Antimicrobial Resistance of Staphylococci at Animal Human Interface in Smallholders and Dairy Farms in Central Oromia, Ethiopia.

Purpose: Staphylococcus species come from a variety of sources and can contaminate milk during milking, cause mastitis and other diseases in animals and humans. The enterotoxins they produce cause food poisoning. Our objectives were to isolate, biochemically characterize, and determine antimicrobial susceptibility profiles of Staphylococcus species from dairy farms in central Oromia, Ethiopia. Methods: A total of 339 samples (n = 135 [raw milk], n = 135 [udders' swabs], n = 25 [milkers' hands swabs], n = 44 [pooled milking utensils' swabs]) were collected from smallholders and dairy farms. Bacteriological culture and biochemical tests were performed to isolate and identify Staphylococcus species, and the Kirby Bauer disk diffusion method was used for antimicrobial susceptibility testing. Results: Across all sample types and dairy farms, 247 (72.9%) Staphylococcus isolates were obtained which comprised of 101 (74.8%) isolates from raw milk, 98 (72.6%) from udder swabs, 30 (68.2%) from pooled utensil swabs, and 18 (72%) from milkers' hand swabs. Fifty coagulase-positive Staphylococcus isolates (20 S. aureus, 20 S. hyicus and 10 S. intermedius) subjected to antimicrobial susceptibility tests have shown various degrees of resistance. All S. aureus isolates were 100% resistant to ampicillin and penicillin. Out of 20 S. hyicus isolates, 90% were resistant to ampicillin and 85% to penicillin. S. intermedius isolates (n=10) were 70% resistant to nalidixic acid and penicillin whilst remaining 100% resistant to ampicillin. Five S. aureus, three S. intermedius and two S. hyicus isolates from raw milk, milk utensil swabs and milkers' hand swabs were multidrug-resistant (resistance to at least three classes of antimicrobials). Conclusion: This study revealed a high prevalence of staphylococci in the dairy cattle, milkers and milking utensils with multidrug-resistant coagulase-positive Staphylococcus species suggesting the significance of pasteurization. Further research is encouraged on the factors leading to antibiotic resistance in Staphylococcus species.

Veterinary Drug Prescribing Practices at Selected District Veterinary Clinics of Rift Valley Areas of Ethiopia.

The rational use of drugs in veterinary medicine has various significances, such as reducing the risk of drug resistance, increasing efficacy, reducing drug residue, and decreasing adverse drug reactions. A retrospective study was conducted to assess veterinary drug prescribing practices at Batu and Arsi-Negelle district veterinary clinics in the rift valley areas of Ethiopia. A total of 2,464 cases were recorded from the case registration books at both the clinics for diseases treated between September 2012 and February 2015. The study results showed that for a total of 2,464 cases diagnosed at both clinics, 3,811 different drugs were prescribed, with an average per encounter of 1.6. Among the total drugs, oxytetracycline, ivermectin, penstrep, sulfa drugs, and albendazole were the most leading prescribed drugs with a frequency of 43.0%, 17.6%, 10.2%, 6.5%, and 1.3%, respectively. All drugs were prescribed by the generic name without any laboratory support of the disease. About 68.3% of the cases were diagnosed by unspecified professionals, whereas 21.7% and 10.1% were done by animal health assistants and veterinarians, respectively. The prescribing practices showed 61.0% of antibiotics and 29.7% of anthelmintics where 45.3% and 54.7% of antibiotics and 17.8% and 82.2% of anthelmintics were given at Batu and Arsi-Negelle veterinary clinics, respectively. Of the prescribed drugs, 4.6% oxytetracycline and 2.6% penstrep were prescribed irrationally to treat diseases that were tentatively diagnosed as parasitic cases. Similarly, 40.5% ivermectin and 17.7% albendazole were prescribed for bacterial infections. In conclusion, this study revealed problems in antibiotics and anthelmintics use, description of routes of administration and length of treatment, and shortage of laboratory diagnostic facilities. Therefore, veterinary drugs, particularly antibiotics and anthelmintics, should be used appropriately to safeguard the public from residual drug impacts and resistance development.

Policy Perspectives of Dog-Mediated Rabies Control in Resource-Limited Countries: The Ethiopian Situation.

