Effect of a dairy farmworker stewardship training program on antimicrobial drug usage in dairy cows

Antimicrobial use (AMU) is critical to preserving animal health and welfare. However, the development of antimicrobial resistance (AMR) represents a public health threat. Although most antimicrobials used on the farm require a veterinarian prescription, farmworkers make daily on-farm treatment decisions. Therefore, farmworker training is vital to promote responsible AMU. This research project aimed to evaluate the effect of farmworker antimicrobial stewardship (AMS) training on the quantity of AMU on dairy farms in Ohio and California. We hypothesized that farms receiving AMS training would have reduced AMU in dairy cattle compared with farms where training wasn't administered. We designed a quasiexperimental study with 18 conventional dairy farms enrolled in Ohio and California. Twelve farms received AMS training, and 6 farms did not. The AMS program included a 12-wk training focused on accurate identification of cows requiring antimicrobial treatment. We quantified AMU by collecting used drug containers, manually counted by researchers during farm visits. Treatment incidence (TI) was calculated using animal daily doses (ADD), and Poisson regression models were used to analyze the TI data. Disease incidence rate (DIR) in lactating cows was 2.2, 1.5, 1.0, 0.4, 0.3, 0.2, and 0.03/1,000 cow-days for mastitis, lameness, metritis, pneumonia, retained placenta, diarrheas, and other diseases (e.g., conjunctivitis, injuries), respectively. The highest TI by antimicrobial class (provided in ADD/1,000 cow-days) was cephalosporin (5.9), penicillin (5.2), tetracyclines (0.4), lincosamides (0.2), and sulfonamides (0.1). Among the trained farms using a within-treatment group analysis, no significant differences were observed in TI pre-intervention (10.9 ADD/1,000 cow-days) compared with TI postintervention (10.3 ADD/1,000 cow-days). Treatment incidence from the training group was 10.8 ADD/1,000 cow-days and although numerically lower, it was not significantly different compared with TI in the control groups at 13.9 ADD/1,000 cow-days (rate ratio = 0.77, CI = 0.25-2.38). Future research on AMS should incorporate farmworker training with social science approaches to overcome barriers and promote on-farm responsible use.

The use of common antimicrobial agents in US veal calves

The use of antimicrobials in food animals and the selection of antimicrobial-resistant pathogens continue to be prominent concerns for human food safety and public health. To provide optimal stewardship programs, antimicrobial use in animal production operations must be quantified and standardized for benchmarking and creating goals, monitoring temporal trends, and identifying causes of emerging resistance. In the United States, quantified estimates of antimicrobial use are available in dairy and beef cattle, but these data have not been generated for veal calf herds. Therefore, the objective of this study was to estimate the treatment incidence (TI) of antimicrobials for eight US veal calf farms in one rearing cycle. Treatment incidences were compared between calculated doses defined by the labeled daily dose (LDD), animal-defined daily dose (ADD) from the European Medicines Agency (EMA) guideline, and the used daily dose (UDD) from the farm treatment protocols. Among eight farms, veal calves received a mean of 34.40 LDD, 34.88 ADD, and 28.68 UDD of an antimicrobial per 100 days. The lower TI based on the UDD administration was a result of higher farm protocol dosing relative to the labeled and EMA daily doses. Higher quantities of antimicrobial administration were observed in the first three weeks (day 1-21) of rearing (Tukey-adjusted p < .05). This study is the first to quantitatively estimate the TI of antimicrobials on the US veal calf operations and serves as an important step toward the development of antimicrobial stewardship programs.

