Prevalence of multidrug-resistant Escherichia coli isolated from Jember hospital food handler in Indonesia

Abstract

Introduction: Foodborne illness is a significant global public health issue. Improper food handling and personal cleanliness can result in a few ailments. Over 400 food-related infections have been found by the CDC, of which food handlers cause 20%. Escherichia coli is often found in hospital food handler hand and nasal swabs. This study aimed to ascertain the prevalence of  E. coli and the antibiotic susceptibility profile of food handlers working in hospitals in Jember City, Indonesia. Method: A cross-sectional investigation uses a total sampling method held between October and November 2022. Inclusion criteria are asymptomatic food handlers that have not taken antibiotics for the last three months and have already given informed consent. Exclusion criteria are food handlers who’s sick or with incomplete questionnaires. We performed hand and nasal swabs and continued with bacteria identification, culture, and antibiotic sensitivity tests. Result: Ten food workers (14.71%) and fourteen (20.59%) of the 68 who underwent hand and nasal swab culture screenings for E. coli were positive. All E. coli hand swab isolates were susceptible to levofloxacin and azithromycin antibiotics. Still, of the 10 E. coli hand swab isolates, 90% were resistant to the antibiotics; penicillin, Cefotaxime, and ceftriaxone, while 70% were resistant to erythromycin. For E. coli isolates originating from nasal swabs, 85.71% were resistant to Cefotaxime, 71.43% to Penicillin and Cefepime, and 57.14% were resistant to Ceftriaxone and Erythromycin. E. coli  Multiple Antibiotic Resistance (MAR) index for hand and nasal swab specimens is 0.18 – 0.82. Most of the hand swab specimens (90%) are Multidrug Resistant (MDR), while nasal swab specimen shows 78.57% Multidrug Resistant (MDR). Conclusion: The predominance of multidrug-resistant E. coli among hospital food handlers makes it imperative to implement infection control measures, including better biosecurity, to ensure that they do not enter the food supply and limit alternatives to inpatient therapy.