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Meng F, Zhou D, Li R, Lang F, Xiang B, Yang L, Cheng Z. Emergence of linezolid-resistant Enterococcus cecorum clade F harboring optrA/fexA causing enterococcal spondylitis in commercial broilers in China. BMC Microbiol 2025; 25:313. [PMID: 40399787 DOI: 10.1186/s12866-025-04045-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2025] [Accepted: 05/14/2025] [Indexed: 05/23/2025] Open
Abstract
BACKGROUND Enterococcus cecorum, long regarded as a commensal bacterium in the avian gut, has recently emerged as a significant pathogen causing enterococcal spondylitis. The widespread use of antibiotics has driven the emergence of multidrug resistance in Enterococcus, particularly linezolid-resistant strains, posing risks to poultry farming and public health. Here, we report the first isolation and characterization of a linezolid-resistant E. cecorum strain (2023EC-GS-SDAU-1) harboring the optrA/fexA resistance gene cluster from Chinese commercial broilers, and analyze its genomic profile, resistance mechanisms, and pathogenicity. RESULTS Whole-genome sequencing identified 15 resistance genes, including optrA, fexA, catA8, SAT-4, AAC(6')-Ie-APH(2'')-Ia, and aad(6)-all newly identified in E. cecorum. The optrA/fexA/ermA cluster colocalized on chromosomal genomic island GI12 is flanked by codirectional insertion sequences (ISEfa5), forming a mobile transposon-like unit. Phylogenetic analysis placed the strain within clade F, closely related to pathogenic isolates from the U.S. and France. Antimicrobial susceptibility testing confirmed multidrug resistance to aminoglycosides, macrolides, florfenicol, and linezolid. Additionally, 31 virulence genes were identified, and experimental infections in broilers recapitulated spondylitis lesions, validating pathogenicity. CONCLUSION This study is the first to characterize a linezolid-resistant E. cecorum strain harboring the optrA/fexA cluster in poultry in China, implicating ISEfa5-mediated mobilization in resistance dissemination. The findings underscore the poultry production chain as a critical reservoir for oxazolidinone resistance (optrA) and highlight urgent needs for enhanced surveillance to mitigate zoonotic risks.
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Affiliation(s)
- Fanrun Meng
- College of Veterinary Medicine, Shandong Agriculture University, Taian, China
- College of Veterinary Medicine, Hebei Agricultural University, Baoding, China
| | - Defang Zhou
- College of Veterinary Medicine, Shandong Agriculture University, Taian, China
| | - Ruiqi Li
- College of Veterinary Medicine, Shandong Agriculture University, Taian, China
| | - Feng Lang
- College of Veterinary Medicine, Shandong Agriculture University, Taian, China
| | - Bin Xiang
- College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
| | - Liangyu Yang
- College of Veterinary Medicine, Yunnan Agricultural University, Kunming, China
| | - Ziqiang Cheng
- College of Veterinary Medicine, Shandong Agriculture University, Taian, China.
- College of Veterinary Medicine, Shandong Agricultural University, No. 7, Panhe Street, Taishan District, Tai'an, 271017, China.
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Ge H, Yu Y, Zhang Y, Zhou Z. Changes of bone and articular cartilage in broilers with femoral head necrosis. Poult Sci 2024; 103:104127. [PMID: 39111237 PMCID: PMC11343062 DOI: 10.1016/j.psj.2024.104127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/19/2024] [Accepted: 07/24/2024] [Indexed: 08/26/2024] Open
Abstract
Femoral head necrosis (FHN) in broilers is a common leg disorder in intensive poultry farming, giving rise to poor animal health and welfare. Abnormal mechanical stress in the hip joint is a risk factor for FHN, and articular cartilage is attracting increasing attention as a cushion and lubrication structure for the joint. In the present study, broilers aged 3 to 4 wk with FHN were divided into femoral head separation (FHS) and femoral head separation with growth plate lacerations (FHSL) groups, with normal broilers as control. The features of the hip joint, bone, and cartilage were assessed in FHN progression using devices including computed tomography (CT), atomic force microscope (AFM), and transmission electron microscopy (TEM). Broilers with FHN demonstrated decreased bone mechanical properties, narrow joint space, and thickened femoral head stellate structures. Notably, abnormal cartilage morphology was observed in FHN-affected broilers, characterized by increased cartilage thickness and rough cartilage surfaces. In addition, as FHN developed, cartilage surface friction and friction coefficient dramatically increased, while cartilage modulus and stiffness decreased. The ultramicro-damage occurred in chondrocytes and the extracellular matrix (ECM) of cartilage. Cell disintegration, abnormal mitochondrial accumulation, and oxidative stress damage were observed in chondrocytes. A notable decline in cartilage collagen content was observed in ECM during the initial stages of FHN, accompanied by a pronounced reduction in collagen fiber diameter and proteoglycan content as FHN progressed. Furthermore, the noticeable loosening of the collagen fiber structure and the appearance of type I collagen were noted in cartilage. In conclusion, there was a progressive decrease in bone quality and multifaceted damage of cartilage in the femoral head, which was closely linked to the severity of FHN in broilers.
