Assessment Of Antimicrobial Resistance Research Articles

Assessment of antimicrobial resistance, biofilm formation, and surface modification potential in hospital strains of Pseudomonas aeruginosa and Klebsiella pneumoniae

The occurrence of healthcare-associated infections is a multifactorial phenomenon related to hospital space contamination by bacteria. The ESKAPE group, specifically Pseudomonas aeruginosa and Klebsiella pneumoniae, play a relevant role in the occurrence of these infections. Therefore, comprehensive research is needed to identify characteristics that justify the prevalence of these species in the healthcare environment. In this line, the study aimed to determine the antimicrobial resistance, biofilm formation, and the potential for polymer degradation in a collection of 33 P. aeruginosa strains and 2 K. pneumoniae strains sampled from various equipment and non-critical surfaces in a Portuguese hospital. Antimicrobial susceptibility tests revealed that none of the strains was categorized as multidrug-resistant (non-MDR). An assessment of their biofilm-forming capabilities indicated that 97 % of the strains exhibited biofilm-producing characteristics. Notably, within this group, the majority of P. aeruginosa and half of K. pneumoniae strains were classified as strong biofilm producers. Furthermore, the strains were evaluated for their potential to cause damage or change medical devices, namely infusion sets, nasal cannula, and urinary catheters. Three P. aeruginosa strains, two strong and one moderate biofilm producers, showed the highest ability to modify surfaces of the nasal cannula and infusion sets. Additionally, the Chi-square test revealed a statistically significant relationship between the presence of P. aeruginosa strains and the water accession spots. In conclusion, this work suggests that bacteria from this group hold a significant ability to grow in the healthcare environment through the degradation of non-critical materials. This suggests a potential concern for the persistence and proliferation of these organisms in hospital environments, emphasizing the importance of robust infection control measures to mitigate the risks associated with bacterial growth on such surfaces.

Assessment of freshwater fish farms for the identification of the geographical areas harbouring antimicrobial resistance

Assessment of antimicrobial resistance (AMR) in freshwater fish farms has been rarely investigated. Aeromonas are considered as an indicator organism for monitoring AMR in aquatic environment. Identification of the geographical areas harbouring AMR have implications for developing AMR mitigation strategies. The present study investigated the prevalence of AMR in freshwater fish farms (n = 124) in four districts (A-D) of Uttar Pradesh, India. The study revealed significantly higher AMR in fish farms of district D for ceftazidime, cefotaxime and trimethoprim-sulfamethoxazole. Similarly, AMR to ciprofloxacin and tetracycline was significantly higher in district A, and cefoxitin (FOX) in district B. District D also showed the highest number of MDR strains, AmpC and ESBL producers. Overall, maximum AMR was seen to β-lactams (35.5%) and aminoglycosides (14.5%). Twenty-five AMR phenotypes and eighteen AMR genotypes were detected in the study. The farms of district D showed significantly higher number of resistant phenotypes (≥3 antimicrobials). Furthermore, the study identified the species of Aeromonas contributing to AMR. Two clusters were observed: cluster I- resistant to FOX only, and cluster II (comprising of A. caviae and A. veronii bv veronii)- resistant to multiple antimicrobials and included majority of AmpC producers. A. caviae had significantly higher MAR than other Aeromonas species. The ARGs shared among the cluster II species and its close relative A. veronii bv sobria were blaTEM,sul1, tet(E) and blaCIT. Overall, our study identified the geographical districts harbouring higher AMR in the freshwater fish farms. These findings suggest the need for spatial assessment of AMR in aquaculture.

Response of viable bacteria to antibiotics in aerobic granular sludge: Resistance mechanisms and behaviors, bacterial communities, and driving factors

