Antibiotics utilization and farmers' knowledge of its effects on soil ecosystem in the coastal drylands of Ghana

Antimicrobial use in animal farms in Egypt: rates, patterns, and determinants

BACKGROUND

While antimicrobial use (AMU) in human healthcare has received significant attention as a key driver of antimicrobial resistance (AMR), less emphasis has been placed on AMU practices and attitudes in animal husbandry. To address this gap, this study examines the patterns and underlying drivers of AMU on animal farms.

METHODS

A survey instrument was distributed to farm staff in 150 animal farms across 15 Egyptian governorates. Farms were selected from a list curated by a private platform specialized in Egypt's poultry and cattle industry. An online search was conducted to identify additional farms not included in the list or when the contact information was unavailable. The instrument covered key items related to AMU including types of antimicrobials used, indications, their perceived benefits, and the feed conversion ratio (FCR). Using the theory of reasoned action (TRA) as a guiding theoretical framework, this study assesses key factors influencing the AMU behavior of farm personnel.

RESULTS

Out of 150 farm personnel invited to fill out the survey forms, 111 (74%) responded and agreed to participate. All surveyed personnel reported using antimicrobials, and almost two-thirds (65%) reported using them for non-therapeutic purposes. Non-therapeutic use of antimicrobials, however, had no impact on FCR across all farm types (poultry, cattle, and mixed). The most used antimicrobials were penicillins (81%), followed by macrolides (78%) and tetracyclines (72%). Half of the studied farms reported using colistin, with more than half of this segment (55%) reporting using it for non-therapeutic purposes. Farm personnel's AMU behavior was associated with the TRA constructs: perceived benefits of antimicrobials (attitude) and perceived AMU behavior in other farms (subjective norm).

CONCLUSIONS

Antimicrobials are unanimously used in animal farms in Egypt, including those classified as last-resort options, such as colistin. Using antimicrobials for disease prevention or growth promotion did not decrease the FCR. Interventions that target the farm personnel's attitude and the subjective norm should be carried out to change their behavior regarding the use of antimicrobials. Egyptian guidelines for AMU in livestock are urgently needed, along with training to raise awareness of AMR and safer practices. The use of last-resort drugs like colistin should be banned in animal farming, and national surveillance systems should monitor AMU and AMR trends.

Knowledge, Attitudes, Practices on Antimicrobial Use in Animals Among Livestock Sector Stakeholders in Kenya

Background: Antimicrobials are used on farms to manage livestock diseases. In many developing countries, antimicrobial use (AMU) is insufficiently controlled, and antimicrobials are prone to misuse and abuse, thereby fostering the emergence of antimicrobial resistance (AMR). AMR remains a challenge in Kenya, and the extent remains unknown. This study assessed the knowledge, attitudes, and practices (KAP) regarding AMU among multisectoral stakeholders in Kenya. Methods: The cross-sectional survey was conducted in August 2021 among 381 livestock farmers in Busia, Nakuru, and Isiolo Counties, while 47 animal health service providers (AHSPs) and 32 One Health practitioners (OHPs) were enrolled across Kenya. The data collection tool uploaded on KoBoCollect software was used to collect information on demographics, farming systems, KAP on AMR and AMU, and sources of information. Descriptive statistics were performed. Knowledge was either correct or incorrect, while practices were assigned as desirable or undesirable. Bivariable analysis to assess factors associated with KAP using odds ratio (OR) at 95% confidence level (CL). The Pearson correlation test was conducted to test the correlation between demographic independent variables and farmers' KAP, p < 0.05. Results: Most farmers, 234 (61.4%), were young adults between 30 and 49 years old. Additionally, 48.9% of the farmers had less than 5 years of experience in farming. Among the AHSPs, 76.6% were male, with 21 (44.7%) having 2-5 years of experience. All (32) OHPs had over 15 years of experience. Correct knowledge in AMR/AMU was observed in 52.6% of the farmers, 88.2% of AHSPs, and all OHPs. Desirable practices were observed in 133 (34.9%) of farmers, 22 (45.1%) of AHSPs, and 25 (76.4%) of OHPs. Among the farmers, having basic education was associated with correct knowledge (OR 4.07, p=0.0007); however, being male (OR 1.584, p=0.0456) and having a higher education level (OR 1.582, p=0.0165) were associated with desirable practices. There was a significant positive correlation between having correct knowledge and level of education (p < 0.0001), years of farming, and correct knowledge (p < 0.0001). However, years of farming negatively correlated with the desirable practices (p < 0.0001). Farmers' preferred sources of information regarding AMR/AMU were friends 130 (33.9%), farmer meetings/workshops 99 (25.9%), and radio 41 (10.7%). AHSPs obtain information from scientific conferences/trainings (17) (65.4%), workshops (13) (50.0%), and TV and radio (12) (46.2%), while OHSPs mostly get information through college training (14) (58.3%) and workshops (8) (33.3%). Conclusion: Correct knowledge of AMR/AMU did not result in adopting the desirable practices. A better understanding of the socioeconomic aspects of welfare, good livestock production measures, and AMU stewardship will be desired. This study provides a foundation for developing effective antimicrobial stewardship, best farm practices, and intervention programs to reduce inappropriate AMU. Public Implication: Farmers' AHSP practices are likely to promote the emergence of AMR, a health challenge for animals and humans.