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Affiliation(s)
- Hongfan Ge
- Department of Clinical Sciences, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, 210095, China
| | - Yaling Yu
- Department of Clinical Sciences, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, 210095, China
| | - Yanyan Zhang
- Department of Clinical Sciences, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, 210095, China
| | - Zhenlei Zhou
- Department of Clinical Sciences, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, 210095, China.
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3
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Anthney A, Do ADT, Alrubaye AAK. Bacterial chondronecrosis with osteomyelitis lameness in broiler chickens and its implications for welfare, meat safety, and quality: a review. Front Physiol 2024; 15:1452318. [PMID: 39268189 PMCID: PMC11390708 DOI: 10.3389/fphys.2024.1452318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 08/06/2024] [Indexed: 09/15/2024] Open
Abstract
The exponential increase in global population continues to present an ongoing challenge for livestock producers worldwide to consistently provide a safe, high-quality, and affordable source of protein for consumers. In the last 50 years, the poultry industry has spearheaded this effort thanks to focused genetic and genomic selection for feed-efficient, high-yielding broilers. However, such intense selection for productive traits, along with conventional industry farming practices, has also presented the industry with a myriad of serious issues that negatively impacted animal health, welfare, and productivity-such as woody breast and virulent diseases commonly associated with poultry farming. Bacterial chondronecrosis with osteomyelitis (BCO) lameness is one such issue, having rapidly become a key issue affecting the poultry industry with serious impacts on broiler welfare, meat quality, production, food safety, and economic losses since its discovery in 1972. This review focuses on hallmark clinical symptoms, diagnosis, etiology, and impact of BCO lameness on key issues facing the poultry industry.
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Affiliation(s)
- Amanda Anthney
- Center of Excellence for Poultry Science, University of Arkansas, Fayetteville, AR, United States
| | - Anh Dang Trieu Do
- Center of Excellence for Poultry Science, University of Arkansas, Fayetteville, AR, United States
- Cell and Molecular Biology Program, University of Arkansas, Fayetteville, AR, United States
| | - Adnan A K Alrubaye
- Center of Excellence for Poultry Science, University of Arkansas, Fayetteville, AR, United States
- Cell and Molecular Biology Program, University of Arkansas, Fayetteville, AR, United States
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4
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Song M, Tang Q, Ding Y, Tan P, Zhang Y, Wang T, Zhou C, Xu S, Lyu M, Bai Y, Ma X. Staphylococcus aureus and biofilms: transmission, threats, and promising strategies in animal husbandry. J Anim Sci Biotechnol 2024; 15:44. [PMID: 38475886 PMCID: PMC10936095 DOI: 10.1186/s40104-024-01007-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/03/2024] [Indexed: 03/14/2024] Open
Abstract
Staphylococcus aureus (S. aureus) is a common pathogenic bacterium in animal husbandry that can cause diseases such as mastitis, skin infections, arthritis, and other ailments. The formation of biofilms threatens and exacerbates S. aureus infection by allowing the bacteria to adhere to pathological areas and livestock product surfaces, thus triggering animal health crises and safety issues with livestock products. To solve this problem, in this review, we provide a brief overview of the harm caused by S. aureus and its biofilms on livestock and animal byproducts (meat and dairy products). We also describe the ways in which S. aureus spreads in animals and the threats it poses to the livestock industry. The processes and molecular mechanisms involved in biofilm formation are then explained. Finally, we discuss strategies for the removal and eradication of S. aureus and biofilms in animal husbandry, including the use of antimicrobial peptides, plant extracts, nanoparticles, phages, and antibodies. These strategies to reduce the spread of S. aureus in animal husbandry help maintain livestock health and improve productivity to ensure the ecologically sustainable development of animal husbandry and the safety of livestock products.