One Health disease-control programs are believed to be most effective when implemented within the population transmitting the disease. The World Health Organization (WHO) and partners have targeted the elimination of dog-mediated human rabies by 2030 primarily through mass dog vaccination. Mass vaccination, however, has been constrained by financial resource limitations. The current owner-charged dog vaccination strategy, used in most resource-limited countries like Ethiopia, has not reached the minimum coverage required to build population immunity. Dog vaccination is non-existing in most rural areas of Ethiopia, and coverage is <20% in urban areas. Although the health and economic benefits of rabies elimination outweigh the costs, the direct beneficiaries (public in general) and those who bear the costs (dog owners) are not necessarily the same. In this perspective paper, we aggregate evidence on the socioeconomic burden of rabies in Ethiopia as well as the implications for potential opportunities to control the disease and possibilities to obtain the required funding sources for evidence-based interventions in the control of rabies in Ethiopia.

Updating the global occurrence of Culicoides imicola, a vector for emerging viral diseases.

Culicoides imicola is the main vector transmitting viruses causing animal diseases such as Bluetongue, African Horse Sickness, and Schmallenberg. It has become widely distributed, with reports from South Africa to southern Europe, and from western Africa to southern China. This study presents a global compendium of Culicoides imicola occurrence between 1943 and 2018, reflecting the most recently compiled and harmonized global dataset derived from peer-reviewed literature. The procedures used in producing the data, as well as the geo-coding methods, database management and technical validation procedures are described. The study provides an updated and comprehensive global database of C. imicola occurrence, consisting of 1 039 geo-coded records from 50 countries. The datasets can be used for risk mapping of the diseases transmitted by C. imicola as well as to develop the global habitat suitability for the vector.

Modeling the global distribution of Culicoides imicola: an Ensemble approach.

Culicoides imicola is a midge species serving as vector for a number of viral diseases of livestock, including Bluetongue, and African Horse Sickness. C. imicola is also known to transmit Schmallenberg virus experimentally. Environmental and demographic factors may impose rapid changes on the global distribution of C. imicola and aid introduction into new areas. The aim of this study is to predict the global distribution of C. imicola using an ensemble modeling approach by combining climatic, livestock distribution and land cover covariates, together with a comprehensive global dataset of geo-positioned occurrence points for C. imicola. Thirty individual models were generated by 'biomod2', with 21 models scoring a true skill statistic (TSS) >0.8. These 21 models incorporated weighted runs from eight of ten algorithms and were used to create a final ensemble model. The ensemble model performed very well (TSS = 0.898 and ROC = 0.991) and indicated high environmental suitability for C. imicola in the tropics and subtropics. The habitat suitability for C. imicola spans from South Africa to southern Europe and from southern USA to southern China. The distribution of C. imicola is mainly constrained by climatic factors. In the ensemble model, mean annual minimum temperature had the highest overall contribution (42.9%), followed by mean annual maximum temperature (21.1%), solar radiation (13.6%), annual precipitation (11%), livestock distribution (6.2%), vapor pressure (3.4%), wind speed (0.8%), and land cover (0.1%). The present study provides the most up-to-date predictive maps of the potential distributions of C. imicola and should be of great value for decision making at global and regional scales.

Impact of One-Health framework on vaccination cost-effectiveness: A case study of rabies in Ethiopia.

Livestock losses due to rabies and health and the corresponding benefits of controlling the disease are not often considered when the cost-effectiveness of rabies control is evaluated. In this research, assessed the benefits of applying a One Health perspective that includes these losses to the case of canine rabies vaccination in Ethiopia. We constructed a dynamic epidemiological model of rabies transmission. The model was fit to district-specific data on human rabies exposures and canine demography for two districts with distinct agro-ecologies. The epidemiological model was coupled with human and livestock economic outcomes to predict the health and economic impacts under a range of vaccination scenarios. The model indicates that human exposures, human deaths, and rabies-related livestock losses would decrease monotonically with increasing vaccination coverage. In the rural district, all vaccination scenarios were found to be cost-saving compared to the status quo of no vaccination, as more money could be saved by preventing livestock losses than would be required to fund the vaccination campaigns. Vaccination coverages of 70% and 80% were identified as most likely to provide the greatest net health benefits at the WHO cost-effectiveness threshold over a period of 5 years, in urban and rural districts respectively. Shorter time frames led to recommendations for higher coverage in both districts, as did even a minor threat of rabies re-introduction. Exclusion of rabies-related livestock losses reduced the optimal vaccination coverage for the rural district to 50%. This study demonstrated the importance of including all economic consequences of zoonotic disease into control decisions. Analyses that include cattle and other rabies-susceptible livestock are likely better suited to many rural communities in Africa wishing to maximize the benefits of canine vaccination.

