Antimicrobial resistance in diarrheagenic Escherichia coli from ready-to-eat foods

Occurrence and genomic characterization of antimicrobial-resistant and potential pathogenic Escherichia coli from Italian artisanal food productions of animal origin

Escherichia coli can harbor a broad repertoire of virulence and antimicrobial resistance (AMR) genes, which can be exchanged across the human gastrointestinal microflora, thus posing a public health risk. In this study, 6 batches of artisanal soft cheese and a 6-month ripened fermented dried sausage were investigated to assess the occurrence, phylogeny, and genomic traits (AMR, virulence, and mobilome) of E. coli. 30 and 3 strains isolated from salami and cheese food chains, respectively, were confirmed as E. coli by whole genome sequencing. The accumulation of single nucleotide polymorphism differences within small clusters of strains encompassing batches or processing stages, combined with high serotype and phylogroup diversity, suggested the occurrence of different contamination phenomena among the facilities. A total of 8 isolates harbored plasmid-mediated resistance genes, including one cheese strain that carried an IncQ1 plasmid carrying AMR determinants to macrolides [mph(B)], sulfonamides (sul1, sul2), trimethoprim (dfrA1), and aminoglycosides [aph(3")-Ib and aph(6)-Id]. A pool of virulence-associated genes in the class of adhesion, colonization, iron uptake, and toxins, putative ColV-positive iron uptake systems sit, iro, or iuc (8 salami and 2 cheese), plasmid-encoded hemolysin operon hlyABCD (one salami), and potential atypical enteropathogenic E. coli (3 salami environment) were reported. Overall, our findings underscore the importance of routine surveillance of E. coli in the artisanal food chain to prevent the dissemination of AMR and virulence.

Assessing the Microbial Quality of Shrimp (Xiphonaeus kroyeri) and Mussels (Perna perna) Illegally Sold in the Vitória Region, Brazil, and Investigating the Antimicrobial Resistance of Escherichia coli Isolates

The consumption of seafood is crucial for food security, but poor hygiene along the food production chain can result in low microbiological quality, posing significant risks for public health and seafood quality. Thus, this study aimed to assess the microbiological quality and antimicrobial sensitivity of E. coli from 69 samples of illegally marketed shrimp and mussels in the Vitória Region, Brazil. These foods exhibited poor microbiological quality due to high counts of mesophilic, psychrotrophic, and enterobacteria microorganisms. While this issue is widespread in this area, shrimp samples displayed higher microbial counts compared to mussels, and fresh mussels had elevated counts of enterobacteria compared to frozen ones. Among the 10 E. coli isolates, none carried the genes blaCTX-M-1, blaCTX-M-2, blaCTX-M-3, blaCTX-M-15, mcr-1, mcr-2, mcr-3, mcr-4, and tet, associated with antibiotic resistance. Phenotypical resistance to tetracycline and fosfomycin was not observed in any isolate, while only 20% demonstrated resistance to ciprofloxacin. Regarding ampicillin and amoxicillin with clavulanic acid, 60% of isolates were resistant, 10% showed intermediate susceptibility, and 30% were sensitive. One isolate was considered simultaneously resistant to β-lactams and quinolones, and none were conserved as ESBL producers. These findings highlight the inherent risks to local public health that arise from consuming improperly prepared seafood in this area.

Pentavalent outer membrane vesicles immunized mice sera confers passive protection against five prevalent pathotypes of diarrhoeagenic Escherichia coli in neonatal mice

Diarrhoeagenic Escherichia coli (DEC) pathotypes are one of the major causative agents of diarrhoea induced childhood morbidity and mortality in developing countries. Licensed vaccines providing broad spectrum protection against DEC mediated infections are not available. Outer membrane vesicles (OMVs) are microvesicles released by gram-negative bacteria during the growth phase and contain multiple immunogenic proteins. Based on prevalence of infections, we have formulated a pentavalent outer-membrane vesicles (POMVs) based immunogen targeting five main pathotypes of DEC responsible for diarrhoeal diseases. Following isolation, OMVs from five DEC pathotypes were mixed in equal proportions to formulate POMVs and 10 µg of the immunogen was intraperitoneally administered to adult BALB/c mice. Three doses of POMVs induced significant humoral immune response against whole cell lysates (WCLs), outer membrane proteins (OMPs) and lipopolysaccharides (LPS) isolated from DEC pathotypes along with significant induction of cellular immune response in adult mice. Passive transfer of POMVs immunized adult mice sera protected neonatal mice significantly against DEC infections. Overall, this study finds POMVs to be immunogenic in conferring broad-spectrum passive protection to neonatal mice against five main DEC pathotypes. Altogether, these findings suggest that POMVs can be used as a potent vaccine candidate to ameliorate the DEC-mediated health burden.

