Nezam El-Tayebat Fact CheckA scientific assessment of the “نظام الطيبات” nutrition system
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Mostly true True only under certain conditions Certainty of evidence: moderate provisional C-CHK-05

Industrial chicken is raised with routine antibiotics, and antibiotic-resistant bacteria (e.g., ESBL E. coli, MRSA, resistant Campylobacter, mcr-1) spread from poultry to humans via the food chain.

In short: This claim is largely correct: antibiotic use in poultry selects resistant bacteria that reach people via meat; the size of the problem depends on the country, being larger where routine use is common (as reported for Egypt) and smaller in the EU, where growth promoters are banned and food explains about a fifth of community carriage in Dutch modelling.
Conclusion: Antibiotic use in poultry does contribute to resistant bacteria reaching humans; the size of the problem depends strongly on the country.
  1. Original statement
  2. Scientific assessment
  3. Scientific evidence in detail
  4. In plain language
  5. Studies on this claim
  6. Regional context
  7. What applies in my country?
  8. References

Original statement

فهو مُربّى بالمضادات الحيوية وأدوية الزرنيخ ... ويحمل بكتيريا متعددة المقاومة تنتقل إلى الإنسان عبر السلسلة الغذائية

verbatim according to source. Translation by the project; the Arabic wording is authoritative.

Translation

Industrial chicken is raised with routine antibiotics, and antibiotic-resistant bacteria (e.g., ESBL E. coli, MRSA, resistant Campylobacter, mcr-1) spread from poultry to humans via the food chain.

Origin

Source status
Archive editors
Attribution
Archive editors (not Elawady)
Origin
https://eltayebat.com/rule/industrial-chicken/
Attribution uncertainty
Narrative and study selection written by the archive operators; the archive states the forbidden section is documented independently of Dr. Diaa's words.
Claimed mechanism

Routine/sub-therapeutic antibiotic use selects resistant bacteria that reach humans via meat.

Claimed health effect

Infections with resistant bacteria; loss of last-resort antibiotics.

Population concerned

general population (not specified)

Geographic restriction by Elawady

none found

Diverging source versions

Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
Dr Diaa Al Awady د ضياء العوضي is live! الالتهاب ايه هوه ؟ (Open source)
Published
26 September 2025
Timestamp
not available (transcript has no timings)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); wording may contain transcription errors; no timestamps available.
Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
البكتيريا النافعة ؟! Bacterial Flora , What do we know about it ？ (Open source)
Published
11 January 2025
Timestamp
not available (transcript has no timings)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); wording may contain transcription errors; no timestamps available.
Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
ودي الحلقه التانيه من البودكاست…حلقه استثنائيه وقولولي رأيكوا (Open source)
Published
10 April 2026
Timestamp
not available (transcript has no timings)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); wording may contain transcription errors; no timestamps available.

Scientific assessment

Mostly true – Correct at its core, but with limitations or minor inaccuracies.

Certainty of evidence: moderate – Further research may still affect the assessment.

1. What was claimed?

Chickens are raised on routine antibiotics and pass multidrug-resistant bacteria to humans.

2. What is demonstrably correct?

Global livestock antibiotic use was estimated at 63,151 tons (2010), projected +67% by 2030 (A-CHK-05). Dutch data: 94% of retail chicken samples contained ESBL producers, with poultry-type genes in human isolates (A-CHK-02, A-CHK-03). mcr-1 was found in Chinese animals, meat and patients (A-CHK-11). Restricting antibiotic use lowers resistance in animals and was associated with lower prevalence in humans (I-CHK-01). The 2023-2024 EU report found rising ciprofloxacin resistance in poultry-associated Salmonella and C. jejuni from humans in more than half of reporting countries (I-CHK-116). WHO recommends ending antibiotic use for growth promotion and prevention (I-CHK-118). In Egypt, all 111 surveyed farms used antimicrobials, 65% for non-therapeutic purposes, and half used colistin (I-CHK-117).

3. What is wrong or exaggerated?

'Routine antibiotics' is not a uniform reality: the EU banned antibiotics as growth promoters from 2006 and restricts preventive use. A Dutch source-attribution model attributed about 19% of community carriage of ESBL E. coli to food and about 60% to human-to-human transmission (I-CHK-115), so food is a real but not the main route in the EU. Some cited studies concern pork (A-CHK-14) or only the US/China. In the US retail-meat study, chicken isolates had the lowest multidrug-resistance rate and no MRSA (A-CHK-01).

4. What remains unclear?

The share of human resistant infections attributable to poultry consumption versus human antibiotic use.

5. Which studies support it?

A-CHK-02, A-CHK-03, A-CHK-05, A-CHK-07, A-CHK-08, A-CHK-11, A-CHK-15, A-CHK-17, A-CHK-19, I-CHK-01, I-CHK-04, I-CHK-09, I-CHK-13, I-CHK-116, I-CHK-117, I-CHK-118, I-RES-101; A-CHK-01 (limited).

6. Which studies contradict it?

I-CHK-115 (food about 19% of community ESBL carriage in the Netherlands); A-CHK-14 (pork, no difference conventional vs antibiotic-free).

7. What applies to Germany and Europe?

EU: growth promoters banned since 2006; harmonised AMR monitoring shows resistance varies greatly by country, with encouraging downward trends in key indicators in several Member States over 7 years (I-CHK-04). Increasing resistance to critically important antimicrobials in poultry-associated Salmonella and Campylobacter from humans was observed in at least half of reporting countries.

8. What is known about Egypt?

Egyptian broiler studies report high multidrug resistance in Salmonella (76.7% of isolates in one province, I-CHK-09), frequent antibiotic residues above MRLs in chicken tissues (I-CHK-12), and colistin resistance (I-CHK-13). This suggests the concern is more relevant for Egypt than for the EU, but national surveillance data were not reviewed.

9. What practical conclusion is appropriate?

Antibiotic resistance via poultry is a real One Health problem; it is addressed through prudent use, regulation and kitchen hygiene (resistant bacteria are killed by cooking like others).

Assessment details

Rationale for certainty of evidence

Consistent microbiological and molecular evidence (shared ESBL genes/plasmids/strains in Dutch chicken and patients; mcr-1 in Chinese animals, meat and patients; FQ-resistant Campylobacter linked to poultry) plus a systematic review showing that restricting antibiotic use lowers resistance in animals and, with less evidence, in humans. Population-level attribution of human infections to poultry is less certain.

Source quality

Archive editorial with accurately cited, mostly high-quality studies; some (MRSA in pork, A-CHK-14) concern pork, not chicken.

Regional transferability

Highly dependent on country: EU banned antibiotic growth promoters from 2006 and monitors resistance; resistance is lower in some EU countries and decreasing in several. Egypt has reported high multidrug resistance in poultry Salmonella and colistin resistance (I-CHK-09, I-CHK-13).

Individual exceptions

Risk is higher for people with direct animal contact (farmers, slaughterhouse workers).

