{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T12:23:10Z","timestamp":1783686190228,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":190,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Canadian Journal of Infectious Diseases and Medical Microbiology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The emergence and spread of antimicrobial\u2010resistant Enterobacterales, particularly extended\u2010spectrum beta\u2010lactamase\u2013producing Enterobacterales (ESBL\u2010PE), represent the major global public health concern. The objective of this study was to determine the fecal carriage, antimicrobial resistance pattern, and associated factors of ESBL\u2010PE among apparently healthy food handlers who work in the students\u2019 cafeteria at Arba Minch University, Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      An institution\u2010based cross\u2010sectional study was conducted from May 1 to August 30, 2025. A pretested, semistructured questionnaire was used to collect sociodemographic, clinical, behavioral, and other related data. Stool samples were collected from participants and inoculated on MacConkey agar. Bacterial colonies on the MacConkey agar were identified using standard biochemical tests. Screening and confirmation of extended\u2010spectrum\n                      <jats:italic>\u03b2-<\/jats:italic>\n                      lactamase production was done by Kirby Bauer\u2019s disk diffusion method on Mueller\u2013Hinton agar. The Statistical Package for the Social Sciences (SPSS) Version 25 was used to analyze the data. Bivariate and multivariate binary logistic regression analyses were used to assess the presence of association, and then the strength of the association was determined by using AOR and 95% confidence intervals, and\n                      <jats:italic>p<\/jats:italic>\n                      values at &lt; 0.05 were considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall prevalence of fecal carriage of ESBL\u2010PE was 51\/319 (16%; CI 12.2\u201320.1). The most predominant ESBL\u2010PE was\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      (34\/51, 66.7%) and\n                      <jats:italic>Klebsiella pneumonia<\/jats:italic>\n                      (14\/51, 27.5%), followed by\n                      <jats:italic>Citrobacter freundii<\/jats:italic>\n                      (2\/51, 3.9%) and\n                      <jats:italic>Proteus mirabilis<\/jats:italic>\n                      (1\/51, 1.9%). All ESBL\u2010PE isolates in the present study were found to be multidrug\u2010resistant (MDR). High\u2010level resistance among ESBL\u2010producing Enterobacterales was observed against trimethoprim\u2013sulfamethoxazole (88.2%), whereas meropenem remained highly effective with susceptibility ranging from 76.5% to 100% across different genera. Antibiotic use in the last three months (AOR\u2009=\u20092.485; CI: 1.12\u20135.51), lack of knowledge on the principle of safe food handling practice (AOR\u2009=\u20090.325; CI: 0.128\u20130.828), consumption of raw meat (AOR\u2009=\u20092.706; CI: 1.22\u20135.99), and drinking unpasteurized milk (AOR\u2009=\u20092.014; CI: 1.03\u20133.96) were significantly associated with fecal carriage of ESBL\u2010PE among food handlers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study revealed a high prevalence of extended\u2010spectrum\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2010lactamase\u2013producing and MDR Enterobacterales among food handlers. Antibiotic use in the last three months, lack of knowledge of the principle of safe food handling practices, consumption of raw meat, and drinking unpasteurized milk were significantly associated with fecal carriage of ESBL\u2010PE among food handlers. Therefore, routine screening, health education, and strict infection prevention and control measures are essential to prevent the spread of ESBL\u2010PE and MDR\u2010resistant Enterobacterales from food handlers to the student community.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/cjid\/1139443","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T12:07:39Z","timestamp":1783685259000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence, Drug Resistance Patterns, and Associated Factors of Extended\u2010Spectrum Beta\u2010Lactamase\u2013Producing Enterobacterales Among Food Handlers in Student Cafeterias at Arba Minch University, Southern Ethiopia"],"prefix":"10.1155","volume":"2026","author":[{"given":"Yigrem","family":"Alebachew","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zerihun","family":"Zerdo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7653-3685","authenticated-orcid":false,"given":"Belayneh Regasa","family":"Dadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13756-019-0626-z","article-title":"Fecal Carriage of Extended-Spectrum \u03b2-Lactamase-Producing Enterobacterales in Hospital and Community Settings in Chad","volume":"8","author":"Ouchar Mahamat O.","year":"2019","journal-title":"Antimicrobial Resistance and Infection