Veterinary medicinal product usage among food animal producers and its health implications in Central Ethiopia.

BACKGROUND: Antimicrobials and anthelmintics are the most commonly used veterinary drugs to control animal diseases. However, widespread use of these drugs could contribute to the emergence of drug resistance. Information on the practice of antimicrobial usage among food animal raising communities in Central Ethiopia is scarce. We used a standardised questionnaire survey to assess knowledge, awareness, and practices related to drug use and resistance in food animals among the farmers in and around Bishoftu town. RESULTS: Of the total of 220 livestock owners interviewed, around 80% of the respondents were not able to define what antimicrobials are and for what purposes they are used. Only 14.1% (n = 31) of the respondents had awareness about antimicrobial resistance (AMR) and its consequences; and 35.5% (n = 11/31) and 9.7% (n = 3/31) of them agreed that the irrational use of antimicrobials in animals could lead to AMR in animals and humans. Oxytetracycline was the most commonly available antibiotic in veterinary drug shops/pharmacies and the most widely used drug in the area. However, 43.3% of the respondents did not see clinical improvements after using antibiotics. Similarly, the respondents explained that no response was observed in 73.3, 70.8 and 52.5% of the cases after medication with anthelmintics, antiprotozoal and acaricides, respectively. About 56.7% of the respondents considered traditional medicines equally important to modern medicines. It was also noted that there were illegal drug vendors, dispensing medicines under unfavourable conditions which include a direct exposure to sunlight, which practice violates the drug handling and storage recommendations given by WHO. CONCLUSION: The study revealed that there is a general lack of awareness among food animal owners about the correct use of antibiotics and anthelmintics. The widespread misuse and improper drug dispensing and handling practices observed in this study can affect the drug quality and can also contribute to the development of drug resistance in central Ethiopia.

Risk Perceptions and Protective Behaviors Toward Bovine Tuberculosis Among Abattoir and Butcher Workers in Ethiopia.

Bovine Tuberculosis (BTB) is a serious cause of economic losses and public health threat, especially in developing countries. Humans acquire BTB through consumption of raw or undercooked meat, inhalation of aerosol and occupational exposure. A cross-disciplinary approach to study diseases connecting society and biology helps to understand the ways in which social, cultural, behavioral, and economic circumstances influence a healthy life. The objective of this study was to assess the risk perceptions and protective behaviors toward BTB among abattoir and butcher workers in central Ethiopia. A health belief model was used to generate the desired data following health belief model constructs. A total of 300 meat handlers working in local abattoirs, export abattoirs and butcher houses in Bishoftu, Modjo, Dukem, and Akaki towns of central Ethiopia were selected using a systematic random sampling method. Univariate and multivariable logistic regression analysis were used to assess factors associated with risk of exposure to BTB through the consumption of raw meat. The results showed that among the study participants, 95% heard about BTB and 93% knew that eating raw meat could be a source of BTB for humans. More than 62.7% of the respondents in the high risk group strongly agreed that contracting BTB would prevent them from coming to work, keep them in bed for an extended period of time and cause death. The majority of the respondents believed that free provision of personal protective clothing, compensation with test and slaughter campaigns, television and radio advertisements, educational programs and government-imposed penalties would help in prevention of BTB. Despite the high perceived severity and risk perception, the multivarable logistic regression model showed low-risk protective behavior among male (OR: 2.3, 95% CI: 1.2-4.3) and older age (>30) individuals (OR: 14.4 95% CI: 2.1-125.8). The study also noted the importance of media for health education as means for prevention of BTB. The authors strongly recommended the need of promotion of behavioral change toward the consumption of raw meat wich would have potential implications for the public health impacts of zoonotic tuberculosis and ultimately help national and global efforts toward prevention and control of tuberculosis.

Understanding Factors Influencing Dog Owners' Intention to Vaccinate Against Rabies Evaluated Using Health Belief Model Constructs.