Regional scope of the claim
depends on production conditions
Last reviewed
26 October 2026 provisional

Scientific evidence in detail

True only under certain conditions – The claim holds only for certain doses, groups of people, preparations or circumstances.

Research question: Does antibiotic use in poultry production select resistant bacteria (ESBL E. coli, resistant Campylobacter/Salmonella, mcr-1) that reach humans through the food chain, and how large is this contribution?

Research question in detail (PECO)
Population
Consumers and general population
Intervention or exposure
Antibiotic use in poultry; consumption/handling of poultry meat
Comparison
Lower or restricted antibiotic use; other sources of resistance
Geographic scope
production-dependent (country-specific use and regulation)
Outcomes
  • resistant bacteria in meat
  • human carriage/infection with poultry-associated resistant strains
  • attributable fraction

Study results as reported by the authors. Our assessment follows below.

What speaks for the claim?

  • Less antibiotics in farm animals, less resistance

    Tang KL et al.. Lancet Planet Health 2017 · PMID 29387833 · DOI 10.1016/S2542-5196(17)30141-9 Meta-analysisfull text, structured risk-of-bias assessment

    Systematic review/meta-analysis of interventions restricting antibiotic use in food animals.

    Actual result
    Resistance in animals reduced (pooled risk differences mostly -0.10 to -0.15); in humans about 24% lower prevalence, stronger with animal contact.
    Methodological quality
    moderate (SR of mostly observational studies)
    Relevance
    direct
    Limitations
    Human evidence thinner than animal evidence.

    Original publication

  • Same resistance genes in Dutch chicken and patients

    Leverstein-van Hall MA et al.. Clin Microbiol Infect 2011 · PMID 21463397 · DOI 10.1111/j.1469-0691.2011.03497.x Cross-sectional studyabstract checked

    Dutch genotyping of ESBL genes in retail chicken and patients.

    Actual result
    94% of retail chicken with ESBL producers; 35% of human isolates with poultry-associated ESBL genes; 19% on plasmids indistinguishable from poultry.
    Methodological quality
    moderate (molecular epidemiology)
    Relevance
    direct
    Limitations
    Shared genes do not prove direction or share of transmission.

    Original publication

  • EU report 2023-2024: resistant bacteria from poultry still common

    EFSA and ECDC. EFSA J 2026 · DOI 10.2903/j.efsa.2026.9887 Measurement / residue studyabstract checkednewly added

    EU AMR summary report 2023-2024.

    Actual result
    Rising ciprofloxacin resistance in poultry-associated Salmonella and C. jejuni from humans in more than half of reporting countries; large country differences.
    Methodological quality
    high (harmonised surveillance)
    Relevance
    direct
    Limitations
    Abstract only.

    Original publication

What speaks against the claim?

What does the overall evidence say?

Editorial assessment based on the studies above – not itself a study result.

Which position is better supported?

Antibiotic use in poultry contributes to resistant bacteria reaching humans, but in the EU food is a minority source of community carriage; the problem is larger where use is routine and unregulated, as reported for Egypt.

Why some studies weigh more

Surveillance (I-CHK-116), molecular studies (A-CHK-02/03, A-CHK-11) and an intervention meta-analysis (I-CHK-01) consistently support the pathway; attribution modelling (I-CHK-115) quantifies a moderate share. Egyptian survey data (I-CHK-117) show routine non-therapeutic use including colistin.

Is a causal relationship established? Yes, established Selection of resistance by use, shared strains/genes, and decreases after restriction together establish the pathway; magnitude varies.

Remaining uncertainty

Share of human resistant infections attributable to poultry in Egypt; national Egyptian AMU and AMR data are lacking.

Justified conclusion

Largely correct; 'routine antibiotics' describes Egypt and other countries but not legal EU practice, and food is not the main source of resistance carriage in the EU.

Why do studies seem to disagree?

I-CHK-115 (food 19%) vs A-CHK-02 (94% of chicken ESBL-positive): high contamination of meat does not translate into a dominant share of human carriage because cooking, hygiene and human-to-human spread intervene. Different questions, not a contradiction.

Does this depend on the country?
General biological effects
Selection of resistance is universal.
Eating habits
Kitchen hygiene and cooking reduce transmission.
Origin of the food
Imported meat can carry higher resistance (I-CHK-116: imported broiler meat).
Contaminants
Resistant bacteria are killed by cooking like susceptible ones.
National production conditions
Egypt: all surveyed farms use antimicrobials, 65% non-therapeutically, half use colistin (I-CHK-117).
Legal rules
EU: growth promoters banned since 2006, Reg. 2019/6 restricts prophylaxis; Egypt: no GOVS decision on growth promoters found (the project's research files).
Actual monitoring data
EU harmonised AMR monitoring (I-CHK-116); Egypt: no national AMU/AMR data found.

A regional difference is supported by robust data.

Statistical re-check
  • Plausibility of attribution shares – Shares sum to about 100% (60.1+6.9+18.9+7.9+3.6+2.6 = 100.0); credible intervals wide. not recalculable from the published data
Certainty of the overall evidence (GRADE, simplified)
Main outcome
Transmission of poultry-associated resistant bacteria to humans
Starting level
low (observational studies)
Reasons for upgrading
  • consistency across molecular, surveillance and intervention data
  • dose-response (restriction reduces resistance)
Result
moderate

Simplified assessment by a single reviewer, following the GRADE approach; not a formal GRADE panel. GRADE rates the body of evidence for one outcome, not individual studies.

Clinical guidelines and official statements checked
  • WHO: WHO guidelines on use of medically important antimicrobials in food-producing animals (summary, Aidara-Kane et al. 2018, PMID 29375825) (2017) · Original publication
    Complete restriction of antimicrobial use for growth promotion and for prevention in healthy animals; reduce overall use of medically important antimicrobials.
  • EFSA/ECDC: EU Summary Report on AMR in zoonotic and indicator bacteria 2023-2024 (I-CHK-116) (2026) · Original publication
    High resistance to common antimicrobials in Salmonella and Campylobacter; increasing ciprofloxacin resistance in poultry-associated Salmonella and C. jejuni from humans in more than half of reporting countries; country differences large.
Search strategy

Documented literature searches for this review (search strings in the original database syntax).

DatabaseDateSearchLooking forHitsIncluded
Europe PMC26 October 2026(TITLE:ESBL OR TITLE:"extended-spectrum") AND (TITLE:attribution OR TITLE:"attributable")both directions4
PubMed26 October 2026(ESBL[tiab] OR extended-spectrum[tiab]) AND (attribut*[ti]) AND (food[tiab] OR chicken[tiab])contradicting evidence3
Europe PMC26 October 2026TITLE:"European Union summary report on antimicrobial resistance" AND PUB_YEAR:[2025 TO 2026]supporting evidence3
Crossref26 October 2026query.title=European Union summary report on antimicrobial resistance zoonotic indicator bacteria 2023-2024supporting evidence5
Europe PMC26 October 2026TITLE:"WHO guidelines on use of medically important antimicrobials in food-producing animals"guidelines3
the project's research files (EG vet_drugs, RS-EG-41) then PubMed efetch26 October 2026Egyptian antimicrobial use surveysupporting evidence1

Open questions

National Egyptian AMU and resistance surveillance; attribution of resistant infections in Egypt.

