scholarly journals Phenotypic and Genotypic Study of Antibiotics Resistance Profile in Escherichia coli Isolated from Broilers in Cianjur, Indonesia

2021 ◽  
Vol 9 (2) ◽  
pp. 97-104
Author(s):  
Aprilia Hardiati ◽  
Safika ◽  
I Wayan Teguh Wibawan ◽  
Fachriyan Hasmi Pasaribu
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Resistant Isolate ◽  
Diffusion Method ◽  
Future Research ◽  
Antibiotics Resistance ◽  
Isolation And Identification ◽  
Resistance Profile ◽  
E Coli ◽  
Encoding Gene

This study aimed to investigate the phenotypic and genotypic of antibiotics resistance profile in Escherichia coli. The 30 samples come from cloacal swab of broilers in Cianjur, Indonesia. Isolation and identification of E. coli was performed by culture in McConkey agar, eosin methylene blue agar, Gram staining and five essential biochemical tests (IMViC). In this study, 10 isolates (33.3%) were confirmed E. coli positive. Phenotypic profile was performed by screening all isolates with 8 antibiotics of 6 antibiotic groups. The screening was carried by Kirby-Bauer disk diffusion method based on the standard of CLSI. For genotypic profile, each resistant isolate was detected antibiotic resistance-encoding gene. The result showed all isolates (100%) resistant against tetracyclin, oxytetracycline and erythromycin. Nine isolates (90%) detected nalidixic acid and enrofloxacin-resistant. The ciprofloxacin and gentamicin-resistant isolates were 70% and 40%, respectively. There was no resistant isolate for chloramphenicol. Multi drug-resistant was detected on 90% isolates. Only gyrA (100%) and tetA (80%) genes were detected. This study showed high rate of occurrence of antibiotic resistance in E. coli. Not all resistant isolates were detected in the antibiotic resistance-encoding gene in this study. Future research to detect resistance genes should use more varied target genes.

scholarly journals Prevalence and antibiotic resistance profile of Shiga toxin-producing Escherichia coli isolated from diarrheal samples

2020 ◽  
Author(s):  
Farzad Esavand Heydari ◽  
Mojtaba Bonyadian ◽  
Hamdallah Moshtaghi ◽  
Masoud Sami
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Shiga Toxin ◽  
Virulence Genes ◽  
Enterohemorrhagic Escherichia Coli ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Resistance Profile ◽  
E Coli ◽  
Antibiotic Resistance Profile

Background and Objectives: Enterohemorrhagic Escherichia coli (EHEC) causes bloody and non-bloody diarrhea, intestinal infection and extraintestinal complications in humans. This study aimed to isolate and evaluate the prevalence of E. coli O157: H7 and other Shiga toxin-producing E. coli (STEC) and identify the virulence genes (stx1, stx2, hly and eaeA) from patients with diarrhea. Also, the antibiotic resistance profile of the isolated strains was evaluated. Materials and Methods: A total of 100 stool samples were collected from patients with acute diarrhea referring to the hospital and clinics in Isfahan County, Iran. Phenotypic tests and PCR assay were used for detection of E. coli O157: H7 and other Shiga toxin-producing E. coli. The presence of virulence genes (stx1, stx2, hly and eaeA) were identified by PCR. The antibiotic resistance profile of the isolates was determined using the agar disk diffusion method. The results were analyzed descriptively by Sigma stat version 4 software. Results: Seventy - eight out of 100 samples (78%) were contaminated with E. coli. E. coli O157 was isolated from five samples (6.4%), of which only two strains (2.56%) were identified as E. coli O157: H7. According to the results, out of two E. coli O157: H7 isolates, one (50%) isolate contained eaeA and two isolates (100%) contained Stx1, Stx2, hlyA genes. Out of three (3.84%) E. coli O157: HN, one of the isolate (33.3%) contained stx1 and, two isolates (66.7%) were positive for hlyA genes. Also, the results revealed that six strains (7.69%) were non-O157: H7 STEC, of which two isolates (33.3%) contained stx1 and four isolates (66.7%) were positive for stx2 and hlyA genes. The results of antibiogram tests revealed that all of the STEC isolates (100%) were sensitive to imipenem followed by kanamycin, gentamicin and nitrofurantoin (91%). High resistance (54.5%) to ampicillin and ciprofloxacin was observed among the STEC isolates. Conclusion: The results of the current study showed that although the prevalence of E. coli O157: H7 was low among patients with diarrhea, the other STEC strains with relative resistance to antibiotics are more prevalent.