Cross-sectional, commercial testing, and chromatographic study of the occurrence of antibiotic residues throughout an artisanal raw milk cheese production chain

This study investigated antibiotic utilization in artisanal dairies and residue occurrence throughout the raw milk cheese production chain using commercial testing (Charm KIS and Eclipse Farm3G) and UHPLC-QqQ-MS/MS and LC-QqQ-MS/MS. The cross-sectional survey results revealed gaps in the producers' knowledge of antibiotic use. Commercial testing detected antibiotic levels close to the LOD in 12.5 % of the samples, mainly in raw milk and whey, with 10.0 % testing positive, specifically in fresh and ripened cheeses, indicating that antibiotics are concentrated during cheese-making. Chromatographically, several antibiotics were identified in the faeces of healthy animals, with chlortetracycline (15.7 ± 34.5 µg/kg) and sulfamethazine (7.69 ± 16.5 µg/kg) predominating. However, only tylosin was identified in raw milk (3.28 ± 7.44 µg/kg) and whey (2.91 ± 6.55 µg/kg), and none were found in fresh or ripened cheeses. The discrepancy between commercial and analytical approaches is attributed to compounds or metabolites not covered chromatographically.

Knowledge and practice of antimicrobial usage and resistance among poultry farmers: A systematic review, meta-analysis, and meta-regression

A systematic review was conducted to summarize and synthesize the existing research on poultry farmers' knowledge, practices, and awareness regarding antimicrobial use (AMU) and antimicrobial resistance (AMR). It was undertaken by systematically searching databases, screening and characterizing relevant studies, extracting data, and evaluating the risk of bias. The outcomes were stratified into several subgroups, and pooled prevalence of each subgroup was calculated using a random-effect meta-analysis. Meta-regression was used for selected outcomes to further investigate the potential sources of heterogeneity across studies. Poultry farmers had knowledge and practice gaps on antimicrobial use. While most (65%; 95% CI: 50%-80%) used antimicrobials on poultry for therapeutic purposes, a portion used them to prevent disease (45%; 95% CI: 34%-55%) or boost growth (29%; 95% CI: 13%-46%) and productivity (20%; 95% CI: 6%-34%). 60% (95% CI: 50%-69%) of farmers approached veterinarians for antimicrobial advice, although many consulted drug sellers and fellow farmers. Insufficient antimicrobial residue knowledge (45%; 95% CI: 29%-62%), as well as inadequate awareness and faulty practice on withdrawal periods, were identified. Only 43% (95% CI: 34%-53%) were knowledgeable about AMR. Around half of farmers understood AMR's impacts on poultry, human health, and the environment. Meta-regression demonstrated that the source of heterogeneity for therapeutic antimicrobial use was the type of poultry farmers sampled and their educational qualifications; geographical region was significantly associated with antimicrobial usage based on farmers' experience; and the country's economic state was correlated with farmers' understanding of antimicrobial residue. This study recommends implementing legislation for judicious antimicrobial use, and farmer awareness campaigns to reinforce knowledge about prudent AMU and AMR.