The assessment of antimicrobial resistance (AMR) risk by DNA-based techniques mainly relies on total bacterial DNA. In this case, AMR risk recognition is restricted to the genotype level, lacking crucial phenotypic information, such as the distribution of antibiotic resistance genes (ARGs) and mobile genetic elements (MGEs) in dead and viable bacteria. This limitation hinders the recognition of AMR behavior. Herein, based on propidium monoazide (PMA) shielding method, this work firstly quantified the intracellular ARGs/MGEs in viable and dead bacteria, and the impact of viable bacteria composition on the formation of intracellular/extracellular polymeric substance-related /cell-free ARGs (i/e/cARGs) and MGEs (i/e/cMGEs) in aerobic granular sludge (AGS). The shielding efficiency of PMA against dead bacteria was optimized to be as high as 97.5% when the MLSS of AGS was 2.0 g/L. Under antibiotic stimulation, 29.0% ∼ 49.0% of iARGs/iMGEs were carried by viable bacteria, and the remaining proportion were carried by dead bacteria. 18 out of the top 20 dominant genera showed a change in abundance by more than 1% after PMA treatment. 29 viable hosts were identified to associate with 52 iARGs, of which 28 and 15 hosts were also linked to 40 eARGs and 26 cARGs. Also, partial least-squares path model and variance partitioning analysis disclosed that viable bacteria and i/e/cMGEs had a positive effect on i/e/cARGs, with both contributing as much as 64.5% to the total ARGs enrichment. These results better visualized the AMR risk carried by viable bacteria and the categories of viable hosts. This work provides a novel insight into analyzing the actual AMR risk and viable hosts, helping to the reduction and control of AMR in wastewater treatment plants.

Antimicrobial susceptibility testing using infrared attenuated total reflection (IR-ATR) spectroscopy to monitor metabolic activity

Fast and accurate detection of antimicrobial resistance in pathogens remains a challenge, and with the increase in antimicrobial resistance due to mis- and overuse of antibiotics, it has become an urgent public health problem. We demonstrate how infrared attenuated total reflection (IR-ATR) can be used as a simple method for assessment of bacterial susceptibility to antibiotics. This is achieved by monitoring the metabolic activities of bacterial cells via nutrient consumption and using this as an indicator of bacterial viability. Principal component analysis of the obtained spectra provides a tool for fast and simple discrimination of antimicrobial resistance in the acquired data. We demonstrate this concept using four bacterial strains and four different antibiotics, showing that the change in glucose concentration in the growth medium after 2 h, as monitored by IR-ATR, can be used as a spectroscopic diagnostic technique, to reduce detection time and to improve quality in the assessment of antimicrobial resistance in pathogens.

Knowledge gaps in the assessment of antimicrobial resistance in surface waters.

ABSTRACTThe spread of antibiotic resistance in the water environment has been widely described. However, still many knowledge gaps exist regarding the selection pressure from antibiotics, heavy metals and other substances present in surface waters as a result of anthropogenic activities, as well as the extent and impact of this phenomenon on aquatic organisms and humans. In particular, the relationship between environmental concentrations of antibiotics and the acquisition of ARGs by antibiotic-sensitive bacteria as well as the impact of heavy metals and other selective agents on antimicrobial resistance (AMR) need to be defined. Currently, established safety values are based on the effects of antibiotic toxicity neglecting the question of AMR spread. In turn, risk assessment of antibiotics in waterbodies remains a complex question implicating multiple variables and unknowns reinforced by the lack of harmonized protocols and official guidelines. In the present review, we discussed current state-of-the-art and the knowledge gaps related to pressure exerted by antibiotics and heavy metals on aquatic environments and their relationship to the spread of AMR. Along with this latter, we reflected on (i) the risk assessment in surface waters, (ii) selective pressures contributing to its transfer and propagation and (iii) the advantages of metagenomics in investigating AMR. Furthermore, the role of microplastics in co-selection for metal and antibiotic resistance, together with the need for more studies in freshwater are highlighted.

Metagenomics and Other Omics Approaches to Bacterial Communities and Antimicrobial Resistance Assessment in Aquacultures.

The shortage of wild fishery resources and the rising demand for human nutrition has driven a great expansion in aquaculture during the last decades in terms of production and economic value. As such, sustainable aquaculture production is one of the main priorities of the European Union’s 2030 agenda. However, the intensification of seafood farming has resulted in higher risks of disease outbreaks and in the increased use of antimicrobials to control them. The selective pressure exerted by these drugs provides the ideal conditions for the emergence of antimicrobial resistance hotspots in aquaculture facilities. Omics technology is an umbrella term for modern technologies such as genomics, metagenomics, transcriptomics, proteomics, culturomics, and metabolomics. These techniques have received increasing recognition because of their potential to unravel novel mechanisms in biological science. Metagenomics allows the study of genomes in microbial communities contained within a certain environment. The potential uses of metagenomics in aquaculture environments include the study of microbial diversity, microbial functions, and antibiotic resistance genes. A snapshot of these high throughput technologies applied to microbial diversity and antimicrobial resistance studies in aquacultures will be presented in this review.

