Extended-Spectrum β-Lactamase-Producing Enterobacterales in Free-Roaming Cats in Israel

Amid the rising prevalence of antimicrobial resistance (AMR), attention is increasingly directed toward investigating additional factors that may contribute to or mediate its development, among which companion animals have emerged as a potential reservoir and transmission interface. Despite this, the contribution of free-roaming animal populations living in proximity to humans and domestic animals has yet to be thoroughly investigated worldwide. Accordingly, this study aimed to determine the prevalence and antimicrobial resistance patterns of extended-spectrum β-lactamase (ESBL)-producing Enterobacterales in free-roaming cats in Israel. Rectal swabs were collected from 214 free-roaming cats admitted to two veterinary clinics between 2023 and 2024. ESBL-PE were recovered from 51 cats (23.8%), yielding 61 isolates, which were tested for susceptibility to multiple antimicrobials. Eleven bacterial species were identified, with Escherichia coli being the most frequently recovered (62.3%, 38/61). Nine purposively selected E. coli isolates underwent whole-genome sequencing (WGS). Multidrug resistance (MDR), defined as non-susceptibility to at least one agent in three or more antimicrobial categories, was observed in 72.1% (44/61) of isolates, and four isolates were carbapenemase-producing Enterobacterales (CPE). These findings suggest that free-roaming cats may serve as a previously overlooked 'One Health' link, possibly connecting environmental contamination to human and animal health risks.