How deeply was this checked?

22 linked studies: 7 checked in full text (5 of them with a structured risk-of-bias assessment), 15 on the basis of the abstract, 0 bibliographically only. No formal assessment with two independent reviewers and no independent human expert review has taken place yet.

Last scientific review: 26 October 2026

History of the verdict
  1. 25 October 2026 · Phase 1 · Initial assessment: Mostly true (moderate)
  2. 26 October 2026 · Phase 4 (systematic evidence review) · Re-examined with extended evidence; verdict unchanged: Mostly true (moderate)
    New EU surveillance, WHO guideline and Egyptian use data strengthen the pathway; Dutch attribution modelling limits the size of the food route. Verdict and certainty unchanged.
    New sources: I-CHK-115 I-CHK-116 I-CHK-117 I-CHK-118

In plain language

The archive says chickens are given many antibiotics and that resistant bacteria can pass from chicken to people. This is largely supported: Dutch studies found the same resistance genes in chicken meat and in patients, and countries that limited antibiotics in animals saw less resistance. The European Union has banned antibiotics as growth boosters since 2006, while studies from Egypt show high levels of resistance and drug residues in chicken. Proper cooking and kitchen hygiene reduce the risk for consumers.

Studies on this claim

Studies supporting the claim (18)

  • Resistant Staphylococcus on US meat

    Waters AE et al.. Clin Infect Dis 2011 · PMID 21498385 · DOI 10.1093/cid/cir181
    Cross-sectional studycited by the Tayebat archivefull text, structured risk-of-bias assessment★ key study

    Almost half of meat samples carried S. aureus; about half of the isolates were multidrug-resistant, but for chicken it was about a quarter and no MRSA was found on chicken.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    What are the prevalence, resistance and genotypes of S. aureus in US meat and poultry?

    How was the study done?

    Cross-sectional microbiological survey of retail meat and poultry with susceptibility testing and genotyping

    How many people, animals or samples were studied?

    136 samples; Retail meat and poultry samples

    What was actually found?

    S. aureus: turkey 77%, pork 42%, chicken 41%, beef 37%; multidrug resistance 52% overall (chicken 26%); MRSA 3 isolates, none from chicken.

    How large was the observed effect?

    Proportions; comparisons between sample types

    What do the results mean in everyday life?

    Raw meat can carry resistant bacteria; hygiene and cooking matter.

    What are the study's limitations?

    Small convenience sample; mixed meats; no human outcomes; funded by an advocacy foundation; authors say public-health relevance is unclear.

    What does it say about Elawady's specific claim?

    Supports presence of resistant bacteria on meat.

    Do the results apply to Germany and Europe?

    Moderate; EU AMR monitoring covers MRSA.

    What can explicitly not be concluded from this study?

    Cannot show how many people get sick.

    Scientific details →

  • Same resistance genes in Dutch chicken and patients

    Leverstein-van Hall MA et al.. Clin Microbiol Infect 2011 · PMID 21463397 · DOI 10.1111/j.1469-0691.2011.03497.x
    Cross-sectional studycited by the Tayebat archiveabstract checked★ key study

    Most retail chicken had ESBL bacteria, and many human isolates shared the same genes and plasmids.

    Does the study support the specific claim? Yes · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    What proportion of human clinical ESBL E. coli carry poultry-associated genes, plasmids and strains?

    How was the study done?

    Molecular epidemiological study comparing ESBL genes, plasmids and strains from poultry, retail chicken and human clinical isolates

    How many people, animals or samples were studied?

    98 retail chicken samples; 516 human clinical samples; Retail chicken, poultry, human clinical samples from 31 labs

    What was actually found?

    94% of retail meat samples contained ESBL producers; 39% of these belonged to E. coli genotypes also present in human samples. 35% of human isolates contained poultry-associated ESBL genes; 19% had PA genes on IncI1 plasmids indistinguishable from poultry.

    How large was the observed effect?

    Descriptive proportions; microarray, pMLST, MLST

    What do the results mean in everyday life?

    Resistance genes can move from poultry to people.

    What are the study's limitations?

    Cross-sectional; direction of transmission inferred; 2009 data

    What does it say about Elawady's specific claim?

    Supports the claim.

    Do the results apply to Germany and Europe?

    High (EU country).

    What can explicitly not be concluded from this study?

    Cannot say how many human infections come from chicken.

    Scientific details →

  • ESBL genes in Dutch chicken meat and people

    Overdevest I et al.. Emerg Infect Dis 2011 · PMID 21762575 · DOI 10.3201/eid1707.110209
    Cross-sectional studycited by the Tayebat archiveabstract checked

    Four in five chicken samples had ESBL genes, matching those found in people.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    What are prevalence and characteristics of ESBL genes in retail chicken and humans in the Netherlands?

    How was the study done?

    Cross-sectional study of ESBL genes in retail chicken and human rectal/blood isolates

    How many people, animals or samples were studied?

    Not stated in abstract; Retail chicken; patients in 4 hospitals

    What was actually found?

    ESBL genes in 79.8% of chicken meat; predominant genes identical in meat and human rectal swabs; frequently in blood isolates; high similarity of E. coli strains.

    How large was the observed effect?

    Descriptive

    What do the results mean in everyday life?

    Resistant bacteria on raw chicken are common in some countries.

    What are the study's limitations?

    Directionality inferred; Sample sizes not in abstract

    What does it say about Elawady's specific claim?

    Supports the claim.

    Do the results apply to Germany and Europe?

    High.

    What can explicitly not be concluded from this study?

    Cannot prove transmission direction.

    Scientific details →

  • Global antibiotic use in farm animals

    Van Boeckel TP et al.. Proc Natl Acad Sci U S A 2015 · PMID 25792457 · DOI 10.1073/pnas.1503141112
    Othercited by the Tayebat archiveabstract checked★ key study

    Models estimated about 63,000 tons used in 2010 with a projected 67% increase by 2030.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    How much antimicrobial is used in livestock globally and how will it change?

    How was the study done?

    Bayesian modelling of global antimicrobial use in food animals for 2010 and 2030

    How many people, animals or samples were studied?

    Not applicable; Global livestock (cattle, chicken, pigs)

    What was actually found?

    Average 45 (cattle), 148 (chicken), 172 (pigs) mg/kg. Increase of 67% from 63,151 +/- 1,560 t to 105,596 +/- 3,605 t (2010-2030). Up to a third of increase from middle-income countries shifting to intensive systems; BRICS +99%.

