Poultry workers and drug resistant E. coli

Being a poultry worker, in any country is not wonderful. There's the risk of bird flu, of course. And lots of opportunity to be seriously injured. And its strenuous, difficult, low paying and dirty work, which is why it employs so many undocumented workers.

It also turns out it is a great way to pick up drug resistant E. coli:

Poultry workers in the United States are 32 times more likely to carry E. coli bacteria resistant to the commonly used antibiotic, gentamicin, than others outside the poultry industry, according to a recent study conducted by researchers at the Johns Hopkins Bloomberg School of Public Health. While drug resistant bacteria, such as E. coli, are common in the industrial broiler chicken environment, this is the first U.S. research to show exposure occurring at a high level among industrial poultry workers. (Hopkins press office; you can see the study in the December Environmental Health Perspectives)

The culprit -- once again -- seems to be the profligate use of antibiotics in industrial food production. One estimate has it that over half of all antibiotics used in the US are for this purpose. The bottom line: drug resistant bugs aren't just a hospital problem:

In the present study, 50% of the poultry workers were colonized with GEN-resistant E. coli. This was in stark contrast to the proportion of community referents colonized with GEN-resistant E. coli (3%) and to the rates reported among hospital isolates (6.3%) (Friedland et al. 2003). Aminoglycosides are not absorbed through the gastrointestinal tract; therefore, human use is limited to intravenous, intramuscular, subcutaneous, and topical administration. The inability to administer GEN orally limits outpatient use; thus, there is probably minimal selection of GEN-resistant E. coli in the community. In contrast, GEN has been reported to be the most commonly used antimicrobial in broiler production, where it is administered prophylactically to day-old chicks to prevent bacterial infections (Luangtongkum et al. 2006). GEN resistance is common among poultry-associated enteric bacteria. A recent survey revealed that 69% of avian pathogenic E. coli isolates were resistant to GEN (Zhao et al. 2005). The disproportionately high prevalence of GEN-resistant E. coli among the poultry workers in the present study is consistent with the hypothesis that poultry workers are at increased risk of becoming colonized with antimicrobial-resistant E. coli resulting from occupational exposures to these strains in the broiler chicken environment. (Silbergeld et al., Environmental Health Perspectives)

The GEN-resistance here is resistance to the antibiotic gentamicin, which is used in hospitals to treat serious bacterial infections -- if they are susceptible. It's not an everyday antibiotic and has some adverse effects. But when you need it, you need it. If you are a poultry worker with an E. coli infection, though, there's a good chance it won't work. Even if you need it.