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Affiliation(s)
- Mengda Song
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
- Key Laboratory of Innovative Utilization of Local Cattle and Sheep Germplasm Resources (Co-Construction by Ministry and Province), Ministry of Agriculture and Rural Affairs, School of Agricultural Sciences, Zhengzhou University, Zhengzhou, 450001, China
| | - Qi Tang
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Yakun Ding
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Peng Tan
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Yucheng Zhang
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Tao Wang
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Chenlong Zhou
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Shenrui Xu
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Mengwei Lyu
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Yueyu Bai
- Key Laboratory of Innovative Utilization of Local Cattle and Sheep Germplasm Resources (Co-Construction by Ministry and Province), Ministry of Agriculture and Rural Affairs, School of Agricultural Sciences, Zhengzhou University, Zhengzhou, 450001, China.
| | - Xi Ma
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China.
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Asnayanti A, Do ADT, Alharbi K, Alrubaye A. Inducing experimental bacterial chondronecrosis with osteomyelitis lameness in broiler chickens using aerosol transmission model. Poult Sci 2024; 103:103460. [PMID: 38301493 PMCID: PMC10846381 DOI: 10.1016/j.psj.2024.103460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/12/2023] [Accepted: 01/09/2024] [Indexed: 02/03/2024] Open
Abstract
Lameness disease attributed to bacterial chondronecrosis with osteomyelitis in broilers affects production, animal welfare, and food safety in the poultry industry. The disease is characterized by necrotic degeneration of the rapidly growing femora and tibiae due to bacterial translocation from the respiratory or gastrointestinal tracts into the blood circulation, eventually colonizing the growth plate of the long bones. To investigate the etiology, pathogenesis, and intervention measures for BCO, developing an experimental model that reliably induces BCO lameness is of the utmost importance. In the past, we have employed a wire-flooring model and a litter-flooring model administered with a bacterial challenge to investigate strategies for mitigating BCO. However, multiple issues on labor-intensive barn setup and cleanout efforts for the wire-flooring system and concern of direct pathogenic exposure to the broilers for the litter-flooring models rendered these research models less effective. Thus, we investigated a new approach to induce experimental BCO lameness using an aerosol transmission model employing a group of birds reared on wire-flooring pens as a BCO infection source, and the disease is further disseminated through the airborne transmission to other birds reared on litter flooring in the same housing environment. The effectiveness of the aerosol transmission model in inducing BCO lameness was concluded from 4 independent experiments. The cumulative lameness generated from the BCO source group on the wire floors versus negative control treatments on the litter floors from Experiments 1, 2, 3, and 4 were 84% vs. 69.33%, P = 0.09; 54.55% vs. 60%, P = 0.56; 78% vs. 73.50%, P = 0.64; 81% vs. 74.50%, P = 0.11. Overall, the cumulative lameness generated from the wire floors was successfully transmitted to the birds on litter floors without significant statistical differences (P > 0.05). The effectiveness of the aerosol transmission model for experimentally triggering BCO lameness provides a reliable system for evaluating practical intervention strategies for BCO lameness in broilers.
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Affiliation(s)
- Andi Asnayanti
- Cell and Molecular Biology Program, University of Arkansas, Fayetteville, AR, USA; Center of Excellence for Poultry Science, University of Arkansas, Fayetteville, AR, USA; National Agency of Drug and Food Control, Jakarta, Indonesia
| | - Anh D T Do
- Cell and Molecular Biology Program, University of Arkansas, Fayetteville, AR, USA; Center of Excellence for Poultry Science, University of Arkansas, Fayetteville, AR, USA
| | - Khawla Alharbi
- Cell and Molecular Biology Program, University of Arkansas, Fayetteville, AR, USA; Center of Excellence for Poultry Science, University of Arkansas, Fayetteville, AR, USA
| | - Adnan Alrubaye
- Cell and Molecular Biology Program, University of Arkansas, Fayetteville, AR, USA; Center of Excellence for Poultry Science, University of Arkansas, Fayetteville, AR, USA.