    How large was the observed effect?

    Bayesian models

    What do the results mean in everyday life?

    Antibiotic use in farming is large and growing in middle-income countries.

    What are the study's limitations?

    Extrapolation from high-income data; Model uncertainty larger than reported SD may suggest

    What does it say about Elawady's specific claim?

    Supports the context of the claim.

    Do the results apply to Germany and Europe?

    Moderate.

    What can explicitly not be concluded from this study?

    Cannot show use in a given country.

    Scientific details →

  • Resistant Campylobacter linked to poultry in the US

    Kassenborg HD et al.. Clin Infect Dis 2004 · PMID 15095200 · DOI 10.1086/381597
    Case-control studycited by the Tayebat archiveabstract checked

    Domestic resistant infections were linked to eating chicken or turkey at restaurants.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    What are risk factors for fluoroquinolone-resistant Campylobacter infection?

    How was the study done?

    Population-based case-control study (FoodNet)

    How many people, animals or samples were studied?

    858 isolates tested; 64 FQ-resistant vs 582 susceptible with travel data; 33 matched case-control pairs; Patients with Campylobacter infection and matched controls

    What was actually found?

    11% resistant. Travel OR 7.6 (4.3-13.4). Domestic cases: eating chicken or turkey at commercial establishment matched OR 10.0 (1.3-78).

    How large was the observed effect?

    OR, matched OR

    What do the results mean in everyday life?

    Poultry can transmit resistant Campylobacter.

    What are the study's limitations?

    Very wide CI (only 33 pairs); Recall bias

    What does it say about Elawady's specific claim?

    Supports.

    Do the results apply to Germany and Europe?

    Moderate.

    What can explicitly not be concluded from this study?

    Precise risk size.

    Scientific details →

  • US ban of fluoroquinolones in poultry

    Nelson JM et al.. Clin Infect Dis 2007 · PMID 17342653 · DOI 10.1086/512369
    Narrative reviewcited by the Tayebat archiveabstract checked

    Resistance concerns led the US to withdraw enrofloxacin from poultry in 2005.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    What happened after fluoroquinolones were withdrawn from US poultry?

    How was the study done?

    Review of FQ-resistant Campylobacter and US regulatory withdrawal of enrofloxacin in poultry

    How many people, animals or samples were studied?

    Not applicable; US

    What was actually found?

    FDA proposed withdrawal in 2000; enrofloxacin withdrawn from poultry effective September 2005; resistant strains continue to circulate.

    How large was the observed effect?

    Not applicable

    What do the results mean in everyday life?

    Regulators can restrict drugs that drive resistance.

    What are the study's limitations?

    Narrative; Authors from US agencies

    What does it say about Elawady's specific claim?

    Supports problem existence.

    Do the results apply to Germany and Europe?

    Moderate.

    What can explicitly not be concluded from this study?

    Cannot quantify impact.

    Scientific details →

  • Discovery of transferable colistin resistance (mcr-1) in China

    Liu YY et al.. Lancet Infect Dis 2016 · PMID 26603172 · DOI 10.1016/S1473-3099(15)00424-7
    Othercited by the Tayebat archiveabstract checked★ key study

    A transferable gene making bacteria resistant to the last-resort antibiotic colistin was found in animals, meat and some patients.

    Does the study support the specific claim? Yes · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Is there plasmid-mediated polymyxin resistance in Enterobacteriaceae in China?

    How was the study done?

    Surveillance plus microbiological and molecular study discovering plasmid-mediated colistin resistance (mcr-1)

    How many people, animals or samples were studied?

    804 animals; 523 raw meat samples; 1,322 inpatient samples; E. coli and K. pneumoniae from food animals, raw meat and inpatients in five provinces

    What was actually found?

    mcr-1 in 166/804 (21%) animals, 78/523 (15%) raw meat, 16/1322 (1%) inpatients; transferable by conjugation; negated colistin in mice.

    How large was the observed effect?

    Descriptive; conjugation frequencies; mouse model

    What do the results mean in everyday life?

    Farm antibiotic use can threaten important human medicines.

    What are the study's limitations?

    China-specific surveillance; Index strain from a pig; poultry-specific share not given in abstract

    What does it say about Elawady's specific claim?

    Supports resistance concern.

    Do the results apply to Germany and Europe?

    Moderate.

    What can explicitly not be concluded from this study?

    Not specific to chicken.

    Scientific details →

  • Less resistance on farms that stopped antibiotics

    Sapkota AR et al.. Environ Health Perspect 2011 · PMID 21827979 · DOI 10.1289/ehp.1003350
    Cross-sectional studycited by the Tayebat archiveabstract checked

    Poultry houses that switched to organic had far fewer multidrug-resistant bacteria.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Does transition to organic practices lower antibiotic-resistant Enterococcus on poultry farms?

    How was the study done?

    Field comparison of resistant Enterococcus in conventional vs newly organic poultry houses

    How many people, animals or samples were studied?

    20 houses; 259 Enterococcus isolates; 10 conventional and 10 newly organic poultry houses

    What was actually found?

    MDR E. faecalis 42% conventional vs 10% organic (p=0.02); MDR E. faecium 84% vs 17% (p<0.001).

    How large was the observed effect?

    GLMM

    What do the results mean in everyday life?

    Reducing antibiotic use reduces resistance.

    What are the study's limitations?

    Small number of houses; Farm environment, not meat

    What does it say about Elawady's specific claim?

    Supports.

    Do the results apply to Germany and Europe?

    Moderate.

    What can explicitly not be concluded from this study?

    Cannot show human health effect.

    Scientific details →

  • US Salmonella outbreak from one chicken company

    Gieraltowski L et al.. PLoS One 2016 · PMID 27631492 · DOI 10.1371/journal.pone.0162369
    Outbreak reportcited by the Tayebat archivefull text, structured risk-of-bias assessment

    634 people fell ill from resistant Salmonella traced to one company's chicken.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    What caused a large multistate MDR Salmonella Heidelberg outbreak?

    How was the study done?

    Outbreak investigation (epidemiological, laboratory, traceback)

    How many people, animals or samples were studied?

    634 cases; 435 interviewed; 634 US case-patients

    What was actually found?

    634 sick (38% hospitalised, no deaths); 87% of those with brand data ate Company A chicken; 67% of tested patient isolates resistant, 35% multidrug-resistant; Salmonella in 26% of samples at the implicated plants, down to about 5% after fixes.

    How large was the observed effect?

    Descriptive

    What do the results mean in everyday life?

    Shows why safe handling of raw chicken matters.

    What are the study's limitations?

    Single outbreak

    What does it say about Elawady's specific claim?

    Supports existence of hazard.

    Do the results apply to Germany and Europe?

    Moderate.

    What can explicitly not be concluded from this study?

    Cannot give routine prevalence in chicken and does not support an 80-85% contamination rate.

