{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T01:15:56Z","timestamp":1788225356315,"version":"build-2803163510"},"reference-count":10,"publisher":"American Society for Microbiology","issue":"7","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100007155","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/R015074\/1, MR\/S004793\/1"],"award-info":[{"award-number":["MR\/R015074\/1, MR\/S004793\/1"]}],"id":[{"id":"10.13039\/501100007155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,7,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      In sub-Saharan Africa, extended-spectrum beta-lactamase (ESBL)-producing bacterial infections pose significant public health risks. The importance of ESBL transmission within the food chain, as well as the role of urban marketplaces in this relationship, is becoming increasingly recognized. ESBL\n                      <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                      also represents a key indicator organism within global antimicrobial resistance surveillance strategies, including the World Health Organization Tricycle protocol. Therefore, evaluating simple, cost-effective, and scalable detection methods for ESBL-producing\n                      <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                      is crucial. In 2021, a modified Colilert-18 method and a conventional ChromAgar ESBL culture method were assessed for the detection of ESBL\n                      <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                      in water samples from four urban marketplaces in Blantyre, Malawi. ESBL\n                      <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                      were detected in water samples obtained from urban marketplaces using both ChromAgar ESBL culture (39% [\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 65\/167]) and IDEXX Colilert-18 methods (76% [\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 127\/167]). Using ChromAgar ESBL as a reference standard, the modified Colilert-18 method showed a sensitivity of 86% and a specificity of 30%. Agreement between the methods was low (Cohen\u2019s kappa = 0.141,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). The cost per test was lower for Colilert than for ChromAgar, indicating potential cost-effectiveness in primary ESBL\n                      <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                      detection. At the time of sampling, water collected from urban marketplaces was contaminated with ESBL\n                      <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                      , posing possible public health risks. Both the ChromAgar method and the modified IDEXX method offer valuable tools for microbiological surveillance of ESBL\n                      <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                      in urban markets. However, further studies must be conducted to optimize their use and determine additional considerations to factor into cost-effectiveness.\n                    <\/jats:p>\n                    <jats:sec>\n                      <jats:title>IMPORTANCE<\/jats:title>\n                      <jats:p>This study highlights the role of urban marketplaces as hotspots for potential transmission of extended-spectrum beta-lactamase (ESBL) bacteria. The findings suggest that markets are critical sites that warrant for environmental surveillance, particularly in settings with limited water, sanitation, and hygiene infrastructure. We investigated the differences in detection performance and the cost-effectiveness of a modified IDEXX Colilert-18 method compared to conventional culture using ChromAgar. We found that the higher detection rate and lower cost of the Colilert-18 method point to its potential as a viable alternative for surveillance of ESBLs in water samples. These findings are particularly relevant for low-income settings, where routine environmental monitoring is constrained due to poor laboratory capacity and limited resources. Our study contributes to the evidence on cost-effective methods for environmental surveillance of antimicrobial-resistant bacteria and emphasizes the need for locally appropriate, scalable tools to support public health responses to antimicrobial resistance.<\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.01695-25","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T13:02:56Z","timestamp":1779282176000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of detection performance and cost-effectiveness of IDEXX Colilert-18 and ChromAgar for environmental surveillance of extended-spectrum beta-lactamase\n                    <i>Escherichia coli<\/i>\n                    in water samples from urban marketplaces in Blantyre, Malawi"],"prefix":"10.1128","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6659-4677","authenticated-orcid":true,"given":"Effita Fifi","family":"Masoamphambe","sequence":"first","affiliation":[{"name":"Malawi-Liverpool Wellcome Programme","place":["Blantyre, Malawi"]},{"id":[{"id":"https:\/\/ror.org\/03svjbs84","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Sciences, Liverpool School of Tropical Medicine","place":["Liverpool, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jones","family":"Chipinga","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool Wellcome Programme","place":["Blantyre, Malawi"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madalitso","family":"Mphasa","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool Wellcome Programme","place":["Blantyre, Malawi"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kondwani","family":"Chidziwitsano","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00zw9nc64","id-type":"ROR","asserted-by":"publisher"}],"name":"Centre for Water, Sanitation, Health, and Appropriate Technology Development (WASHTED)","place":["Blantyre, Malawi"]},{"id":[{"id":"https:\/\/ror.org\/05vatjr87","id-type":"ROR","asserted-by":"publisher"}],"name":"Malawi University of Business and Applied Sciences","place":["Blantyre, Malawi"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mindy","family":"Panulo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00zw9nc64","id-type":"ROR","asserted-by":"publisher"}],"name":"Centre for Water, Sanitation, Health, and Appropriate Technology Development (WASHTED)","place":["Blantyre, Malawi"]},{"id":[{"id":"https:\/\/ror.org\/05vatjr87","id-type":"ROR","asserted-by":"publisher"}],"name":"Malawi University of Business and Applied Sciences","place":["Blantyre, Malawi"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Jafali","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool Wellcome Programme","place":["Blantyre, Malawi"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Feasey","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool Wellcome Programme","place":["Blantyre, Malawi"]},{"id":[{"id":"https:\/\/ror.org\/03svjbs84","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Sciences, Liverpool School of Tropical Medicine","place":["Liverpool, United Kingdom"]},{"id":[{"id":"https:\/\/ror.org\/02wn5qz54","id-type":"ROR","asserted-by":"publisher"}],"name":"School of Medicine, University of St Andrews","place":["St Andrews, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Berendes","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/042twtr12","id-type":"ROR","asserted-by":"publisher"}],"name":"U.S. Centers for Disease Control and Prevention","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Kirby","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/042twtr12","id-type":"ROR","asserted-by":"publisher"}],"name":"U.S. Centers for Disease Control and Prevention","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy","family":"Morse","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00zw9nc64","id-type":"ROR","asserted-by":"publisher"}],"name":"Centre for Water, Sanitation, Health, and Appropriate Technology Development (WASHTED)","place":["Blantyre, Malawi"]},{"id":[{"id":"https:\/\/ror.org\/00n3w3b69","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Civil and Environmental Engineering, University of Strathclyde","place":["Glasgow, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6670-2713","authenticated-orcid":false,"given":"Derek","family":"Cocker","sequence":"additional","affiliation":[{"name":"Malawi-Liverpool Wellcome Programme","place":["Blantyre, Malawi"]},{"id":[{"id":"https:\/\/ror.org\/03svjbs84","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Sciences, Liverpool School of Tropical Medicine","place":["Liverpool, United Kingdom"]},{"id":[{"id":"https:\/\/ror.org\/04xs57h96","id-type":"ROR","asserted-by":"publisher"}],"name":"David Price Evans Infectious Disease and Global health Group, University of Liverpool","place":["Liverpool, United 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WHO integrated global surveillance on ESBL-producing E. coli using a one health approach: implementation and opportunities. World Health Organization. Available from: https:\/\/iris.who.int\/handle\/10665\/340079"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad117"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(23)00062-9"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2024.174142"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1039\/d2em00189f"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.12688\/wellcomeopenres.17581.2"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanmic.2025.101224"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro3270"}],"container-title":["Microbiology Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.01695-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.01695-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T01:00:28Z","timestamp":1788224428000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/spectrum.01695-25"}},"subtitle":[],"editor":[{"given":"Warish","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":10,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,7]]}},"alternative-id":["10.1128\/spectrum.01695-25"],"URL":"https:\/\/doi.org\/10.1128\/spectrum.01695-25","relation":{},"ISSN":["2165-0497"],"issn-type":[{"value":"2165-0497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]},"assertion":[{"value":"2025-06-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01695-25"}}