Ethiopia has one of the highest incidence levels of human rabies in Africa, with 3-7 deaths per 100,000 people annually. The country has no official rabies control programme, despite the availability of an effective canine vaccine to control rabies. To support effective rabies control, an understanding of the factors affecting dog owners' voluntary intentions to vaccinate their dogs is important. As such, this study examined factors influencing dog owners' intentions to vaccinate their dogs using the constructs of health belief theory. In this cross-sectional study, a questionnaire, designed based on the Health Belief Model constructs was completed by 249 dog owners in 9 randomly selected wards of Bishoftu town in central Ethiopia between October and December 2016. An ordinal regression model was then fitted to explore factors which best predict the likelihood of a dog owner's intention. A classification and regression tree (CART) model was then used for recursive partitioning of the Likert scale in the significant variables to distinctively classify ordinal categories of vaccination intention. Participants' preventive intention was associated with the six constructs of the Health Belief Model: perceived susceptibility, readiness to action, self-efficacy, perceived threat, benefits, and barriers. Dog owner's knowledge about rabies was found to be positively associated with intention to vaccinate, whereas distance from vaccination centers and difficulty of dog transportation were found to be negatively associated to intention to vaccinate. Distance from vaccination center was found to be the best predictor for the intention to vaccinate. The results of this study have policy implications for controlling rabies including increasing dog owners' knowledge about rabies, locating vaccination centers at shorter distances from dog populations and providing suitable means to transport dogs to vaccination centers.

Estimating the burden of rabies in Ethiopia by tracing dog bite victims.

In developing countries where financial resources are limited and numerous interests compete, there is a need for quantitative data on the public health burden and costs of diseases to support intervention prioritization. This study aimed at estimating the health burden and post-exposure treatment (PET) costs of canine rabies in Ethiopia by an investigation of exposed human cases. Data on registered animal bite victims during the period of one year were collected from health centers in three districts, i.e. Bishoftu, Lemuna-bilbilo and Yabelo, to account for variation in urban highland and lowland areas. This data collection was followed by an extensive case search for unregistered victims in the same districts as the registered cases. Victims were visited and questioned on their use of PET, incurred treatment costs and the behavioral manifestations of the animal that had bitten them. Based on the collected data PET costs were evaluated by financial accounting and the health burden was estimated in Disability-Adjusted Life Years (DALYs). In total 655 animal bite cases were traced of which 96.5% was caused by dog bites. 73.6% of the biting dogs were suspected to be potentially rabid dog. Annual suspected rabid dog exposures were estimated per evaluated urban, rural highland and rural lowland district at, respectively, 135, 101 and 86 bites, which led, respectively, to about 1, 4 and 3 deaths per 100,000 population. In the same district order average costs per completed PET equaled to 23, 31 and 40 USD, which was significantly higher in rural districts. Extrapolation of the district results to the national level indicated an annual estimate of approximately 3,000 human deaths resulting in about 194,000 DALYs per year and 97,000 exposed persons requiring on average 2 million USD treatment costs per year countrywide. These estimations of the burden of rabies to the Ethiopian society provide decision makers insights into the potential benefits of implementing effective interventions.

A Smartphone-Based Application Improves the Accuracy, Completeness, and Timeliness of Cattle Disease Reporting and Surveillance in Ethiopia.

Accurate disease reporting, ideally in near real time, is a prerequisite to detecting disease outbreaks and implementing appropriate measures for their control. This study compared the performance of the traditional paper-based approach to animal disease reporting in Ethiopia to one using an application running on smartphones. In the traditional approach, the total number of cases for each disease or syndrome was aggregated by animal species and reported to each administrative level at monthly intervals; while in the case of the smartphone application demographic information, a detailed list of presenting signs, in addition to the putative disease diagnosis were immediately available to all administrative levels via a Cloud-based server. While the smartphone-based approach resulted in much more timely reporting, there were delays due to limited connectivity; these ranged on average from 2 days (in well-connected areas) up to 13 days (in more rural locations). We outline the challenges that would likely be associated with any widespread rollout of a smartphone-based approach such as the one described in this study but demonstrate that in the long run the approach offers significant benefits in terms of timeliness of disease reporting, improved data integrity and greatly improved animal disease surveillance.

Global risk mapping for major diseases transmitted by Aedes aegypti and Aedes albopictus.