Screening the Presence of Non-Typhoidal Salmonella in Different Animal Systems and the Assessment of Antimicrobial Resistance.

Simple SummaryIn this study, for the first time in Chile, we compared resistance profiles of Salmonella strains isolated from 4047 samples from domestic and wild animals. A total of 106 Salmonella strains (2.61%) were isolated, and their serogroups were characterized and tested for susceptibility to 16 different antimicrobials. This study reports 47 antimicrobial-resistant (AMR) Salmonella strains (44.3% of total strains). Of the 47, 28 corresponded to single-drug resistance (26.4%) and 19 to multidrug resistance (17.9%). The association between AMR and a subset of independent variables was evaluated using multivariate logistic models. Interestingly, S. Enteritidis was highly persistent in animal production systems; however, we report that serogroup D strains were 18 times less likely to be resistant to at least one antimicrobial agent than the most common serogroup (serogroup B). The antimicrobials presenting the greatest contributions to AMR were ampicillin, streptomycin and tetracycline.Salmonella is a major bacterial foodborne pathogen that causes the majority of worldwide food-related outbreaks and hospitalizations. Salmonellosis outbreaks can be caused by multidrug-resistant (MDR) strains, emphasizing the importance of maintaining public health and safer food production. Nevertheless, the drivers of MDR Salmonella serovars have remained poorly understood. In this study, we compare the resistance profiles of Salmonella strains isolated from 4047 samples from domestic and wild animals in Chile. A total of 106 Salmonella strains (2.61%) are isolated, and their serogroups are characterized and tested for susceptibility to 16 different antimicrobials. The association between antimicrobial resistance (AMR) and a subset of independent variables is evaluated using multivariate logistic models. Our results show that 47 antimicrobial-resistant strains were found (44.3% of the total strains). Of the 47, 28 correspond to single-drug resistance (SDR = 26.4%) and 19 are MDR (17.9%). S. Enteritidis is highly persistent in animal production systems; however, we report that serogroup D strains are 18 times less likely to be resistant to at least one antimicrobial agent than the most common serogroup (serogroup B). The antimicrobials presenting the greatest contributions to AMR are ampicillin, streptomycin and tetracycline. Additionally, equines and industrial swine are more likely to acquire Salmonella strains with AMR. This study reports antimicrobial-susceptible and resistant Salmonella in Chile by expanding the extant literature on the potential variables affecting antimicrobial-resistant Salmonella.

Prevalence, Antimicrobial Resistance, and Molecular Characterization of Staphylococcus aureus Isolated from Animals, Meats, and Market Environments in Xinjiang, China.

Staphylococcus aureus has been recognized as an important foodborne pathogen. However, knowledge about the epidemiology and genetic characteristics of S. aureus in the meat production chain from farm to market is limited. The aim of this study was to investigate the genetic characteristics of S. aureus in animal samples isolated from Xinjiang province farms and farmer' markets, by determining staphylococcal protein A (spa) repeat region and virulence factor typing, and by assessment of antimicrobial resistance. Out of 1324 samples, 128 (9.7%) were positive for S. aureus, 26 (2.0%) of them were identified as methicillin-resistant S. aureus (MRSA) and 88 (6.6%) of them were identified as vancomycin-resistant S. aureus (VRSA). Antimicrobial resistance was determined using the disk diffusion method. S. aureus isolates showed resistance to penicillin G (98.4%), clarithromycin (69.5%), erythromycin (69.5%), vancomycin (68.8%), and tetracycline (67.2%). A total of 80.4% of isolates showed resistance to three or more antimicrobial classes. PCR was used to detect ten virulence genes such as the enterotoxin (sea, seb, and sec), hemolysin (hla and hlb), clumping factor (clfA), and fibronectin-binding proteins A and B (fnbA and fnbB). Our study showed that isolates harbored two or seven virulence genes. All strains encode hla and clfA, and half of them encode hlb and enterotoxin genes. The spa typing results showed that the 128 isolates were grouped into 32 spa types. The main spa types were t127 (22.7%), t2592 (12.5%), t437 (10.9%), and t2616 (10.9%). Notably, isolates of t437 type accounted for 46.2% of the MRSA. Our data indicate that meats in the slaughterhouse and farmers' markets were contaminated with S. aureus. S. aureus virulence genes and spa types were diverse, and its antibiotic resistance was serious. The presence of MRSA and VRSA represents potential public health risks and warrants further investigation regarding the driving factors of such resistance and their transmission to humans.

