{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:07:55Z","timestamp":1789430875880,"version":"build-2803163510"},"reference-count":67,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T00:00:00Z","timestamp":1728518400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Union Horizon 2020 research, innovation programme\/Trials of Excellence","award":["EDCTP2\/TESA III"],"award-info":[{"award-number":["EDCTP2\/TESA III"]}]},{"name":"European Union Horizon 2020 research, innovation programme\/Trials of Excellence","award":["CSA2020NOE3104"],"award-info":[{"award-number":["CSA2020NOE3104"]}]},{"name":"Key Project of TESA III","award":["EDCTP2\/TESA III"],"award-info":[{"award-number":["EDCTP2\/TESA III"]}]},{"name":"Key Project of TESA III","award":["CSA2020NOE3104"],"award-info":[{"award-number":["CSA2020NOE3104"]}]},{"name":"Fleming Fund","award":["EDCTP2\/TESA III"],"award-info":[{"award-number":["EDCTP2\/TESA III"]}]},{"name":"Fleming Fund","award":["CSA2020NOE3104"],"award-info":[{"award-number":["CSA2020NOE3104"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Extended-spectrum \u03b2-lactamases (ESBL) in Escherichia coli are a serious concern due to their role in developing multidrug resistance (MDR) and difficult-to-treat infections. Objective: This study aimed to identify ESBL-carrying E. coli strains from both clinical and environmental sources in Lusaka District, Zambia. Methods: This cross-sectional study included 58 ESBL-producing E. coli strains from hospital inpatients, outpatients, and non-hospital environments. Antimicrobial susceptibility was assessed using the Kirby\u2013Bauer disk diffusion method and the VITEK\u00ae 2 Compact System, while genotypic analyses utilised the Illumina NextSeq 2000 sequencing platform. Results: Among the strains isolated strains, phylogroup B2 was the most common, with resistant MLST sequence types including ST131, ST167, ST156, and ST69. ESBL genes such as blaTEM-1B, blaCTX-M,blaOXA-1, blaNDM-5, and blaCMY were identified, with ST131 and ST410 being the most common. ST131 exhibited a high prevalence of blaCTX-M-15 and resistance to fluoroquinolones. Clinical and environmental isolates carried blaNDM-5 (3.4%), with clinical isolates showing a higher risk of carbapenemase resistance genes and the frequent occurrence of blaCTX-M and blaTEM variants, especially blaCTX-M-15 in ST131. Conclusions: This study underscores the public health risks of blaCTX-M-15- and blaNDM-5-carrying E. coli. The strengthening antimicrobial stewardship programmes and the continuous surveillance of AMR in clinical and environmental settings are recommended to mitigate the spread of resistant pathogens.<\/jats:p>","DOI":"10.3390\/antibiotics13100951","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T07:54:09Z","timestamp":1728546849000},"page":"951","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Genotypic Characterisation and Antimicrobial Resistance of Extended-Spectrum \u03b2-Lactamase-Producing Escherichia coli in Humans, Animals, and the Environment from Lusaka, Zambia: Public Health Implications and One Health Surveillance"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1724-7934","authenticated-orcid":false,"given":"Maisa","family":"Kasanga","sequence":"first","affiliation":[{"name":"Department of Pathology and Microbiology, University Teaching Hospitals, Lusaka 15101, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1270-0365","authenticated-orcid":false,"given":"M\u00e1ri\u00f3","family":"Gajd\u00e1cs","sequence":"additional","affiliation":[{"name":"Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, 6720 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Muleya","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3738-4584","authenticated-orcid":false,"given":"Odion O.","family":"Ikhimiukor","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, State University of New York, Albany, NY 12222, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1692-8981","authenticated-orcid":false,"given":"Steward","family":"Mudenda","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka 15101, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maika","family":"Kasanga","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University Teaching Hospitals, Lusaka 15101, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Chizimu","sequence":"additional","affiliation":[{"name":"Zambia National Public Health Institute, Ministry of Health, Lusaka 10101, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4945-6746","authenticated-orcid":false,"given":"Doreen Mainza","family":"Shempela","sequence":"additional","affiliation":[{"name":"Department