Promoting Judicious Antimicrobial Use in Beef Production: The Role of Quarantine

Judicious antimicrobial stewardship in livestock industry is needed to reduce the use of antimicrobials (AMU) and the associated risk of antimicrobial resistance. Biosecurity measures are acknowledged for their role against the spread of diseases and the importance in reducing AMU in different species. However, their effectiveness in beef production has been scarcely considered. The aim of this study was to investigate the effect of the quarantine strategy on AMU in beef cattle. A total of 1206 Charolaise animals in five farms were included in the trial. Roughly half of the animals followed the standard procedure of the fattening cycle (no-quarantine; NO-QUA group) and half followed a 30-day period of quarantine (QUA group) since their arrival. Performance and antimicrobial data were recorded and a treatment incidence 100 (TI100it) per animal was calculated. Penicillins was the most used class of antimicrobials. Differences between groups were significant for males only, with NO-QUA group having greater TI100it (3.76 vs. 3.24; p < 0.05) and lower body weight at slaughter (713.4 vs. 723.7 kg; p < 0.05) than QUA group. Results suggest that quarantine strategy can reduce AMU in males without compromising their performance, whereas further investigation is needed for females.

Assigning Defined Daily/Course Doses for Antimicrobials in Turkeys to Enable a Cross-Country Quantification and Comparison of Antimicrobial Use

Antimicrobial resistance (AMR) threatens our public health and is mainly driven by antimicrobial usage (AMU). For this reason the World Health Organization calls for detailed monitoring of AMU over all animal sectors involved. Therefore, we aimed to quantify AMU on turkey farms. First, turkey-specific Defined Daily Dose (DDD_turkey) was determined. These were compared to the broiler alternative from the European Surveillance of Veterinary Antimicrobial Consumption (DDD_vet), that mention DDD_vet as a proxy for other poultry species. DDD_turkey ranged from being 81.5% smaller to 48.5% larger compared to its DDD_vet alternative for broilers. Second, antimicrobial treatments were registered on 60 turkey farms divided over France, Germany and Spain between 2014 and 2016 (20 flocks per country). Afterwards, AMU was quantified using treatment incidence (TI) per 100 days. TI expresses the percentage of the rearing period that the turkeys were treated with a standard dose of antimicrobials. Minimum, median and maximum TI at flock level and based on DDD_turkey = 0.0, 10.0 and 65.7, respectively. Yet, a huge variation in amounts of antimicrobials used at flock level was observed, both within and between countries. Seven farms (12%) did not use any antimicrobials. Aminopenicillins, polymyxins, and fluoroquinolones were responsible for 72.2% of total AMU. The proportion of treating farms peaked on week five of the production cycle (41.7%), and 79.4% of the total AMU was administered in the first half of production. To conclude, not all DDD_vet values for broilers can be applied to turkeys. Additionally, the results of AMU show potential for reducing and improving AMU on turkey farms, especially concerning the usage of critically important antimicrobials.

Antimicrobial use in poultry flocks in Austria between 2013 and 2019

BACKGROUND

The increase in bacteria that are resistant to antimicrobials-often selected for a high level of antimicrobial uses (AMUs) in human beings or food-producing animals-is a global concern. The Austrian Poultry Health Service (QGV) has established a database containing comprehensive information on poultry flocks in Austria.

METHODS

AMU in 32,411 broiler flocks and 2946 turkey flocks between 2013 and 2019 is analysed by calculating different metrics, including the treatment incidence TI₁₀₀₀ . Furthermore, the Austrian benchmarking system for poultry is introduced.

RESULTS

Annual AMU in broilers decreased from 1030.8 kg of active ingredient to 762.5 kg between 2013 and 2016 but rose again to 1165.0 kg in 2019; while for turkeys annual AMU dropped from 1196.4 kg to 569.0 kg between 2013 and 2019. At the same time, the proportion of treated flocks decreased from 34.2% to 24.8% for broilers and from 54.3% to 44.0% for turkeys. In both broilers and turkeys, the most frequently used antimicrobial class, according to the TI₁₀₀₀ unit, in broilers and turkeys is polymyxins.

CONCLUSION

Calculating different metrics enables a deeper insight into AMU. Total AMU reduced without legislation but the increase of AMU in broiler production needs further investigation.