OBJECTIVES: The objective of this study was to map the global risk of the major arboviral diseases transmitted by Aedes aegypti and Aedes albopictus by identifying areas where the diseases are reported, either through active transmission or travel-related outbreaks, as well as areas where the diseases are not currently reported but are nonetheless suitable for the vector. METHODS: Data relating to five arboviral diseases (Zika, dengue fever, chikungunya, yellow fever, and Rift Valley fever (RVF)) were extracted from some of the largest contemporary databases and paired with data on the known distribution of their vectors, A. aegypti and A. albopictus. The disease occurrence data for the selected diseases were compiled from literature dating as far back as 1952 to as recent as 2017. The resulting datasets were aggregated at the country level, except in the case of the USA, where state-level data were used. Spatial analysis was used to process the data and to develop risk maps. RESULTS: Out of the 250 countries/territories considered, 215 (86%) are potentially suitable for the survival and establishment of A. aegypti and/or A. albopictus. A. albopictus has suitability foci in 197 countries/territories, while there are 188 that are suitable for A. aegypti. There is considerable variation in the suitability range among countries/territories, but many of the tropical regions of the world provide high suitability over extensive areas. Globally, 146 (58.4%) countries/territories reported at least one arboviral disease, while 123 (49.2%) reported more than one of the above diseases. The overall numbers of countries/territories reporting autochthonous vector-borne occurrences of Zika, dengue, chikungunya, yellow fever, and RVF, were 85, 111, 106, 43, and 39, respectively. CONCLUSIONS: With 215 countries/territories potentially suitable for the most important arboviral disease vectors and more than half of these reporting cases, arboviral diseases are indeed a global public health threat. The increasing proportion of reports that include multiple arboviral diseases highlights the expanding range of their common transmission vectors. The shared features of these arboviral diseases should motivate efforts to combine interventions against these diseases.

Assisting differential clinical diagnosis of cattle diseases using smartphone-based technology in low resource settings: a pilot study.

BACKGROUND: The recent rise in mobile phone use and increased signal coverage has created opportunities for growth of the mobile Health sector in many low resource settings. This pilot study explores the use of a smartphone-based application, VetAfrica-Ethiopia, in assisting diagnosis of cattle diseases. We used a modified Delphi protocol to select important diseases and Bayesian algorithms to estimate the related disease probabilities based on various clinical signs being present in Ethiopian cattle. RESULTS: A total of 928 cases were diagnosed during the study period across three regions of Ethiopia, around 70% of which were covered by diseases included in VetAfrica-Ethiopia. Parasitic Gastroenteritis (26%), Blackleg (8.5%), Fasciolosis (8.4%), Pasteurellosis (7.4%), Colibacillosis (6.4%), Lumpy skin disease (5.5%) and CBPP (5.0%) were the most commonly occurring diseases. The highest (84%) and lowest (30%) levels of matching between diagnoses made by student practitioners and VetAfrica-Ethiopia were for Babesiosis and Pasteurellosis, respectively. Multiple-variable logistic regression analysis indicated that the putative disease indicated, the practitioner involved, and the level of confidence associated with the prediction made by VetAfrica-Ethiopia were major determinants of the likelihood that a diagnostic match would be obtained. CONCLUSIONS: This pilot study demonstrated that the use of such applications can be a valuable means of assisting less experienced animal health professionals in carrying out disease diagnosis which may lead to increased animal productivity through appropriate treatment.

Dog rabies data reported to multinational organizations from Southern and Eastern African countries.

OBJECTIVE: Rabies is one of the viral diseases with the highest case fatality rate in humans. The main transmission route to humans is through bites, especially of infected dogs. Decisions on the allocation of resources to control and reduce the socio-economic impacts of rabies require reliable data. Several national, regional and international organizations have been gathering rabies data for more than a decade. The objective of this paper was to examine the consistencies in the number of dog rabies cases reported to different multinational organizations by Southern and Eastern African countries and to explore the presence of any time trend among the reported rabies data. RESULTS: Data was systematically extracted from the databases of the Southern and Eastern African Rabies Group-SEARG and the World Organization for Animal Health/World animal health information-OIE/WAHID. Despite differences in entities by which data have been reported to the two organisations, reported numbers were significantly correlated (Spearman's rho = 0.52, P < 0.001). The reported data did not indicate the presence of any trend in the number of reported dog rabies outbreaks. Inconsistencies in the reported numbers were observed between the databases, possibly due to the fact that human and animal health authorities report separately to the organisations involved in addition to the use of indefinite definitions of report categories set by report receiving organizations.

Assessment of Staphylococcus aureus along milk value chain and its public health importance in Sebeta, central Oromia, Ethiopia.