Microbiological quality and antimicrobial resistance of Bacteria species recovered from ready-to-eat food, water samples, and palm swabs of food vendors in Accra, Ghana

This study sought to investigate microbial quality and antimicrobial resistance of bacteria species from Ready-to-Eat (RTE) food, water, and vendor palm swab samples. Between 2019 and 2020, RTE food, water and vendor palm swab samples were collected from food vending sites in Accra, Ghana. Samples were cultured and confirmed using the Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF). Antimicrobial susceptibility testing (AST) was conducted using disk diffusion method. Beta-lactamase and Diarrheagenic Escherichia coli (DEC) genes were determined using Polymerase Chain Reaction (PCR). Total plate count (TPC) and Total coliform count (TCC) were performed on food and water samples. In total, 179 RTE food, 72 water and 10 vendor palm swab samples were collected. Enterobacter spp. (16.8 %), Citrobacter spp. (10.1 %), Enterococcus faecalis (7.8 %), Pseudomonas spp. (6.7 %) and Klebsiella pneumoniae (4.0 %) occurred in food. Isolates from water and palm were Klebsiella pneumoniae (20.8 %), Aeromonas spp. (16.7 %) and Enterobacter cloacae (11.1 %). Resistance to Amoxicillin-clavulanate, Tetracycline, Azithromycin, Sulfamethoxazole-trimethoprim, and Nitrofurantoin were common among Enterobacterales. High mean TPC and TCC showed in some RTE food and different water types used in vending depicting their unsafe condition for consumption and usage. The bla_SHV and bla_TEM genes were present in some Enterobacterales from food and water. The lt gene was identified in two food samples. AMR organisms associated with nosocomial infections in the samples investigated, calls for continuous surveillance in the food industry in Ghana. Also, the unsafe outcome of RTE food and water depicts the need for the enforcement of Ghana's food safety laws.

Isolation, identification, and antibiogram studies of Escherichia coli from ready-to-eat foods in Mymensingh, Bangladesh

Background and Aim

Ready-to-eat (RTE) foods are widely used at home, restaurants, and during festivals in Bangladesh. So it is very important to investigate possible microbial contamination in RTE foods. Therefore, this study aimed to determine the total coliform count (TCC), isolate, identify, and characterize the Escherichia coli in RTE foods. The antimicrobial sensitivity of E. coli obtained from RTE foods was also performed using 12 commonly used antibiotics.

Materials and Methods

A total of 100 RTE food samples were collected aseptically and comprised of ten samples each: Burger, pizza, sandwich, chicken roll, chicken meat loaf, chicken fry, salad vegetable, ice-cream, yogurt, and milkshake sold in Mymensingh City. Samples were inoculated onto Eosin methylene blue agar and incubated at 37°C for 24 h. Isolation and identification of bacteria were performed based on cultural, staining, and biochemical properties, followed by a polymerase chain reaction.

Results

The TCC in Chicken meat loaf, burger, pizza, sandwich, salad vegetable ice-cream, and yogurt samples were 3.57 ± 0.96, 3.69 ± 0.08, 3.50 ± 0.60, 2.60 ± 0.20, 4.09 ± 0.29, 4.44 ± 0.25, and 3.14 ± 0.30 mean log colony-forming units ± standard deviation/mL, respectively. The study found a higher prevalence of E. coli in RTE salad vegetable products than in RTE meat and milk products. Forty percent of the mixed vegetable salad samples showed positive results for E. coli. Whereas E. coli prevalence in RTE meat and milk products was 20% and 16.7%, respectively. All the 21 isolates were subjected to antibiotic susceptibility test against 12 different antibiotics. It was observed that 46.1% were susceptible, 16.6% were intermediate, 46.1% were resistant, and 47.6% were multidrug-resistant (MDR) among seven different antibiotic classes. E. coli isolates were resistant to cephalexin, ceftazidime, oxytetracycline, and ampicillin and sensitive to gentamycin, followed by kanamycin, ceftriaxone, colistin, and enrofloxacin.