Genetic characterization and antimicrobial susceptibility of Escherichia coli isolated from household water sources in northern Ghana

The microbial quality of household water is an important issue in developing countries, especially in Ghana, where many people still depend on unimproved sources of water. The present study investigated the prevalence, genetic characteristics, and antimicrobial resistance profile of Escherichia coli from surface water sources. Fifty-two water samples were analyzed by using a spread plate, a biochemical test, and multiplex polymerase chain reactions. E. coli was isolated from each of the 52 water samples. Of these isolates, 75% were noted to possess virulence genes. Approximately 54% of the isolates were characterized as follows: enterotoxigenic E. coli (ETEC, 10.26%), enteropathogenic E. coli (EPEC, 17.95%), verotoxigenic E. coli (VTEC, 23.07%), and enteroinvasive E. coli (EIEC, 2.57%). Eighteen of the fifty-two isolates could not be characterized due to heterogeneity in banding. The disc diffusion method was used to test for antimicrobial susceptibility. The isolates were most resistant to ceftazidime, augmentin, and cefuroxime. Multidrug resistance was recorded in 48.1% of the isolates. In contrast, the isolates were most susceptible to ciprofloxacin (86.5%), nitrofurantoin (84.6%), and ofloxacin (75%). These results revealed a high diversity and widespread of E. coli in northern Ghana. The study provides important data for public health nationwide surveillance of E. coli in surface water across the country.

Awareness of Antimicrobial Resistance and Associated Factors among Layer Poultry Farmers in Zambia: Implications for Surveillance and Antimicrobial Stewardship Programs

Antimicrobial resistance (AMR) is a global public health problem affecting animal and human medicine. Poultry production is among the primary sources of income for many Zambians. However, the increased demand for poultry products has led to a subsequent increase in antimicrobial use. This study assessed the awareness of AMR and associated factors among layer poultry farmers in Zambia. A cross-sectional study was conducted among 77 participants from September 2020 to April 2021. Data was analysed using Stata version 16.1. The overall awareness of AMR among the farmers was 47% (n = 36). The usage of antibiotics in layer poultry production was high at 86% (n = 66). Most antibiotics were accessed from agrovets (31%, n = 24) and pharmacies (21%, n = 16) without prescriptions. Commercial farmers were more likely to be aware of AMR compared to medium-scale farmers (OR = 14.07, 95% CI: 2.09–94.70), as were farmers who used prescriptions to access antibiotics compared to those who did not (OR = 99.66, 95% CI: 7.14–1391.65), and farmers who did not treat market-ready birds with antibiotics compared to those who did (OR = 41.92, 95% CI: 1.26–1396.36). The awareness of AMR among some layer farmers was low. Therefore, policies that promote the rational use of antibiotics need to be implemented together with heightened surveillance activities aimed at curbing AMR.

Categorisation of Antimicrobial Use in Fijian Livestock Production Systems

Antimicrobial resistance (AMR) is a major global threat to human and animal health. The use of antimicrobials in the livestock sector is considered to contribute to AMR. Therefore, a reduction in and prudent use of antimicrobials in livestock production systems have been advocated. This cross-sectional survey aimed to investigate the extent of imprudent antimicrobial use (AMU) and to determine whether the AMU practice was affected by either the farming system or species of farmed livestock in the largest island (Viti Levu) of Fiji. A total of 276 livestock enterprises were surveyed and antimicrobials were used on 309 occasions over 90 days. Overall, in 298 of 309 (96%) incidents, antimicrobials were used imprudently, comprising antibiotics, 160 of 170 (94%) and anthelmintics, 138 of 139 (99%). Prudent use of antibiotics was associated with commercial farming systems (X2 = 13, p = 0.001), but no association was observed with anthelmintic use (p > 0.05). Imprudent antibiotic use was associated with dairy (OR = 7.6, CI = 1.41, 41.57, p = 0.018) followed by layer and beef (p > 0.05) compared to broiler enterprises. Imprudent AMU was more common in the backyard and semi-commercial enterprises compared to commercial broiler enterprises. Policies promoting the prudent use of antimicrobials in Fiji should focus on smaller livestock production systems and enterprises.