of Laboratory Services and Research, Churches Health Association of Zambia, Lusaka 10101, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin Bisesa","family":"Solochi","sequence":"additional","affiliation":[{"name":"Department of Pathology and Microbiology, University Teaching Hospitals, Lusaka 15101, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark John","family":"Mwikisa","sequence":"additional","affiliation":[{"name":"Department of Pathology, Lusaka Trust Hospital, Lusaka 10101, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaunda","family":"Yamba","sequence":"additional","affiliation":[{"name":"Zambia National Public Health Institute, Ministry of Health, Lusaka 10101, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4428-0924","authenticated-orcid":false,"given":"Cheryl P.","family":"Andam","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, State University of New York, Albany, NY 12222, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Chanda","sequence":"additional","affiliation":[{"name":"Department of Pathology and Microbiology, University Teaching Hospitals, Lusaka 15101, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5477-9054","authenticated-orcid":false,"given":"Duncan","family":"Chanda","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Adult Infectious Diseases, University Teaching Hospitals, Lusaka 15101, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0151-8883","authenticated-orcid":false,"given":"Geoffrey","family":"Kwenda","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka 15101, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Authority, European Food Safety, and European Centre for Disease Prevention and Control (ECDC) (2023). The European Union Summary Report on Antimicrobial Resistance in zoonotic and indicator bacteria from humans, animals and food in 2020\/2021. EFSA J., 21, e07867.","DOI":"10.2903\/j.efsa.2023.7867"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s13756-017-0208-x","article-title":"The threat of antimicrobial resistance in developing countries: Causes and control strategies","volume":"6","author":"Ayukekbong","year":"2017","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"379","DOI":"10.4236\/pp.2022.1310029","article-title":"Antibiotic Prescribing Patterns in Adult Patients According to the WHO AWaRe Classification: A Multi-Facility Cross-Sectional Study in Primary Healthcare Hospitals in Lusaka, Zambia","volume":"13","author":"Mudenda","year":"2022","journal-title":"Pharmacol. Pharm."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"dlae061","DOI":"10.1093\/jacamr\/dlae061","article-title":"Antimicrobial resistance profiles of Escherichia coli isolated from clinical and environmental samples: Findings and implications","volume":"6","author":"Kasanga","year":"2024","journal-title":"JAC Antimicrob. Resist."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Salam, M.A., Al-Amin, M.Y., Salam, M.T., Pawar, J.S., Akhter, N., Rabaan, A.A., and Alqumber, M.A.A. (2023). Antimicrobial Resistance: A Growing Serious Threat for Global Public Health. Healthcare, 11.","DOI":"10.20944\/preprints202305.0555.v1"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10123-023-00462-x","article-title":"Antimicrobial use and resistance in food animal production: Food safety and associated concerns in Sub-Saharan Africa","volume":"27","author":"Odey","year":"2024","journal-title":"Int. Microbiol."},{"key":"ref_7","unstructured":"(2024, June 15). Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report: 2022. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240062702."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Lipworth, S., Vihta, K.-D., Chau, K., Barker, L., George, S., Kavanagh, J., Davies, T., Vaughan, A., Andersson, M., and Jeffery, K. (2021). Molecular epidemiology of Escherichia coli and Klebsiella species bloodstream infections in Oxfordshire (UK) 2008\u20132018. medRxiv.","DOI":"10.1101\/2021.01.05.20232553"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","article-title":"Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis","volume":"399","author":"Murray","year":"2022","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3589","DOI":"10.2147\/IDR.S342753","article-title":"Antimicrobial Resistance Rates and Surveillance in Sub-Saharan Africa: Where Are We Now?","volume":"15","author":"Kariuki","year":"2022","journal-title":"Infect. Drug Resist."