Antimicrobial resistance is of concern to global health security worldwide. We aimed to identify the prevalence, resistance patterns, and risk factors associated with Escherichia coli (E. coli) 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 E. coli 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 E. coli 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 (p < 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 E. coli antimicrobial resistance in the participating states of east coast peninsular Malaysia. We observed that the resistance patterns of E. coli 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 E. coli 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.

中文翻译：

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马来西亚半岛东海岸家禽场中与抗性大肠杆菌分离株相关的危险因素的鉴定：横断面研究

抗菌素耐药性是全球范围内全球卫生安全所关注的问题。我们旨在确定马来西亚东部沿海吉兰丹州，登嘉楼州和彭亨州的家禽养殖场与大肠埃希菌（E. coli）抗药性相关的患病率，抗药性模式和危险因素。在2019年2月8日至2020年2月23日之间，共收集了371个样本（泄殖腔拭子= 259;粪便= 84;污水= 14，自来水= 14）。使用半结构化问卷，获得了样本农场的特征，包括经营类型，生物安全性和病史。推定大肠杆菌基于菌落形态鉴定分离株，随后进行生化和PCR确认。针对一组12种抗菌素测试了分离物的敏感性，并与从调查中获得的危险因素数据一起进行了解释。我们从家禽和环境样品中分离出717个大肠杆菌样品。我们的发现表明，泄殖腔（17.8％，46/259），粪便（22.6％，19/84），污水（14.3％，2/14）和自来水（7.1％，1/14）显着（p<0.003）对至少三类抗菌药具有抗性。在粪便样品中主要观察到对四环素类的抗性（69％，58/84），其次是泄殖腔（64.1％，166/259），污水（35.7％，5/14）和自来水（7.1％，1 / 84）。污水（OR = 7.22，95％CI = 0.95-15-1.21）与抗菌素耐药性（AMR）的获得显着相关。多变量回归分析表明，在马来西亚东海岸半岛各参与州，包括污水样品（OR = 7.43，95％CI = 0.96-15.6.87）和养殖场规模的风险因素是大肠杆菌抗药性的主要驱动因素。我们观察到大肠杆菌的耐药模式在马来西亚东海岸的所有选定州中，针对12种抗微生物药的分离株通常相似。耐药率最高的是四环素（91.2％），土霉素（89.1％），磺胺甲恶唑/甲氧苄氨嘧啶（73.1％），多西环素（63％）和磺胺甲恶唑（63％）。不同风险因素与抗药性大肠埃希菌菌株的高流行之间密切相关，反映出耐药菌的暴露增加，并引起人们对日益增加的兽用抗菌药物滥用的关注，这可能会导致未来出现多药耐药性病原体分离株的威胁。需要针对影响细菌传播的当地家禽养殖场量身定制旨在限制抗菌素耐药性的公共卫生干预措施。