Fecal Carriage Rate of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Among Apparently Health Food Handlers in Dilla University Student Cafeteria

Figures & data

Figure 1 (A and B) The phenotypic confirmation test of ESBL producers performed using double disc synergy between amoxicillin-clavulanic acid and cefotaxime, ceftazidime, and aztreonam on Mueller-Hinton agar plate.

Table 1 Characteristics of Food Handlers and Fecal Carriage Rate of ESBLs-Producing and Non-ESBLs-Producing E. coli and K. pneumoniae in Dilla University Students’ Cafeteria, Southern Ethiopia (n=220)

Variables	Category	Number Tested	Proportion of E. coli (n=119)		Proportion of K. pneumonia (n=27)		P-value
			ESBLs-Positive (n=29)	ESBLs-Negative (n=90)	ESBLs-Positive (n=8)	ESBLs-Negative (n=19)
Sex	Male	20	1 (0.84%)	5 (4.2%)	1 (3.7%)	7 (25.9%)	1
	Female	200	28 (23.5%)	85 (71.4%)	7 (25.9%)	12 (44.4%)	0.213
Age in years	<20	10	1 (0.84%)	28 (23.5%)	1 (3.7%)	4 (14.8%)	1
	20–40	186	26 (21.8%)	61 (51.3%)	5 (18.5%)	9 (33.3%)	0.121
	>40	24	2 (1.7%)	18(15.1%)	2 (7.4%)	6 (22.2%)	0.301
Service years	1–5 year	38	2 (1.7%)	28 (23.5%)	3 (11.1%)	6 (22.2%)	1
	>5 year	170	27 (22.7%)	62 (52.1%)	5 (18.5%)	13 (48.1%)	0.513
Medical checkups	Yes	113	9 (7.6%)	31 (26.1%)	3 (11.1%)	8 (29.6%)	1
	No	107	20 (16.8%)	59 (49.6%)	5 (18.5%)	11 (40.7%)	0.08
Hands washing habit	Yes	216	28 (23.5%)	83 (69.7%)	6 (22.2%)	15 (55.6%)	1
	No	4	1 (0.84%)	7 (5.9%)	2 (7.4%)	4 (14.8%)	0.612
Finger nail status	Trimmed	180	24 (20.2%)	60 (50.4%)	5 (18.5%)	13 (48.1%)	1
	Not trimmed	40	5 (4.2%)	30 (25.2%)	3 (11.1%)	6 (22.2%)	0.341
Antibiotics used in the last 3 months	Yes	139	27 (22.7%)	58 (48.7%)	7 (25.9%)	12 (44.4%)	0.001*
	No	81	2 (1.7%)	32 (26.9%)	1 (3.7%)	7 (25.9%)	1
Wear hair garment	Yes	152	22 (18.5%)	48 (40.3%)	6 (22.2%)	14 (51.9%)	0.53
	No	68	7 (5.9%)	42 (35.3%)	2 (7.4%)	5 (18.5%)	1
Hands wash with soap	Only with water	45	18 (15.1%)	15 (12.6%)	6 (22.2%)	3 (11.1%)	0.154
	With soap	175	11 (9.2%)	75 (63.1%)	2 (7.4%)	16 (59.3%)	1
Source of water for drinking	Pipe	214	28 (23.5%)	78 (65.5%)	5 (18.5%)	12 (44.4%)	1
	Hand dug well	25	1 (0.84%)	9 (7.5%)	2 (7.4%)	5 (18.5%)	0.301
	Other	195	28 (23.5%)	3 (2.5%)	1 (3.7%)	2 (7.4%)	0.462
Unpasteurized milk	Yes	29	1 (0.84%)	9 (7.6%)	2 (7.4%)	5 (18.5%)	1
	No	191	28 (23.5%)	81 (68.1%)	6 (22.2%)	14 (51.9%)	0.211
Eating raw meat	Yes	93	11 (9.2%)	40 (33.6%)	3 (11.1%)	6 (22.2%)	1
	No	127	18 (15.1%)	50 (42.1%)	5 (18.5%)	13 (48.1%)	0.412

Note: *Indicates ESBL producers isolates were significantly associated with food handlers who used antibiotics repeatedly in the last 3 months.