},{"key":"ref_11","unstructured":"(2024, August 13). Antimicrobial Resistance (AMR). Available online: https:\/\/www.healthdata.org\/research-analysis\/health-risks-issues\/antimicrobial-resistance-amr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.jointm.2022.10.001","article-title":"Antimicrobial stewardship in the intensive care unit","volume":"3","author":"Ture","year":"2023","journal-title":"J. Intensive Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e22109","DOI":"10.1016\/j.heliyon.2023.e22109","article-title":"Multidrug-resistant Escherichia coli isolated from patients and surrounding hospital environments in Bangladesh: A molecular approach for the determination of pathogenicity and resistance","volume":"9","author":"Moniruzzaman","year":"2023","journal-title":"Heliyon"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"66","DOI":"10.2166\/wh.2022.194","article-title":"Genetic diversity and prevalence of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in aquatic environments receiving untreated hospital effluents","volume":"21","author":"Girijan","year":"2023","journal-title":"J. Water Health"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Muteeb, G., Rehman, M.T., Shahwan, M., and Aatif, M. (2023). Origin of Antibiotics and Antibiotic Resistance, and Their Impacts on Drug Development: A Narrative Review. Pharmaceuticals, 16.","DOI":"10.20944\/preprints202306.1921.v1"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Kasanga, M., Kwenda, G., Wu, J., Kasanga, M., Mwikisa, M.J., Chanda, R., Mupila, Z., Yankonde, B., Sikazwe, M., and Mwila, E. (2023). Antimicrobial Resistance Patterns and Risk Factors Associated with ESBL-Producing and MDR Escherichia coli in Hospital and Environmental Settings in Lusaka, Zambia: Implications for One Health, Antimicrobial Stewardship and Surveillance Systems. Microorganisms, 11.","DOI":"10.3390\/microorganisms11081951"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"16","DOI":"10.21157\/ijtvbr.v4i1.13806","article-title":"Isolation of Extended-Spectrum B-Lactamase (ESBL) Producing Escherichia coli and Klebsiella pneumiae from Dr. Zainoel Abidin General Hospital, Aceh","volume":"4","author":"Hayati","year":"2019","journal-title":"Int. J. Trop. Vet. Biomed. Res."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Nolan, L.K., Li, G., and Logue, C.M. (2015). Origin and Dissemination of Antimicrobial Resistance among Uropathogenic Escherichia coli. Microbiol. Spectr., 3.","DOI":"10.1128\/microbiolspec.UTI-0007-2012"},{"key":"ref_19","first-page":"27","article-title":"Antimicrobial resistance in the African Region: Issues, challenges and actions proposed","volume":"16","author":"Ndihokubwayo","year":"2013","journal-title":"Afr. Health Monit."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Masich, A.M., Vega, A.D., Callahan, P., Herbert, A., Fwoloshi, S., Zulu, P.M., Chanda, D., Chola, U., Mulenga, L., and Hachaambwa, L. (2020). Antimicrobial usage at a large teaching hospital in Lusaka, Zambia. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0228555"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Chirwa, E., Mulundu, G., Ndashe, K., Kanongesha, K., Simpokolwe, K., Kachinda, W., and Hangombe, B.M. (2020). Antimicrobial Susceptibility Pattern and Detection of Extended-Spectrum Beta-Lactamase (blaCTX-M) Gene in Escherichia coli from Urinary Tract Infections at the University Teaching Hospital in Lusaka, Zambia. medRxiv.","DOI":"10.1101\/2020.05.16.20103705"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s42522-023-00079-0","article-title":"Quinolone-resistant Escherichia coli at the interface between humans, poultry and their shared environment- a potential public health risk","volume":"5","author":"Aworh","year":"2023","journal-title":"One Health Outlook"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1093\/cid\/ciw283","article-title":"Fecal Colonization with Extended-spectrum Beta-lactamase\u2013Producing Enterobacteriaceae and Risk Factors Among Healthy Individuals: A Systematic Review and Metaanalysis","volume":"63","author":"Karanika","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Husna, A., Rahman, M.M., Badruzzaman, A.T.M., Sikder, M.H., Islam, M.R., Rahman, M.T., Alam, J., and Ashour, H.M. (2023). Extended-Spectrum \u03b2-Lactamases (ESBL): Challenges and Opportunities. Biomedicines, 11.","DOI":"10.3390\/biomedicines11112937"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Shawa, M., Furuta, Y., Paudel, A., Kabunda, O., Mulenga, E., Mubanga, M., Kamboyi, H., Zorigt, T., Chambaro, H., and Simbotwe, M. (2022). Clonal relationship between multidrug-resistant Escherichia coli ST69 from poultry and humans in Lusaka, Zambia. FEMS Microbiol. Lett., 368.","DOI":"10.1093\/femsle\/fnac004"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/s13756-021-00941-8","article-title":"Novel chromosomal insertions of ISEcp1-blaCTX-M-15 and diverse antimicrobial resistance genes in Zambian clinical isolates of Enterobacter cloacae and Escherichia coli","volume":"10","author":"Shawa","year":"2021","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"27. Arcilla, M.S., Van Hattem, J.M., Bootsma, M.C., van Genderen, P.J., Goorhuis, A., Grobusch, M.P., Klaassen, C.H., Lashof, A.M.O., Schultsz, C., and Stobberingh, E.E. (2020). Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in a population of Dutch travellers: A cross-sectional study. Travel Med. Infect. Dis., 33.","DOI":"10.1016\/j.tmaid.2019.101547"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Ribeiro, L.F., Nespolo, N.M., Rossi, G.A.M., and Fairbrother, J.M. (2024). Exploring Extended-Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli in Food-Producing Animals and Animal-Derived Foods. Pathogens, 13.","DOI":"10.3390\/pathogens13040346"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"dlad060","DOI":"10.1093\/jacamr\/dlad060","article-title":"Antimicrobial resistance profiles of Escherichia coli isolated from laying hens in Zambia: Implications and significance on one health","volume":"5","author":"Mudenda","year":"2023","journal-title":"JAC Antimicrob. Resist"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Shawa, M., Paudel, A., Chambaro, H., Kamboyi, H., Nakazwe, R., Alutuli, L., Zorigt, T., Sinyawa, T., Samutela, M., and Chizimu, J. (2024). Trends, patterns and relationship of antimicrobial use and resistance in bacterial isolates tested between 2015\u20132020 in a national referral hospital of Zambia. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0302053"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.22207\/JPAM.18.3.23","article-title":"Increasing Resistance of Nosocomial and Community-Acquired Escherichia coli in Clinical Samples from Hospitals and Clinics in Sana\u2019a City","volume":"18","author":"Alharazi","year":"2024","journal-title":"J. Pure Appl. Microbiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"166","DOI":"10.4103\/UA.UA_109_20","article-title":"Susceptibility of hospital-acquired uropathogens to first-line antimicrobial agents at a tertiary health-care hospital, Saudi Arabia","volume":"13","author":"Alamri","year":"2021","journal-title":"Urol. Ann."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.jgar.2019.07.019","article-title":"Uropathogens and antibiotic resistance in the community and hospital-induced urinary tract infected children","volume":"20","author":"Demir","year":"2020","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e26597","DOI":"10.1097\/MD.0000000000026597","article-title":"Clinical significance of YAP1 and TAZ in esophageal squamous cell carcinoma","volume":"100","author":"Liu","year":"2021","journal-title":"Medicine"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Sintondji, K., Fabiyi, K., Hougbenou, J., Koudokpon, H., L\u00e8gba, B., Amoussou, H., Haukka, K., and Dougnon, V. (2023). Prevalence and characterization of ESBL-producing Escherichia coli in healthy pregnant women and hospital environments in Benin: An approach based on Tricycle. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1227000"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Mudenda, S., Malama, S., Munyeme, M., Hang\u2019ombe, B.M., Mainda, G., Kapona, O., Mukosha, M., Yamba, K., Bumbangi, F.N., and Mfune, R.L. (2022). Awareness of Antimicrobial Resistance and Associated Factors among Layer Poultry Farmers in Zambia: Implications for Surveillance and Antimicrobial Stewardship Programs. Antibiotics, 11.","DOI":"10.3390\/antibiotics11030383"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Fenollar-Penad\u00e9s, A., Catal\u00e1-Gregori, P., Tall\u00e1-Ferrer, V., Castillo, M.\u00c1., Garc\u00eda-Ferr\u00fas, M., and Jim\u00e9nez-Belenguer, A. (2024). Evolution of the Antibiotic Resistance Levels, Multi-Resistance Patterns, and Presence of Antibiotic Resistance Genes in E. coli Isolates from the Feces of Breeding Hens during the Rearing Period. Antibiotics, 13.","DOI":"10.3390\/antibiotics13080753"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Mohanty, D., Das, B.K., Kumari, P., Dey, S., Bera, A.K., Sahoo, A.K., Dasgupta, S., and Roy, S. (2024). Prevalence of Extended-Spectrum \u03b2-Lactamases (ESBLs) Producing Aeromonas spp. Isolated from Lamellidens marginalis (Lamark, 1819) of Sewage-Fed Wetland: A Phenotypic and Genotypic Approach. Microorganisms, 12.","DOI":"10.3390\/microorganisms12040723"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Mshana, S.E., Falgenhauer, L., Mirambo, M.M., Mushi, M.F., Moremi, N., Julius, R., Seni, J., Imirzalioglu, C., Matee, M., and