Surveillance plays a crucial role in controlling the spread of AMR . Identifying resistance patterns and mechanisms helps create timely and efficient AMR control strategies. The problem of AMR spread can be addressed by implementing and promoting the One Health approach . WHO’s first global report on AMR surveillance showed that monitoring the AMR is very helpful for orienting treatment choices, understanding the evolving patterns of AMR, and determining priority areas for interventions. The need for more surveillance in many countries and areas undermines the possibility of therapeutic interventions . However, additional measures are necessary to address the AMR problem more effectively. Since stakeholders, industries, and consumers are involved in the farm to fork process, all these sides should work hand in hand with each other to solve AMR problems. Therefore, public awareness and education is very important measure to help tackle the issue. Another measure is stewardship of farm workers. Therefore, training and education of farm workers is a very important measure that should continue to be implemented across the livestock industry. Developing new antimicrobials and using existing antimicrobials in full capacity are other strategies to combat antimicrobial resistance that prevent infections and improve diagnostics . Lastly, strengthening industrial and academic research on AMR and occupational exposure to AMR is very crucial. The research is necessary for several reasons.First, cannabis growing equipment research on AMR is the bedrock for the formulation of new drugs and improvement of existing drugs.
For example, understanding mechanisms of resistance and how they develop is crucial for designing a new drug. Second, robust research is fundamental in improving surveillance systems and diagnostics because advanced surveillance methods and accurate diagnostics help to provide appropriate treatments and infection control actions. Third, collaborative actions of industrial and academic researchers can bring the knowledge and resources together to fight AMR, as academic researchers might have expertise and novel ideas that can be implemented by industrial partners who have resources for drug development. Finally, research on AMR is essential in raising public awareness and can cause governments to improve their policies on fighting AMR . In conclusion, controlling, reducing, and optimizing antimicrobial usage are the main methods to fight AMR. Controlling and reducing the spread of AMR and optimizing antimicrobial consumption require collective, coordinated actions at local, regional, and international levels. Also, strengthening research is crucial in order to develop new drugs or improve existing drugs, improve surveillance systems and diagnostics, raise public awareness, and affect government policies.The literature review examined the existing literature on ways of transmission of antimicrobial resistance bacteria in the food chain. The literature review revealed that occupational exposure of farm workers to antimicrobial resistance has been neglected due to a variety of factors and need for more research to improve the awareness of stakeholders, farm owners and farm workers. With the growing concern of dissemination of AMR globally, occupational exposure needs serious attention to assist in combat with AMR. Additionally, the literature review critically assessed the existing body of literature on antimicrobial resistance patterns of Salmonella inretail meat as this type of pathogen becomes very dangerous if acquired multi-resistance to antimicrobials.
Despite being the most populous state in the U.S. and the leading agricultural producer in agriculture, antimicrobial resistance patterns in retail meat in California have yet to be adequately characterized. With the advent of the development of WGS, an opportunity has arisen to confirm phenotypic resistance detected by AST genotypically using WGS. This literature review also discussed the pros and cons of using WGS for tracking and monitoring AMR. In the end, AMR mitigation strategies and surveillance’s vital role were discussed.Antimicrobial resistance occurs when microorganisms survive by developing resistant mechanisms after exposure to antibiotics or without exposure to antibiotics by evolution . Continuous use of antimicrobial drugs for therapeutic purposes in food animal production and human medicine selects for antimicrobial-resistant bacteria . As a result, infections caused by ARB are increasing, which are difficult and expensive to treat . Moreover, some infections due to AMR cannot be treated with existing drugs, leading to increased morbidity and mortality . Therefore, antimicrobial resistance is a serious public health issue . Approximately 2.8 million clinical cases of individuals infected by ARB result in 35,000 deaths annually in the U.S. . In addition, the estimated economic burden of AMR is $21,832 per case, which results in total costs of $20 billion to the U.S. healthcare system . The poultry industry is a substantial portion of food animal production where antibiotics have historically been widely used to treat sick birds and prevent disease . However, intensive poultry production in confinement in large-scale operations with flocks can increase the spread of ARB among the animal population and their surroundings, potentially posing health risks to workers . A significant portion of zoonotic diseases and infectious disease outbreaks that make humans sick are caused by pathogens . Antimicrobial-resistant genes can be transferred through mobile genetic elements between zoonotic pathogens and commensal bacteria .
