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Scali F, Ganio S, Roullet C, Ruffier M, Bergagna S, Pagliasso G, Romeo C, Formenti N, Maisano AM, Santucci G, Tonni M, Guadagno F, Mazza F, Guarneri F, Bontempi G, Candela L, Alborali GL. Regional-Scale Analysis of Antimicrobial Usage in Smallholder Cattle Herds (Aosta Valley, Italy): Why Surveillance Matters. Antibiotics (Basel) 2024; 13:204. [PMID: 38534639 DOI: 10.3390/antibiotics13030204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/28/2024] Open
Abstract
Optimising antimicrobial usage (AMU) in livestock is pivotal to counteract the emergence of antimicrobial resistance. We analysed AMU in more than 1000 cattle herds over 11 years (2008-2018) in the Aosta Valley (Italy), a region where 80% of farms house less than 50 cattle. Dairy cows accounted for over 95% of AMU. AMU was estimated using the defined daily dose animal for Italy (DDDAit) per biomass for the whole herd and a treatment incidence 100 (TI100) for cows. Average annual herd-level AMU was low, with 3.6 DDDAit/biomass (range: 3.2-4.0) and 1.2 TI100 in cows (range: 1.1-1.3). Third and fourth generation cephalosporins, which are critical for human medicine, represented almost 10% of usage, and intramammary antimicrobials accounted for over 60%. We detected significant downward temporal trends in total AMU, as well as a positive relationship with herd size. The magnitude of such effects was small, leaving scant room for further reduction. However, the frequent use of critical antimicrobials and intramammary products should be addressed, following the principles of prudent AMU. Our findings highlight the importance of monitoring AMU even in low-production, smallholding contexts where a low usage is expected, to identify any deficiencies and implement interventions for further AMU optimisation.
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Affiliation(s)
- Federico Scali
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, 25124 Brescia, Italy
| | - Sandra Ganio
- Azienda USL della Valle d'Aosta, SC Igiene Allevamenti, 11100 Aosta, Italy
| | - Claudio Roullet
- Azienda USL della Valle d'Aosta, SC Igiene Allevamenti, 11100 Aosta, Italy
| | - Mauro Ruffier
- Assessorato Sanità, Salute e Politiche Sociali della Valle d'Aosta, Igiene e Sanità Pubblica Veterinaria, 11100 Aosta, Italy
| | - Stefania Bergagna
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, 25124 Turin, Italy
| | - Giulia Pagliasso
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, 25124 Turin, Italy
- Azienda Sanitaria Locale di Ciriè, Chivasso e Ivrea, 10073 Ciriè, Italy
| | - Claudia Romeo
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, 25124 Brescia, Italy
- Globe Institute, University of Copenhagen, 1350 København, Denmark
| | - Nicoletta Formenti
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, 25124 Brescia, Italy
| | - Antonio Marco Maisano
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, 25124 Brescia, Italy
| | - Giovanni Santucci
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, 25124 Brescia, Italy
| | - Matteo Tonni
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, 25124 Brescia, Italy
| | - Federica Guadagno
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, 25124 Brescia, Italy
| | - Francesca Mazza
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, 25124 Brescia, Italy
| | - Flavia Guarneri
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, 25124 Brescia, Italy
| | - Giorgio Bontempi
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, 25124 Brescia, Italy
| | - Loredana Candela
- Ministero della Salute della Repubblica Italiana, 00144 Rome, Italy
| | - Giovanni Loris Alborali
- Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, 25124 Brescia, Italy
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Werner T, Käsbohrer A, Wasner B, Köberl-Jelovcan S, Vetter SG, Egger-Danner C, Fuchs K, Obritzhauser W, Firth CL. Antimicrobial resistance and its relationship with antimicrobial use on Austrian dairy farms. Front Vet Sci 2023; 10:1225826. [PMID: 37546336 PMCID: PMC10403287 DOI: 10.3389/fvets.2023.1225826] [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: 05/19/2023] [Accepted: 07/06/2023] [Indexed: 08/08/2023] Open
Abstract
The aim of this study was to investigate the prevalence of ESBL/AmpC-producing E. coli and the resistance pattern of commensal E. coli, as well as the link between the use of antibiotics (AMU) and the occurrence of resistance in E. coli on Austrian dairy farms. AMU data from 51 farms were collected over a one-year period in 2020. Fecal samples were collected from cows, pre-weaned and weaned calves in 2020 and 2022. Samples were then analyzed using non-selective and selective agar plates, E. coli isolates were confirmed by MALDI-TOF analysis. Broth microdilution was used for antimicrobial susceptibility testing. The AMU of each farm was quantified as the number of Defined Daily Doses (nDDDvet) and Defined Course Doses (nDCDvet) per cow and year. Cephalosporins (mean 1.049; median 0.732 DDDvet/cow/year) and penicillins (mean 0.667; median 0.383 DDDvet/cow/year) were the most frequently used antibiotics on these farms, followed by tetracyclines (mean 0.275; median 0.084 DDDvet/cow/year). In 2020, 26.8% of the E. coli isolated were resistant to at least one antibiotic class and 17.7% of the isolates were classified as multidrug resistant (≥3 antibiotic classes). Out of 198 E. coli isolates, 7.6% were identified as extended-spectrum/AmpC beta-lactamase (ESBL/AmpC) producing E. coli. In 2022, 33.7% of E. coli isolates showed resistance to at least one antibiotic and 20.0% of isolates displayed multidrug resistance. Furthermore, 29.5% of the samples carried ESBL/AmpC-producing E. coli. In 2020 and 2022, the most frequently determined antibiotic resistances among commensal E. coli isolates were to tetracyclines, sulfonamides and penicillins. In addition, pre-weaned calves had the highest resistance rates in both years. Statistical analyses showed a significant association between low and high use AMU classifications for penicillins (in nDDDvet/cow/year) and their respective resistance among commensal E. coli isolates in 2020 (p = 0.044), as well as for sulfonamide/trimethoprim (p = 0.010) and tetracyclines (p = 0.042). A trend was also noted between the total amount of antibiotics used on farm in 2020 (by nDDDvet/cow/year) and multidrug resistances in commensal E. coli isolated on farm that year (p = 0.067). In conclusion, the relationship between AMU and antimicrobial resistance (AMR) on dairy farms continues to be complex and difficult to quantify.