Conclusion

The study revealed that RTE foods are a serious issue from a public health point of view. To achieve a safer level of E. coli in RTE foods sold for human consumption, public food outlets must improve hygienic and good production procedures. Moreover, MDR E. coli in these foods pose serious public health threats.

Processed ready-to-eat (RTE) foods sold in Yenagoa Nigeria were colonized by diarrheagenic Escherichia coli which constitute a probable hazard to human health

The study aimed to recover diarrheagenic Escherichia coli strains from processed ready-to-eat (RTE) foods in Yenagoa, Nigeria and characterize them using culture-based and molecular methods. Three hundred RTE food samples were collected randomly from different food outlets between February 2021 and August 2021 and assessed for the occurrence of E. coli using standard bacteriological procedures. The virulence factor formation and antibiotic susceptibility profile of the isolates was carried out using standard microbiological procedures. Polymerase chain reaction (PCR) was used to confirm the identity of the isolates via specific primers and further used to assay the diarrheagenic determinants of the E. coli isolates. The prevalence of E. coli positive samples based on the proliferation of E. coli on Chromocult coliform agar forming purple to violet colonies was 80(26.7%). The population density of E. coli from the RTE foods ranged from 0–4.3 × 10⁴ ± 1.47 CFU/g. The recovered E. coli isolates (n = 62) were resistant to antibiotics in different proportions such as ampicillin 62(100%), aztreonam 47(75.81%) and chloramphenicol 43(69.35%). All the recovered E. coli isolates were resistant to ≥ 2 antibiotics. The multiple antibiotic-resistant index (MARI) ranged from 0.13–0.94 with 47(75.8%) of isolates having MARI >2. A total of 48(77.4%) of the isolates were multidrug-resistant (MDR). The proportion of extracellular virulence factor formation is as follows: protease 12(19.35%), curli 39(62.9%), cellulose 21(33.89%), ornithine decarboxylase 19(30.65%) and aesculin hydrolysis 14(22.58%). The overall proportion of diarrheagenic E. coli was 33/62(53.2%). The distributions of typical diarrheagenic E. coli includes: tETEC 9(14.5%), tEPEC 13(20.9%), tEAEC 6(9.7%), tEIEC 2(3.2%) and tEHEC 3(4.8%). The proportions of atypical strains include aETEC 10(16.1%), aEAEC 5(8.1%), aEPEC 1(1.6%) and aEIEC 3(4.8%). This study demonstrated that some RTE foods sold in Yenagoa, Nigeria, are contaminated and constitute a probable human health hazard. Thus, there is a need for intensive surveillance of this isolate in RTE foods variety to spot evolving AMR phenotypes and avert food-borne infections.

Characterization of diarrheagenic Escherichia coli with special reference to antimicrobial resistance isolated from hospitalised diarrheal patients in Kolkata (2012-2019), India

AIMS

This study analyzes the prevalence and antimicrobial resistance (AMR) of major diarrheagenic Escherichia coli (DEC) pathotypes detected in hospitalized diarrheal patients in Kolkata, India, during 2012-2019.

