Human exposure to antimicrobial resistance from poultry production: Assessing hygiene and waste-disposal practices in Bangladesh
Human exposure to antimicrobial resistance from poultry production: Assessing hygiene and waste-disposal practices in Bangladesh
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DOI：
10.1016/j.ijheh.2019.07.007
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发表时间：
2019-09-01
影响因子：
6
通讯作者：
Unicomb, Leanne
中科院分区：
文献类型：
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作者：
Mahbub-Ul Alam;Rahman, Mahbubur;Unicomb, Leanne
抗生素的无管制使用与发展中经济体的集约化家禽养殖业有关。在低收入和中等收入国家，抗菌素耐药性(AMR)的传播也被归因于污染、公共卫生基础设施差和废物处理做法不当。关于孟加拉国小规模商业和家庭家禽养殖和市场销售的卫生和废物处理做法的数据有限。我们的目标是探索家禽饲养和加工过程中的人类暴露、卫生和废物处理做法，以确定AMR细菌的可能传播途径。我们采用深度访谈和结构化观察的混合方法来评估孟加拉国与家禽生产相关的暴露、卫生行为和废物处理做法。对商业家禽养殖户、后院家禽饲养者和活禽市场工作人员进行了访谈(n=18)。在5个家庭、5个商业农场和5个城市活禽市场进行了6-h的结构化观察，以评估在这些环境中传播/接触事件的频率。访谈强调了有助于抗菌素耐药性细菌从家禽传播到人类的现有做法。在家庭和农场，未经处理的家禽粪便和身体被丢弃在农田和水体中，这些水体可能会用家禽粪便污染地表水和土壤。没有使用生物安全预防措施，在处理家禽后很少用肥皂洗手。在城市市场，活禽屠宰和加工是在现场徒手进行的，然后用不带肥皂的容器中储存的水冲洗。家禽加工所产生的固体废物被弃置入都市废物处理站，而液体废物则被弃置在明渠。结构观察显示，活家禽市场的工人与家禽及家禽废物的直接接触程度最高，比家禽农场或家禽工作人员高出近十倍(59次对544次直接接触家禽)，使他们接触粪便细菌的风险特别高。生物安全措施有限；在某些情况下，商业农场和城市市场的工人有手套和口罩，但往往不使用。在88%(606/689)的暴露事件中，没有洗手。在所有三个环境中，都观察到在接触家禽后和不洗手的情况下进食和饮用。这些数据表明，应优先考虑有效的干预战略，以减少环境污染和减少传播风险。关于危险行为的流行率和AMR沿着环境途径向人类传播的数据可以为政策和干预战略提供参考。
The unregulated use of antibiotics is linked with intensive poultry farming in developing economies. In low-and middle-income countries, the dissemination of antimicrobial resistance (AMR) has also been attributed to contamination, poor public health infrastructure and inadequate waste disposal practices. There are limited data on hygiene and waste disposal practices in small-scale commercial and household poultry farming and market sales in Bangladesh. Our objective was to explore human exposures, hygiene and waste disposal practices in poultry raising and processing to identify probable pathways for transmission of AMR bacteria.We employed mixed methods approaches of in-depth interviews and structured observations to assess exposures, hygiene behaviours and waste-disposal practices relating to poultry production in Bangladesh. Interviews (n = 18) were conducted with commercial poultry farmers, backyard poultry owners, and live poultry market workers. Structured observations were conducted for 6-h in five households, five commercial farms and five urban live bird markets to assess the frequency of transmission/exposure events in these settings.Interviews highlighted existing practices that can contribute to transmission of antimicrobial resistant bacteria from poultry to humans. In households and farms, untreated poultry waste and carcasses were disposed of on agricultural fields and in water bodies which may contaminate surface water and soil with poultry faeces. Biosecurity precautions were not used, and hands were rarely washed with soap after handling poultry. In urban markets, live poultry slaughter and processing was done on site with bare hands which were subsequently rinsed in water stored in containers without soap. Solid waste from poultry processing was disposed into municipal waste disposal stations and liquid waste was discarded into open drains.Structured observations revealed that workers in live poultry markets had the highest direct contact with poultry and poultry waste, almost tenfold higher than those working in poultry farms or with domestic poultry (59 vs 544 observed direct poultry exposure events) placing them at particularly high risk of exposure to faecal bacteria. Biosecurity measures were limited; in some cases, workers in commercial farms and urban markets had gloves and masks but often did not use them. In 88% (606/689) of exposure events no handwashing took place. Eating and drinking after handling poultry and without washing hands was observed in all three settings. These data suggest effective intervention strategies to reduce environmental contamination and to decrease risks of transmission should be prioritized. Data on prevalence of risk behaviours and AMR transmission to humans along environmental pathways can inform policy and intervention strategies.