High Prevalence of Extended-Spectrum Beta-Lactamase CTX-M–Producing Escherichia coli in Small-Scale Poultry Farming in Rural Ecuador

Hayden D. Hedman School for Environment and Sustainability, University of Michigan, Ann Arbor, Michigan;

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Joseph N. S. Eisenberg Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan;

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Karla A. Vasco Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador;

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Christopher N. Blair Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, Michigan;

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Gabriel Trueba Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador;

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Veronica J. Berrocal Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan;

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Lixin Zhang Department of Epidemiology and Biostatistics, Michigan State University, East Lancing, Michigan

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Small-scale farming may have large impacts on the selection and spread of antimicrobial resistance to humans. We conducted an observational study to evaluate antibiotic-resistant Escherichia coli populations from poultry and humans in rural northwestern Esmeraldas, Ecuador. Our study site is a remote region with historically low resistance levels of third-generation antibiotics such cefotaxime (CTX), a clinically relevant antibiotic, in both poultry and humans. Our study revealed 1) high CTX resistance (66.1%) in farmed broiler chickens, 2) an increase in CTX resistance over time in backyard chicken not fed antibiotics (2.3–17.9%), and 3) identical blaCTX-M sequences from human and chicken bacteria, suggesting a spillover event. These findings provide evidence that small-scale meat production operations have direct impacts on the spread and selection of clinically important antibiotics among underdeveloped settings.

Author Notes

Address correspondence to Joseph N. S. Eisenberg, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109. E-mail: jnse@umich.edu

Financial support: This work was supported by the National Institute of Allergy and Infectious Diseases (grant R01AI050038), the National Science Foundation, Ecology and Evolution of Infectious Diseases program (grant 08119234), the Courtney Wilson Memorial Award, the International Institute Fellowship at the University of Michigan, Rackham Graduate School at the University of Michigan, and the Tinker Field Research Grant through the Latin American and Caribbean Studies at the University of Michigan.

Authors’ addresses: Hayden D. Hedman, School for Environment and Sustainability, University of Michigan, Ann Arbor, MI, E-mail: hedmanh@umich.edu. Joseph N. S. Eisenberg, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, E-mail: jnse@umich.edu. Karla A. Vasco and Gabriel Trueba, Institute of Microbiology, Universidad San Francisco de Quito, Quito, Ecuador, E-mails: kvasco@usfq.edu.ec and gtrueba@usfqedu.ec. Christopher N. Blair, Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, MI, E-mail: chbl@med.umich.edu. Veronica J. Berrocal, Department of Biostatistics, University of Michigan, Ann Arbor, MI, E-mail: berrocal@umich.edu. Lixin Zhang, Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, E-mail: lxzhang@epi.msu.edu.

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