title: Elevated risk of carrying gentamicin-resistant Escherichia coli among U.S. poultry workers.
abstract: 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.
authors: The Johns Hopkins University School of Medicine, Baltimore, MD 21224-2780, USA. lprice@jhsph.edu
authors: Lance B
authors: LB
authors: Price
authors: Jay P
authors: JP
authors: Graham
authors: Leila G
authors: LG
authors: Lackey
authors: Amira
authors: A
authors: Roess
authors: Rocio
authors: R
authors: Vailes
authors: Ellen
authors: E
authors: Silbergeld
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins