Occurrence, Pathogenic Potential and Antimicrobial Resistance of Escherichia coli Isolated from Raw Milk Cheese Commercialized in Banat Region, Romania

Metagenomic analysis of the bacterial microbiome, resistome and virulome distinguishes Portuguese Serra da Estrela PDO cheeses from similar non-PDO cheeses: An exploratory approach

This study aimed to evaluate the microbiome, resistome and virulome of two types of Portuguese cheese using high throughput sequencing (HTS). Culture-dependent chromogenic methods were also used for certain groups/microorganisms. Eight samples of raw ewe's milk cheese were obtained from four producers: two producers with cheeses with a PDO (Protected Designation of Origin) label and the other two producers with cheeses without a PDO label. Agar-based culture methods were used to quantify total mesophiles, Enterobacteriaceae, Escherichia coli, Staphylococcus, Enterococcus and lactic acid bacteria. The presence of Listeria monocytogenes and Salmonella was also investigated. The selected isolates were identified by 16S rRNA gene sequencing and evaluated to determine antibiotic resistance and the presence of virulence genes. The eight cheese samples analyzed broadly complied with EC regulations in terms of the microbiological safety criteria. The HTS results demonstrated that Leuconostoc mesenteroides, Lactococcus lactis, Lactobacillus plantarum, Lacticaseibacillus rhamnosus, Enterococcus durans and Lactobacillus coryniformis were the most prevalent bacterial species in cheeses. The composition of the bacterial community varied, not only between PDO and non-PDO cheeses, but also between producers, particularly between the two non-PDO cheeses. Alpha-diversity analyses showed that PDO cheeses had greater bacterial diversity than non-PDO cheeses, demonstrating that the diversity of spontaneously fermented foods is significantly higher in cheeses produced without the addition of food preservatives and dairy ferments. Despite complying with microbiological regulations, both PDO and non-PDO cheeses harbored potential virulence genes as well as antibiotic resistance genes. However, PDO cheeses exhibited fewer of these virulence and antibiotic resistance genes compared to non-PDO cheeses. Therefore, the combination of conventional microbiological methods and the metagenomic approach could contribute to improving the attribution of the PDO label to this type of cheese.

Phenotypic and genotypic characterization of antimicrobial resistances reveals the effect of the production chain in reducing resistant lactic acid bacteria in an artisanal raw ewe milk PDO cheese

Antimicrobial resistance (AMR) is a significant public health threat, with the food production chain, and, specifically, fermented products, as a potential vehicle for dissemination. However, information about dairy products, especially raw ewe milk cheeses, is limited. The present study analysed, for the first time, the occurrence of AMRs related to lactic acid bacteria (LAB) along a raw ewe milk cheese production chain for the most common antimicrobial agents used on farms (dihydrostreptomycin, benzylpenicillin, amoxicillin and polymyxin B). More than 200 LAB isolates were obtained and identified by Sanger sequencing (V1-V3 16S rRNA regions); these isolates included 8 LAB genera and 21 species. Significant differences in LAB composition were observed throughout the production chain (P ≤ 0.001), with Enterococcus (e.g., E. hirae and E. faecalis) and Bacillus (e.g., B. thuringiensis and B. cereus) predominating in ovine faeces and raw ewe milk, respectively, along with Lactococcus (L. lactis) in whey and fresh cheeses, while Lactobacillus and Lacticaseibacillus species (e.g., Lactobacillus sp. and L. paracasei) prevailed in ripened cheeses. Phenotypically, by broth microdilution, Lactococcus, Enterococcus and Bacillus species presented the greatest resistance rates (on average, 78.2 %, 56.8 % and 53.4 %, respectively), specifically against polymyxin B, and were more susceptible to dihydrostreptomycin. Conversely, Lacticaseibacillus and Lactobacillus were more susceptible to all antimicrobials tested (31.4 % and 39.1 %, respectively). Thus, resistance patterns and multidrug resistance were reduced along the production chain (P ≤ 0.05). Genotypically, through HT-qPCR, 31 antimicrobial resistance genes (ARGs) and 6 mobile genetic elements (MGEs) were detected, predominating Str, StrB and aadA-01, related to aminoglycoside resistance, and the transposons tnpA-02 and tnpA-01. In general, a significant reduction in ARGs and MGEs abundances was also observed throughout the production chain (P ≤ 0.001). The current findings indicate that LAB dynamics throughout the raw ewe milk cheese production chain facilitated a reduction in AMRs, which has not been reported to date.