    Scientific details →

  • Urinary infection E. coli genes in Danish chicken and pork

    Jakobsen L et al.. Int J Food Microbiol 2010 · PMID 20656368 · DOI 10.1016/j.ijfoodmicro.2010.06.025
    Cross-sectional studycited by the Tayebat archiveabstract checked

    E. coli from meat had virulence genes similar to those from patients with urinary infections.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Could broiler meat and pork be sources of ExPEC strains in humans?

    How was the study done?

    Molecular comparison of ExPEC virulence genes in E. coli from UTI patients, community humans, meat and animals

    How many people, animals or samples were studied?

    964 isolates; 964 E. coli isolates

    What was actually found?

    Seven of eight ExPEC-related genes detected in isolates from broiler meat, broilers, pork and pigs; strong similarities between human and meat/animal isolate profiles.

    How large was the observed effect?

    PCR; cluster analysis

    What do the results mean in everyday life?

    Meat could be one source of bacteria causing urinary infections.

    What are the study's limitations?

    Gene presence, not transmission proof

    What does it say about Elawady's specific claim?

    Supports plausibility.

    Do the results apply to Germany and Europe?

    High.

    What can explicitly not be concluded from this study?

    Cannot prove transmission.

    Scientific details →

  • Less antibiotics in farm animals, less resistance

    Tang KL et al.. Lancet Planet Health 2017 · PMID 29387833 · DOI 10.1016/S2542-5196(17)30141-9
    Meta-analysisindependent cross-checkfull text, structured risk-of-bias assessment★ key study

    Restricting antibiotics in livestock reduced resistant bacteria in animals and, in fewer studies, in people.

    Does the study support the specific claim? Yes · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Effect of restricting antibiotic use in food animals on resistance in animals and humans

    How was the study done?

    Systematic review and meta-analysis (WHO-commissioned)

    How many people, animals or samples were studied?

    181 studies (179 animal, 21 human); Food-producing animals; humans

    What was actually found?

    In animals resistance was usually 10-15 percentage points lower with restrictions (poultry 18 points); in studied humans 24 points lower, mainly in farm workers (29 points) and much less in non-farm people (9 points, 3 studies).

    How large was the observed effect?

    Random-effects risk differences

    What do the results mean in everyday life?

    Prudent farm antibiotic use protects human medicine.

    What are the study's limitations?

    Mostly cross-sectional, poorly adjusted studies; very high heterogeneity; few human studies, mostly farm workers; possible publication bias in human studies; almost no data from low- and middle-income countries.

    What does it say about Elawady's specific claim?

    Supports.

    Do the results apply to Germany and Europe?

    High.

    What can explicitly not be concluded from this study?

    Cannot quantify effect on all consumers.

    Scientific details →

  • EU report on antibiotic resistance in food animals

    EFSA, ECDC. EFSA J 2024 · PMID 38419967 · DOI 10.2903/j.efsa.2024.8583
    Otherindependent cross-checkabstract checked

    Resistance in poultry-linked bacteria is common and varies by country, but key indicators improved in several countries.

    Does the study support the specific claim? Yes · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    AMR in Salmonella, Campylobacter, indicator E. coli, MRSA in humans, animals, food

    How was the study done?

    EU harmonised AMR monitoring report

    How many people, animals or samples were studied?

    Not stated in abstract; EU MSs

    What was actually found?

    Resistance differed greatly between countries; resistance to common antimicrobials frequent in Salmonella and Campylobacter; increasing resistance to a critically important antimicrobial in poultry-associated Salmonella and Campylobacter from humans in at least half of reporting countries; encouraging progress in key outcome indicators in several MSs over 7 years.

    How large was the observed effect?

    Descriptive; trend analysis

    What do the results mean in everyday life?

    The problem is real in the EU too, but monitored.

    What are the study's limitations?

    Country variation in sampling

    What does it say about Elawady's specific claim?

    Supports, with nuance.

    Do the results apply to Germany and Europe?

    Directly EU.

    What can explicitly not be concluded from this study?

    Not consumer risk per meal.

    Scientific details →

  • Salmonella in Egyptian broiler chickens

    Elkenany R et al.. BMC Vet Res 2019 · PMID 31029108 · DOI 10.1186/s12917-019-1867-z
    Cross-sectional studyindependent cross-checkfull text, structured risk-of-bias assessment

    About 29% of retail chicken carcasses and 32% of farm chickens in one Egyptian province had Salmonella, mostly multidrug-resistant.

    Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Prevalence, resistance and virulence genes of Salmonella in broilers and retail carcasses

    How was the study done?

    Cross-sectional microbiological survey

    How many people, animals or samples were studied?

    420 samples from 5 broiler farms and 5 retail shops, El-Sharkia, summer 2017

    What was actually found?

    Salmonella in 28.6% of all samples (carcasses 29.4%, cloacal swabs 32%, environment 22%); 76.7% of isolates multidrug-resistant; all resistant to trimethoprim-sulfamethoxazole; none to imipenem.

    How large was the observed effect?

    Descriptive

    What do the results mean in everyday life?

    In Egypt, careful handling and cooking of chicken is especially important.

    What are the study's limitations?

    Only 5 farms and 5 shops in one province, one season; no human data; descriptive only.

    What does it say about Elawady's specific claim?

    Supports concern but not 80-85%.

    Do the results apply to Germany and Europe?

    Low (Egypt).

    What can explicitly not be concluded from this study?

    Not national.

    Scientific details →

  • Colistin resistance in the Middle East and North Africa

    Saniour R et al.. Microorganisms 2026 · PMID 42655038 · DOI 10.3390/microorganisms14081693
    Narrative reviewindependent cross-checkabstract checked

    Resistance to the last-resort antibiotic colistin is reported in Egypt and other countries, including in poultry.

    Does the study support the specific claim? Yes · Methodological quality: low · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Epidemiology of colistin resistance in MENA

    How was the study done?

    Narrative review

    How many people, animals or samples were studied?

    Not applicable; Humans, animals, food, environment

    What was actually found?

    North Africa prevalence of colistin-resistant Gram-negatives: Tunisia 58.09%, Egypt 24.76%, Algeria 14.29%, Libya 2.86% (from available literature); mcr-1 predominant; resistance documented in poultry and food.

    How large was the observed effect?

    Descriptive

    What do the results mean in everyday life?

    Farm antibiotic use matters for human medicine in Egypt too.

    What are the study's limitations?

    Narrative; heterogeneous sources

    What does it say about Elawady's specific claim?

    Supports.

    Do the results apply to Germany and Europe?

    Low.

    What can explicitly not be concluded from this study?

    Not precise prevalence.

    Scientific details →

  • EU report 2023-2024: resistant bacteria from poultry still common

    EFSA and ECDC. EFSA J 2026 · DOI 10.2903/j.efsa.2026.9887
    Measurement / residue studyindependent cross-checkabstract checked

    Resistance to common antibiotics is frequent in Salmonella and Campylobacter, and ciprofloxacin resistance is rising in poultry-associated strains in humans.

