*3.2. Antibiotic Resistance Pattern of E. coli in Various Sources*

All (six) isolates from one child and two household drinking-water samples were susceptible to all drugs and no isolates from any of the samples showed resistance to all antibiotics. The overall percentage of resistant isolate is significantly higher in samples from humans compared to those from the environment (*p* = 0.04). The percentage of resistance for individual antibiotics is also high in humans, except for gentamycin, amikacin, and tigecycline (Figure 2A). Nearly 70% of human stool had co-resistance *E. coli*, of which 57% (73/127) were extended spectrum beta-lactamase (ESBL) producers, and 33% were MDR isolates. In animals, 19% isolates were fully susceptible, 29% co-resistant, 23% ESBL producers and 14% MDR. Co-resistance was more frequent (MDR 41% and ESBL producer 33%) in wastewater isolates than in source water and household drinking water (MDR in 30% and ESBL producer 24%) isolates (Figure 2B). The load of resistant isolates (described as <3 or ≥3 resistant isolates among six collected *E. coli* isolates per sample), in each sample is significantly higher (*p* = 0.001) in human stool than in household drinking-water samples (Table 3), but the resistant isolates from drinking-water were distributed in a higher number of samples. The samples from nuclear families significantly showed less resistance (*p* = 0.05) than in samples from joint families. The resistance pattern of a child and his/her respective household drinking water was not significantly (*p* = 0.05) dissimilar.

**Figure 2.** Antibiotic resistance pattern to tested antibiotics in *E. coli* and non-*E. coli* isolates from various sources in a rural setting of Central India. (**A**) Percentage of resistance to various drugs of *E. coli* from human and environmental samples; (**B**) Pattern of resistant *E. coli* isolated from various sources; (**C**) Pattern of resistant non-*E. coli* isolated from various sources. SW: source-water; WW: wastewater; HDW: household drinking water; MDR: multidrug resistance; ESBL: extended spectrum beta-lactamase producers.

#### *3.3. Antibiotic Resistance Pattern of E. coli to Various Antibiotic Groups*

There was no resistance to the polymyxin (colistin) group in any of the sample types. There was high resistance frequency to penicillins, quniolones, and cephalosporins in human (23%–77%) and environmental (12%–25%) isolates. The MDR combinations having penicillin + cephalosporins + quinolones and sulfonamides + cephalosporin + quinolones groups of drugs were more common than the cephalosporin + quinolone + aminoglycosides or carbapenem combinations (Figure 2A). Most of the isolates from all the sources showed resistance simultaneously to ceftazidime, cefotaxime, cefapime, ampicillin, tetracycline, and co-trimoxazole.
