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14 protocols using api 20e galleries

1

Salmonella Isolation and Identification

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Isolation and identification of Salmonella spp. were performed according to ISO 6579 [18 ] using the media described in international standard protocols (Table 2).
Five suspected colonies from each Petri dish were streaked on Columbia blood agar (CBA) (Becton & Dickinson, Franklin Lakes, NJ, USA) and incubated at 35 °C for 24 ± 2 h. One isolated colony from each CBA plate was analyzed with a MALDI Biotyper® Sirius System mass spectrometer (Bruker Daltonik GmbH, Bremen, Germany) using the extended direct transfer (eDT) procedure. One loop of biomass was transferred to a MBT96 polished steel BC target plate (Bruker Daltonik GmbH) spot. The air-dried sample spot was overlaid with 1 µL of a formic acid water solution (70% v/v) and, after air-drying, with 1 µL of matrix HCCA (α-cyano-4-hydroxycinnamic acid) solution (Bruker Daltonik GmbH). Target plates of the samples were analyzed, and spectra were acquired in positive ion mode in the m/z range 2000–20,000. As an alternative, one isolated colony from each CBA plate was streaked on triple sugar iron agar (TSI) (Biolife Italiana S.r.l., Milan, Italy). Positive TSI colonies were confirmed by biochemical analysis using API 20E galleries (bioMérieux, Marcy l’Étoile, France).
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2

Isolation and Identification of E. coli

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In the bacteriology laboratory of the Interdisciplinary Center for Medical Research of Franceville (CIRMF), the bacteria culture consisted of emulsifying some of the faecal specimens in sterile water and streaking a loopful of the resultant on MacConkey agar medium (MCA) (bioMérieux, France). After eighteen to twenty-four hours of incubation, several colonies (never more than two or three from one medium Petri dish), differentiated by structure and colour, were picked up and streaked in the same medium and incubated in the same conditions. A loop of liquid was removed from the cultures and streaked onto methylene eosin blue agar (EMB) plates (bioMérieux, France) for E. coli isolation. Plates were examined for the characteristic appearance of E. coli (metallic green sheen) and colonies with green metallic sheen were interpreted as E. coli isolates [117 (link),118 (link),119 (link)]. Purified green metallic colonies were subjected to biochemical identification using the Api 20 E galleries (bioMérieux, Marcy l’étoile, France) and the VITEK® 2 Compact 15 system (bioMérieux, Marcy l’étoile, France). Isolates were confirmed by using phylogenetic group detection PCR as described by Clermont et al. [52 (link),53 (link)].
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3

Antibiotic-Resistant Enterobacterales in Wild Birds

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Wild birds (n = 200) were purchased alive on the Sousse market, Tunisia, between January and February 2022 during the legal hunting period. Birds were caught in Bizerte, Zaghouan, or Gabès (Fig. S1), and kept in aviaries for as short a time as possible, without being fed. The intestine of each bird was collected immediately after the death of the bird using a sterile scalpel and stored at −20°C. Intestinal content was emptied in 10 mL of Trypto-casein soy broth (Biokar), homogenized and incubated for 18–24 h at 37°C. Overnight cultures were inoculated on selective MacConkey agar plates supplemented with cefotaxime or imipenem (2 mg/L), for the detection of ESC- or CP-resistant Enterobacterales. One colony per morphology and per plate was picked up. Identification was performed using API20E galleries (bioMérieux).
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4

Enterobacteriaceae Detection in Newborns

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Two rectal swabs were collected from each newborn. The initial sample was performed up to 6 hours from admission to the NICUs and the second one after 5 days of hospitalization. Rectal swab specimens were enriched in nutrient broth BHI (Brain Heart infusion, Oxoid®) at 37°C for 24h. Then, they were inoculated on Mac Conkey agar plates and then incubated at 37° C for 24h. The identification of Enterobacteriaceae isolates was performed by classical bacteriological techniques and confirmed by using API20E galleries (Biomérieux, Marcy l’Etoile, France).
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5

Antibiotic-Resistant Enterobacterales in Wild Birds

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Wild birds (n = 200) were purchased alive on the Sousse market, Tunisia, between January and February 2022 during the legal hunting period. Birds were caught in Bizerte, Zaghouan, or Gabès (Fig. S1), and kept in aviaries for as short a time as possible, without being fed. The intestine of each bird was collected immediately after the death of the bird using a sterile scalpel and stored at −20°C. Intestinal content was emptied in 10 mL of Trypto-casein soy broth (Biokar), homogenized and incubated for 18–24 h at 37°C. Overnight cultures were inoculated on selective MacConkey agar plates supplemented with cefotaxime or imipenem (2 mg/L), for the detection of ESC- or CP-resistant Enterobacterales. One colony per morphology and per plate was picked up. Identification was performed using API20E galleries (bioMérieux).
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6