    Resistance in poultry-associated Salmonella and Campylobacter, including rising ciprofloxacin resistance in human cases.

    Does the study support the specific claim? Yes · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    What are the AMR levels and trends in Salmonella, Campylobacter and indicator E. coli from humans, food-producing animals and meat in the EU?

    How was the study done?

    EU harmonised AMR monitoring report

    How many people, animals or samples were studied?

    EU-wide monitoring (numbers not in abstract)

    What was actually found?

    High proportions of Salmonella and Campylobacter isolates from humans and animals resistant to ampicillin, tetracycline and sulfonamides. Increasing ciprofloxacin resistance in human infections with a poultry-associated Salmonella serovar and in C. jejuni in more than half of reporting countries. Resistance differed greatly between countries. Very high third-generation cephalosporin resistance in Salmonella from imported broiler and turkey meat. Encouraging progress in reducing AMR in food-producing animals in several Member States over the past decade, partly plateauing.

    How large was the observed effect?

    High proportions of Salmonella and Campylobacter isolates from humans and animals resistant to ampicillin, tetracycline and sulfonamides. Increasing ciprofloxacin resistance in human infections with a poultry-associated Salmonella serovar and in C. jejuni in more than half of reporting countries. Resistance differed greatly between countries. Very high third-generation cephalosporin resistance in Salmonella from imported broiler and turkey meat. Encouraging progress in reducing AMR in food-producing animals in several Member States over the past decade, partly plateauing.

    What do the results mean in everyday life?

    Antibiotic resistance linked to poultry is a real, monitored problem in Europe, improving in some countries.

    What are the study's limitations?

    Abstract only (read via Crossref); No PMID located

    What does it say about Elawady's specific claim?

    Supports the resistance part of the claim for the EU, with country differences.

    Do the results apply to Germany and Europe?

    Directly EU data.

    What can explicitly not be concluded from this study?

    Does not quantify how many human infections come from eating chicken.

    Scientific details →

  • Egyptian farms report routine antibiotic use, often without medical need

    ElSayed N et al.. J Egypt Public Health Assoc 2025 · PMID 39828782 · DOI 10.1186/s42506-024-00180-w
    Cross-sectional studyindependent cross-checkabstract checked

    All 111 farms used antibiotics; 65% also used them for prevention or growth.

    Routine and non-therapeutic antibiotic use, including colistin, reported on Egyptian farms.

    Does the study support the specific claim? Yes · Methodological quality: low · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    What antimicrobials are used on Egyptian animal farms, for what purposes, and why?

    How was the study done?

    Cross-sectional survey of farm personnel

    How many people, animals or samples were studied?

    111 of 150 farms (74% response)

    What was actually found?

    All surveyed personnel reported antimicrobial use; 65% used them for non-therapeutic purposes (prevention or growth promotion). Non-therapeutic use had no impact on FCR in any farm type. Most used: penicillins 81%, macrolides 78%, tetracyclines 72%. Half used colistin; 55% of these non-therapeutically.

    How large was the observed effect?

    All surveyed personnel reported antimicrobial use; 65% used them for non-therapeutic purposes (prevention or growth promotion). Non-therapeutic use had no impact on FCR in any farm type. Most used: penicillins 81%, macrolides 78%, tetracyclines 72%. Half used colistin; 55% of these non-therapeutically.

    What do the results mean in everyday life?

    In Egypt, routine antibiotic use in animals is common.

    What are the study's limitations?

    Self-report; Farms selected from a private platform list; Small sample

    What does it say about Elawady's specific claim?

    Supports 'routine antibiotics' for Egypt.

    Do the results apply to Germany and Europe?

    Not applicable to the EU (growth promoters banned since 2006).

    What can explicitly not be concluded from this study?

    Not representative of all Egyptian farms.

    Scientific details →

  • WHO: stop using antibiotics to make farm animals grow

    Aidara-Kane A et al.. Antimicrob Resist Infect Control 2018 · PMID 29375825 · DOI 10.1186/s13756-017-0294-9
    Guideline / position statementindependent cross-checkabstract checked

    WHO recommends ending antibiotic use for growth promotion and for prevention in healthy animals.

    WHO states antimicrobial use in food animals selects for resistance transmissible to humans and recommends ending growth promotion.

    Does the study support the specific claim? Yes · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    How should medically important antimicrobials be used in food-producing animals?

    How was the study done?

    Summary of WHO guideline developed with GRADE and commissioned systematic reviews

    How many people, animals or samples were studied?

    not applicable

    What was actually found?

    Recommends reduction in overall use of medically important antimicrobials, complete restriction of use for growth promotion and for disease prevention in healthy animals, and no use of critically important antimicrobials unless susceptibility testing shows they are the only option.

    How large was the observed effect?

    Recommends reduction in overall use of medically important antimicrobials, complete restriction of use for growth promotion and for disease prevention in healthy animals, and no use of critically important antimicrobials unless susceptibility testing shows they are the only option.

    What do the results mean in everyday life?

    The international health authority agrees that farm antibiotic use is a resistance problem.

    What are the study's limitations?

    Recommendations rest partly on low-certainty evidence

    What does it say about Elawady's specific claim?

    Supports the resistance concern; does not quantify human harm.

    Do the results apply to Germany and Europe?

    EU rules (Reg. 2019/6) largely implement these principles.

    What can explicitly not be concluded from this study?

    Not a measure of current use in any country.

    Scientific details →

  • Gentamicin found in one in five Egyptian chicken samples, mostly in liver

    Kamouh HM et al.. Open Vet J 2024 · PMID 38633178 · DOI 10.5455/OVJ.2024.v14.i1.40
    Measurement / residue studyindependent cross-checkfull text checked★ key study

    21% of samples contained gentamicin, most often liver and gizzard; boiling removed over 90%.

    Residues of several antibiotics in Egyptian chicken indicate frequent use.

    Does the study support the specific claim? Partly · Methodological quality: low · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    How often are oxytetracycline, gentamicin and ciprofloxacin residues present in retail chicken in Egypt, and does boiling reduce them?

    How was the study done?

    Cross-sectional residue survey (microbial inhibition test plus HPLC) with a boiling experiment

    How many people, animals or samples were studied?

    100 samples (25 per tissue)

    What was actually found?

    Positive: oxytetracycline 23%, gentamicin 21%, ciprofloxacin 17% of samples. Gentamicin by tissue: breast 16%, thigh 16%, gizzard 20%, liver 32%; mean concentrations (ng/g) 31.8, 52.5, 201.3, 243.2 (max liver 378.5). Above the MRL used: breast 1/25, thigh 2/25, gizzard 4/25, liver 5/25. Boiling 30 min reduced gentamicin by 91.8-95.2% (liver 378.5 -> 18.3 ng/g), oxytetracycline by 88.2% and ciprofloxacin by 23-31%.