Occurrence of extended-spectrum beta-lactamaseand AmpC-type cephalosporinase-producing Escherichia coli in mastitic cow’s milk

The aim of the study was to evaluate the occurrence of Escherichia coli producing extended-spectrum betalactamases (ESBL and/or AmpC) in the milk of cows with mastitis. A total 2,500 milk samples from mastitic cows were tested in 2014-2018. The investigations included the culture of bacteria on MacConkey agar with cefotaxime, identification with the API Rapid 32 E test, synergy disc test D68C, assessment of antimicrobial resistance by the microdilution method and confirmation of the occurrence of genes encoding ESBL and AmpC. Out of 133 isolates identified as E. coli, 87 were recognized as ESBL producers and 46 as chromosomally encoded cephalosporinase AmpC producers. The blaTEM was predominant in the ESBL producers. All 46 AmpC-positive strains had the blaCMY gene. The results confirmed the occurrence of extended-spectrum betalactamase- producing E. coli in inflammatory secretions from mastitic

Epidemiological assessment of antimicrobial resistance of Salmonella species from wildlife at human-animal interface in Bangladesh

Epidemiological assessment of antimicrobial resistance of Salmonella species from wildlife at human-animal interface in Bangladesh

Application of artificial intelligence to the in silico assessment of antimicrobial resistance and risks to human and animal health presented by priority enteric bacterial pathogens

Application of artificial intelligence to the in silico assessment of antimicrobial resistance and risks to human and animal health presented by priority enteric bacterial pathogens

First outbreak reported caused by Erysipelothrix species strain 2 in turkeys from poultry-producing farms in Brazil

The aims of this study were to report the first isolation of Erysipelothrix sp. strain 2 (ES2) associated with clinical signs of diseases as well as mortality in turkeys and identify the antimicrobial resistance of the isolates. We evaluated 118 farms for bacteriological analysis and TaqMan real-time PCR to identify the microorganism in different organs. After this, we made the epidemiological analysis between the positive flocks and the mortality mean. We performed the sequencing of the 16S rRNA region and the assessment of antimicrobial resistance. We have identified 18 (15.25%) as ES2-positive flocks, without any other species from the same genus being found. After analysing the organ samples, we found liver as the organ of choice for the isolation of the ES2. The sequencing of 16S rRNA region of ES2 identified high homology with E. tonsillarum and E. rhusiopathiae, suggesting that it is not the best-suited target to identify this species. We have found a positive association between isolation of the bacteria in organs and flocks’ mortality. Positive flocks had a mortality mean rate of 6.87%, which is significantly greater than 3.76% in negative flocks. Ill turkeys had gross lesions of generalized septicaemia. The bacterial isolates showed high resistance to fosfomycin and trimethoprim/sulfamethoxazole and sensibility to norfloxacin, amoxicillin and lincomycin/spectinomycin. This is the first study in the world that addressed ES2 as the causative agent of erysipelas in turkey.

Assessment of Antimicrobial Resistance in the Food Chains in Norway

Assessment of Antimicrobial Resistance in the Food Chains in Norway

Molecular analysis of integrons and antimicrobial resistance profile in Shigella spp. isolated from acute pediatric diarrhea patients.

Introduction: Shigella spp. is a growing global health concern due to increasing multiple drug resistance, commonly resulting in therapeutic failure. Integrons are gene expression systems run by integrase genes. The aims of this study were detection of class I, II and III integrons and assessment of antimicrobial resistance in Shigella spp. isolated from acute pediatric diarrhea patients.Materials and methods: From January to December 2015, 16 Shigella spp. were isolated from 310 non-duplicative diarrheal stool samples in Children’s Medical Center, Tehran, Iran. The isolates were analyzed for their antibiotic susceptibility using CLSI guidelines M100-S14. Multiplex PCR was used for amplification of I, II and III integron-associated integrase (intl) genes.Results: Of 310 stool samples, 16 (5.2%) were positive for Shigella spp., in 7 of them S. sonnei and in 9 of them S. flexneri were identified. Results of the antimicrobial susceptibility test showed that 6.2%, 50%, 31.2%, 6.2%, 81.2%, 56.2% and 31.2% of the isolates were resistant to gentamicin, chloramphenicol, nalidixic acid, ciprofloxacin, tetracycline, ampicillin and trimethoprim-sulfamethoxazole, respectively. Multiplex PCR results revealed that 6.2% (1/16), 31.2% (5/16), 50% (8/16) of Shigella isolates carried intlI, intlII and both intlI/intllI genes. No class 3 integrons were detected.Discussion: In this study, multidrug resistance was seen in Shigella isolates similar to that in isolates from other geographical areas. This is possible due to inappropriate use of antimicrobials. Furthermore, prevalence of multidrug resistance was significantly linked to the presence of integrin genes. Conclusion: A class 2 integron plays a role in presence of multidrug resistance in Shigella spp. It is vital to prevent the spread of antibiotic resistance through continuous monitoring.