scholarly journals Antibiotic Resistance Profile of Escherichia coli Isolated from Bovine Subclinical Mastitis of Dairy Farms in Algeria from 2017 to 2019

2021 ◽  
Vol 11 (3) ◽  
pp. 402-415
Author(s):  
Loubna Ghallache ◽  
Abdellah Mohamed-Cherif ◽  
Bernard China ◽  
Faiza Mebkhout ◽  
Nesrine Boilattabi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Dairy Farms ◽  
Subclinical Mastitis ◽  
Diffusion Method ◽  
Human Populations ◽  
Resistance Profile ◽  
E Coli ◽  
Milk Samples ◽  
Antibiotic Resistance Profile

Mastitis in cows is a major problem in dairy farms leading to a decrease in the quantity and quality of milk. The aim of the present study was to examine the association between the presence of Escherichia coli (E. coli) in milk and the subclinical mastitis, and to characterize the antibiotic resistance profiles of the isolated E. coli. In the current study, a total of 360 cow raw milk samples from three dairy farms of the region of Algiers were analyzed. The analysis period lasted from Spring 2017 to Winter 2019. The California Mastitis Test (CMT) was applied to detect subclinical mastitis. The E. coli strains were isolated from milk using conventional bacteriological methods. The antibiotic resistance profile of the isolated E. coli strains to 12 different antibiotics was tested using the disk diffusion method. On β-lactamase-producing strains, a double diffusion test was applied to identify the Extended-spectrum β-lactamase (ESBL) phenotype. Finally, the ctXx-M genes were amplified by PCR. Two-thirds (66.4%) of the milk samples were positive for the CMT test. A total of 97 E. coli strains were isolated from the milk samples, their resistance to antibiotics was tested, and 3.1% of the strains were resistant to trimethoprim-sulfamethoxazole, 6.2% to chloramphenicol, 12.3% to gentamicin, 13.4% to colistin, 23.3% to amoxicillin/clavulanate, 31.9% to kanamycin, 39.2% to enrofloxacin, 51.5% to cefotaxime, 52% to tetracycline, 57.7% to ampicillin, 74.3% to nalidixic acid, and 75.3% to amoxicillin. Furthermore, most of the E. coli strains (92.8%) were resistant to more than one antibiotic with a Multiple Antibiotic Resistance index ranging from 0 to 0.8. The 50 strains resistant to cefotaxime were analyzed for an ESBL phenotype. 39 of them (78%) were positive to the double-disk synergy test. Among the 39 ESBL positive strains, 27 (69.2%) were confirmed for the presence of a CTX-M gene by PCR. The present study showed that multiple drug-resistant E. coli, including ESBL-carriers, were frequently isolated from the milk of dairy cows in Algeria. The results underlined that the use of antibiotics on farms must be reasoned to avoid the spread of resistant strains in animals and human populations.

scholarly journals Antibiotic resistance and prevalence of class 1 and 2 integrons in Escherichia coli isolated from hospital wastewater

2018 ◽  
Vol 37 (3) ◽  
pp. 209 ◽  
Author(s):  
Reza Ranjbar ◽  
Maryam Zeynali ◽  
Nooshin Sohrabi ◽  
Asghar Ali Kamboh
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Hospital Wastewater ◽  
Isolation And Identification ◽  
Antibiotic Resistant ◽  
E Coli ◽  
Class 1 ◽  
Hospital Wastewaters

BACKGROUND <br />Hospital wastewaters may contain antibiotic resistant bacteria such as Escherichia coli. These E. coli harbor integron genes that are responsible for antibiotic resistance. The purpose of the current study was to evaluate the frequency of class 1 and 2 integrons in environmental antibiotic resistant E. coli strains isolated from the hospital wastewaters in Tehran, Iran.<br /><br />METHODS<br />As a descriptive cross-sectional study, this research was performed from April to September 2015 on hospital wastewaters in Tehran. Bacterial isolation and identification was performed by standard biochemical and bacteriological procedures. Susceptibility testing was done by employing the disk diffusion method using different antibiotics. Total DNAs were extracted to evaluate the presence of class 1 and 2 integrons by using the polymerase chain reaction (PCR) method with specific primers. <br /><br />RESULTS<br />Fifty E. coli strains were isolated and identified from the wastewaters of 25 hospitals in Tehran. The phenotype results showed that 46 isolates (92%) were resistant to at least one antibiotic and 27 isolates (54%) were multidrug resistant. PCR showed that 35 (70%) and 20 (40%) of the isolates had class 1 and 2 integrons respectively and 14 isolates (28%) had both class 1 and class 2 integrons.<br /><br />CONCLUSION<br />This study has shown a considerable presence of class 1 and class 2 integrons in E. coli strains isolated from hospital wastewaters in Tehran. Proper antibiotics prescription and appropriate hospital wastewater treatment can prevent resistance genes in E. coli from circulating in the environment.

scholarly journals EVALUATION OF THE IMPACT OF PLASMID CURING ON ANTIBIOTIC RESISTANCE ON SOME CLINICAL ISOLATES OF ESCHERICHIA COLI

2020 ◽  
Vol 4 (3) ◽  
pp. 323-327
Author(s):  
Mamunu Abdulkadir SULAIMAN ◽  
H.S Muhammad ◽  
Aliyu Muhammad Sani ◽  
Aminu Ibrahim ◽  
Ibrahim Muhammad Hussain ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Plasmid Curing ◽  
Sensitivity Testing ◽  
E Coli ◽  
Risk Of Death ◽  
Mar Index ◽  
The Impact

Multidrug resistance (MDR) exhibited by some strains of Escherichia coli may be due to acquiring mobile genetic element (R-plasmid) by the bacteria, or intrinsically induced by inappropriate use of antibiotics by the hosts.  Infection by such strains may result to prolonged illness and greater risk of death. The study evaluated the impact of curing on antibiotic resistance on selected clinical isolates of E. coli. Twenty clinical isolates of E. coli from our previous studies were re-characterized using conventional microbiological techniques. Antibiotic sensitivity testing was determined by disk diffusion method, MDR selected based on resistance to ≥ 2 classes of antibiotics. Multiple antibiotic resistance (MAR) index was determined as ratio of the number of antibiotic resisted to the total number of antibiotics tested and considered significant if ≥. 0.2. The isolates that showed significant MAR index were subjected to plasmid curing using acridine orange, thereafter, profiled for plasmid and the cured ones were re-tested against the antibiotics they initially resisted. Out of the 20 isolates, 19 (95%) were confirmed as E. coli, all (100%) of which were MDRs, which was highest against augmentin (78.9%) followed by amoxacillin (52.6%). However, after the plasmid curing only 6 (31.6%) out of the 19 isolates cured retained significant MAR index and the level of the significance had reduced drastically in 16 (84.2%) isolates. Conclusively, curing assay can completely eliminate R-plasmid acquired resistance. More studied on plasmid curing agents for possible augmentation of the agents into antibiotics may see the rise of successful antibiotic era again.

scholarly journals Antimicrobial Resistance Profile of Escherichia coli Isolates from Different Clinical Samples in Abeokuta, Ogun State

2020 ◽  
pp. 12-18
Author(s):  
S. L. Owolabi ◽  
I. A. Azeez
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Multiple Drug Resistance ◽  
Resistance Rate ◽  
Clinical Samples ◽  
Isolation And Identification ◽  
Resistance Profile ◽  
E Coli ◽  
Ogun State ◽  
Antimicrobial Resistance Profile

The alarming increase of antibiotic resistance of Escherichia coli has posed a great challenge in the public health sector. Thus, this microorganism is a leading cause of different human infections and it can be found in various environments. The aim of this study is to investigate the antimicrobial susceptibility patterns and the multiple antimicrobial resistance profile of Escherichia coli isolates obtained from some hospitals in Abeokuta, Ogun State, Nigeria. Isolates of E. coli were obtained from different clinical samples and were re-identified morphologically and biochemically. E. coli was isolated from 30% out of a total of 70 clinical samples analyzed for isolation and identification. The isolation rate of E. coli was highest in urine samples 10(47.6%) when compared to other clinical samples. There was significant increase in the resistance rate of E. coli to tetracycline (14.3%), ceftazidime (14.2%), and ampicillin (14.2%).Also, an increased sensitivity rate to augmentin (71.4%), ofloxacin (66.7%), cefuroxime (66.7%), ciprofloxacin (61.9%) and ceftazidime (61.9%) were observed. Furthermore, the overall multiple drug resistance rates obtained was 14(66.7%) and it was established that, multiple antimicrobial resistance of the E. coli isolates was plasmid mediated. E. coli isolates exhibited high resistance rate to multiple antimicrobial agents, however, its sensitivity to augmentin, ofloxacin, cefuroxime, ciprofloxacin and ceftazidime showed that these antimicrobials are still effective against E. coli infections in the study area.

scholarly journals Prevalence and molecular detection of fluoroquinolone-resistant genes (qnrA and qnrS) in Escherichia coli isolated from healthy broiler chickens

2018 ◽  
pp. 1720-1724 ◽  
Author(s):  
Shahin Mahmud ◽  
K. H. M. Nazmul Hussain Nazir ◽  
Md. Tanvir Rahman
Keyword(s):  
Escherichia Coli ◽  
Broiler Chickens ◽  
Molecular Detection ◽  
16S Rrna Genes ◽  
Rrna Genes ◽  
Diffusion Method ◽  
Isolation And Identification ◽  
E Coli ◽  
Pcr Targeting ◽  
Apparently Healthy

Aim: The present study was carried out to determine the prevalence and molecular detection of fluoroquinolone-resistant Escherichia coli carrying qnrA and qnrS genes in healthy broiler chickens in Mymensingh, Bangladesh, and also to identify the genes responsible for such resistance. Materials and Methods: A total of 65 cloacal swabs were collected from apparently healthy chickens of 0-14 days (n=23) and 15-35 days (n=42) old. The samples were cultured onto Eosin Methylene Blue Agar, and the isolation and identification of the E. coli were performed based on morphology, cultural, staining, and biochemical properties followed by polymerase chain reaction (PCR) targeting E. coli 16S rRNA genes. The isolates were subjected to antimicrobial susceptibility test against five commonly used antibiotics under fluoroquinolone (quinolone) group, namely gatifloxacin, levofloxacin, moxifloxacin, ofloxacin, and pefloxacin by disk diffusion method. Detection of qnrA and qnrS genes was performed by PCR. Results: Among the 65 cloacal samples, 54 (83.08%) were found to be positive for E. coli. Antibiotic sensitivity test revealed that, of these 54 isolates, 18 (33.33%) were found to be resistant to at least one fluoroquinolone antibiotic. The highest resistance was observed against pefloxacin (61.11%). By PCR, of 18 E. coli resistant to fluoroquinolone, 13 (72.22%) were found to be positive for the presence of qnrS. None of the isolates were found positive for qnrA. Conclusion: Fluoroquinolone-resistant E. coli harboring qnrS genes is highly prevalent in apparently healthy broiler chickens and possesses a potential threat to human health.

scholarly journals A Preliminary Study: Antibiotic Resistance Patterns of Escherichia coli and Enterococcus Species from Wildlife Species Subjected to Supplementary Feeding on Various South African Farms

Animals ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 396 ◽  
Author(s):  
Michaela Sannettha van den Honert ◽  
Pieter Andries Gouws ◽  
Louwrens Christiaan Hoffman
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Supplementary Feeding ◽  
Health Concern ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
E Coli ◽  
Wildlife Species ◽  
Human Contact ◽  
Resistance Patterns