METHODS AND RESULTS

A total of 8,891 stool samples were collected from the Infectious Diseases Hospital, Kolkata and screened for the presence of enteric pathogens. Multiplex-PCR identified the presence of DEC in 7.8% of the samples, in which ETEC was most common (47.7%) followed by EAEC (38.4%) and EPEC (13.9%). About 54% cases were due to sole DEC infections. Majority of the mixed DEC infections was caused by the Vibrio spp. (19.1%) followed by Rotavirus (14.1%) and Campylobacter spp. (8.4%). ETEC and EAEC were associated significantly with diarrhea in children <5 years of age, whereas EPEC and also ETEC were prevalent in patients aged between 5 and 14 years. AMR profile showed high prevalence of multidrug resistance (MDR) among DEC (56.9%) in which 9% were resistant to antibiotics of six different antimicrobial classes. Screening of the AMR conferring genes of DEC showed the presence of bla_CTX-M3 (30.2%) in highest number followed by bla_TEM (27.5%), tetB (18%), sul2 (12.6%), strA (11.8%), aadA1 (9.8%), bla_OXA-1 (9%), dfrA1 (1.6%) and bla_SHV (1.2%).

CONCLUSIONS

These findings highlighted the high prevalence of MDR in major DEC pathotypes that could be considered as the leading etiologic bacterial agent responsible for diarrhea and suggests a significant public health threat.

SIGNIFICANCE AND IMPACT OF THE STUDY

The results of this study can help to improve the understanding of the epidemiology of DEC infections in patients with diarrhea. Monitoring of AMR surveillance needs special attention because the DEC isolates were highly resistant to commonly used antimicrobials in the treatment of diarrhea.

Characterization of Escherichia coli from Water and Food Sold on the Streets of Maputo: Molecular Typing, Virulence Genes, and Antibiotic Resistance

The aim of this study was to investigate the pathogenic potential and antibiotic resistance of 59 Escherichia coli isolates from ready-to-eat (RTE) street food (n = 31) and drinking water (n = 28) sold in the city of Maputo, Mozambique. The isolates were characterized by XbaI subtyping analysis via pulsed field gel electrophoresis. Multiplex PCRs were performed targeting five virulence genes (stx, lt, st, astA, and eae) and three groups of antibiotic-resistant genes, namely ß-lactamases (extended-spectrum ß-lactamase and AmpC), tetracycline (tetA, tetB, and tetM) and sulfamethoxazole/trimethoprim (sul1, sul2, and sul3). The stx virulence gene, encoding the Shiga/Vero (VT) toxin produced by the verotoxin-producing E. coli (VTEC), was identified with similar frequency in isolates from food (5/31) and water (6/28). The highest percentages of resistant isolates from food and water were found for ß-lactams imipenem (35.5 and 39.3%, respectively) and ampicillin (39.3 and 46.4%, respectively). Multidrug resistance was observed in 31.3% of the isolates, being higher in E. coli isolates from water (45.5%) compared to RTE street food isolates (19.2%). Virulence genes were detected in 73% of the multidrug-resistant isolates. Concerning antibiotic-resistant genes, ESBL was the most frequent (57.7%) among β-lactamases while tetA was the most frequent (50%) among non-β-lactamases.

High prevalence of multidrug-resistant Escherichia coli and first detection of IncHI2/IncX4-plasmid carrying mcr-1 E. coli in retail ready-to-eat foods in China

Antibiotic-resistant bacteria in food pose an important threat to public health. Multidrug-resistant strains in ready-to-eat (RTE) foods can be transferred to humans through diet, which increases their health risk. This study systematically investigated antibiotic resistance and antibiotic resistance genes in E. coli isolated from retail RTE foods and characterized plasmid-mediated colistin-resistant E. coli strains. A total of 1118 RTE food samples were collected from markets in 39 cities in China, and 126 E. coli strains, >95% of which were multidrug-resistant, were isolated. The isolates showed a high prevalence of resistance to tetracycline (95.24%), ampicillin (82.54%), trimethoprim-sulfamethoxazole (77.78%), nalidixic acid (74.60%), cephalothin (72.22%), chloramphenicol (66.67%), and streptomycin (53.97%). Twenty-two extended-spectrum β-lactamase (ESBL)-producing E. coli and four colistin-resistant E. coli were identified. The resistance genes TEM, CTX-M, tetA, sul2, strA/strB, aadA, and qnrS were the most frequently detected. CTX-M-55 and CTX-M-14 were the predominant CTX-M types. All the four colistin-resistant E. coli isolates were positive for mcr-1. The mcr-1 gene can be transferred to E. coli C600 through conjugation and transformation. Whole-genome sequencing revealed that the mcr-1 genes were found in IncX4 and IncHI2 plasmids. To the best of our knowledge, this is the first report of IncHI2/IncX4 plasmid-bearing mcr-1-positive E. coli strains in RTE foods sold in markets, and the first report of the isolation of the international epidemic E. coli clone ST101 and mcr-1-carrying ESBL-producing E. coli from RTE foods. These results provide valuable information for assessing antibiotic-resistant E. coli infections and controlling antibiotic-resistant E. coli.

