Prevalence and risk factors for multi-drug resistant Escherichia coli among poultry workers in the Federal Capital Territory, Abuja, Nigeria
Prevalence and risk factors for multi-drug resistant Escherichia coli among poultry workers in the Federal Capital Territory, Abuja, Nigeria
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DOI：
10.1371/journal.pone.0225379
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发表时间：
2019-11-21
期刊：
影响因子：
3.7
通讯作者：
Thakur, Siddhartha
中科院分区：
文献类型：
--
作者：
Aworh, Mabel Kamweli;Kwaga, Jacob;Thakur, Siddhartha
背景抗生素耐药性已成为全球健康威胁。与敏感菌株引起的感染相比，抗菌药物耐药性大肠杆菌感染的发病率和支出较高。在尼日利亚，抗菌药物很容易在非处方药店买到，可能会被家禽养殖户滥用，并最终产生耐药性。本研究的目的是调查尼日利亚阿布贾家禽工人 (PW) 中多重耐药大肠杆菌的患病率和风险因素。材料和方法对 2018 年 12 月至 2019 年 4 月在市政和库耶地区委员会随机抽取的 122 名表面健康的家禽工人（家禽养殖者/销售者）进行了横断面研究。使用结构化访谈问卷收集了有关社会人口统计和暴露因素的数据。从家禽工人的粪便样本中分离并鉴定出大肠杆菌。采用KirbyBauer纸片扩散法进行抗生素敏感性试验。多药耐药性（MDR）被定义为对三类或更多类抗菌药物的耐药性。通过计算比例、患病率比值比(POR)和5%显着性水平的逻辑回归来分析数据。结果在PW中，有121名男性(99.2%)。男性工人的平均年龄为 30.6 +/- 9.7 岁，54.6% (n = 66) 已婚，57.9% (n = 70) 受过中等教育，62.0% (n = 75) 是农场工人。与家禽销售商相比，大肠杆菌的患病率为 39.7% (n = 48)，农场工人的患病率最高（POR = 2.7，95% 置信区间 [CI] = 1.3-5.7；p = 0.01）。在 48 株大肠杆菌分离株中，16.7% (n = 8) 是超广谱 β 内酰胺酶 (ESBL) 生产者，79.2% (n = 38) 是 MDR。我们检测到对四环素的耐药性：（83.3％，n = 40），磺胺甲恶唑-甲氧苄啶：（79.2％，n = 38），氨比西林：（77.1％，n = 37），链霉素：（72.9％，n = 35），萘啶酸：（50％，n = 24），庆大霉素： (41.7%，n = 20)、氯霉素：(31.3%，n = 15)、头孢噻吩：(27.1%，n = 13)、呋喃妥因：(10.4%，n = 5) 和亚胺培南：(6.3%，n = 3)。没有厕所（POR = 2.7，95% CI = 1.16.7）；农场/市场存在超过 10 年（POR = 2.5，95% CI = 1.1-5.4）和 PW 最近三个月的腹泻病史（POR = 2.8，CI = 1.2-6.3）与 MDR 相关。控制年龄、没有厕所（调整后 OR [aOR] = 4.31，95% CI = 1.6-11.9）； PW 最近三个月的腹泻病史 (aOR = 3.3,95%CI = 1.3-8.5) 和工作暴露 > 10 年 (aOR = 0.3, 95%CI = 0.1-0.9) 仍然是 MDR 的独立危险因素。 结论 农场工人中耐药大肠杆菌的患病率最高，并与老旧农场/市场、10 年以上职业暴露和卫生条件差有关措施。建议市政府和库杰地区委员会的管理层在农场住区/市场提供公共厕所。强调了在家禽生产中手部卫生和负责任地使用抗菌药物的重要性。
BackgroundAntimicrobial resistance has emerged as a global health threat. Antimicrobial resistant Escherichia coli infections are associated with high morbidity and expenditure when compared with infections caused by susceptible strains. In Nigeria, antimicrobial drugs are readily available over-the-counter with potential for indiscriminate use by poultry farmers and eventual development of drug resistance. The objective of this study was to investigate prevalence and risk factors for multi-drug resistant E. coli among poultry workers (PW) in Abuja, Nigeria.Materials and methodsA cross-sectional study was conducted among 122 randomly selected apparently healthy poultry workers (poultry-farmers/ sellers) in Municipal and Kuje Area Councils from December 2018 to April 2019. Data was collected on socio-demographics and exposure factors using a structured interviewer-administered questionnaire. E. coli was isolated and identified from stool samples of poultry workers. Antibiotic susceptibility testing was done using KirbyBauer disk diffusion method. Multidrug resistance (MDR) was defined as resistance to three or more classes of antimicrobials. Data was analyzed by computing proportions, prevalence odds-ratios (POR) and logistic regression at 5% significance level.ResultsAmong PW, there were 121 males (99.2%). Mean age of the male workers was 30.6 +/- 9.7years, 54.6% (n = 66) married, 57.9% (n = 70) had secondary education and 62.0% (n = 75) were farm-workers. Prevalence of E. coli was 39.7% (n = 48), highest among farm-workers (POR = 2.7, 95% Confidence Interval [CI] = 1.3-5.7; p = 0.01) compared to poultrysellers. Of the 48 E. coli isolates, 16.7% (n = 8) were extended spectrum beta lactamase (ESBL) producers and 79.2% (n = 38) were MDR. We detected resistance against Tetracycline: (83.3%, n = 40), Sulfamethoxazole-Trimethoprim: (79.2%, n = 38), Ampicillin: (77.1%, n = 37), Streptomycin: (72.9%, n = 35), Nalidixic acid: (50%, n = 24), Gentamicin: (41.7%, n = 20), Chloramphenicol: (31.3%, n = 15), Cephalothin: (27.1%, n = 13), Nitrofurantoin: (10.4%, n = 5) and Imipenem: (6.3%, n = 3). Absence of lavatory (POR = 2.7, 95% CI = 1.16.7); existence of farm/market for >10years (POR = 2.5, 95% CI = 1.1-5.4) and PW's history of diarrhea in last three months (POR = 2.8, CI = 1.2-6.3) were associated with MDR. Controlling for age, absence of lavatory (adjusted OR [aOR] = 4.31, 95% CI = 1.6-11.9); PW's history of diarrhea in last three months (aOR = 3.3,95%CI = 1.3-8.5) and work exposure >10years (aOR = 0.3, 95%CI = 0.1-0.9) remained independent risk factors for MDR.ConclusionPrevalence of resistant E. coli was highest among farm-workers and associated with older farms/markets, occupational exposure of over 10 years and poor hygienic measures. The management of Municipal and Kuje Area Councils were recommended to provide lavatories for public use in farm-settlements/markets. The importance of hand-hygiene and responsible use of antimicrobials in poultry production was emphasized.