Studies have shown that antibiotic resistance among wild animals is becoming a public health concern, owing to increased contact and co-habitation with domestic animals that, in turn, results in increased human contact, indirectly and directly. This type of farming practice intensifies the likelihood of antibiotic resistant traits in microorganisms transferring between ecosystems which are linked via various transfer vectors, such as rivers and birds. This study aimed to determine whether the practice of wildlife supplementary feeding could have an influence on the antibiotic resistance of the bacteria harboured by the supplementary fed wildlife, and thus play a potential role in the dissemination of antibiotic resistance throughout nature. Escherichia coli and Enterococcus were isolated from the faeces of various wildlife species from seven different farms across South Africa. The Kirby-Bauer disk diffusion method was used according to the Clinical and Laboratory Standards Institute 2018 guidelines. The E. coli (F: 57%; N = 75% susceptible) and Enterococcus (F: 67%; N = 78% susceptible) isolates from the supplementary fed (F) wildlife were in general, found to be more frequently resistant to the selection of antibiotics than from those which were not supplementary fed (N), particularly towards tetracycline (E. coli F: 56%; N: 71%/Enterococcus F: 53%; N: 89% susceptible), ampicillin (F: 82%; N = 95% susceptible) and sulphafurazole (F: 68%; N = 98% susceptible). Interestingly, high resistance towards streptomycin was observed in the bacteria from both the supplementary fed (7% susceptible) and non-supplementary fed (6% susceptible) wildlife isolates. No resistance was found towards chloramphenicol and ceftazidime.

scholarly journals Antimicrobial Resistance Pattern of Escherichia coli Isolated from Frozen Chicken Meat in Bangladesh

Pathogens ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 420 ◽  
Author(s):  
Mst. Sonia Parvin ◽  
Sudipta Talukder ◽  
Md. Yamin Ali ◽  
Emdadul Haque Chowdhury ◽  
Md. Tanvir Rahman ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Foodborne Pathogens ◽  
Biochemical Properties ◽  
Chicken Meat ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Isolation And Identification ◽  
E Coli ◽  
Encoding Genes

Escherichia coli is known as one of the most important foodborne pathogens in humans, and contaminated chicken meat is an important source of foodborne infection with this bacterium. The occurrence of extended-spectrum β-lactamase (ESBL)-producing E. coli (ESBL-Ec), in particular, in chicken meat is considered a global health problem. This study aimed to determine the magnitude of E. coli, with special emphasis on ESBL-Ec, along with their phenotypic antimicrobial resistance pattern in frozen chicken meat. The study also focused on the determination of ESBL-encoding genes in E. coli. A total of 113 frozen chicken meat samples were purchased from 40 outlets of nine branded supershops in five megacities in Bangladesh. Isolation and identification of E. coli were done based on cultural and biochemical properties, as well as PCR assay. The resistance pattern was determined by the disc diffusion method. ESBL-encoding genes were determined by multiplex PCR. The results showed that 76.1% of samples were positive for E. coli, of which 86% were ESBL producers. All the isolates were multidrug-resistant (MDR). Resistance to 9–11 and 12–13 antimicrobial classes was observed in 38.4% and 17.4% isolates, respectively, while only 11.6% were resistant to 3–5 classes. Possible extensive drug resistance (pXDR) was found in 2.3% of isolates. High single resistance was observed for oxytetracycline (93%) and amoxicillin (91.9%), followed by ampicillin (89.5%), trimethoprim–sulfamethoxazole, and pefloxacin (88.4%), and tetracycline (84.9%). Most importantly, 89.6% of isolates were resistant to carbapenems. All the isolates were positive for the blaTEM gene. However, the blaSHV and blaCTX-M-2 genes were identified in two ESBL-non producer isolates. None of the isolates carried the blaCTX-M-1 gene. This study provided evidence of the existence of MDR and pXDR ESBL-Ec in frozen chicken meat in Bangladesh, which may pose a risk to human health if the meat is not properly cooked or pickled raw only. This emphasizes the importance of the implementation of good slaughtering and processing practices by the processors.