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Liu KL, He YF, Xu BW, Lin LX, Chen P, Iqbal MK, Mehmood K, Huang SC. Leg disorders in broiler chickens: a review of current knowledge. Anim Biotechnol 2023; 34:5124-5138. [PMID: 37850850 DOI: 10.1080/10495398.2023.2270000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Ensuring improved leg health is an important prerequisite for broilers to achieve optimal production performance and welfare status. Broiler leg disease is characterized by leg muscle weakness, leg bone deformation, joint cysts, arthritis, femoral head necrosis, and other symptoms that result in lameness or paralysis. These conditions significantly affect movement, feeding and broiler growth performance. Nowadays, the high incidence of leg abnormalities in broiler chickens has become an important issue that hampers the development of broiler farming. Therefore, it is imperative to prevent leg diseases and improve the health of broiler legs. This review mainly discusses the current prevalence of broiler leg diseases and describes the risk factors, diagnosis, and prevention of leg diseases to provide a scientific basis for addressing broiler leg health problems.
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Affiliation(s)
- Kai-Li Liu
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, P. R. China
| | - Yan-Feng He
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, P. R. China
| | - Bo-Wen Xu
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, P. R. China
| | - Lu-Xi Lin
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, P. R. China
| | - Pan Chen
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, P. R. China
| | - Muhammad Kashif Iqbal
- Institute of Continuing Education and Extension, Cholistan University of Veterinary and Animal Sciences Bahawalpur, Bahawalpur, Pakistan
| | - Khalid Mehmood
- Faculty of Veterinary and Animal Sciences, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Shu-Cheng Huang
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, P. R. China
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Cummins ML, Li D, Ahmad A, Bushell R, Noormohammadi AH, Wijesurendra DS, Stent A, Marenda MS, Djordjevic SP. Whole Genome Sequencing of Avian Pathogenic Escherichia coli Causing Bacterial Chondronecrosis and Osteomyelitis in Australian Poultry. Microorganisms 2023; 11:1513. [PMID: 37375015 DOI: 10.3390/microorganisms11061513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
Bacterial chondronecrosis with osteomyelitis (BCO) impacts animal welfare and productivity in the poultry industry worldwide, yet it has an understudied pathogenesis. While Avian Pathogenic Escherichia coli (APEC) are known to be one of the main causes, there is a lack of whole genome sequence data, with only a few BCO-associated APEC (APECBCO) genomes available in public databases. In this study, we conducted an analysis of 205 APECBCO genome sequences to generate new baseline phylogenomic knowledge regarding the diversity of E. coli sequence types and the presence of virulence associated genes (VAGs). Our findings revealed the following: (i) APECBCO are phylogenetically and genotypically similar to APEC that cause colibacillosis (APECcolibac), with globally disseminated APEC sequence types ST117, ST57, ST69, and ST95 being predominate; (ii) APECBCO are frequent carriers of ColV-like plasmids that carry a similar set of VAGs as those found in APECcolibac. Additionally, we performed genomic comparisons, including a genome-wide association study, with a complementary collection of geotemporally-matched genomes of APEC from multiple cases of colibacillosis (APECcolibac). Our genome-wide association study found no evidence of novel virulence loci unique to APECBCO. Overall, our data indicate that APECBCO and APECcolibac are not distinct subpopulations of APEC. Our publication of these genomes substantially increases the available collection of APECBCO genomes and provides insights for the management and treatment strategies of lameness in poultry.