Relative performance of antimicrobial susceptibility assays on clinical Escherichia coli isolates from animals

The assessment of antimicrobial resistance in bacteria derived from animals is often performed using the disc diffusion assay. However broth-microdilution is the preferred assay for national antimicrobial resistance surveillance programs. This study aimed to evaluate the accuracy of disc diffusion relative to broth-microdilution across a panel of 12 antimicrobials using data from a collection of 994 clinical Escherichia coli isolates from animals. Disc diffusion performance was evaluated by diagnostic sensitivity, specificity, likelihood ratio pairs and receive-operating characteristic (ROC) analysis. Data was dichotomised using CLSI susceptible and resistant clinical breakpoints. In addition, disc diffusion breakpoints produced using diffusion Breakpoint Estimation Testing Software (dBETS) were evaluated. Analysis revealed considerable variability in performance estimates for disc diffusion susceptible and resistant breakpoints (AUC ranges: 0.78–0.99 and 0.92–1.0, respectively) across the panel of antimicrobials. Ciprofloxacin, tetracycline, and ampicillin estimates were robust across both breakpoints, whereas estimates for several antimicrobials including amoxicillin-clavulanic acid, cefoxitin and gentamicin were less favourable using susceptible breakpoints. Overall performance estimates were moderately improved when dBETS susceptible breakpoints were applied. For most antimicrobials, disc diffusion was accurate at predicting resistance of clinical E. coli from animals that could otherwise be determined by broth-microdilution. While disc diffusion is suboptimal for assessing the proportion of fully susceptible isolates for some drugs, sensitivity and specificity estimates provided here allow for the use of standard formula to correct this. For this reason, disc diffusion has applicability in national surveillance provided the performance of the assay is taken into account.

Analysis of complement gene variants in the clinical laboratory: Comparison of Next-Generation Sequencing (NGS) and Sanger methods

The assessment of antimicrobial resistance in bacteria derived from animals is often performed using the disc diffusion assay. However broth-microdilution is the preferred assay for national antimicrobial resistance surveillance programs. This study aimed to evaluate the accuracy of disc diffusion relative to broth-microdilution across a panel of 12 antimicrobials using data from a collection of 994 clinical Escherichia coli isolates from animals. Disc diffusion performance was evaluated by diagnostic sensitivity, specificity, likelihood ratio pairs and receive-operating characteristic (ROC) analysis. Data was dichotomised using CLSI susceptible and resistant clinical breakpoints. In addition, disc diffusion breakpoints produced using diffusion Breakpoint Estimation Testing Software (dBETS) were evaluated. Analysis revealed considerable variability in performance estimates for disc diffusion susceptible and resistant breakpoints (AUC ranges: 0.78–0.99 and 0.92–1.0, respectively) across the panel of antimicrobials. Ciprofloxacin, tetracycline, and ampicillin estimates were robust across both breakpoints, whereas estimates for several antimicrobials including amoxicillin-clavulanic acid, cefoxitin and gentamicin were less favourable using susceptible breakpoints. Overall performance estimates were moderately improved when dBETS susceptible breakpoints were applied. For most antimicrobials, disc diffusion was accurate at predicting resistance of clinical E. coli from animals that could otherwise be determined by broth-microdilution. While disc diffusion is suboptimal for assessing the proportion of fully susceptible isolates for some drugs, sensitivity and specificity estimates provided here allow for the use of standard formula to correct this. For this reason, disc diffusion has applicability in national surveillance provided the performance of the assay is taken into account.

