Human Colonization with Extended-Spectrum Beta-Lactamase-Producing E. coli in Relation to Animal and Environmental Exposures in Bangladesh: An Observational One Health Study.
Human Colonization with Extended-Spectrum Beta-Lactamase-Producing E. coli in Relation to Animal and Environmental Exposures in Bangladesh: An Observational One Health Study.
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DOI：
10.1289/ehp7670
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发表时间：
2021-03
影响因子：
10.4
通讯作者：
Islam MA
中科院分区：
文献类型：
--
作者：
Rousham EK;Asaduzzaman M;Mozmader TIMAU;Amin MB;Rahman M;Hossain MI;Islam MR;Mahmud ZH;Unicomb L;Islam MA
人类暴露于集约化养殖的牲畜是耐药性细菌（ARB）传播的潜在风险，但很少有研究评估ARB在低资源社区环境中的动物与环境来源的相对作用。我们进行了一项观察性研究，以比较孟加拉国农村家庭、商业家禽养殖场和城市市场中高或低暴露于家禽的人群中ARB定植和耐药基因的患病率和丰度。产超广谱（ESBL）和碳青霉烯类耐药大肠杆菌。对来自40个农村家庭、40个家禽养殖场和40个城市市场的高或低家禽接触量成年人（分别）、家禽（）、饮用水（）和废水（）的粪便中的大肠杆菌进行了定量。产ESBL E.大肠埃希菌（ESBL-EC）在成人、家禽和废水中的检出率分别为67.5%（95%CI：61.0，74.0）、68.0%（95%CI：61.5，74.5）和92.5%（95%CI：87.7，97.3）。耐碳青霉烯E.大肠杆菌在市场废水中的流行率较高[30%（95%CI：15.0，45.0）]，但在人类（1%）和家禽（1%）中较低。人类、家禽和废水分离株具有共同的耐药基因：qnr和。人类定植与接触家禽或环境（农村、农场或市场）无显著相关性。95%的商业家禽养殖场常规使用抗生素。对7种抗生素中的4种，家庭与农场和市场家禽分离株的敏感性试验存在显著差异。在人类分离株中，除氨基糖苷类耐药（16.4%高暴露vs 4.4%低暴露）外，无差异。城市市场废水和家禽样品中ESBL-EC的浓度显著高于农场和农村家庭样品。ESBL-EC在人类中的定植率较高，但与家禽暴露无显著相关性。在这些社区环境中，抗生素耐药性可能在人类、家禽和环境之间双向传播，这突出了“一个健康”缓解策略的重要性。https://doi.org/10.1289/EHP7670
Human exposure to intensively farmed livestock is a potential risk for transmission of antibiotic-resistant bacteria (ARB) but few studies have assessed the relative role of animal vs. environmental sources of ARB in low-resource community settings. We conducted an observational study to compare ARB colonization and antibiotic-resistant gene prevalence and abundance in humans with high or low exposure to poultry in rural households, commercial poultry farms, and urban markets in Bangladesh. Extended-spectrum (ESBL)-producing and carbapenem-resistant E. coli were quantified in feces from adults with high or low poultry exposure (, respectively), poultry (), drinking water (), and wastewater () from 40 rural households, 40 poultry farms, and 40 urban markets. ESBL-producing E. coli (ESBL-EC) prevalence was 67.5% (95% CI: 61.0, 74.0) in samples from adults, 68.0% (95% CI: 61.5, 74.5) in samples from poultry, and 92.5% (95% CI: 87.7, 97.3) in wastewater samples. Carbapenem-resistant E. coli prevalence was high in market wastewaters [30% (95% CI: 15.0, 45.0)] but low in humans (1%) and poultry (1%). Human, poultry, and wastewater isolates shared common resistance genes: , qnr, and . Human colonization was not significantly associated with exposure to poultry or setting (rural, farm, or market). Ninety-five percent of commercial poultry farms routinely administered antibiotics. Susceptibility tests were significantly different in household vs. farm and market poultry isolates for four of seven antibiotic classes. In human isolates, there were no differences except aminoglycoside resistance (16.4% high vs. 4.4% low exposure, ). Urban market wastewaters and poultry samples had significantly higher concentrations of ESBL-EC () and () compared with samples from farms and rural households. ESBL-EC colonization was high in humans but not significantly associated with exposure to poultry. Bidirectional transmission of antibiotic resistance is likely between humans, poultry, and the environment in these community settings, underlining the importance of One Health mitigation strategies. https://doi.org/10.1289/EHP7670