Figure 2 The distribution of ESBL-producing E. coli and K. pneumoniae isolated from the stool of apparently healthy food handlers.

Table 2 Antimicrobial Resistance Patterns of ESBLs-Positive and ESBLs-Negative E. coli and K. pneumonia Isolated from Food Handlers in Dilla University Student Cafeteria, Southern Ethiopia (n=220)

Antibiotics	Pattern	Antimicrobial Resistance Pattern of E. coli (n=119)		Antimicrobial Resistance Pattern of K. pneumonia (n=27)
		ESBLs-Positive (n=29)	ESBLs-Negative (n=90)	ESBLs-Positive (n=8)	ESBLs-Negative (n=19)
Ampicillin	S	0 (0.0%)	20 (22.2%)	0 (0.0%)	2 (10.5%)
	R	29 (100%)	70 (77.8%)	8 (100%)	17 (89.5%)
Aztreonam	S	1 (3.4%)	6 (6.7%)	1 (12.5%)	2 (10.5%)
	R	28 (96.6%)	84 (93.7%)	7 (87.5%)	17 (89.5%)
Cefotaxime	S	1 (3.4%)	7 (7.8%)	0 (0.0%)	2 (10.5%)
	R	28 (96.6%)	83 (92.2%)	8 (100%)	17 (89.5%)
Cefuroxime	S	2 (6.9%)	6 (6.7%)	1 (12.5%)	2 (10.5%)
	R	27 (93.1%)	84 (93.7%)	7 (87.5%)	17 (89.5%)
Ceftazidime	S	0 (0.0%)	6 (6.7%)	0 (0.0%)	2 (10.5%)
	R	29 (100%)	84 (93.3%)	8 (100%)	17 (89.5%)
Ceftriaxone	S	1 (3.4%)	13 (14.4%)	1 (12.5%)	6 (31.6%)
	R	28 (96.6%)	77 (85.6%)	7 (87.5%)	13 (68.4%)
Ciprofloxacin	S	9 (31.0%)	29 (32.2%)	2 (25.0%)	5 (26.3%)
	R	20 (69.0%)	61 (67.8%)	6 (75.0%)	14 (73.7%)
Imipenem	S	25 (86.2%)	68 (75.6%)	7 (87.5%)	14 (73.7%)
	R	4 (13.8%)	22 (24.4%)	1 (12.5%)	5 (26.3%)
Nitrofurantoin	S	9 (31.0%)	29 (32.2%)	2 (25.0%)	5 (26.3%)
	R	20 (69.0%)	61 (67.8%)	6 (75.0%)	14 (73.7%)
Tetracycline	S	1 (3.4%)	5 (5.6%)	0 (0.0%)	2 (10.5%)
	R	28 (96.6%)	85 (94.4%)	8 (100%)	17 (89.5%)
Trimethoprim sulfamethoxazole	S	9 (31.0%)	29 (32.2%)	2 (25.0%)	5 (26.3%)
	R	20 (69.0%)	61 (67.8%)	6 (75.0%)	14 (73.7%)

Table 3 Multidrug Resistance Pattern of E. coli and K. pneumonia Fecal Carriage Isolated from Food Handlers in Dilla University Student Cafeteria, Southern Ethiopia (n=220)

Antibiotics Categories	E. coli (n=29)	K. pneumonia (n=8)	Total MDR Rate (n=37)
β-lactams+TET	27 (93.1%)	7 (87.5%)	34 (91.9%)
β-lactams+TET, CIP	20 (69.0%)	6 (75.0%)	26 (70.3%)
β-lactams+TET, SXT	15 (51.7%)	5 (62.5%)	20 (54.1%)
β-lactams+TET, SXT, CIP	13 (44.8%)	4 (50.0%)	17 (45.9%)
β-lactams+TET, SXT, NIT, CIP	9 (31.0%)	3 (37.5%)	12 (32.4%)
β-lactams+CIP, IM, NIT, TET, SXT	6 (20.7%)	2 (25.0%)	8 (21.6%)

Abbreviations: Beta-lactams groups, ampicillin, cefotaxime, cefuroxime, ceftazidime, ceftriaxone; CIP, ciprofloxacin; IM, imipenem; NIT, nitrofurantoin; TET, tetracycline; SXT, trimethoprim sulfamethoxazole.