Utilization of Whey for Eco-Friendly Bio-Preservation of Mexican-Style Fresh Cheeses: Antimicrobial Activity of Lactobacillus casei 21/1 Cell-Free Supernatants (CFS)

Using whey, a by-product of the cheese-making process, is important for maximizing resource efficiency and promoting sustainable practices in the food industry. Reusing whey can help minimize environmental impact and produce bio-preservatives for foods with high bacterial loads, such as Mexican-style fresh cheeses. This research aims to evaluate the antimicrobial and physicochemical effect of CFS from Lactobacillus casei 21/1 produced in a conventional culture medium (MRS broth) and another medium using whey (WB medium) when applied in Mexican-style fresh cheese inoculated with several indicator bacteria (Escherichia coli, Salmonella enterica serovar Typhimurium, Staphylococcus aureus, and Listeria monocytogenes). The CFSs (MRS or WB) were characterized for organic acids concentration, pH, and titratable acidity. By surface spreading, CFSs were tested on indicator bacteria inoculated in fresh cheese. Microbial counts were performed on inoculated cheeses during and after seven days of storage at 4 ± 1.0 °C. Moreover, pH and color were determined in cheeses with CFS treatment. Lactic and acetic acid were identified as the primary antimicrobial metabolites produced by the Lb. casei 21/1 fermentation in the food application. A longer storage time (7 days) led to significant reductions (p < 0.05) in the microbial population of the indicator bacteria inoculated in the cheese when it was treated with the CFSs (MRS or WB). S. enterica serovar Typhimurium was the most sensitive bacteria, decreasing 1.60 ± 0.04 log10 CFU/g with MRS-CFS, whereas WB-CFS reduced the microbial population of L. monocytogenes to 1.67 log10 CFU/g. E. coli and S. aureus were the most resistant at the end of storage. The cheese's pH with CFSs (MRS or WB) showed a significant reduction (p < 0.05) after CFS treatment, while the application of WB-CFS did not show greater differences in color (ΔE) compared with MRS-CFS. This study highlights the potential of CFS from Lb. casei 21/1 in the WB medium as an ecological bio-preservative for Mexican-style fresh cheese, aligning with the objectives of sustainable food production and guaranteeing food safety.

Multiple Drug Resistant Streptococcus Strains-An Actual Problem in Pig Farms in Western Romania

Streptococci are a type of bacteria that can cause severe illnesses in humans and animals. Some typical species like S. suis, or atypical species like S. porcinus and, S. dysgalactiae subsp. dysgalactiae, can cause infections like septicemia, meningitis, endocarditis, arthritis, and septic shock. S. suis is considered a newly emerging zoonotic pathogen. Although human streptococcal infection outbreaks are rare, it is appropriate to review the main streptococcal species isolated in pig farms in western Romania, due to the high degree of antibiotic resistance among most isolates commonly used in human treatment. This study examines the resistance patterns of these isolates over 5 years (2018-2023). The research investigated the antimicrobial susceptibility of 267 strains of Streptococcus spp. isolated from pigs, primarily from lung and brain tissues. This report is the first to describe the distribution of atypical Streptococcus species (SDSE, S. porcinus, S. hyovaginalis, S. pluranimalium, S. canis) in Romania, as well as the antibiotic resistance profile of these potentially zoonotic species. It is important to re-evaluate and consider the high rates of resistance of S. suis to tetracyclines, lincosamides, macrolides, and aminoglycosides, as well as the high recovery rates of S. suis from the lungs and brain when treating swine diseases.

Evaluation of Antimicrobial Resistance Profiles of Bacteria Isolated from Biofilm in Meat Processing Units