BACKGROUND: Staphylococcus aureus is one of the leading causes of gastroenteritis acquired from contaminated foods such as milk and milk products. However, such information is limited in Ethiopia. A cross-sectional study was conducted to assess the contamination of milk with S. aureus and knowledge, attitudes and practices (KAP) of actors along the milk value chain in Sebeta, Central Oromia, Ethiopia. A total of 291 samples collected from dairy farms, milk collection centers (MCCs) and processing plant were examined using standard microbiological techniques. The antimicrobial susceptibility profiles of the isolates were also investigated. The KAP of actors in milk value chain were evaluated through a structured questionnaire. RESULTS: Overall, 23.4% (n = 68) of the samples were positive for S. aureus. The prevalence of S. aureus was 19.6% (95% CI: 14.5-25.6) and 80.0% (95% CI: 14.5-25.6) at farm level and MCCs, respectively. Higher isolation rate was observed in the MCCs (p = 0.000) than the farms. The contamination rates of hands of milkers' and milking buckets with S. aureus were 32% and 11.1%, respectively. S. aureus was not isolated from pasteurized milk samples. The isolates were found to be resistant to cefoxitin (100%), penicillin G (98.5%), and streptomycin (77.9%). Among 23 interviewed farmers, 35% of them consumed raw milk, none of them wash their hands and 82.6% did not wash udder and teat before milking. Six percent of consumers had the habit of raw milk consumption. Eighty seven percent of dairy farmers and 54% of consumers had no awareness about milk borne diseases and staphylococcal food poisoning. CONCLUSIONS: The study revealed a high prevalence of S. aureus along the milk value chain, poor milk handling practices, raw milk consumption behavior, lack of awareness about milk borne diseases and occurrence of antimicrobials resistant S. aureus. S. aureus seems to pose a public health risk in Sebeta. Authors recommended the urgent need of public awareness creation about the importance of hygienic milk production and proper handling and adequate heat treatment of milk before consumption and further study to assess cost-effective preventive and control options.

Prevalence of Escherichia coli O157:H7 in beef cattle at slaughter and beef carcasses at retail shops in Ethiopia.

BACKGROUND: There is paucity of information regarding the epidemiology of Escherichia coli O157: H7 in developing countries. In this study, we investigated the occurrence of E. coli O157: H7 associated with beef cattle at processing plants and at retail shops in Ethiopia. METHODS: Various samples were collected from beef cattle at slaughter/processing plants, carcass at retail shops and humans at health centers. E. coli O157: H7 was isolated, identified and characterized for antimicrobial resistance, using standard microbiological methods. RESULTS: At the processing plants E. coli O157: H7 was detected in 1.89% of fecal, 0.81% of intestinal mucosal swab, 0.54% of skin swab and 0.54% of carcass internal swab samples. At retail shops it was detected in 0.8% of carcass and 0.8% of cutting board swab samples, while all samples from utensils, hands from workers, and fecal and stool samples were negative. All isolates were resistant to Amoxicillin, moderately resistant to Cefoxitine and Nitrofurantoins but susceptible to other antimicrobials tested. CONCLUSIONS: E. coli O157: H7 occurs at low prevalence in beef cattle, and the current sanitary dressing procedures in the processing plants and storage conditions in the retail shops are effective against E. coli O157: H7.

Prevalence and antimicrobial susceptibility of Escherichia coli O157 in beef at butcher shops and restaurants in central Ethiopia.

BACKGROUND: Ethiopia bears the largest burden of foodborne diseases in Africa, and diarrheal diseases are the second leading causes of premature deaths. Enterohemorrhagic Escherichia coli O157 causes an asymptomatic infection to severe diarrhea and/or hemolytic-uremic syndrome in humans. METHODS: A total of 440 beef carcass and in-contact surface swabs from 55 butcher shops and 85 minced beef samples from 40 restaurants in central Ethiopia were collected and examined for the presence of E. coli O157. Standard microbiological methods were used to isolate and identify E. coli O157 and to characterize the antimicrobial resistance of the isolates. RESULTS: E. coli O157 was detected in 4.5% carcass swabs (n = 5) and 3.6% cutting board swabs (n = 4) samples from butcher shops. E. coli O157 was not detected in any of the minced beef samples obtained from restaurants. All isolates (n = 9) were 100% susceptible to five drugs, but five isolates were resistant to amoxicillin, two isolates to streptomycin and three isolates to chloramphenicol. One isolate was resistant to two drugs and another to three drugs. CONCLUSIONS: The present study shows a low prevalence of E. coli O157 in beef sold at butcher shops. Nevertheless, given the low infective dose of this pathogen and the deep-rooted tradition of consuming raw or undercooked beef, the current prevalence should not be considered lightly from a public health perspective.