Elevated risk of carrying gentamicin-resistant Escherichia coli among U.S. poultry workers.
BACKGROUND
Antimicrobial use in food-animal production is an issue of growing concern. The application of antimicrobials for therapy, prophylaxis, and growth promotion in broiler chicken production has been associated with the emergence and dissemination of antimicrobial-resistant enteric bacteria. Although human exposure to antimicrobial-resistant bacteria through food has been examined extensively, little attention has been paid to occupational and environmental pathways of exposure.


OBJECTIVE
Our objective was to measure the relative risk for colonization with antimicrobial-resistant Escherichia coli among poultry workers compared with community referents.


METHODS
We collected stool samples and health surveys from 16 poultry workers and 33 community referents in the Delmarva region of Maryland and Virginia. E. coli was cultured from stool samples, and susceptibility to ampicillin, ciprofloxacin, ceftriaxone, gentamicin, nitrofurantoin, and tetracycline was determined for each E. coli isolate. We estimated the relative risk for carrying antimicrobial-resistant E. coli among poultry workers compared with community referents.


RESULTS
Poultry workers had 32 times the odds of carrying gentamicin-resistant E. coli compared with community referents. The poultry workers were also at significantly increased risk of carrying multidrug-resistant E. coli.


CONCLUSIONS
Occupational exposure to antimicrobial-resistant E. coli from live-animal contact in the broiler chicken industry may be an important route of entry for antimicrobial-resistant E. coli into the community.
Price
Lance B
LB
The Johns Hopkins University School of Medicine, Baltimore, MD 21224-2780, USA. lprice@jhsph.edu
Graham
Jay P
JP
Lackey
Leila G
LG
Roess
Amira
A
Vailes
Rocio
R
Silbergeld
Ellen
E
D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002645:Chickens; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects; D004926:Escherichia coli / Q000187:drug effects*; D005260:Female; D005839:Gentamicins / Q000494:pharmacology*; D006801:Humans; D008297:Male; D016273:Occupational Exposure; D011200:Poultry; D012111:Residence Characteristics; D012307:Risk Factors; D014481:United States
D000900:Anti-Bacterial Agents; D005839:Gentamicins