The aim of this study was to assess the hygiene of pork, beef, and poultry carcasses and to determine the phenotypic antibiotic susceptibility of the bacteria embedded in the biofilm formed on the carcasses kept in cooling chambers for at least three days. The level of hygiene was assessed by determining the total aerobic colony count (TACC) and the Enterobacteriaceae level in different sampling points of the carcasses, along with the detection of E. coli and Pseudomonas spp. embedded in the biofilm. Furthermore, the E. coli and Pseudomonas spp. isolates were tested for antimicrobial resistance profiles. A total of 130 samples collected from pork, beef, and poultry from processing units were analyzed to determine the total aerobic colony count as well as to measure the level of Enterobacteriaceae found on the carcasses. The antimicrobial susceptibility of 44 Escherichia coli and eight Pseudomonas spp. strains isolated from the carcasses were assessed using the Vitek 2 system using two different cards. Overall, the regulatory limits for the TACC were exceeded in 7.6% of the samples, and 65% of the samples exceeded the regulatory limits for Enterobacteriaceae levels. The antimicrobial susceptibility tests of the E. coli isolates analyzed with the AST-GN27 card revealed the highest resistance to be that towards ampicillin (76.1%), followed by cefazolin (71.4%), amoxicillin/clavulanic acid (61.9%), nitrofurantoin (52.3%), cefoxitin (47.6%), tetracycline (38.1%), piperacillin, norfloxacin (19%), trimethoprim-sulfamethoxazole (11.9%), cefotaxime (9.5%), ceftazidime, cefazolin, amikacin, gentamicin, and ciprofloxacin (4.7%). However, all of the isolates were sensitive to piperacillin-tazobactam and imipenem. Thirty-two (61.5%; 95% CI 47.9-73.5) out of fifty-two isolates exhibited multidrug resistance, resulting in the expression of 10 resistance profiles. The findings of this study highlight serious hygienic and sanitary deficiencies within the meat processing units and demonstrate that the resulting meat can harbor Multidrug-resistant Escherichia coli and Pseudomonas spp., both of which pose a serious public health risk. However, further research with a larger number of samples is required to reach thorough results.

Virulence factors and antimicrobial resistance of Escherichia coli isolated from commercialized fresh cheese in the south of Espírito Santo

Cheeses are dairy products that can potentially contain a diverse range of harmful bacteria that could be consumed by humans, including the enteric pathogen Escherichia coli. This study aimed to characterize the presence of total coliforms, assess the antimicrobial susceptibility profiles of the main commercial antimicrobial classes and biocides, and evaluate the ability of 50 E. coli isolates obtained from fresh cheese sold in the southern region of Espírito Santo, Brazil, to produce biofilms. The counts of total coliforms + E. coli obtained averages of (A) 7.22 × 106 CFU/g, (B) 9.35 × 107 CFU/g, and (C) 1.16 × 106 CFU/g for different brands. All isolates were capable of forming biofilms, with 8%, 76%, and 16% of these isolates presenting high, moderate, and low adherence in biofilm formation, respectively. Most strains showed inhibition halos for the biocides chlorhexidine digluconate 2% (16 mm ± 4.34), iodopovidone 10% (7.14 mm ± 0.36), and sodium hypochlorite 2% (7.12 mm ± 0.33). Out of the 50 strains, 21 (42%) were resistant to at least one of the antimicrobials. Regarding the multiple resistance index, 3 (6%) strains were resistant to 3 or more antimicrobial classes. Furthermore, 2 (4%) were extended-spectrum beta-lactamases producers. Resistance to ampicillin and amoxicillin was observed in 20% and 40% of the strains, respectively. In contrast, gentamicin was the most effective antimicrobial, with a sensitivity rate of 100%. The findings indicate that E. coli present in fresh cheese may possess unique physiological characteristics that could be associated with their persistence, virulence, and multidrug resistance. These results raise significant public health concerns since contaminated food can pose risks to consumers' health, emphasizing the importance of reinforcing hygienic-sanitary controls at all stages of production.

Colibacillosis in lambs and kids in Egypt: Prevalence, serogroups, antibiogram profile, virulence genes distribution and antimicrobial resistance genes

Background

Small ruminants have a socioeconomic impact on Egypt's production of meat, milk, and wool. Hence, every effort should be taken to prevent infections.

Aim

To elucidate the prevalence and serogrouping of Escherichia coli (E. coli) strains from diarrheic lambs and kids, determine their antibiotic susceptibility and associated risk factors affecting the occurrence of the disease, and establish the most common virulence genes marker and major antimicrobial resistance genes.

Methods

A total of 150 diarrheic animals (95 lambs and 55 kids) at different ages and seasons were subjected to clinical examination. Rectal swabs were collected from 150 diarrheic animals for isolation and biochemical identification of E. coli.