Chakraborty, T. (2016). Predictors of blaCTX-M-15 in varieties of Escherichia coli genotypes from humans in community settings in Mwanza, Tanzania. BMC Infect. Dis., 16.","DOI":"10.1186\/s12879-016-1527-x"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Mwakyoma, A.A., Kidenya, B.R., Minja, C.A., Mushi, M.F., Sandeman, A., Sabiti, W., Holden, M.T.G., and Mshana, S.E. (2023). Allele distribution and phenotypic resistance to ciprofloxacin and gentamicin among extended-spectrum \u03b2-lactamase-producing Escherichia coli isolated from the urine, stool, animals, and environments of patients with presumptive urinary tract infection in Tanzania. Front. Antibiot., 2.","DOI":"10.3389\/frabi.2023.1164016"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Silago, V., Kovacs, D., Samson, H., Seni, J., Matthews, L., Oravcov\u00e1, K., Lupindu, A.M., Hoza, A.S., and Mshana, S.E. (2021). Existence of Multiple ESBL Genes among Phenotypically Confirmed ESBL Producing Klebsiella pneumoniae and Escherichia coli Concurrently Isolated from Clinical, Colonization and Contamination Samples from Neonatal Units at Bugando Medical Center, Mwanza, Tanzania. Antibiotics, 10.","DOI":"10.3390\/antibiotics10050476"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1007\/s00248-021-01803-x","article-title":"Detection of blaTEM, blaCTX-M, blaCMY, and blaSHV Genes among Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Isolated from Migratory Birds Travelling to Bangladesh","volume":"83","author":"Islam","year":"2022","journal-title":"Microb. Ecol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Zhang, Z., Guo, H., Li, X., Li, W., Yang, G., Ni, W., Zhan, M., Lu, L., Zhang, Z., and Li, X. (2021). Genetic Diversity and Characteristics of blaNDM-Positive Plasmids in Escherichia coli. Front. Microbiol., 12.","DOI":"10.3389\/fmicb.2021.729952"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s13052-024-01599-9","article-title":"Prevalence of extended-spectrum beta-lactamase and molecular detection of blaTEM, blaSHV, and blaCTX-M genotypes among gram-negative Bacilli isolates from hospital acquired infections in pediatrics, one institutional study","volume":"50","author":"Elsayed","year":"2024","journal-title":"Ital. J. Pediatr."},{"key":"ref_45","first-page":"6","article-title":"Prevalence of blatem, blashv, and blactx-m genes among esbl-producing Escherichia coli isolated from the blood samples of icus patients of university hospitals in Sana\u2019a city, Yemen","volume":"8","author":"Othman","year":"2024","journal-title":"Univ. J. Pharm. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1080\/14787210.2023.2234082","article-title":"High frequency and molecular characterization of ESBL-producing Enterobacteriaceae isolated from wound infections in North Lebanon","volume":"21","author":"Hamwi","year":"2023","journal-title":"Expert. Rev. Anti-Infect. Ther."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Telling, K., Brauer, A., Laht, M., Kalmus, P., Toompere, K., Kisand, V., Maimets, M., Remm, M., Tenson, T., and Lutsar, I. (2020). Characteristics of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae and Contact to Animals in Estonia. Microorganisms, 8.","DOI":"10.3390\/microorganisms8081130"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Tadesse, S., Mulu, W., Genet, C., Kibret, M., and Belete, M.A. (2022). Emergence of High Prevalence of Extended-Spectrum Beta-Lactamase and Carbapenemase-Producing Enterobacteriaceae Species among Patients in Northwestern Ethiopia Region. Biomed. Res. Int., 2022.","DOI":"10.1155\/2022\/5727638"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Vargas-Gutierrez, P., Silva-Sanchez, J., Uribe-Salas, F.J., Lopez-Jasso, F., Juarez-Perez, E.Y., del Rocio Gonzalez-Martinez, M., and Camacho, H.B. (2024). Molecular Characterization of Extended Spectrum \u03b2-Lactamase-Producing Escherichia coli: Insights into the O25b-ST131 Clone in Mexican Urinary Tract Infections. Jundishapur J. Microbiol., 17.","DOI":"10.5812\/jjm-143352"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1089\/mdr.2020.0530","article-title":"Clinical and Molecular Findings of Infections Caused by Extended-Spectrum \u03b2-Lactamase-Producing Enterobacterales in Patients with Solid Tumors: A Single-Center Study","volume":"27","author":"Szymankiewicz","year":"2021","journal-title":"Microb. Drug Resist."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Huang, J., Lv, C., Li, M., Rahman, T., Chang, Y.