Cultivation and Phenotyping of Pdd Bacteria

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Pdd strains used here are described in Table 1. Genetically-modified Pdd strains, Escherichia coli strains, and plasmids used and constructed in this study are described in Table 2. Pdd cells were routinely grown at 25 °C on tryptic soy agar and broth supplemented with 1% NaCl (TSA-1 and TSB-1, respectively), supplemented with antibiotics when appropriate. E. coli strains were routinely grown at 37 °C in LB broth and LB agar supplemented with antibiotics when appropriate. Antibiotics were used at the following final concentrations: Kanamycin (Km) at 50 µg mL−1, ampicillin at 50 µg mL−1, and gentamicin at 15 µg mL−1. For sucrose fermentation phenotypical tests, Pdd strains were grown on TSA-1 plates overnight at 25 °C, and isolated colonies were seeded on thiosulfate-citrate-bile salts-sucrose agar plates (TCBS) and incubated at 25 °C for 18–24 h. Alternatively, API-20E galleries (Biomérieux, Marcy l’Etoile, France) were used for sucrose fermentation assays, following manufacturer’s recommendations.
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7

Stool Culture for Enteric Pathogens

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A single stool sample was collected from each study participant using a sterile and disinfectant-free container. Stool specimens were immediately taken to the laboratory and cultured within 30 minutes of collection on Salmonelle-Shigelle (SS) agar, Hektoen enteric agar, eosin methylene blue (EMB) agar, and MacConkey agar. The plates were incubated at 37°C for 24 h, and the isolated organisms were identified based on colonial morphology and Gram stain, and using API 20E galleries (Biomérieux, Lyon, France) as described by the manufacturer.
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8

Isolation and Identification of Antibiotic-Resistant Bacteria from Fecal Samples

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Samples were thawed and 2 g of each sample of faeces was inoculated into 40 mL of either Tryptic Soy Broth (TSB, Liofilchem, Roseto degli Abruzzi, Italy) or TSB containing a cefotaxime 30 µg disk (Liofilchem, Roseto degli Abruzzi, Italy) and incubated for 24 h at 37 °C. A volume of 100 µL of each enrichment step was plated on MacConkey Agar (MAC, Liofilchem, Roseto degli Abruzzi, Italy) supplemented with cefotaxime (2 µg/mL). One colony per morphology was picked from selective media for further analysis. Samples were plated on antibiotic-free MAC as a growth control. One colony per morphology was picked and plated onto CHROMagar Orientation (CHROMagar, Paris, France) for presumptive identification, and identification was further confirmed by API 20E galleries (Biomérieux, Marcy l’Etoile, France). All isolates were stored in TSB + 20% glycerol for further characterisation.
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9

Phenotypic Detection of ESBL and Carbapenemase

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Specimens came from the routinely clinical activity. GNB were isolated on Columbia 5% sheep blood agar (COS-bioMérieux, Marcy l’Etoile, France), lactose-containing Mac Conkey (bioMérieux, France), and chromogenic media for the detection of ESBL production (ESBL Brilliance agar-Oxoid, Basingstoke, UK) and carbapenem resistance (Brilliance CRE agar-Oxoid, UK). For bacterial identification, we used API 20E galleries (bioMérieux, France) or the Vitek automated system (bioMérieux, France). Sensitivity to antimicrobial agents was tested according to the Clinical Laboratory and Standards Institute (CLSI) criteria, by determining the minimum inhibitory concentration (MIC) with the Vitek system, which was supplemented when needed by the disk diffusion method [10 ].
The phenotypic confirmation of ESBL production was done using the synergy test between extended-spectrum cephalosporins and clavulanic acid and the double-disk synergy test with cefotaxime, ceftazidime, and cefepime with and without clavulanic acid [10 ,11 (link)]. Carbapenemase production was demonstrated either by the modified Hodge test or by combined disc methods (KPC, MBL, and OXA-48 Confirm kit, Rosco Diagnostica, Denmark) [10 ,12 (link),13 (link)].
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10

Identification and Typing of CTX-resistant Enterobacteriaceae

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CTX-resistant colonies of Enterobacteriaceae were collected (one colony per animal), and identified by using API 20E galleries (bioMérieux). Non-Enterobacteriaceae isolates (mostly Pseudomonas spp.) were discarded.
Multilocus sequence typing (MLST) was carried out according to the protocol described on the E. coli (http://mlst.warwick.ac.uk/mlst/dbs/Ecoli) and C. freundii (https://pubmlst.org/cfreundii) MLST website.
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