Results

The bacteriological examination revealed that 62/95 lambs and 26/55 kids with percentages of 65% and 47%, respectively, showed infection with E. coli. Serotyping of 88 isolates of E. coli revealed the strains belonging to O2(8), O55(17), O84(5), O17(4), O6(8), O91(17), O26(9), O103(5), O126(5), O124(6), and O159(4). A total of 21 isolates were examined by multiplex polymerase chain reaction assay for detection of virulence and resistance genes. All examined isolates possessed a combination between intimin gene and heat-stable toxin (100%), the serine protease (pic) gene on 8/21 isolates of O55, O2, O6 (38%), and α-hemolysin gene on 8/21 isolates of O26, O91(38%) while adherent invasive gene (invA) gene on 3/21 isolates of O124, O159 (14%) which divided diarrheagenic E. coli into four types assigned to be atypical enteropathogenic E. coli (48%), atypical enterohemorrhagic E. coli 35%), atypical enterotoxigenic E. coli (6%), and atypical enteroinvasive E. coli (11%). On the other hand, the results of antimicrobial susceptibility testing revealed high resistance to ampicillin, erythromycin, and tetracycline (100%) and amoxicillin/clavulanic acid (92%) but were highly sensitive to gentamicin, imipenem, norfloxacin, ciprofloxacin, chloramphenicol, and amikacin (100%). Concerning to ß lactams antibiotic resistance genes of examined isolates had blaSHV (100%) and blaCTX-M (43%). For tetracycline, we detected the tetA in all examined isolates.

Conclusion

The wide spread of atypical E. coli strains among diarrheic lambs and kids with marked resistance to several antibiotics of interest and the detection of major resistance genes assess the potential risk of this pathogen to animal and public health.

The emergence of multi-drug resistant and virulence gene carrying Escherichia coli strains in the dairy environment: a rising threat to the environment, animal, and public health

Escherichia coli is a common inhabitant of the intestinal microbiota and is responsible for udder infection in dairy cattle and gastro-urinary tract infections in humans. We isolated E. coli strains from a dairy farm environment in Xinjiang, China, and investigated their epidemiological characteristics, phenotypic and genotypic resistance to antimicrobials, virulence-associated genes, and phylogenetic relationship. A total of 209 samples were collected from different sources (feces, slurry, water, milk, soil) and cultured on differential and selective agar media (MAC and EMB). The presumptive identification was done by the VITEK2 system and confirmed by 16S rRNA gene amplification by PCR. Antimicrobial susceptibility testing was done by micro-dilution assay, and genomic characterization was done by simple and multiplex polymerase chain reaction (PCR). A total of 338 E. coli strains were identified from 141/209 (67.5%) of the samples. Most of the E. coli strains were resistant to sulfamethoxazole/trimethoprim (62.43%), followed by cefotaxime (44.08%), ampicillin (33.73%), ciprofloxacin (31.36%), tetracycline (28.99%), and a lesser extent to florfenicol (7.99%), gentamicin (4.44%), amikacin (1.77%), and fosfomycin (1.18%). All of the strains were susceptible to meropenem, tigecycline, and colistin sulfate. Among the resistant strains, 44.4% were identified as multi-drug resistant (MDR) showing resistance to at least one antibiotic from ≥3 classes of antibiotics. Eighteen out of 20 antibiotic-resistance genes (ARGs) were detected with sul2 (67.3%), blaTEM (56.3%), gyrA (73.6%), tet(B) (70.4%), aph(3)-I (85.7%), floR (44.4%), and fosA3 (100%, 1/1) being the predominant genes among different classes of antibiotics. Among the virulence-associated genes (VAGs), ompA was the most prevalent (86.69%) followed by ibeB (85.0%), traT (84.91%), ompT (73.96%), fyuA (23.1%), iroN (23.1%), and irp2 gene (21.9%). Most of the E. coli strains were classified under phylogenetic group B1 (75.45%), followed by A (18.34%), C (2.96%), D (1.18%), E (1.18%), and F (0.30%). The present study identified MDR E. coli strains carrying widely distributed ARGs and VAGs from the dairy environment. The findings suggested that the dairy farm environment may serve as a source of mastitis-causing pathogens in animals and horizontal transfer of antibiotic resistance and virulence genes carrying bacterial strains to humans via contaminated milk and meat, surface water and agricultural crops.

