: public health burden associated with ready-to-eat foods in Himachal Pradesh, India.

The study determined incidence, enterotoxigenecity and antimicrobial susceptibility profiles of isolated from ready-to-eat (RTE) milk products (n = 80), RTE meat products (n = 40), beverages (n = 40) and water samples (n = 60, from food preparing and serving outlets/restaurants) collected from eight different tourist places of Himachal Pradesh. 11.4% (25/220) samples were contaminated with and isolates were identified as (76.0%, n = 19), (12.0%, n = 3) (8.0%, n = 2) and (4.0%, n = 1) by conventional and molecular methods. incidence was highest in cheese based foods (25.0%) followed by vegetable soups (16.7%), khoa based foods (14.0%), milk based beverages (10.5%), paneer based foods (8.6%), cream based foods (8.3%) and water (8.3%) samples. Multiplex polymerase chain reaction detected enterotoxigenic genes only in isolates. complex (encoding non-haemolytic enterotoxins, ABC) genes were detected only in isolates. 57.6% (11/19), 36.8% (7/19) and 5.3% (1/19) harboured all three (, ), two () and one () gene, respectively. Among complex genes (encoding haemolytic enterotoxins CAD), only (36.8%, 7/19) was detected. Incidence (encoding cytotoxin enterotoxin) was 52.6% (10/19). Each isolate harboured two or more enterotoxigenic genes. Seven isolates had at least one gene from haemolytic and non-haemolytic complexes along with . High levels (> 50%) of antimicrobial resistance were recorded for penicillin, amoxicillin, ampicillin cefixime and ceftazidine in tested isolates. Two isolates were identified as multidrug resistant isolates with resistance to ≥ 3 antibiotic classes.