Commensal Escherichia coli is common in chickens, and Salmonella is a major pathogen in chickens . Commensal E. Coli has shown resistance to a wide range of essential antimicrobials, and multidrug resistance of E. coli results in treatment failure . Antimicrobial-resistant Salmonella has been shown to cause elevated morbidity and mortality among infected patients, with 212 500 infectious diseases and 70 deaths each year in the U.S. . Multidrug resistance in Salmonella causes more severe and prolonged illnesses in humans and animals that are harder and sometimes impossible to treat . It has been reported by many studies that animal farm workers can be exposed to ARB via direct contact with animals, through a contaminated environment, or due to poor hygiene . However, occupational exposure of farmworkers to ARB has been largely neglected compared to other aspects of ARB research due to a lack of awareness of the farmworker’s lack of resources and regulations . A few studies have examined the occupational exposure of poultry farmworkers to ARB; most of these studies were conducted in Europe and in other countries . In the U.S., very few studies have assessed poultry farm workers’ risk for colonization with antimicrobial-resistant E. coli. The results of one of the found studies showed that gentamicin-resistant E. coli from worker’s stool samples were 32 times higher compared with stool samples from community references . Despite the substantial research in establishing pathways for the spread of ARB, the transmission routes of ARB from the poultry production environment to workers are still unclear . Besides, with the increasing prevalence of small-scale poultry farms in the U.S. in recent years, cannabis drying trays and studies are needed to identify ARB transmission routes in these farms . Some studies have shown that workers in small farms do not follow bio-security rules such as wearing personal protective equipment, washing hands with soup, and avoiding stepping into boot baths . Moreover, no studies examined occupational exposure and AMR patterns at university-owned small-scale poultry facilities in the U.S. Here, students and interns who are employed and their safety is a priority. Therefore, the objective of this study was to conduct a pilot study in a university-owned small-scale poultry production facility to characterize ARB phenotypes and identify potential transmission routes of ARB from the working environment to employees in the facility.The samples for this study were collected weekly for ten consecutive weeks from the Hopkins Avian facility of the University of California, Davis between June 2022 and September 2022. The facility had two houses: layer house , where adult layers hens were kept, and floor house , where young chickens were kept after hatching until their age reached ten weeks. In the LH, the birds were kept in cages as a group hovered above the floor with manure under the cage’s concrete slab. The FH was divided into pens with pine shavings as litter. A total of 70 samples were collected from the environment and employees , who were responsible for the following animal care in both houses: feeding, checking water, collecting eggs, nail trimming, and cleaning the houses. All samples were collected at the end of the workday, with employees exposed to the working environment for 5-6 hours before sample collection. The same employee worked in both houses on each duty period. Therefore the samples were collected only for one employee in each sampling week. Three types of environmental samples were collected from the LH: a mix of feces and litter from the floor, cage swabs, and fresh eggs. Two types of environmental samples were collected from the FH: a mix of feces and litter from the floor front door swabs of the pens.
Two types of samples were collected from employees at the end of the workday: outwear and boots swab. In order to collect fecal samples from LH, two rows of cages were chosen randomly each time, and ten pellets mix of feces and litter were collected by hand; then pellets were placed into a non-filtered Whirl Pak bag and mixed by hand to homogenize the pooled sample. For FH, five pens were chosen randomly, and five pellets of a mix of feces and litter from each pen were collected by hand and placed into a non-filtered Whirl Pak bag at each sampling point. The bag’s contents were mixed by hand to homogenize the pooled sample. Five pens were chosen randomly, and the handles of each front door were swabbed using EZ-Reach™ sponge samplers . After swabbing, the sponges were placed into their original bags sealed, and the bags were placed on ice in coolers. Workers’ swab samples were collected by swabbing the entire surface of workers’ outwear and boots using EZ-Reach™ sponge samplers . Additionally, at each sample collection time, a tray with 30 eggs was chosen, and the surface of eggs was swabbed using one EZ-Reach™ sponge samplers .After sample collection, all the collected samples in plastic bags were transported on ice to the laboratory for further processing, including bacteria isolation and enumeration within 2 hours. Ten grams of the fecal and litter mix samples were put in a sterile filter bag , with 90 ml of Tryptic Soy Broth . Afterwards, the bags were homogenized by hand for 3 minutes and incubated at 35°C for 24 hours. For swab samples, 10 ml of phosphate-buffered saline was added to each sponge bag. Then, the bags were homogenized for 40 seconds by hand. Homogenized mixtures were serially diluted into buffered peptone water tubes. For the enumeration of aerobic bacteria and E. coli, 1 mL of contents from the bags with feces and sponges were serially diluted into the tubes, and appropriate dilutions were then plated onto E. coli and APC petrifilms . Escherichia coli petrifilms were incubated at 35°C for 24 hours and APC petrifilms were incubated at 35°C for 48 hours. After the incubation period, E. coli and aerobic bacteria were counted from the E. coli and APC petrifilms, respectively. Three colonies from the E. coli petrifilms per sample type were randomly selected and were streaked one more time onto MacConkey Difco™ Sorbitol agar . Colonies were inoculated into TSB culture and incubated at 37°C for 20-24 hours. Then, 667 µL of the overnight culture added to 333 µL of 50% glycerol in a 2 mL screw top tube and gently mixed by vortexing. The glycerol stock tubes were put into an 80°C freezer until further characterization for antimicrobial susceptibility test . The results of the present study showed that farm workers can be exposed to ARB in their working environment, and wearing personal protective equipment such as boots and outwear is a crucial measure to protect workers from exposure to ARB. The outcomes of the present study will help lay the foundation for a large-scale study to mitigate the risks of occupational exposure to ARB. Salmonella was not recovered from any collected samples in the present study. In previous studies, the Salmonella recovery rate was very diverse from collected poultry environmental samples . Such variability of prevalence in Salmonella in these studies might be caused by factors such as geographic location, season, farm environment, feed and water quality, farm size and type, antibiotic usage, sample collection methods, and farm bio-security practices. Therefore, comparing prevalence results from different studies should be cautiously assessed, considering all the factors that might affect the outcome. For example, a study found that fecal samples in an organic poultry farm have lower Salmonella prevalence than a conventional poultry farm, 5.6% and 38.8%, respectively .