{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T03:34:06Z","timestamp":1791689646604,"version":"4.3.4"},"reference-count":101,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005872","name":"Bahir Dar University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005872","id-type":"DOI","asserted-by":"publisher"}]},{"name":"EU project EpiGen"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Extended spectrum \u03b2-lactamase (ESBL) and carbapenemase-producing\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      (\n                      <jats:italic>E. coli<\/jats:italic>\n                      ) and\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      (\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      ) emanating from raw cow milk are among the leading contributors to the spread of antimicrobial resistance (AMR). Due to the misuse and overuse of antibiotics in dairy farms, cow\u2019s milk has become a reservoir of ESBL- and carbapenemase-producing\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      posing a growing public health threat, especially in areas where the consumption of raw milk is common. However, compared to the clinical sector, the prevalence of ESBL- and carbapenemase-producing\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      in the food sector is under-studied.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      This study aimed to determine the prevalence of ESBL and carbapenemase-producing\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      in raw bulk cow milk from Dairy Cooperatives in Northwest Amhara, Ethiopia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional study was conducted from January to April, 2025 among 257 dairy cooperative member farms. Sociodemographic and related data were collected using a structured questionnaire. Five milliliters of raw bulk cow milk were collected aseptically from each farm in four Dairy Cooperatives (DCs) (DC-A to D). 10 microliters of milk sample were directly inoculated into MacConkey agar.\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      and\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      were identified using standard microbiological techniques. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method. ESBL and carbapenemase production were confirmed phenotypically via combination disk tests and modified carbapenem inactivation methods, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\/or\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      in raw cow milk was 21% (95% CI, 16.5\u201326.4%), with respective individual prevalence of 8.2% and 14.8%. ESBL-producing\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      accounted for 23.8% and 15.8% of isolates, respectively, while 2.6% of isolates (only\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      ) were carbapenemase producers. Resistance to ampicillin and amoxicillin-clavulanic acid exceeded 70%. All\n                      <jats:italic>E. coli<\/jats:italic>\n                      and 94.7% of\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      isolates remained susceptible to carbapenems. Nearly half of all isolates (45.8%) were multidrug resistant (MDR), and 51.9% of MDR isolates were co-resistant to at least six antibiotics. Having additional non-farming occupations (AOR: 4.17, 95% CI: 1.49\u201311.67), large herd size (AOR: 3.21, 95% CI: 1.26\u20138.18), having pet animals (AOR: 6.53, 95% CI: 1.39\u201330.7), and use of calabash milk pail (AOR: 7.37, 95% CI: 1.45\u201337.49) were significantly associated with milk culture positive result for\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\/or\n                      <jats:italic>K. pneumoniae.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Raw milk in Northwest Amhara harbors ESBL and carbapenemase-producing\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      posing a substantial public health risk coupled with MDR and resistance to critically important antimicrobials. Strengthened AMR surveillance, improved farm hygiene, restricted antibiotic use, and public education on milk safety are urgently needed.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0336987","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T18:40:10Z","timestamp":1763145610000},"page":"e0336987","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Prevalence of extended spectrum \u03b2-lactamase and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in raw bulk cow milk from dairy cooperatives, Northwest Amhara, 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