Association of intestinal colonization of ESBL-producing Enterobacteriaceae in poultry slaughterhouse workers with occupational exposure—A German pilot study

• Published in: PloS one 2020-06, Vol.15 (6), p.e0232326-e0232326
• Main Authors: Wadepohl, Katharina, Müller, Anja, Seinige, Diana, Rohn, Karl, Blaha, Thomas, Meemken, Diana, Kehrenberg, Corinna
• Format: Article
• Language: English
• Subjects: Abattoirs; Antimicrobial resistance; Beta lactamases; Biology and Life Sciences; Chickens; Colonization; Contact potentials; Drug resistance; E coli; Employees; Enterobacteriaceae; Enterobacteriaceae infections; Epidemiology; Escherichia coli; Exposure; Food quality; Food safety; Food science; Genes; Genomics; Health risks; Intestine; Laboratories; Livestock; Meat industry; Medical research; Medicine and Health Sciences; Microbial drug resistance; Occupational exposure; Occupational health; Officials and employees; Pork industry; Poultry; Poultry industry; Poultry production; Questionnaires; Risk analysis; Risk factors; Safety and security measures; Slaughterhouses; Social Sciences; Statistical analysis; Swine production; Veterinary medicine
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0232326

Bacteria that have acquired antimicrobial resistance, in particular ESBL-producing Enterobacteriaceae, are an important healthcare concern. Therefore, transmission routes and risk factors are of interest, especially for the carriage of ESBL-producing E. coli. Since there is an enhanced risk for pig slaughterhouse employees to carry ESBL-producing Enterobacteriaceae, associated with animal contact as potential risk factor, the present study investigated the occurrence of ESBL-producing Enterobacteriaceae in poultry slaughterhouse employees. Due to the higher level of resistant Enterobacteriaceae in primary poultry production than in pig production, a higher risk of intestinal colonization of poultry slaughterhouse employees was expected. ESBL-producing Enterobacteriaceae were detected in 5.1% (5 of 99) of the fecal samples of slaughterhouse workers. The species of these isolates was confirmed as E. coli. PCR assays revealed the presence of the genes bla.sub.CTX-M-15 (n = 2) and bla.sub.SHV-12 (n = 3) in these isolates, partly in combination with the [beta]-lactamase gene bla.sub.TEM-135 . Participants were divided into two groups according to their occupational exposure and results indicated an increased probability of colonization with ESBL-producing Enterobacteriaceae for the group of 'higher exposure' (OR 3.7, exact 95% CI 0.6-23.5; p = 0.4). For intestinal colonization with ESBL-producing Enterobacteriaceae, a prevalence of 10% (3/30) was observed in the group of 'higher exposure' versus 2.9% (2/69) in the group of 'lower exposure'. Employees in working steps such as 'hanging' poultry in the process of slaughter and 'evisceration' seemed to have a higher risk for intestinal colonization with ESBL-producing Enterobacteriaceae compared to the group of 'lower exposure'. This study is the first of its kind to collect data on the occupational exposure of slaughterhouse workers to ESBL-producing Enterobacteriaceae in Europe. The results suggested that colonization with ESBL-producing Enterobacteriaceae is associated with occupational exposure in poultry slaughterhouses. However, the presence of ESBL-producing E. coli isolates in only 5.1% (5/99) of the tested employees in poultry slaughterhouses suggests a lower transmission risk than in pig slaughterhouses.