    How large was the observed effect?

    Positive: oxytetracycline 23%, gentamicin 21%, ciprofloxacin 17% of samples. Gentamicin by tissue: breast 16%, thigh 16%, gizzard 20%, liver 32%; mean concentrations (ng/g) 31.8, 52.5, 201.3, 243.2 (max liver 378.5). Above the MRL used: breast 1/25, thigh 2/25, gizzard 4/25, liver 5/25. Boiling 30 min reduced gentamicin by 91.8-95.2% (liver 378.5 -> 18.3 ng/g), oxytetracycline by 88.2% and ciprofloxacin by 23-31%.

    What do the results mean in everyday life?

    Antibiotic traces are real in Egyptian chicken, especially in offal; cooking removes most gentamicin; the amounts are tiny compared with medical doses.

    What are the study's limitations?

    Small sample from one governorate; Gentamicin MRLs taken from EU bovine/porcine values (EU 37/2010 lists gentamicin MRLs only for bovine and porcine species, I-RES-01); Inconsistent counts (21 MIT-positive vs 25 positive in Table 7 text); No dietary risk assessment

    What does it say about Elawady's specific claim?

    Supports that gentamicin is used in Egyptian broilers; does not support kidney or hearing damage.

    Do the results apply to Germany and Europe?

    Not applicable to EU production.

    What can explicitly not be concluded from this study?

    Cannot show any health effect.

    Scientific details →

Studies contradicting or limiting the claim (2)

  • MRSA in US retail pork

    O'Brien AM et al.. PLoS One 2012 · PMID 22276147 · DOI 10.1371/journal.pone.0030092
    Cross-sectional studycited by the Tayebat archiveabstract checked

    Pork raised without antibiotics carried MRSA as often as conventional pork.

    Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    What is S. aureus/MRSA prevalence in conventional vs alternative retail pork?

    How was the study done?

    Cross-sectional retail survey of S. aureus and MRSA in pork

    How many people, animals or samples were studied?

    395 pork samples; Retail pork from 36 stores

    What was actually found?

    S. aureus 64.8%; MRSA 6.6% (4.3-9.5%); no significant differences between conventional and alternative pork.

    How large was the observed effect?

    Proportions, 95% CI

    What do the results mean in everyday life?

    Not about chicken.

    What are the study's limitations?

    Pork, not poultry

    What does it say about Elawady's specific claim?

    Limits the claim.

    Do the results apply to Germany and Europe?

    Moderate.

    What can explicitly not be concluded from this study?

    Says nothing about chicken.

    Scientific details →

  • EU ban on antibiotic growth promoters

    European Parliament and Council. Official Journal of the EU (copy at legislation.gov.uk) 2003
    Guideline / position statementindependent cross-checkfull text checked

    Since 2006, antibiotics may not be used as growth-promoting feed additives in the EU.

    Does the study support the specific claim? No · Methodological quality: not applicable · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Rules for feed additives including phase-out of antibiotic growth promoters

    How was the study done?

    EU regulation

    How many people, animals or samples were studied?

    Not applicable; EU animal feed

    What was actually found?

    Article 11(2): antibiotics, other than coccidiostats and histomonostats, may be marketed and used as feed additives only until 31 December 2005; from 1 January 2006 deleted from the Register. Recital 25 cites the Scientific Steering Committee: growth-promoting antimicrobials from classes used in medicine should be phased out.

    How large was the observed effect?

    Not applicable

    What do the results mean in everyday life?

    "Routine antibiotics for growth" is not legal in the EU.

    What are the study's limitations?

    Therapeutic and prophylactic veterinary use regulated separately (not covered)

    What does it say about Elawady's specific claim?

    Limits the claim for the EU.

    Do the results apply to Germany and Europe?

    Directly EU.

    What can explicitly not be concluded from this study?

    Does not cover therapeutic use.

    Scientific details →

Studies with mixed or unclear results (2)

  • Antibiotic residues in Egyptian chicken

    Noah SM et al.. Sci Rep 2026 · PMID 42527435 · DOI 10.1038/s41598-026-63227-2
    Measurement / residue studyindependent cross-checkfull text, structured risk-of-bias assessment★ key study

    Many chicken samples had antibiotic residues above legal limits, especially in liver, but estimated health risk was low.

    Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Antibiotic residues in chicken tissues and consumer risk

    How was the study done?

    Cross-sectional residue survey (HPLC) with risk assessment

    How many people, animals or samples were studied?

    180 samples (60 breast, 60 thigh, 60 liver); Chicken tissues from poultry shops

    What was actually found?

    Detected: enrofloxacin 51.67%, oxytetracycline 71.67%, sulfadimidine 16.67%; of positives, 54.84%, 55.81% and 70% exceeded MRLs. Liver had highest levels (e.g., oxytetracycline mean 10,625 ug/kg). EDI 0.012-0.590 ug/kg bw/day; HQ 0.0002-0.050, indicating no significant health risk.

    How large was the observed effect?

    Descriptive; HQ

    What do the results mean in everyday life?

    Withdrawal periods are not always respected in some Egyptian supply chains.

    What are the study's limitations?

    One city; unclear shop selection; no confirmatory LC-MS/MS; risk estimate uses average levels and intakes only; eggs not studied.

    What does it say about Elawady's specific claim?

    Supports residue concern in Egypt; not toxicity.

    Do the results apply to Germany and Europe?

    Low (Egypt).

    What can explicitly not be concluded from this study?

    Cannot generalise nationwide.

    Scientific details →

  • Most resistant gut bacteria in Dutch people come from other people, about one fifth from food

    Mughini-Gras L et al.. Lancet Planet Health 2019 · PMID 31439317 · DOI 10.1016/S2542-5196(19)30130-5
    Risk assessmentindependent cross-checkabstract checked★ key study

    Food accounted for about 19% of community carriage of ESBL E. coli; human-to-human spread for about 60%.

    Food contributes (about 19%), but human-to-human spread dominates; limits the size of the poultry route.

    Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    What proportion of community-acquired ESBL/pAmpC E. coli carriage is attributable to human, animal, food and environmental sources?

    How was the study done?

    Population-based source-attribution modelling (ESBL/pAmpC genes), Netherlands 2005-2017

    How many people, animals or samples were studied?

    1,220 human and 6,275 non-human gene occurrences

    What was actually found?

    Human-to-human transmission within/between households 60.1% (95% CrI 40.0-73.5); secondary transmission from high-risk groups 6.9%; food 18.9% (7.0-38.3); companion animals 7.9%; farm animals (non-occupational) 3.6%; environment 2.6%. R0 for intracommunity transmission 0.63.

    How large was the observed effect?

    Human-to-human transmission within/between households 60.1% (95% CrI 40.0-73.5); secondary transmission from high-risk groups 6.9%; food 18.9% (7.0-38.3); companion animals 7.9%; farm animals (non-occupational) 3.6%; environment 2.6%. R0 for intracommunity transmission 0.63.