Control"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2015.01.008"},{"key":"e_1_2_13_3_2","first-page":"1","article-title":"High Prevalence of ESBL-Producing E. coli in Private and Shared Latrines in an Informal Urban Settlement in Dar es Salaam, Tanzania","volume":"7","author":"Erb S.","year":"2018","journal-title":"Antimicrobial Resistance and Infection Control"},{"key":"e_1_2_13_4_2","doi-asserted-by":"crossref","first-page":"168","DOI":"10.17511\/jopm.2017.i02.17","article-title":"Incidence of Infections With Extended Spectrum Beta Lactamase (ESBL)-Producing Gram-Negative Bacteria Among Patients Admitted in Medical Intensive Care Unit of Tertiary Care Hospital","volume":"3","author":"Peruma P. G.","year":"2017","journal-title":"Tropical Journal of Pathology and Microbiology"},{"key":"e_1_2_13_5_2","doi-asserted-by":"crossref","DOI":"10.1155\/2022\/7905350","article-title":"Carbapenemase-Producing Enterobacterales Family of Bacteria From Diarrheal Stool Samples in Northwest Ethiopia","volume":"2022","author":"Worku M.","year":"2022","journal-title":"Interdisciplinary Perspectives on Infectious Diseases"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens11050504"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis581"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-05272-4"},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2019.11.025"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2019.08.019"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics10060747"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.4103\/1119-0388.130175"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.4172\/2376-0214.1000345"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-5740.2004.00088.x"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.22207\/jpam.15.3.48"},{"key":"e_1_2_13_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.02929-15"},{"key":"e_1_2_13_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2021.04.009"},{"key":"e_1_2_13_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-018-0369-2"},{"key":"e_1_2_13_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkac167"},{"key":"e_1_2_13_20_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0200894","article-title":"Prevalence and Risk Factors for Faecal Carriage of Extended Spectrum \u03b2-Lactamase Producing Enterobacterales Among Food Handlers in Lower Basic Schools in West Coast Region of the Gambia","volume":"13","author":"Sanneh B.","year":"2018","journal-title":"PLoS One"},{"key":"e_1_2_13_21_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0264818"},{"key":"e_1_2_13_22_2","doi-asserted-by":"publisher","DOI":"10.2147\/idr.s269425"},{"key":"e_1_2_13_23_2","first-page":"p148","volume-title":"Testing S. M100 Performance Standards for Antimicrobial","author":"CLSI Clinical Laboratory Standards Institutes","year":"2021"},{"key":"e_1_2_13_24_2","doi-asserted-by":"publisher","DOI":"10.3855\/jidc.2900"},{"key":"e_1_2_13_25_2","doi-asserted-by":"crossref","first-page":"52","DOI":"10.18231\/2394-5478.2018.0010","article-title":"Prevalence and Phenotypic Characterization of ESBL Producing E.Coli and Klebsiella Among the Fecal Isolates of Normal Population","volume":"5","author":"Indernath S.","year":"2020","journal-title":"Indian Journal of Microbiology Research"},{"key":"e_1_2_13_26_2","doi-asserted-by":"publisher","DOI":"10.15835\/nsb11310436"},{"key":"e_1_2_13_27_2","doi-asserted-by":"publisher","DOI":"10.1128\/aac.05539-11"},{"key":"e_1_2_13_28_2","article-title":"Antimicrobial Susceptibility Profiles and Genotypic Characterization of Selected Enterobacterales Strains Isolated From Food Handlers in Nairobi, Kenya","volume":"94","author":"Juma A. O.","year":"2017","journal-title":"East African Medical Journal"},{"key":"e_1_2_13_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2019.101547"},{"key":"e_1_2_13_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.05.033"},{"key":"e_1_2_13_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/11786361221150695"},{"key":"e_1_2_13_32_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms130817702025"},{"key":"e_1_2_13_33_2","doi-asserted-by":"publisher","DOI":"10.3390\/foods14203573"},{"key":"e_1_2_13_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijfoodmicro.2016.08.036"}],"container-title":["Canadian Journal of Infectious Diseases and Medical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cjid\/1139443","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/cjid\/1139443","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cjid\/1139443","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T12:07:41Z","timestamp":1783685261000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/cjid\/1139443"}},"subtitle":[],"editor":[{"given":"Shweta","family":"Negi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/cjid\/1139443"],"URL":"https:\/\/doi.org\/10.1155\/cjid\/1139443","archive":["Portico"],"relation":{},"ISSN":["1712-9532","1918-1493"],"issn-type":[{"value":"1712-9532","type":"print"},{"value":"1918-1493","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-04-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"1139443"}}