A One Health Comparative Assessment of Antimicrobial Resistance in Generic and Extended-Spectrum Cephalosporin-Resistant from Beef Production, Sewage and Clinical Settings.

This study aimed to compare antimicrobial resistance (AMR) in extended-spectrum cephalosporin-resistant and generic from a One Health continuum of the beef production system in Alberta, Canada. A total of 705 extended-spectrum cephalosporin-resistant (ESC) were obtained from: cattle feces (CFeces, = 382), catch basins (CBasins, = 137), surrounding streams (SStreams, = 59), beef processing plants (BProcessing, = 4), municipal sewage (MSewage; = 98) and human clinical specimens (CHumans, = 25). Generic isolates (663) included: CFeces ( = 142), CBasins ( = 185), SStreams ( = 81), BProcessing ( = 159) and MSewage ( = 96). All isolates were screened for antimicrobial susceptibility to 9 antimicrobials and two clavulanic acid combinations. In ESC oxytetracycline (87.7%), ampicillin (84.4%) and streptomycin (73.8%) resistance phenotypes were the most common, with source influencing AMR prevalence ( < 0.001). In generic oxytetracycline (51.1%), streptomycin (22.6%), ampicillin (22.5%) and sulfisoxazole (14.3%) resistance were most common. Overall, 88.8% of ESC, and 26.7% of generic isolates exhibited multi-drug resistance (MDR). MDR in ESC was high from all sources: CFeces (97.1%), MSewage (96.9%), CHumans (96%), BProcessing (100%), CBasins (70.5%) and SStreams (61.4%). MDR in generic was lower with CFeces (45.1%), CBasins (34.6%), SStreams (23.5%), MSewage (13.6%) and BProcessing (10.7%). ESBL phenotypes were confirmed in 24.7% ( = 174) ESC and 0.6% of generic . Prevalence of genes in ESC were (30.1%), (21.6%), (20%), (7.9%), (3.0%), (6.4%), (1.4%) and AmpC β-lactamase (81.3%). The lower AMR in ESC from SStreams and BProcessing and higher AMR in CHumans and CFeces likely reflects antimicrobial use in these environments. Although MDR levels were higher in ESC as compared to generic , AMR to the same antimicrobials ranked high in both ESC and generic sub-populations. This suggests that both sub-populations reflect similar AMR trends and are equally useful for AMR surveillance. Considering that MDR ESC MSewage isolates were obtained without enrichment, while those from CFeces were obtained with enrichment, MSewage may serve as a hot spot for MDR emergence and dissemination.