scholarly journals Detection of biofilm among uropathogenic Escherichia coli and its correlation with antibiotic resistance pattern

2019 ◽  
Vol 11 (01) ◽  
pp. 017-022 ◽  
Author(s):  
Rashmi M. Karigoudar ◽  
Mahesh H. Karigoudar ◽  
Sanjay M. Wavare ◽  
Smita S. Mangalgi
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Biofilm Formation ◽  
Agar Plate ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Susceptibility Pattern ◽  
Sensitivity Testing ◽  
E Coli ◽  
Tract Infections

Abstract BACKGROUND: Escherichia coli accounts for 70%–95% of urinary tract infections (UTIs). UTI is a serious health problem with respect to antibiotic resistance and biofilms formation being the prime cause for the antibiotic resistance. Biofilm can restrict the diffusion of substances and binding of antimicrobials. In this context, the present study is aimed to perform in vitro detection of biofilm formation among E. coli strains isolated from urine and to correlate their susceptibility pattern with biofilm formation. MATERIALS AND METHODS: A total of 100 E. coli strains isolated from patients suffering from UTI were included in the study. The identification of E. coli was performed by colony morphology, Gram staining, and standard biochemical tests. The detection of biofilm was carried out by Congo Red Agar (CRA) method, tube method (TM), and tissue culture plate (TCP) method. Antimicrobial sensitivity testing was performed by Kirby–Bauer disc diffusion method on Muller–Hinton agar plate. RESULTS: Of the 100 E. coli strains, 49 (49%) and 51 (51%) were from catheterized and noncatheterized patients, respectively. Biofilm production was positive by CRA, TM, and TCP method were 49 (49%), 55 (55%), and 69 (69%), respectively. Biofilm producers showed maximum resistance to co-trimoxazole (73.9%), gentamicin (94.2%), and imipenem (11.6%) when compared to nonbiofilm producers. Significant association was seen between resistance to antibiotic and biofilm formation with a P = 0.01 (<0.05). CONCLUSION: A greater understanding of biofilm detection in E. coli will help in the development of newer and more effective treatment. The detection of biofilm formation and antibiotic susceptibility pattern helps in choosing the correct antibiotic therapy.

scholarly journals Virulence Characteristics and Antibiotic Resistance Profiles of Shiga Toxin-Producing Escherichia coli Isolates from Diverse Sources

Antibiotics ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 587
Author(s):  
Momna Rubab ◽  
Deog-Hwan Oh
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Shiga Toxin ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Diffusion Method ◽  
Shiga Toxins ◽  
E Coli ◽  
And Control ◽  
High Degree

Shiga toxin-producing Escherichia coli (STEC) is an enteric pathogen that causes several gastrointestinal ailments in humans across the world. STEC’s ability to cause ailment is attributed to the presence of a broad range of known and putative virulence factors (VFs) including those that encode Shiga toxins. A total of 51 E. coli strains belonging to serogroups O26, O45, O103, O104, O113, O121, O145, and O157 were tested for the presence of nine VFs via PCR and for their susceptibility to 17 frequently used antibiotics using the disc diffusion method. The isolates belonged to eight different serotypes, including eight O serogroups and 12 H types. The frequency of the presence of key VFs were stx1 (76.47%), stx2 (86.27%), eae (100%), ehxA (98.03%), nleA (100%), ureC (94.11%), iha (96.07%), subA (9.80%), and saa (94.11%) in the E. coli strains. All E. coli strains carried seven or more distinct VFs and, among these, four isolates harbored all tested VFs. In addition, all E. coli strains had a high degree of antibiotic resistance and were multidrug resistant (MDR). These results show a high incidence frequency of VFs and heterogeneity of VFs and MDR profiles of E. coli strains. Moreover, half of the E. coli isolates (74.5%) were resistant to > 9 classes of antibiotics (more than 50% of the tested antibiotics). Thus, our findings highlight the importance of appropriate epidemiological and microbiological surveillance and control measures to prevent STEC disease in humans worldwide.

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