Identification of Risk Factors Associated with Resistant<i> Escherichia coli </i>Isolates from Poultry Farms in the East Coast of Peninsular Malaysia: A Cross Sectional Study

• Main Authors: Sharifo Ali Elmi, David Simons, Linzy Elton, Najmul Haider, Muzamil Mahdi Abdel Hamid, Yassir Adam Shuaib, Mohd Azam Khan, Iekhsan Othman, Richard Kock, Abdinasir Yusuf Osman
• Format: Article
• Language: English
• Published: MDPI AG 2021-01-01
• Series: Antibiotics
• Subjects: antimicrobial resistant; <i>Escherichia coli</i>; distribution; poultry farms; environment; east coast of peninsular Malaysia
• Online Access: https://www.mdpi.com/2079-6382/10/2/117

Antimicrobial resistance is of concern to global health security worldwide. We aimed to identify the prevalence, resistance patterns, and risk factors associated with <i>Escherichia coli </i>(<i>E. coli</i>) resistance from poultry farms in Kelantan, Terengganu, and Pahang states of east coast peninsular Malaysia. Between 8 February 2019 and 23 February 2020, a total of 371 samples (cloacal swabs = 259; faecal = 84; Sewage = 14, Tap water = 14) were collected. Characteristics of the sampled farms including management type, biosecurity, and history of disease were obtained using semi-structured questionnaire. Presumptive <i>E. coli </i>isolates were identified based on colony morphology with subsequent biochemical and PCR confirmation. Susceptibility of isolates was tested against a panel of 12 antimicrobials and interpreted alongside risk factor data obtained from the surveys. We isolated 717 <i>E. coli</i> samples from poultry and environmental samples. Our findings revealed that cloacal (17.8%, 46/259), faecal (22.6%, 19/84), sewage (14.3%, 2/14) and tap water (7.1%, 1/14) were significantly (<i>p</i> < 0.003) resistant to at least three classes of antimicrobials. Resistance to tetracycline class were predominantly observed in faecal samples (69%, 58/84), followed by cloacal (64.1%, 166/259), sewage (35.7%, 5/14), and tap water (7.1%, 1/84), respectively. Sewage water (OR = 7.22, 95% CI = 0.95–151.21) had significant association with antimicrobial resistance (AMR) acquisition. Multivariate regression analysis identified that the risk factors including sewage samples (OR = 7.43, 95% CI = 0.96–156.87) and farm size are leading drivers of <i>E. coli</i> antimicrobial resistance in the participating states of east coast peninsular Malaysia. We observed that the resistance patterns of <i>E. coli</i> isolates against 12 panel antimicrobials are generally similar in all selected states of east coast peninsular Malaysia. The highest prevalence of resistance was recorded in tetracycline (91.2%), oxytetracycline (89.1%), sulfamethoxazole/trimethoprim (73.1%), doxycycline (63%), and sulfamethoxazole (63%). A close association between different risk factors and the high prevalence of antimicrobial-resistant <i>E. coli</i> strains reflects increased exposure to resistant bacteria and suggests a concern over rising misuse of veterinary antimicrobials that may contribute to the future threat of emergence of multidrug-resistant pathogen isolates. Public health interventions to limit antimicrobial resistance need to be tailored to local poultry farm practices that affect bacterial transmission.