Phenotypic Characterization and Antibiograms of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Isolated at the Human-Animal-Environment Interface Using a One Health Approach Among Households in Wakiso District, Uganda

Figures & data

Figure 1 Primary cultures and subcultures.

Figure 2 Modified double disc diffusion test results.

Table 1 ESBL-EC Sample Characteristics

Sample Source, N=100	Sample Type	Frequency	Percentage
Animal (56)	Pig	9	16.1
	Dog	3	5.4
	Goat	21	37.5
	Cow	9	16.1
	Chicken	6	10.7
	Duck	3	5.4
	Cat	2	3.6
	Rabbit	2	3.6
	Sheep	1	1.8
Human (35)	Urine	9	25.7
	Fecal	26	74.3
Environment (9)	Equipment	5	55.6
	Soil	4	44.4

Abbreviations: N, sample size; ESBL-EC, Extended Spectrum Beta lactamase producing Escherichia coli.

Table 2 Antibiograms of Different Drugs on the ESBL-EC Isolates

Abbreviation	N=% Resistant	N=% Intermediate	N=% Susceptible
CTX	93	2	5
FEP	90	4	6
ATM	85	5	10
CAZ	82	11	7
TE	80	6	14
SXT	79	9	12
CIP	68	18	14
AMC	44	29	27
CN	22	6	72
MEM	5	7	88
IPM	2	16	82

Abbreviations: N, sample size; ESBL-EC, Extended Spectrum Beta lactamase producing Escherichia coli; CTX, Cefotaxime; FEP, Cefepime; ATM, Aztreonam; CAZ, Ceftazidime; TE, Tetracycline; SXT, Sulfamethoxazole-Trimethoprim; CIP, Ciprofloxacin; AMC, Amoxicillin-clavulanic acid; CN, Gentamicin; MEM, Meropenem; IPM, Imipenem.

Figure 3 Antibiograms of ESBL-EC Human isolates.

Figure 4 Antibiograms of ESBL-EC Environmental isolates.

Figure 5 Antibiograms of ESBL-EC Animal isolates.

Table 3 Frequency and Proportion of Susceptibility for Individual ESBL-EC Isolates from Humans, Animal, and Environment

Sample Source	Sample Type (n)	Percentage (%) Susceptibility
		AMC	SXT	CTX	FEP	IPM	MEM	CN	TE	ATM	CAZ	CIP
Animal	Cow (9)	11.1	22.2	0.0	0.0	66.7	66.7	66.7	11.1	33.3	11.1	11.1
	Goat (21)	23.8	9.5	4.8	9.5	80.9	80.9	71.4	14.3	9.5	4.8	9.5
	Cat (2)	100.0	50.0	0.0	0.0	100.0	100.0	100.0	0.0	50.0	0.0	50.0
	Chicken (6)	50.0	33.3	0.0	0.0	100.0	100.0	100.0	50.0	16.7	0.0	16.7
	Dog (3)	0.0	33.3	0.0	0.0	66.7	66.7	33.3	0.0	0.0	0.0	0.0
	Duck (3)	66.7	0.0	0.0	0.0	100.0	66.7	100.0	33.3	0.0	0.0	33.3
	Rabbit (2)	0.0	100.0	0.0	0.0	100.0	100.0	100.0	0.0	0.0	0.0	50.0
	Sheep (1)	100.0	0.0	0.0	0.0	100.0	100.0	100.0	0.0	0.0	0.0	0.0
	Pig (9)	33.3	0.0	11.1	11.1	88.9	100.0	77.8	11.1	0.0	0.0	22.2
Human	Fecal (26)	30.8	3.9	7.7	7.7	76.9	92.3	69.2	11.5	7.7	15.4	11.5
	Urine (9)	11.1	11.1	0.0	00.0	88.9	88.9	44.4	11.1	0.0	0.0	0.0
Environment	Equipment (5)	0.0	0.0	20.0	20.0	80.0	100.0	80.0	20.0	20.0	20.0	40.0
	Soil (4)	25.0	0.0	0.0	0.0	75.0	100.0	75.0	0.0	0.0	0.0	0.0

Abbreviations: n, sample size; ESBL-EC, Extended Spectrum Beta lactamase producing Escherichia coli; CTX, Cefotaxime; FEP, Cefepime; ATM, Aztreonam; CAZ, Ceftazidime; TE, Tetracycline; SXT, Sulfamethoxazole-Trimethoprim; CIP, Ciprofloxacin; AMC, Amoxicillin-clavulanic acid; CN, Gentamicin; MEM, Meropenem; IPM, Imipenem.

Table 4 Drug Resistance Profile of ESBL-EC Isolates

Resistance to Drugs	Frequency	MARI
R3	5	0.27
R4	7	0.36
R5	9	0.45
R6	20	0.55
R7	21	0.64
R8	24	0.73
R9	11	0.82

Notes: R3-R9 signifies resistance to 3 drug - 9 drugs respectively; Numerical values of MARI indicate a factor of the number of drugs that were resisted by the organism when compared to the total antibiotics used; frequency is the number of organisms that resisted the recorded number of antibiotics.

Abbreviation: MARI, Multiple antibiotic resistance index.

Figure 6 Antibiotic sensitivity profiles for isolates from four unique households.

Table 5 Matrix for the Highest Resistance Among Households

ID	Sample Source	Sample Type	Husbandry	Resistance Profile
A	Animal	Goat	Intensive	SXT, CTX, FEP, MEM, CN, TE, ATM, CAZ, CIP
B	Animal	Goat	Intensive	SXT, CTX, FEP, CN, TE, ATM, CAZ, CIP
C	Human	Fecal	Intensive	AMC, SXT, CTX, FEP, CN, TE, ATM, CAZ, CIP
C	Human	Urine	Intensive	AMC, SXT, CTX, FEP, CN, TE, ATM, CAZ, CIP
D	Animal	Goat	Intensive	AMC, SXT, CTX, FEP, CN, TE, ATM, CAZ, CIP
E	Human	Urine	Intensive	SXT, CTX, FEP, MEM, CN, TE, ATM, CAZ, CIP
E	Environment	Soil	Intensive	AMC, SXT, CTX, FEP, CN, TE, ATM, CAZ, CIP
F	Human	Fecal	Intensive	AMC, CTX, FEP, IPM, CN, TE, ATM, CAZ, CIP
G	Human	Urine	Intensive	AMC, SXT, CTX, FEP, CN, TE, ATM, CAZ, CIP
H	Animal	Cow	Intensive	AMC, SXT, CTX, FEP, CN, TE, ATM, CAZ, CIP

Abbreviations: ID, Unique identifier of households; CTX, Cefotaxime; FEP, Cefepime; ATM, Aztreonam; CAZ, Ceftazidime; TE, Tetracycline; SXT, Sulfamethoxazole-Trimethoprim; CIP, Ciprofloxacin; AMC, Amoxicillin-clavulanic acid; CN, Gentamicin; MEM, Meropenem; IPM, Imipenem.