583 Three Year Survey of Blood Stream Infections (Bsi) in a Paediatric Intensive Care Unit (Picu)

Background and AimsNosocomial infection is a common cause of morbidity and mortality in PICU. Timely microbiological surveillance and assessment of antimicrobial resistance is important in treatment. We studied the microbiological...

Towards a compatible probiotic-antibiotic combination therapy: assessment of antimicrobial resistance in the Japanese probiotics

To determine the antimicrobial resistance of the Japanese probiotics available in the market without a pharmacist's supervision. A total of 43 isolates were obtained from 40 samples of probiotics (30 dairy products and 10 products in tablet form). Isolates were identified using 16S rRNA gene sequencing and tested for their susceptibility to 14 antimicrobials. They were screened using PCR for some antibiotic resistance genes. Inactivation of cefepime, clarithromycin and vancomycin by different inocula of 11 strains was evaluated using the antibiotic inactivation bioassay. None of the dairy probiotics showed a level of constitutive resistance or carried inducible resistance genes, making them suitable to be administrated with macrolides. Among the probiotics in tablet form only Enterococcus faecium strains carrying the msrC gene showed an MIC(90) of 4 μg ml(-1). Extended-spectrum β-lactams, tetracyclines and ampicillin exhibited powerful germicidal activity against the vast majority of the probiotic strains. There is a limited choice of the Japanese probiotics that can be administered with clinically used antibiotics. Japanese probiotics are widely distributed all over the world. Through the findings of our study, we have attempted to provide guidance for clinicians interested in using the Japanese probiotics in combination with antibiotics.

Monitoring of antimicrobial resistance in healthy dogs: First report of canine ampicillin-resistant Enterococcus faecium clonal complex 17

National surveillance programs on antimicrobial usage and antimicrobial resistance in animals have been established in various countries but few of them include bacteria from pets. The objectives of this study were to assess the prevalence of antimicrobial resistance in healthy dogs and to search for resistance phenotypes of clinical relevance. Escherichia coli and Enterococcus spp. were isolated from faecal swabs obtained from 127 dogs. Disk diffusion was used to measure antimicrobial susceptibility in 117 Escherichia coli, 10 Enterococcus faecium and 51 Enterococcus faecalis of canine origin. Resistance was relatively low compared with food animal species in Denmark. All Escherichia coli isolates were susceptible to broad-spectrum aminopenicillins, third generation cephalosporins and fluoroquinolones. Despite the low prevalence of resistance, statistical analysis of questionnaire data revealed a significant association ( p = 0.02) between recent antimicrobial treatment and resistance in Escherichia coli. Interestingly, two dogs were found to shed Enterococcus faecium resistant to ampicillin. Multilocus sequence typing of these isolates indicated that the two isolates belonged to sequence types associated with human nosocomial infections, and one (ST-192) was genetically related to human epidemic clonal complex 17. The detection of ampicillin-resistant Enterococcus faecium warrants further studies on the prevalence of these bacteria in dogs and on the possible implications to both animal and human health. The results suggest that distinct methods for detection and assessment of antimicrobial resistance in animals should be considered depending on the target animal species and the purposes of the study.

Evaluation of a rapid screening method for detection of antimicrobial resistance in the commensal microbiota of the gut

The assessment of antimicrobial resistance among commensal bacteria is an indicator of the spread of antimicrobial resistance. Rapid screening methods for detection of antimicrobial-resistant faecal Escherichia coli directly on MacConkey plates have been successfully adopted but suffer from lack of standardisation. The purpose of this study was to evaluate a direct plating method (DPM) for detection of antimicrobial-resistant faecal E. coli and to compare it with a conventional method. Faecal samples were collected from 71 healthy children from Peru and Bolivia. In the DPM, a faecal swab was directly plated onto a MacConkey agar plate and antimicrobial disks were applied onto the seeded plate. Raw data were obtained by direct reading of the plate and were subjected to confirmatory analysis. Good concordance between the DPM and a conventional method was observed in detecting carriage of resistant E. coli, with a higher sensitivity for the DPM. Analysis of the results allowed interpretive criteria to be defined for DPM raw data. The DPM showed good sensitivity and specificity at very low cost (ten times cheaper than the conventional method) to investigate the faecal carriage of drug-resistant E. coli. It may represent a useful tool to conduct large-scale resistance surveillance studies and to monitor resistance control programmes cost effectively, particularly in low-resource countries.