Antimicrobial use in agriculture: critical review of the factors influencing behaviour

Antimicrobial resistance (AMR) is a global health emergency affecting humans and animals, diminishing the effectiveness of medication used to treat illness. The agri-food sector has attracted increased attention for imprudent antimicrobial use (AMU) and its contribution to AMR. Thus, ascertaining farmers' and veterinarians' behaviours surrounding AMU is essential to address imprudent AMU and generate behaviour change within the agri-food sector. Therefore, the aim of this critical review is to investigate, assess and collate the current body of evidence to identify psychosocial factors including knowledge, understanding, perceptions, attitudes and behaviours surrounding AMU. Database searches were limited to articles utilizing qualitative and quantitative methodologies, available in English with no restriction on publication year. Of the 1156 articles identified, 103 were retained for this review. Findings on the psychosocial aspects were thematically analysed. Five key themes emerged from the data: (i) knowledge and awareness of antimicrobials; (ii) attitudes towards antimicrobials; (iii) influential relationships; (iv) resources; and (v) factors influencing AMU. Results indicated that to overcome barriers experienced by key stakeholders, a carefully considered, evidence-based approach, incorporating behaviour change theory, is required when designing intricate interventions/strategies, in order to elicit successful and sustained AMU behaviour change.

Antimicrobial Use and Resistance in Agriculture and Food Production Systems in Africa: A Systematic Review

In Africa, there is dearth of information on antimicrobial use (AMU) in agriculture and food production systems and its consequential resistance in pathogens that affect animal, human and environmental health. Data published between 1980 and 2021 on the magnitude of AMU and AMR in agriculture and food productions systems in Africa were reviewed. Data from 13-27 countries in Africa indicate that 3558-4279 tonnes of antimicrobials were used in animals from 2015 to 2019. Tetracyclines and polypeptides contributed the largest proportion of antimicrobials used. Cattle and poultry production account for the largest consumption of antimicrobials in Africa. Although limited studies have reported AMR in crops, fish and beekeeping, AMR from a variety of farm animals has been substantially documented in Africa. Some countries in Africa have developed policies/plans to address AMU and AMR in agriculture and food production systems; however, their enforcement is challenged by weak regulations. In conclusion, although there is limited information on the quantities of antimicrobials used in agriculture and food production system, the levels of AMR are high. There is a need to strengthen regulatory authorities with a capacity to monitor AMU in agriculture and food production systems in Africa.

Farmer perceptions of dairy farm antibiotic use and transport pathways as determinants of contaminant loads to the environment

Agricultural antibiotic contamination into milk and beef products has been considered extensively, but antibiotic transport into soil and water environments is less regulated and studied. Farmer perceptions of these transport processes are critical to understanding how antibiotics reach soils and surface waters and what management strategies can be implemented to reduce environmental antibiotic loads. We have conducted semi-structured interviews with twenty-seven dairy farmers in central New York to understand farmer perceptions of environmental transport of antibiotics and decisions that reduce environmental antibiotic loads. Interviews were qualitatively analyzed and coded using thematic analysis. We found that farmers extensively considered transport of antibiotics into milk and beef, while consideration of antibiotic transport into manure was less common, and no farmers discussed antibiotic transport from carcasses into soil from on-farm animal mortality. Farmers highlighted decisions that reduce antibiotic environmental loads through disease prevention actions, usage of non-antibiotic treatments, and culturing bacterial samples before antibiotic treatment. Farmers did not cite reduction of environmental antibiotic loads as a driver of their waste management decisions. Farmers perceived antibiotic usage was already minimized on farms in the region, suggesting future environmental antibiotic contamination mitigation strategies should focus on waste management pathways.

