Community acquired infections due to extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) had been increased. The fecal flora of children in the community represents a huge potential reservoir for ESBLs which are located on highly transmissible plasmids. This study examined the prevalence of ESBL-PE fecal carriage, antimicrobial susceptibility pattern, possible risk factors, and characterized the genes encoding these ESBL enzymes in Lebanese children community. A total of 125 rectal swabs were taken from healthy children aged from 1 to 5 years. Detection of ESBLs was carried out using combination-disc method test and multiplex PCR. A questionnaire concerning child’s lifestyle and risk factors for ESBL carriage was illustrated. Thirty-one of 125 participants (24.8 %) carried ESBL-PE. Regular consumption of meat, and chicken were significantly associated with high carriage rate of ESBL-PE, while dairy products (milk, yogurt, cheese) association was non-significant. Intimate hygiene habits were found also affecting the carriage rate. Multiple bla genes were the most common, 48.4 % (15/31) of ESBL-PE carried both bla CTX-M and bla TEM, and 22.6 % (7/31) carried bla CTX-M, bla SHV, and bla TEM, 29 % (9) carried bla CTX-M only. Concerning CTX-M-types, CTX-M-9 was the most predominant (24/31) and mostly in combination with CTX-M-15 type. High rate of colonization in healthy children with ESBL-PE was observed, regular consumption of dietary products from animal source (meat or chicken) were associated with this colonization in the community in non-hospitalized children. To our best knowledge it is the first study about regular consumption of dairy product as a risk factor for ESBL-PE community carriage, the first data about the carriage rate of ESBL-PE in community children in Lebanon and Middle East, and for the wide dissemination of CTX-M-9 type in this population.

The emergence of antibiotic-resistant food-borne pathogens, especially Escherichia coli O157:H7, highlights the urgent need for innovative treatment strategies, particularly in light of rising resistances and the ongoing controversy surrounding antibiotic use in response to E. coli O157:H7 infections. To address this issue, we explored the potential of single- and multi-strain probiotics, both independently and in combination with gentamicin, through a series of in vitro and in vivo experiments. In vitro, gentamicin alone produced a mean inhibition zone of 12.9 ± 2.27 mm against E. coli O157:H7. The combination of gentamicin with single-strain probiotics (P1) increased the inhibition zone to 16.5 ± 2.24 mm (p < 0.05), while the combination with multi-strain probiotics (P2) resulted in the largest inhibition zone of 19 ± 2.8 mm (p < 0.05). In vivo, mice infected with E. coli O157:H7 and treated with P2, gentamicin (G), or their combination (G+P2), achieved 100% survival, no pathological symptoms, and full weight recovery within seven days. Conversely, mice treated with P1 or G+P1 exhibited lower survival rates (71.4% and 85%, respectively) and slower weight recovery. Hematological parameters improved across all groups, but kidney function analysis showed significantly higher serum creatinine levels in the P1, G, G+P1, and G+P2 groups compared to the P2 group (P1: 0.63 ± 0.15 mg/dL; G: 0.34 ± 0.09 mg/dL; G+P1: 0.53 ± 0.19 mg/dL; G+P2: 0.5 ± 0.23 mg/dL vs. P2: 0.24 ± 0.2 mg/dL). Histological analysis showed better intestinal and kidney tissue recovery in the P2 group, while the P1 and G+P1 groups exhibited abnormal ileal structures and severe cortical bleeding. These findings highlight the promise of multi-strain probiotics, alone or in conjunction with antibiotics, as a therapeutic strategy for E. coli O157:H7 infections. However, the nephrotoxicity associated with gentamicin co-administration remains a limitation, warranting further studies to optimize this approach.

Colistin is a last‐resort antibiotic used to treat multidrug‐resistant Gram‐negative bacterial infections. The global emergence of colistin resistance has been attributed to plasmid‐mediated mobile colistin resistance ( mcr ) genes. In Lebanon, bacteria carrying the mcr-1 gene have increasingly been identified in food animal sources. This study is aimed at detecting colistin‐resistant Shiga toxigenic Escherichia coli O157:H7 in raw meat samples from local markets in the suburbs of Beirut and evaluating their antimicrobial resistance profiles. A total of 50 meat samples, including 25 minced beef and 25 burger samples, were collected and analyzed. Antimicrobial resistance patterns were determined using the Kirby–Bauer method, while colistin resistance and the presence of mcr-2 and mcr-3 genes were assessed using broth microdilution and PCR amplification techniques. Among these samples, 23 (46%) tested positive for E. coli O157:H7. Resistance to ampicillin and amoxicillin/clavulanic acid was observed in 96% of the samples, while 61% were resistant to trimethoprim/sulfamethoxazole, and 43% to chloramphenicol. Notably, 87% of the samples displayed colistin resistance, with a minimum inhibitory concentration (MIC) of ≥ 4 μ g/mL. The mcr-2 gene was present in four isolates (17.4%), and the mcr-3 gene was identified in 10 isolates (43.4%). This study is the first to document the presence of plasmid‐mediated colistin resistance genes, mcr-2 and mcr-3 , in E. coli O157:H7 strains in Lebanon. These findings highlight a serious public health concern for the Lebanese community. Therefore, the responsible use of antibiotics across all healthcare sectors, combined with strict hygiene measures in food handling, is essential to control the spread of colistin‐resistant genes.