Dohmen W, VAN Gompel L, Schmitt H, Liakopoulos A, Heres L, Urlings B A, Mevius D, Bonten M J M, Heederik D J J
Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
Department of Bacteriology and Epidemiology, Central Veterinary Institute of Wageningen UR, Lelystad, the Netherlands.
Epidemiol Infect. 2017 Jul;145(10):2003-2010. doi: 10.1017/S0950268817000784. Epub 2017 May 2.
We investigated the prevalence of extended-spectrum β-lactamase (ESBL) carriage in slaughterhouse workers and the association with occupational exposure to slaughter animals and products. Stool samples from 334 employees in a Dutch pig slaughterhouse were obtained. Presence of ESBL was determined by selective plating, microarray analysis, and gene sequencing. Questionnaires were used to collect personal and occupational information. The overall prevalence of ESBL carriage was 4·8% (16/334). All ESBL-producing isolates were Escherichia coli. The ESBL genes detected were bla CTX-M-1 (n = 8), bla CTX-M-15 (n = 3), bla CTX-M-27 (n = 2), bla CTX-M-24 (n = 1), bla CTX-M-55 (n = 1), and bla SHV-12 (n = 1). A higher prevalence of ESBL was seen in workers in jobs with as tasks 'removal of lungs, heart, liver, tongue' (33%), and 'removal of head and spinal cord' (25%). For further analysis, participants were divided in two groups based on potential exposure to ESBL as related to their job title. One group with an assumed higher exposure to ESBL (e.g. stable work, stabbing, dehairing, removal of organs) and another group with an assumed lower exposure to ESBL (e.g. refrigeration, packaging and expedition). In the 'higher exposure' group, ten out of 95 (10·5%) were carrying ESBL vs. six out of 233 (2·6%) in the 'lower exposure' group. Human ESBL carriage was significantly associated with job exposure in the slaughterhouse (OR 4·5, CI 1·6-12·6). Results suggest that ESBL carriage in slaughterhouse workers overall is comparable with the Dutch population. Within the slaughterhouse population a difference in carriage exists depending on their position along the slaughter line and tasks involved.
我们调查了屠宰场工人中广谱β-内酰胺酶（ESBL）携带情况以及与职业性接触屠宰动物和产品之间的关联。采集了荷兰一家生猪屠宰场334名员工的粪便样本。通过选择性平板培养、微阵列分析和基因测序来确定ESBL的存在。使用问卷调查收集个人和职业信息。ESBL携带的总体患病率为4.8%（16/334）。所有产ESBL的分离株均为大肠杆菌。检测到的ESBL基因有bla CTX-M-1（n = 8）、bla CTX-M-15（n = 3）、bla CTX-M-27（n = 2）、bla CTX-M-24（n = 1）、bla CTX-M-55（n = 1）和bla SHV-12（n = 1）。在从事“摘除肺、心脏、肝脏、舌头”（33%）和“摘除头部和脊髓”（25%）任务的工人中，ESBL患病率较高。为了进一步分析，根据与工作头衔相关的潜在ESBL暴露情况将参与者分为两组。一组假定为ESBL高暴露组（如饲养工作、刺杀、脱毛、摘除器官），另一组假定为ESBL低暴露组（如冷藏、包装和运输）。“高暴露”组中，95人中有10人（10.5%）携带ESBL，而“低暴露”组中233人中有6人（2.6%）携带ESBL。屠宰场中人类ESBL携带与工作暴露显著相关（比值比4.5，置信区间1.6 - 12.6）。结果表明，屠宰场工人总体上ESBL携带情况与荷兰人群相当。在屠宰场人群中，根据其在屠宰线上的位置和所涉及的任务，携带情况存在差异。