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Affiliation(s)
- Thomas Werner
- Unit of Veterinary Public Health and Epidemiology, Institute of Food Safety, Food Technology and Veterinary Public Health, University of Veterinary Medicine, Vienna, Austria
| | - Annemarie Käsbohrer
- Unit of Veterinary Public Health and Epidemiology, Institute of Food Safety, Food Technology and Veterinary Public Health, University of Veterinary Medicine, Vienna, Austria
- Department for Biological Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Barbara Wasner
- Upper Austrian Animal Health Organization Laboratory, Clinical Microbiology, Upper Austrian Animal Health Organization, Ried im Innkreis, Austria
| | - Sandra Köberl-Jelovcan
- Institute for Medical Microbiology and Hygiene, Centre for Foodborne Infectious Diseases, Division of Public Health, Austrian Agency for Health and Food Safety (AGES), Graz, Austria
| | - Sebastian G. Vetter
- Unit of Veterinary Public Health and Epidemiology, Institute of Food Safety, Food Technology and Veterinary Public Health, University of Veterinary Medicine, Vienna, Austria
| | | | - Klemens Fuchs
- Data, Statistics and Risk Assessment, Austrian Agency for Health and Food Safety (AGES), Graz, Austria
| | - Walter Obritzhauser
- Unit of Veterinary Public Health and Epidemiology, Institute of Food Safety, Food Technology and Veterinary Public Health, University of Veterinary Medicine, Vienna, Austria
- Veterinary Practice, Parschlug, Austria
| | - Clair L. Firth
- Unit of Veterinary Public Health and Epidemiology, Institute of Food Safety, Food Technology and Veterinary Public Health, University of Veterinary Medicine, Vienna, Austria
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Elkholly D, Fraser A, Booth R, O'Neill D, Mateus A, Brunton L, Brodbelt D. Antimicrobial usage in farm animal practices in the UK: A mixed-methods approach. Prev Vet Med 2023; 213:105870. [PMID: 36841042 DOI: 10.1016/j.prevetmed.2023.105870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 01/11/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023]
Abstract
Antimicrobial resistance (AMR) is a growing One Health problem. Monitoring antimicrobial usage in farm animals is crucial for tackling AMR. A cohort study using the electronic clinical records during 2019 from 23 farm animal veterinary practices across the UK belonging to two corporate groups, with a range of 2-14 veterinarians per practice, estimated the usage of antimicrobials and highest priority critically important antimicrobials (HP-CIAs). Risk factors for using HP-CIAs were evaluated using hierarchical mixed-effects logistic regression modelling with practice ID and farm ID added as random effects. Using a qualitative approach, veterinarians from one of the participating practice groups were recruited for a qualitative study to explore the barriers and facilitators in relation to antimicrobial use. Semi-structured interviews were conducted with participants and analysed thematically. During the year 2019, 98,824 antimicrobial prescribing events overall were recorded from the treatment records of the 23 participating practices. The median count of antimicrobial events per practice was 3226 (range 263-22,159). There were 17,111/98,824 (17.3%) HP-CIAs events overall, with a median of 15.4% at practice level (range 4.8-22.1%). Penicillins were the most frequently used antimicrobials 29,539/98,824 (29.9%) followed by tetracyclines 19,015/98,824 (19.2%). HP-CIA use was strongly clustered, with more clustering seen at the farm level (intraclass correlation coefficient (ICC)= 0.56) than at the practice level (ICC= 0.32). Country, route of administration, season and practice type were significantly associated with the usage of HP-CIAs. Four main themes were identified from the analysis of the veterinarians' interviews: pressure from the industry, drug-related factors, knowledge level of veterinarians and clinical factors. Supermarket contracts and farm assurance schemes were facilitators for reducing antimicrobial use and the use of HP-CIAs. Ease of administration and the withdrawal period of the antimicrobials influenced veterinarians' choice of antimicrobials. The clinical condition and clinical signs presented on farm were reported to influence participating veterinarians' prescribing decision. Participants showed a good understanding of AMR, responsible use of antimicrobials and the term 'critically important antimicrobials'. In conclusion, integrating the quantitative and qualitative findings can inform policymaking on antimicrobials stewardship in farm practice. By estimating the relative levels of clustering of antimicrobial use at the practice and farm level, as well as identifying major risk factors for using HP-CIAs, more targeted interventions can be designed to promote responsible antimicrobial use in farm practice. Furthermore, better understanding the industry pressures on farms to reduce antimicrobials usage could reduce the barriers for responsible antimicrobial use by veterinarians.