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Affiliation(s)
- Max L Cummins
- Australian Institute for Microbiology and Infection, University of Technology Sydney, Ultimo, NSW 2007, Australia
- The Australian Centre for Genomic Epidemiological Microbiology, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Dmitriy Li
- Australian Institute for Microbiology and Infection, University of Technology Sydney, Ultimo, NSW 2007, Australia
- The Australian Centre for Genomic Epidemiological Microbiology, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Aeman Ahmad
- Australian Institute for Microbiology and Infection, University of Technology Sydney, Ultimo, NSW 2007, Australia
- The Australian Centre for Genomic Epidemiological Microbiology, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Rhys Bushell
- Faculty of Science, The University of Melbourne, Parkville, VIC 3010, Australia
| | | | | | - Andrew Stent
- Gribbles Veterinary Pathology, Clayton, VIC 3168, Australia
| | - Marc S Marenda
- Faculty of Science, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Steven P Djordjevic
- Australian Institute for Microbiology and Infection, University of Technology Sydney, Ultimo, NSW 2007, Australia
- The Australian Centre for Genomic Epidemiological Microbiology, University of Technology Sydney, Ultimo, NSW 2007, Australia
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Cook J, Greene ES, Ramser A, Mullenix G, Dridi JS, Liyanage R, Wideman R, Dridi S. Comparative- and network-based proteomic analysis of bacterial chondronecrosis with osteomyelitis lesions in broiler's proximal tibiae identifies new molecular signatures of lameness. Sci Rep 2023; 13:5947. [PMID: 37045932 PMCID: PMC10097873 DOI: 10.1038/s41598-023-33060-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 04/06/2023] [Indexed: 04/14/2023] Open
Abstract
Bacterial Chondronecrosis with Osteomyelitis (BCO) is a specific cause of lameness in commercial fast-growing broiler (meat-type) chickens and represents significant economic, health, and wellbeing burdens. However, the molecular mechanisms underlying the pathogenesis remain poorly understood. This study represents the first comprehensive characterization of the proximal tibia proteome from healthy and BCO chickens. Among a total of 547 proteins identified, 222 were differentially expressed (DE) with 158 up- and 64 down-regulated proteins in tibia of BCO vs. normal chickens. Biological function analysis using Ingenuity Pathways showed that the DE proteins were associated with a variety of diseases including cell death, organismal injury, skeletal and muscular disorder, immunological and inflammatory diseases. Canonical pathway and protein-protein interaction network analysis indicated that these DE proteins were involved in stress response, unfolded protein response, ribosomal protein dysfunction, and actin cytoskeleton signaling. Further, we identified proteins involved in bone resorption (osteoclast-stimulating factor 1, OSFT1) and bone structural integrity (collagen alpha-2 (I) chain, COL2A1), as potential key proteins involved in bone attrition. These results provide new insights by identifying key protein candidates involved in BCO and will have significant impact in understanding BCO pathogenesis.
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Affiliation(s)
- Jennifer Cook
- Department of Poultry Science, University of Arkansas, 1260 W. Maple Street, Fayetteville, AR, 72701, USA
| | - Elizabeth S Greene
- Department of Poultry Science, University of Arkansas, 1260 W. Maple Street, Fayetteville, AR, 72701, USA
| | - Alison Ramser
- Department of Poultry Science, University of Arkansas, 1260 W. Maple Street, Fayetteville, AR, 72701, USA
| | - Garrett Mullenix
- Department of Poultry Science, University of Arkansas, 1260 W. Maple Street, Fayetteville, AR, 72701, USA
| | - Jalila S Dridi
- École Universitaire de Kinésithérapie, Université d'Orléans, Rue de Chartres, 45100, Orléans, France
| | - Rohana Liyanage
- Department of Poultry Science, University of Arkansas, 1260 W. Maple Street, Fayetteville, AR, 72701, USA
| | - Robert Wideman
- Department of Poultry Science, University of Arkansas, 1260 W. Maple Street, Fayetteville, AR, 72701, USA
| | - Sami Dridi
- Department of Poultry Science, University of Arkansas, 1260 W. Maple Street, Fayetteville, AR, 72701, USA.
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Ipema AF, Bokkers EA, Gerrits WJ, Kemp B, Elizabeth Bolhuis J. Provision of black soldier fly larvae (Hermetia illucens) in different ways benefits broiler welfare and performance, with largest effects of scattering live larvae. Physiol Behav 2022; 257:113999. [DOI: 10.1016/j.physbeh.2022.113999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/28/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
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