One Health Surveillance of Antimicrobial Use and Resistance: Challenges and Successes of Implementing Surveillance Programs in Sri Lanka

Background: Sri Lanka is a low-income country, as defined by the World Bank. The country suffered further economic downturn during the COVID-19 pandemic. This situation adversely affected the prioritization of policies and programs around healthcare and public health. In particular, inflation, fuel prices, and shortage of food supplies increased struggles to implement antimicrobial resistance (AMR) programs. However, in the long run, it is crucial to gather data and evidence to plan AMR policies and track interventions. (1) Aim: To establish and reiterate the importance of prioritizing AMR programs in the One Health framework, the Fleming Fellows collected and studied antimicrobial use/consumption (AMU/AMC) and resistance (AMR) in humans, food-producing animals, and the environment. (2) Methods: A systematic and cross-sectional study was conducted between 2019 and 2021. By way of coordinating an AMU/AMC and AMR prevalence study across six agencies from human health and food-producing animal sectors, the authors established a field epidemiology study, laboratory testing, and data processing at their institutions. AMU/AMC patterns were surveyed using questionnaires and interviews, while AMR samples were collected for antibiotic susceptibility tests and genomic tests. Samples were tested for phenotypic and genotypic resistance. (3) Results: In human samples, resistance was highest to beta-lactam antibiotics. In non-human samples, resistance was highest to erythromycin, a highest-priority, critically important antibiotic defined by the World Health Organization. From government records, tylosin was sold the most in the food-producing animal sector. (4) Conclusions: Sri Lanka AMU and AMR trends in human and non-human sectors can be ascertained by a One Health framework. Further coordinated, consistent, and sustainable planning is feasible, and can help implement an AMU/AMR surveillance system in Sri Lanka.

Occurrence of diarrheagenic Escherichia coli pathotypes from raw milk and unpasteurized buttermilk by culture and multiplex polymerase chain reaction in southwest Iran

BACKGROUND

In developing countries including Iran, there are limited data on diarrheagenic Escherichia coli (DEC) contamination in milk and unpasteurized buttermilks. This study aimed to determine the occurrence of DEC pathotypes by culture and multiplex polymerase chain reaction (M-PCR) in some dairy products from southwest Iran.

METHODS AND RESULTS

In this cross-sectional study (September to October 2021), 197 samples (87 unpasteurized buttermilk and 110 raw cow milk) were collected from dairy stores of Ahvaz, southwest Iran. The presumptive E. coli isolates were primarily identified using biochemical tests and then confirmed by PCR of uidA gene. The occurrence of 5 DEC pathotypes: enterotoxigenic E. coli (ETEC), enterohemorrhagic E. coli (EHEC), enteropathogenic E. coli (EPEC), enteroaggregative E. coli (EAEC), and enteroinvasive E. coli (EIEC) were investigated using M-PCR. Overall, 76 (76/197, 38.6%) presumptive E. coli isolates were identified by biochemical tests. Using uidA gene, only 50 isolates (50/76, 65.8%) were confirmed as E. coli. DEC pathotypes were detected in 27 of 50 (54.0%) E. coli isolates (74.1%, 20/27 from raw cow milk and 25.9%, 7/27 from unpasteurized buttermilk). The frequency of DEC pathotypes was as follows: 1 (3.7%) EAEC, 2 (7.4%) EHEC, 4 (14.8%) EPEC, 6 (22.2%) ETEC, and 14 (51.9%) EIEC. However, 23 (46.0%) E. coli isolates had only the uidA gene and were not considered DEC pathotypes.

CONCLUSION

Possible health risks for Iranian consumers can be attributed to the presence of DEC pathotypes in dairy products. Hence, serious control and prevention efforts are needed to stop the spread of these pathogens.

β-Lactamase Producing Escherichia coli Encoding blaCTX-M and blaCMY Genes in Chicken Carcasses from Egypt

Escherichia coli with multidrug resistance and β-lactamase genes may constitute a great public health hazard due to the potential for their transmission to humans through the food chain. This study determined the prevalence, antibiotic resistance profiles, phylogroups, and β-lactamase genes of E. coli isolates from chicken carcasses marketed in Mansoura, Egypt. Interestingly, E. coli was detected in 98% (98/100) of the chicken carcasses examined, which seemed among the highest contamination rates by E. coli worldwide. From the 425 genetically verified uidA gene-positive E. coli, 85 isolates were further studied for antimicrobial resistance profiles, phylogroups, and β-lactamase genes. Interestingly, 89.41% of E. coli (76/85) strains tested against 24 different antibiotics were multidrug-resistant. Of the examined 85 E. coli isolates, 22 (25.88%) isolates harbored bla_CTX-M and were resistant to ampicillin, cefazoline, and ceftriaxone, while three of them were resistant to ceftazidime besides. Nine (10.59%) E. coli strains harbored AmpC- β-lactamase bla_CMY and were resistant to ampicillin. One isolate co-carried bla_CMY and bla_CTX-M genes, though it was negative for the bla_TEM gene. Of the 35 isolates that harbored either extended-spectrum β-lactamase (ESBL) and/or AmpC β-lactamase genes, six strains (17.14%) were assigned to pathogenic phylogroup F and one to phylogroup E, whereas 28 (80%) isolates belonged to commensal phylogenetic groups.

