Fecal carriage of carbapenemase-producing Escherichia coli and Klebsiella spp. and associated factors among dairy farm milkers in Tigray Region, Northern Ethiopia

Antimicrobial resistance (AMR) among foodborne and zoonotic bacteria has become a major public health challenge. Dairy farm milkers can harbor resistant bacteria, potentially contributing to raw milk contamination and posing a risk to the wider community. This study aimed to assess the occurrence of fecal carriage and associated factors of carbapenemase-producing (CP) Escherichia coli (E. coli) and Klebsiella spp among dairy farm milkers in the Tigray region, Northern Ethiopia. A cross-sectional study was conducted from December 2024 to May 2025 among 178 dairy farm milkers. Stool samples were collected and analyzed for isolation and identification of E. coli and Klebsiella spp. using standard bacteriological methods. Antimicrobial susceptibility was determined using the Kirby–Bauer disk diffusion method. Carbapenemase production was confirmed phenotypically. Data on socio-demographics, hygiene practices, and food consumption were collected using a structured questionnaire. Firth’s penalized logistic regression was used to identify factors associated with fecal carriage of CP E. coli and Klebsiella spp. Escherichia coli and Klebsiella spp were isolated from 121(68.0%) and 17(9.5%) of study participants. Carbapenemase-producing isolates were detected in 6 (3.4%) of the dairy farm milkers, all of which exhibited multidrug resistance. Multivariable analysis identified recent diarrhea (AOR = 23.02; 95% CI: 3.15–168.24) and raw milk consumption (AOR = 6.35; 95% CI: 1.07–37.46) as independent factors significantly associated with fecal carriage of CP E. coli and Klebsiella spp. Fecal carriage of CP E. coli and Klebsiella spp. was observed among dairy farm milkers. These findings highlight the potential food safety and public health relevance of antimicrobial-resistant bacteria carriage in dairy farm workers and support the inclusion of milkers in One Health-oriented AMR surveillance and hygiene-focused interventions along the dairy value chain.