Antimicrobial Usage Factors and Resistance Profiles of Shiga Toxin-Producing Escherichia coli in Backyard Production Systems From Central Chile

Shiga toxin-producing Escherichia coli (STEC) is a zoonotic pathogen and important cause of foodborne disease worldwide. Many animal species in backyard production systems (BPS) harbor STEC, systems characterized by low biosecurity and technification. No information is reported on STEC circulation, antimicrobial resistance (AMR) and potential drivers of antimicrobial usage in Chilean BPS, increasing the risk of maintenance and transmission of zoonotic pathogens and AMR generation. Thus, the aim of this study was to characterize phenotypic and genotypic AMR and to study the epidemiology of STEC isolated in BPS from Metropolitana region, Chile. A total of 85 BPS were sampled. Minimal inhibitory concentration and whole genome sequencing was assessed in 10 STEC strain isolated from BPS. All strains were cephalexin-resistant (100%, n = 10), and five strains were resistant to chloramphenicol (50%). The most frequent serotype was O113:H21 (40%), followed by O76:H19 (40%), O91:H14 (10%), and O130:H11 (10%). The stx1 type was detected in all isolated strains, while stx2 was only detected in two strains. The Stx subtype most frequently detected was stx1c (80%), followed by stx1a (20%), stx2b (10%), and stx2d (10%). All strains harbored chromosomal bla_AmpC. Principal component analysis shows that BPS size, number of cattle, pet and horse, and elevation act as driver of antimicrobial usage. Logistic multivariable regression shows that recognition of diseases in animals (p = 0.038; OR = 9.382; 95% CI: 1.138–77.345), neighboring poultry and/or swine BPS (p = 0.006; OR = 10.564; 95% CI: 1.996–55.894), visit of Veterinary Officials (p = 0.010; OR = 76.178; 95% CI: 2.860–2029.315) and close contact between animal species in the BPS (p = 0.021; OR = 9.030; 95% CI: 1.385–58.888) increase significantly the risk of antimicrobial use in BPS. This is the first evidence of STEC strains circulating in BPS in Chile, exhibiting phenotypic AMR, representing a threat for animal and public health. Additionally, we identified factors acting as drivers for antimicrobial usage in BPS, highlighting the importance of integration of these populations into surveillance and education programs to tackle the potential development of antimicrobial resistance and therefore the risk for ecosystemic health.

Are We Making the Most of Community Pharmacies? Implementation of Antimicrobial Stewardship Measures in Community Pharmacies: A Narrative Review

Community pharmacists recognize the need to implement antimicrobial stewardship activities in community pharmacies. They are in a unique position to provide triage for common primary care indications and to lower the burden of patients at general practitioners’ offices. However, research shows that, in some areas, dispensing of antimicrobials without valid prescription is still highly prevalent. Regardless of training, every community pharmacist can give his contribution to antimicrobial stewardship. One of the basic elements should be antimicrobial dispensing according to regulations, either prescription only, or according to guidelines where pharmacists have prescribing authority. Patient consultation supported with educational materials, such as leaflets, may reduce patients’ expectations to receive antibiotics for self-limiting infections and reduce pressure on general practitioners to prescribe antibiotics on patients’ demand. Treatment optimization may be achieved in collaboration with the prescribing general practitioners or by providing feedback. At last, pharmacists provided with additional training may be encouraged to provide consultation services to long-term care facilities, to introduce point-of-care testing for infectious diseases in their pharmacies or prescribe antimicrobials for uncomplicated infections. These services are welcomed by patients and communities. Expanding pharmacy services and pharmacists’ prescribing autonomy have shown a positive impact by reducing antibiotics consumption, thus ensuring better compliance with treatment guidelines.