Microbiological Biodiversity of Regional Cow, Goat and Ewe Milk Cheeses Produced in Poland and Antibiotic Resistance of Lactic Acid Bacteria Isolated from Them

(1) Unique sensory values of traditional and regional dairy products made them more and more popular among consumers. Lactic acid bacteria naturally occurring in these products can express antibiotic resistance and be a reservoir of antibiotic resistance genes (ARG) in the environment. The aim of the study was to characterize the microbial diversity of twenty regional cheeses produced from non-pasteurized cow, goat and ewe milk, and investigate the phenotypic and genotypic antibiotic resistance (AR) of lactic acid bacteria isolated from these products. (2) Conventional microbiological methods were applied for the enumeration of lactic acid bacteria (lactobacilli and lactococci) and their isolation, and for the enumeration of Enterococcus, Staphylococcus, Enterobacteriaceae and spores. The disc diffusion method was applied for phenotypic AR. The PCR-based methods were used for strain identification, microbiological diversity of cheeses (PCR-DGGE), and for AR gene detection. (3) Among 79 LAB isolates the most frequent species were L. plantarum (n = 18), Leuc. lactis (n = 17), Lc. lactis (n = 11), Leuc. mesenteroides (n = 9) and L. pentosus (n = 8). Additionally, by using the PCR-DGGE method, DNA of L. casei was found in nine products. Lactobacilli (5.63-8.46 log cfu/g) and lactococci (6.15-8.41 log cfu/g) predominated over Enterococcus (max. 4.89 log cfu/g), Staphylococcus (max. 4.18 log cfu/g), and Enterobacteriaceae (mostly up to 4.88 log cfu/g). Analysis of phenotypic resistance to tetracycline (30 µg), erythromycin (15 µg), and chloramphenicol (30 µg) showed that 29% of LAB isolates were resistant to one antibiotic, 8%-to two, and 12%-to all tested antibiotics. Antibiotic resistance genes (AGR) for tetracycline (tet(M), tet(L), tet(W)), erythromycin (erm(B)) and chloramphenicol (cat-TC) were detected in 30 (38%), 29 (36.7%) and 33 (43.4%) LAB isolates, respectively. Among 31 LAB isolates phenotypically susceptible to all tested antibiotics, only 5 (16%) had no ARGs. (4) The results obtained in our work shed light on the potential threat posed by the widespread presence of ARGs in LAB present in regional cheeses.

Distribution and Genomic Characterization of Third-Generation Cephalosporin-Resistant Escherichia coli Isolated from A Single Family and Home Environment: A 2-Year Longitudinal Study

Third-generation cephalosporin-resistant Escherichia coli (CREC), particularly strains producing extended-spectrum β-lactamases (ESBLs), are a global concern. Our study aims to longitudinally assemble the genomic characteristics of CREC isolates from fecal samples from an index patient with recurrent CREC-related urinary tract infections and his family and swabs from his home environment 12 times between 2019 and 2021 to investigate the distribution of antibiotic resistance genes. CREC identified using the VITEK 2 were subjected to nanopore whole-genome sequencing (WGS). The WGS of 27 CREC isolates discovered in 137 specimens (1 urine, 123 feces, and 13 environmental) revealed the predominance of ST101 and ST131. Among these sequence types, bla_CTX-M (44.4%, n = 12) was the predominant ESBL gene family, with bla_CTX-M-14 (n = 6) being the most common. The remaining 15 (55.6%) isolates harbored bla_CMY-2 genes and were clonally diverse. All E. coli isolated from the index patient’s initial urine and fecal samples belonged to O25b:H4-B2-ST131 and carried bla_CTX-M-14. The results of sequence analysis indicate plasmid-mediated household transmission of bla_CMY-2 or bla_CTX-M-55. A strong genomic similarity was discovered between fecal ESBL-producing E. coli and uropathogenic strains. Furthermore, bla_CMY-2 genes were widely distributed among the CREC isolated from family members and their home environment.