Rapid detection of extended spectrum β-lactamase producing Escherichia coli isolated from fresh pork meat and pig cecum samples using multiplex recombinase polymerase amplification and lateral flow strip analysis

The emergence and dissemination of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli is a global health issue. Food-producing animals, including pigs, are significant reservoirs of antimicrobial resistance (AMR), which can be transmitted to humans. Thus, the rapid detection of ESBLs is required for efficient epidemiological control and treatment. In this study, multiplex recombinase polymerase amplification (RPA) combined with a single-stranded tag hybridization chromatographic printed-array strip (STH-PAS), as a lateral flow strip assay (LFA), was established for the rapid and simultaneous detection of multiple bla genes in a single reaction. Visible blue lines, indicating the presence of the bla_CTX-M, bla_SHV, and bla_OXA genes, were observed within 10 min by the naked eye. The limit of detection of all three genes was 2.5 ng/25 μL, and no cross-reactivity with seven commensal aerobic bacteria was observed. A total of 93.9% (92/98) and 96% (48/50) of the E. coli isolates from pork meat and fecal samples, respectively, expressed an ESBL-producing phenotype. Nucleotide sequencing of the PCR amplicons showed that bla_CTX-M was the most prevalent type (91.3–95.83%), of which the main form was bla_CTX-M-55. The sensitivity and specificity of the RPA-LFA were 99.2% and 100%, respectively, and were in almost perfect agreement (κ = 0.949–1.000) with the results from PCR sequencing. Thus, the RPA-LFA is a promising tool for rapid and equipment-free ESBL detection and may facilitate clinical diagnosis in human and veterinary medicine, as well as AMR monitoring and surveillance.

Bacterial contaminants and their antibiotic susceptibility patterns in ready-to-eat foods vended in Ogun state, Nigeria

Contamination of ready-to-eat (RTE) foods by pathogenic bacteria may predispose consumers to foodborne diseases. This study investigated the presence of bacterial contaminants and their antibiotic susceptibility patterns in three locally processed RTE foods (eko, fufu and zobo) vended in urban markets in Ogun state, Nigeria. Bacteria isolated from a total of 120 RTE food samples were identified by 16S rRNA gene phylogeny while susceptibility patterns to eight classes of antibiotics were determined by the disc diffusion method. Species belonging to the genera Acinetobacter and Enterobacter were recovered from all RTE food types investigated, Klebsiella and Staphylococcus were recovered from eko and fufu samples, while those of Shigella were recovered from eko samples. Enterobacter hormaechei was the most prevalent species in all three RTE food types. Precisely 99% of 149 isolates were multidrug-resistant, suggesting a high risk for RTE food handlers and consumers. Co-resistance to ampicillin and cephalothin was the most frequently observed resistance phenotype. Results demonstrate that improved hygiene practices by food processors and vendors are urgently required during RTE processing and retail. Also, adequate food safety guidelines, regulation and enforcement by relevant government agencies are needed to improve the safety of RTE foods and ensure the protection of consumer health.