-F., Guo, X., Song, Z., Zhao, Y., Li, Q., and Ni, P. (2024). Carbapenem-resistant Escherichia coli exhibit diverse spatiotemporal epidemiological characteristics across the globe. Commun. Biol., 7.","DOI":"10.1038\/s42003-023-05745-7"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Huang, L., Hu, H., Xu, C., Zhou, M., Li, Y., Li, Y., Wu, S., and Dong, N. (2023). Characterization of NDM-5-Producing Escherichia coli Strains Isolated from Pediatric Patients with Bloodstream Infections in a Chinese Hospital. Genes, 14.","DOI":"10.3390\/genes14020520"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Flament-Simon, S.-C., Garc\u00eda, V., Duprilot, M., Mayer, N., Alonso, M.P., Garc\u00eda-Meni\u00f1o, I., Blanco, J.E., Blanco, M., Nicolas-Chanoine, M.-H., and Blanco, J. (2020). High Prevalence of ST131 Subclades C2-H30Rx and C1-M27 Among Extended-Spectrum \u03b2-Lactamase-Producing Escherichia coli Causing Human Extraintestinal Infections in Patients From Two Hospitals of Spain and France During 2015. Front. Cell Infect Microbiol., 10.","DOI":"10.3389\/fcimb.2020.00125"},{"key":"ref_54","first-page":"426","article-title":"Relationship between virulence factors, resistance to antibiotics and phylogenetic groups of uropathogenic Escherichia coli in two locations in Mexico","volume":"35","year":"2017","journal-title":"Enfermedades Infecc. Y Microbiol. Clin."},{"key":"ref_55","unstructured":"(2024, July 24). Total Number of Households by Province, Zambia. Zambia Statistics Agency, Available online: https:\/\/www.zamstats.gov.zm\/total-number-of-household-by-province-zambia-2022\/."},{"key":"ref_56","unstructured":"(2024, September 09). 2022 Census\u2014Zambia Statistics Agency, Available online: https:\/\/www.zamstats.gov.zm\/2022-census\/."},{"key":"ref_57","unstructured":"(2024, September 10). M100 Ed34|Performance Standards for Antimicrobial Susceptibility Testing, 34th Edition. Available online: https:\/\/clsi.org\/standards\/products\/microbiology\/documents\/m100\/."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1093\/ajcp\/45.4_ts.493","article-title":"Antibiotic susceptibility testing by a standardized single disk method","volume":"45","author":"Bauer","year":"1966","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Feldgarden, M., Brover, V., Gonzalez-Escalona, N., Frye, J.G., Haendiges, J., Haft, D.H., Hoffmann, M., Pettengill, J.B., Prasad, A.B., and Tillman, G.E. (2021). AMRFinderPlus and the Reference Gene Catalog facilitate examination of the genomic links among antimicrobial resistance, stress response, and virulence. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-91456-0"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Leggett, R.M., Ramirez-Gonzalez, R.H., Clavijo, B.J., Waite, D., and Davey, R.P. (2013). Sequencing quality assessment tools to enable data-driven informatics for high throughput genomics. Front. Genet., 4.","DOI":"10.3389\/fgene.2013.00288"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1089\/cmb.2012.0021","article-title":"SPAdes: A new genome assembly algorithm and its applications to single-cell sequencing","volume":"19","author":"Bankevich","year":"2012","journal-title":"J. Comput. Biol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1093\/bioinformatics\/btt086","article-title":"QUAST: Quality assessment tool for genome assemblies","volume":"29","author":"Gurevich","year":"2013","journal-title":"Bioinformatics"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1101\/gr.186072.114","article-title":"CheckM: Assessing the quality of microbial genomes recovered from isolates, single cells, and metagenomes","volume":"25","author":"Parks","year":"2015","journal-title":"Genome Res."},{"key":"ref_65","first-page":"e000056","article-title":"SNP-sites: Rapid efficient extraction of SNPs from multi-FASTA alignments","volume":"2","author":"Page","year":"2016","journal-title":"Microb. Genom."},{"key":"ref_66","first-page":"57","article-title":"Some probabilistic and statistical problems in the analysis of DNA sequences","volume":"17","year":"1986","journal-title":"Lect. Math. Life Sci."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"W293","DOI":"10.1093\/nar\/gkab301","article-title":"Intesractive Tree of Life (iTOL) v5: An online tool for phylogenetic tree display and annotation","volume":"49","author":"Letunic","year":"2021","journal-title":"Nucleic Acids Res."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/10\/951\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:10:16Z","timestamp":1760112616000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/10\/951"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,10]]},"references-count":67,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["antibiotics13100951"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics13100951","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,10]]}}}