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Affiliation(s)
- D Elkholly
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom.
| | - A Fraser
- King's Business School, King's College London, London, United Kingdom
| | - R Booth
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom
| | - D O'Neill
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom
| | - A Mateus
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom
| | - L Brunton
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom
| | - D Brodbelt
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom
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Menegon F, Capello K, Tarakdjian J, Pasqualin D, Cunial G, Andreatta S, Dellamaria D, Manca G, Farina G, Di Martino G. Antibiotic Use in Alpine Dairy Farms and Its Relation to Biosecurity and Animal Welfare. Antibiotics (Basel) 2022; 11:antibiotics11020231. [PMID: 35203833 PMCID: PMC8868112 DOI: 10.3390/antibiotics11020231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/31/2022] [Accepted: 02/08/2022] [Indexed: 12/10/2022] Open
Abstract
The quantification of antimicrobial usage (AMU) in food-producing animals can help identify AMU risk factors, thereby enhancing appropriate stewardship policies and strategies for a more rational use. AMU in a sample of 34 farms in the Province of Trento (north-eastern Italy) from 2018 to 2020 was expressed as defined daily doses for animals per population correction unit according to European Surveillance of Veterinary Antimicrobial Consumption guidelines (DDDvet) and according to Italian guidelines (DDDAit). A retrospective analysis was carried out to test the effects of several husbandry practices on AMU. Overall, the average AMU ranged between 6.5 DDDAit in 2018 and 5.2 DDDAit in 2020 (corresponding to 9 and 7 DDDvet, respectively), showing a significant trend of decrement (−21.3%). Usage of the highest priority critically important antimicrobials (HPCIA) was reduced by 83% from 2018 to 2020. Quarantine management, available space, water supply, animals’ cleanliness and somatic cell count had no significant association with AMU. Rather, farms with straw-bedded cubicles had lower AMU levels than those with mattresses and concrete floors (p < 0.05). In conclusion, this study evidenced a decrement in AMU, particularly regarding HPCIA, but only a few risk factors due to farm management.
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Bangsgaard EO, Græsbøll K, Andersen VD, Clasen J, Jasinskytė D, Hansen JE, Folkesson A, Christiansen LE. Mixed effect modeling of tetracycline resistance levels in Danish slaughter pigs. Prev Vet Med 2021; 191:105362. [PMID: 33895502 DOI: 10.1016/j.prevetmed.2021.105362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/10/2021] [Accepted: 04/12/2021] [Indexed: 11/24/2022]
Abstract
Mathematical and statistical modeling can be a very useful tool in understanding and fighting antimicrobial resistance (AMR). Here we present investigations of mixed effect models of varying complexity in order to identify and address possible management factors affecting the tetracycline AMR levels in Danish pig farms. Besides antimicrobial exposure during pigs life cycle, the type of production seems to also have an influence. The results concludes that not only fully integrated farms (CHR integrated) but also farms in a production network with a single ownership (CVR integrated) might have a preventive effect on levels of tetracycline AMR compared to more complex trading patterns.
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Affiliation(s)
| | - Kaare Græsbøll
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Lyngby, Denmark
| | | | - Julie Clasen
- Department of Bioengineering and Biomedicine, Technical University of Denmark, Lyngby, Denmark
| | - Džiuginta Jasinskytė
- Department of Bioengineering and Biomedicine, Technical University of Denmark, Lyngby, Denmark
| | - Julie Elvekjær Hansen
- Department of Bioengineering and Biomedicine, Technical University of Denmark, Lyngby, Denmark
| | - Anders Folkesson
- Department of Bioengineering and Biomedicine, Technical University of Denmark, Lyngby, Denmark
| | - Lasse Engbo Christiansen
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Lyngby, Denmark
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