Prevalence of Antibiotic Resistome in Ready-to-Eat Salad

Ready-to-eat salad harbors microorganisms that may carry various antibiotic resistance genes (ARGs). However, few studies have focused on the prevalence of ARGs on salad, thus underestimating the risk of ARGs transferring from salad to consumers. In this small-scale study, high-throughput quantitative PCR was used to explore the presence, prevalence and abundance of ARGs associated with serving salad sourced from two restaurant types, fast-food chain and independent casual dining. A total of 156 unique ARGs and nine mobile genetic elements (MGEs) were detected on the salad items assessed. The abundance of ARGs and MGEs were significantly higher in independent casual dining than fast-food chain restaurants. Absolute copies of ARGs in salad were 1.34 × 10⁷ to 2.71 × 10⁸ and 1.90 × 10⁸ to 4.87 × 10⁸ copies per g salad in fast-food and casual dining restaurants, respectively. Proteobacteria, Bacteroidetes, Actinobacteria, and Firmicutes were the dominant bacterial phyla detected from salad samples. Pseudomonas, Acinetobacter, Exiguobacterium, Weissella, Enterobacter, Leuconostoc, Pantoea, Serratia, Erwinia, and Ewingella were the 10 most dominant bacterial genera found in salad samples. A significant positive correlation between ARGs and MGEs was detected. These results integrate knowledge about the ARGs in ready-to-eat salad and highlight the potential impact of ARGs transfer to consumers.

Unraveling the Role of Vegetables in Spreading Antimicrobial-Resistant Bacteria: A Need for Quantitative Risk Assessment

In recent years, vegetables gain consumer attraction due to their reputation of being healthy in combination with low energy density. However, since fresh produce is often eaten raw, it may also be a source for foodborne illness. The presence of antibiotic-resistant bacteria might pose a particular risk to the consumer. Therefore, this review aims to present the current state of knowledge concerning the exposure of humans to antibiotic-resistant bacteria via food of plant origin for quantitative risk assessment purposes. The review provides a critical overview of available information on hazard identification and characterization, exposure assessment, and risk prevention with special respect to potential sources of contamination and infection chains. Several comprehensive studies are accessible regarding major antimicrobial-resistant foodborne pathogens (e.g., Salmonella spp., Listeria spp., Bacillus cereus, Campylobacter spp., Escherichia coli) and other bacteria (e.g., further Enterobacteriaceae, Pseudomonas spp., Gram-positive cocci). These studies revealed vegetables to be a potential—although rare—vector for extended-spectrum beta-lactamase-producing Enterobacteriaceae, mcr1-positive E. coli, colistin- and carbapenem-resistant Pseudomonas aeruginosa, linezolid-resistant enterococci and staphylococci, and vancomycin-resistant enterococci. Even if this provides first clues for assessing the risk related to vegetable-borne antimicrobial-resistant bacteria, the literature research reveals important knowledge gaps affecting almost every part of risk assessment and management. Especially, the need for (comparable) quantitative data as well as data on possible contamination sources other than irrigation water, organic fertilizer, and soil becomes obvious. Most crucially, dose–response studies would be needed to convert a theoretical “risk” (e.g., related to antimicrobial-resistant commensals and opportunistic pathogens) into a quantitative risk estimate.

Tracing back multidrug-resistant bacteria in fresh herb production: from chive to source through the irrigation water chain

Environmental antibiotic-resistant bacteria (ARB) can be transferred to humans through foods. Fresh produce in particular is an ideal vector due to frequent raw consumption. A major contamination source of fresh produce is irrigation water. We hypothesized that water quality significantly affects loads of ARB and their diversity on fresh produce despite various other contamination sources present under agricultural practice conditions. Chive irrigated from an open-top reservoir or sterile-filtered water (control) was examined. Heterotrophic plate counts (HPC) and ARB were determined for water and chive with emphasis on Escherichia coli and Enterococcus spp. High HPC of freshly planted chive decreased over time and were significantly lower on control- vs. reservoir-irrigated chive at harvest (1.3 log (CFU/g) lower). Ciprofloxacin- and ceftazidime-resistant bacteria were significantly lower on control-irrigated chive at harvest and end of shelf life (up to 1.8 log (CFU/g) lower). Escherichia coli and Enterococcus spp. repeatedly isolated from water and chive proved resistant to up to six or four antibiotic classes (80% or 49% multidrug-resistant, respectively). Microbial source tracking identified E. coli-ST1056 along the irrigation chain and on chive. Whole-genome sequencing revealed that E. coli-ST1056 from both environments were clonal and carried the same transmissible multidrug-resistance plasmid, proving water as source of chive contamination. These findings emphasize the urgent need for guidelines concerning ARB in irrigation water and development of affordable water disinfection technologies to diminish ARB on irrigated produce.