    What do the results mean in everyday life?

    Food is a real but not the main route for these resistant bacteria in the Netherlands.

    What are the study's limitations?

    Model assumptions; Food not split by type in abstract; Erratum published

    What does it say about Elawady's specific claim?

    Supports the food-chain route but limits its size.

    Do the results apply to Germany and Europe?

    Directly EU-relevant (Netherlands).

    What can explicitly not be concluded from this study?

    Not specific to chicken; different in high-use countries.

    Scientific details →

Regional context

Germany / EU

EU: growth promoters banned since 2006; harmonised AMR monitoring shows resistance varies greatly by country, with encouraging downward trends in key indicators in several Member States over 7 years (I-CHK-04). Increasing resistance to critically important antimicrobials in poultry-associated Salmonella and Campylobacter from humans was observed in at least half of reporting countries.

Egypt

Egyptian broiler studies report high multidrug resistance in Salmonella (76.7% of isolates in one province, I-CHK-09), frequent antibiotic residues above MRLs in chicken tissues (I-CHK-12), and colistin resistance (I-CHK-13). This suggests the concern is more relevant for Egypt than for the EU, but national surveillance data were not reviewed.

What applies in my country?

General scientific assessment

Mostly true Antibiotic use in poultry does contribute to resistant bacteria reaching humans; the size of the problem depends strongly on the country.

The following areas of food safety are relevant to this statement:

  • Pesticides and pesticide residues
  • Veterinary medicines and antibiotics
  • Hormonal growth promoters
  • Contaminants (heavy metals, PFAS, PCBs, dioxins, nitrate)
  • Pathogens (Salmonella, Campylobacter, etc.)
  • Animal husbandry and feed
  • Controls, imports, recalls, labelling

Eggs · Poultry · Dairy · Fish and seafood · Red meat · Fruit and vegetables

Choose a country to see the checked information for it.

Limits: legal rules describe what is allowed, not what every single food contains. Measurement data come from samples and are meaningful only together with their method details.

Country of residence or purchase Compare with another country

References

  1. Multidrug-Resistant Staphylococcus aureus in US Meat and Poultry.. Waters AE et al.. Clin Infect Dis 2011 · PMID 21498385 · DOI 10.1093/cid/cir181
  2. Dutch patients, retail chicken meat and poultry share the same ESBL genes, plasmids and strains.. Leverstein-van Hall MA et al.. Clin Microbiol Infect 2011 · PMID 21463397 · DOI 10.1111/j.1469-0691.2011.03497.x
  3. Extended-spectrum β-lactamase genes of Escherichia coli in chicken meat and humans, The Netherlands.. Overdevest I et al.. Emerg Infect Dis 2011 · PMID 21762575 · DOI 10.3201/eid1707.110209
  4. Global trends in antimicrobial use in food animals.. Van Boeckel TP et al.. Proc Natl Acad Sci U S A 2015 · PMID 25792457 · DOI 10.1073/pnas.1503141112
  5. Fluoroquinolone-resistant Campylobacter infections: eating poultry outside of the home and foreign travel are risk factors.. Kassenborg HD et al.. Clin Infect Dis 2004 · PMID 15095200 · DOI 10.1086/381597
  6. Fluoroquinolone-resistant Campylobacter species and the withdrawal of fluoroquinolones from use in poultry: a public health success story.. Nelson JM et al.. Clin Infect Dis 2007 · PMID 17342653 · DOI 10.1086/512369
  7. Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: a microbiological and molecular biological study.. Liu YY et al.. Lancet Infect Dis 2016 · PMID 26603172 · DOI 10.1016/S1473-3099(15)00424-7
  8. Lower prevalence of antibiotic-resistant Enterococci on U.S. conventional poultry farms that transitioned to organic practices.. Sapkota AR et al.. Environ Health Perspect 2011 · PMID 21827979 · DOI 10.1289/ehp.1003350
  9. National Outbreak of Multidrug Resistant Salmonella Heidelberg Infections Linked to a Single Poultry Company.. Gieraltowski L et al.. PLoS One 2016 · PMID 27631492 · DOI 10.1371/journal.pone.0162369
  10. Broiler chickens, broiler chicken meat, pigs and pork as sources of ExPEC related virulence genes and resistance in Escherichia coli isolates from community-dwelling humans and UTI patients.. Jakobsen L et al.. Int J Food Microbiol 2010 · PMID 20656368 · DOI 10.1016/j.ijfoodmicro.2010.06.025
  11. Restricting the use of antibiotics in food-producing animals and its associations with antibiotic resistance in food-producing animals and human beings: a systematic review and meta-analysis.. Tang KL et al.. Lancet Planet Health 2017 · PMID 29387833 · DOI 10.1016/S2542-5196(17)30141-9
  12. The European Union summary report on antimicrobial resistance in zoonotic and indicator bacteria from humans, animals and food in 2021-2022.. EFSA, ECDC. EFSA J 2024 · PMID 38419967 · DOI 10.2903/j.efsa.2024.8583
  13. Antimicrobial resistance profiles and virulence genotyping of Salmonella enterica serovars recovered from broiler chickens and chicken carcasses in Egypt.. Elkenany R et al.. BMC Vet Res 2019 · PMID 31029108 · DOI 10.1186/s12917-019-1867-z
  14. Overview of Colistin Resistance in the Middle East and North Africa (MENA) Region.. Saniour R et al.. Microorganisms 2026 · PMID 42655038 · DOI 10.3390/microorganisms14081693
  15. The European Union Summary Report on Antimicrobial Resistance in zoonotic and indicator bacteria from humans, animals and food in 2023-2024. EFSA and ECDC. EFSA J 2026 · DOI 10.2903/j.efsa.2026.9887
  16. Antimicrobial use in animal farms in Egypt: rates, patterns, and determinants.. ElSayed N et al.. J Egypt Public Health Assoc 2025 · PMID 39828782 · DOI 10.1186/s42506-024-00180-w
  17. World Health Organization (WHO) guidelines on use of medically important antimicrobials in food-producing animals.. Aidara-Kane A et al.. Antimicrob Resist Infect Control 2018 · PMID 29375825 · DOI 10.1186/s13756-017-0294-9
  18. Assessment of antibiotic residues in chicken meat.. Kamouh HM et al.. Open Vet J 2024 · PMID 38633178 · DOI 10.5455/OVJ.2024.v14.i1.40
  19. MRSA in conventional and alternative retail pork products.. O'Brien AM et al.. PLoS One 2012 · PMID 22276147 · DOI 10.1371/journal.pone.0030092
  20. Regulation (EC) No 1831/2003 on additives for use in animal nutrition (original text, Article 11 and recitals 25-26). European Parliament and Council. Official Journal of the EU (copy at legislation.gov.uk) 2003
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