], and heat-labile enterotoxin [LT]). The few virulence genes harbored in isolates generally did not correlate with isolate antimicrobial resistance or treatment status. However, some of the virulence genes were significantly associated with certain phylogenetic groups.

scholarly journals Profiles of virulence genes in enterotoxigenic Escherichia coli isolates from suckling piglets in Serbia

2020 ◽  
Vol 76 (01) ◽  
pp. 6326-2020
Author(s):  
JADRANKA ŽUTIĆ ◽  
OLIVERA VALČIĆ ◽  
VESNA MILIĆEVIĆ ◽  
LJUBIŠA VELJOVIĆ ◽  
JASNA KURELJUŠIĆ ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Virulence Factors ◽  
Virulence Genes ◽  
Enterotoxigenic Escherichia Coli ◽  
Gene Encoding ◽  
E Coli ◽  
Genes Encoding ◽  
Virulence Pattern ◽  
Suckling Piglets ◽  
Asta Gene

A total of 120 Escherichia coli (E. coli) strains from suckling piglets with diarrhoea and 30 E. coli strains from healthy piglets were tested for the presence of fimbrial and enterotoxin virulence genes. Out of the 120 isolates sampled from diarrheic piglets, 81 (67.5%) expressed one or more genes encoding virulence factors. Adhesin genes were detected in 52 (43.33%) out of 120 E. coli isolates, and the most common among them was F4 adhesin (33.33%). Genes encoding E. coli toxins were detected in 81 (67.5%) isolates. E. coli included in the study carried genes for one or more of the following toxins: STa, STb, LT and EAST1. The astA gene encoding EAST1 was the most prevalent and was identified in 72 (60%) E. coli isolates. EAST1 toxin was detected in 5 out of 30 isolates (16.7%) from healthy piglets. Among the 81 isolates expressing virulence genes, a total of 15 different combinations for fimbrial and toxin genes were found. The most common virulence pattern was F4/STb/LT/EAST1 detected in 23.45% of E. coli strains isolated from suckling piglets with diarrhoea. The results indicate that F4 adhesin and EAST1 toxin are the most common in E. coli isolates sampled from diarrhoeic suckling piglets in Serbia.

scholarly journals Broad-Spectrum Cephalosporin-Resistant and/or Fluoroquinolone-Resistant Enterobacterales Associated with Canine and Feline Urogenital Infections

Antibiotics ◽  
2020 ◽  
Vol 9 (7) ◽  
pp. 387 ◽  
Author(s):  
Igor Loncaric ◽  
Dusan Misic ◽  
Michael P. Szostak ◽  
Frank Künzel ◽  
Sabine Schäfer-Somi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Virulence Factors ◽  
Broad Spectrum ◽  
Virulence Genes ◽  
Enterobacter Cloacae ◽  
Phylogenetic Group ◽  
E Coli ◽  
Urogenital Infections ◽  
Carbapenem Resistant

The aim of the present study was to characterize Enterobacterales resistant to 3rd and 4th generation cephalosporins, carbapenems and/or fluoroquinolones, isolated from dogs and cats with urogenital infections. In total, 36 strains (Escherichia coli (n = 28), Klebsiella pneumoniae (n = 3), Serratia marcescens, Raoultella ornithinolytica, Proteus mirabilis, Citrobacter portucalensis and Enterobacter cloacae (each n = 1)) were included in the present study, 28 from Austria and 8 from Serbia. Isolates were characterized by a polyphasic approach including susceptibility pheno- and genotyping and microarray-based assays. Escherichia (E.) coli isolates were additionally characterized by two-locus (fumC and fimH) sequence phylotyping and multi-locus sequence typing (MLST) of selected isolates. MLST of carbapenem-resistant Enterobacter cloacae isolates was also performed. Among E. coli, the most dominant phylogenetic group was B1 (27.8%), followed by C, (16.6%), A and Clade II (5.5% each), B2 and F (2.77% each). The most predominant β-lactam resistance genes were blaTEM (70%) and blaCTX-M (38.8%), blaCMY (25%). blaNDM was detected in one carbapenem-resistant Enterobacter cloacae ST114. The most common ST among selected E. coli was 744 (10.7% isolates). The pandemic clones ST131 and ST648 carrying CTX-M-15 were also detected. Remaining STs belonged to 469, 1287, 1463 and 1642. E. coli clonotyping revealed 20 CH types. Based on the presence of certain virulence genes, three isolates were categorized as ExPEC/UPEC. The most prevalent virulence factors were fimH detected in 61%, iucD and iss both in 55%, iroN in 27.8%, papC in 13.8% and sat in 8.3% isolates.

scholarly journals The Resistome, Mobilome, Virulome and Phylogenomics of Multidrug-Resistant Escherichia coli Clinical Isolates from Pretoria, South Africa

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Nontombi Marylucy Mbelle ◽  
Charles Feldman ◽  
John Osei Sekyere ◽  
Nontuthuko Excellent Maningi ◽  
Lesedi Modipane ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
South Africa ◽  
Virulence Genes ◽  
Clinical Epidemiology ◽  
Multidrug Resistant ◽  
Antibiotic Resistant ◽  
E Coli ◽  
Class 1 ◽  
Animal Strains ◽  
Plasmid Replicons

Abstract Antibiotic-resistant Escherichia coli is a common occurrence in food, clinical, community and environmental settings worldwide. The resistome, mobilome, virulome and phylogenomics of 20 multidrug resistant (MDR) clinical E. coli isolates collected in 2013 from Pretoria, South Africa, were characterised. The isolates were all extended-spectrum β-lactamase producers, harbouring CTX-M (n = 16; 80%), TEM-1B (n = 10; 50%) and OXA (n = 12, 60%) β-lactamases alongside genes mediating resistance to fluoroquinolones, aminoglycosides, tetracyclines etc. Most resistance determinants were found on contigs containing IncF plasmid replicons and bracketed by composite transposons (Tn3), diverse ISs and class 1 integrons (In13, In54, In369, and In467). Gene cassettes such as blaOXA,dfrA5-psp-aadA2-cmlA1a-aadA1-qac and estX3-psp-aadA2-cmlA1a-aadA1a-qac were encompassed by Tn3 and ISs; several isolates had same or highly similar genomic antibiotic resistance islands. ST131 (n = 10), ST617 (n = 2) and singletons of ST10, ST73, ST95, ST410, ST648, ST665, ST744 and ST998 clones were phylogenetically related to clinical (human and animal) strains from Egypt, Kenya, Niger, Nigeria, Tanzania, and UK. A rich repertoire of virulence genes, including iss, gad and iha were identified. MDR E. coli harbouring chromosomal and plasmid-borne resistance genes in same and multiple clones exist in South Africa, which is very worrying for clinical epidemiology and infectious diseases management.

Sign in / Sign up

Export Citation Format

Share Document