Welfare Assessment in Calves Fattened According to the "Outdoor Veal Calf" Concept and in Conventional Veal Fattening Operations in Switzerland

Simple Summary

Antimicrobial use in humans and animals leads to the selection of resistant bacteria, a serious threat to human and animal health, as such bacteria can lead to treatment failure and death. With the “outdoor veal calf” concept, a novel calf fattening system was developed that allows for reducing antimicrobial use by 80% through improvements in management and housing, such as health check before purchase, short transport, vaccination, quarantine in individual hutches, and fattening in small groups in a roofed, straw-bedded paddock with a group hutch for shelter. In that system, veal calves spend their entire lives outdoors in the fresh air. In our study, we wanted to make sure that the observed reduction in antimicrobial treatments was not achieved at the cost of animal welfare, i.e., that sick animals were not left without treatment in order to obtain better figures for treatment reduction. Our results show that calves in the “outdoor veal calf” system had fewer signs of respiratory and digestive diseases than control calves and that their lungs had fewer lesions of pneumonia than controls after slaughter. Thus, not only was antimicrobial use drastically reduced, but calf health was really improved in the new “outdoor veal calf” system.

Abstract

The “outdoor veal calf” system was developed to encounter the demand for a veal fattening system that allows for reducing antimicrobial use without impairing animal welfare. Management improvements including direct purchase, short transportation, vaccination, three-week quarantine in individual hutches, and open-air housing in small groups in a roofed, straw-bedded paddock with a group hutch were implemented in a prospective intervention study (1905 calves, 19 intervention and 19 control farms, over one year): antimicrobial use was five times lower in "outdoor veal" farms compared to control farms (p < 0.001), but it was crucial to ensure that antimicrobial treatment reduction was not associated with decreased animal welfare, i.e., that sick animals were not left untreated. Welfare was assessed monthly on the farms, and organs of 339 calves were examined after slaughter. Cough and nasal discharge were observed significantly (p ≤ 0.05) less often in intervention than in control farms, mortality (3.1% vs. 6.3%, p = 0.020) and lung lesion prevalence (26% vs. 46%, p < 0.001) were lower; no group difference was seen in abomasal lesion prevalence (65% vs. 72%). Thus, besides reduced antimicrobial use, calf health and welfare were improved in "outdoor veal calf" farms in comparison to traditional operations.

[Analysis of udder health in relation to antimicrobial usage in Swiss dairy farms]

INTRODUCTION

In Switzerland, standards for milk quality are high. This requires a high level of udder health in dairy cows. Previous studies have shown that mastitis and antibiotic dry cow treatments are the most common causes of antimicrobial consumption in dairy cows. This raises the question of whether a high use of antibiotics is necessary to maintain good udder health. The aim of this study was to analyze the relationship between udder health and antimicrobial usage in Swiss dairy farms. A total of 84 participating farms were evaluated over a period of 18 months. Udder health was assessed using the yield corrected bulk milk somatic cell count from the monthly milk yield data and the number of lactating cows over 150'000 cells/ml per month. Data on antimicrobial consumption were also collected on a monthly basis. In a hierarchical regression model, a significant association between udder health and intramammary antibiotics used during lactation was found. The month of Measurement of the Somatic Cell Count and the veterinarian also had a statistically significant influence on udder health. The consumption of antibiotics for dry cow treatments was not associated with udder health. Antibiotics administered systemically and the production label of the farms was also not statistically associated with udder health in our models. The study was able to show that good udder health is possible with low antimicrobial usage.

Do Dairy Farming Systems Differ in Antimicrobial Use?

Simple Summary

The overuse and misuse of antimicrobials in dairy farming may lead to the development of antimicrobial resistance and thus to the reduction of the antimicrobial treatment efficacy against animal or human bacterial diseases. This study aims to investigate antimicrobial use differences in four farm groups: mountain farms with specialized high-yield dairy breeds or with dual-purpose breeds raised for milk production, and lowland farms with specialized high-yield dairy breeds or with dual-purpose breeds raised for milk production. From the results, we found a significant difference between mountain farms with dual-purpose breeds and lowland farms with specialized breeds for the overall antimicrobial use and for the use of those antimicrobial classes that are most important in human medicine. Mountain farms have a generally lower milk production and smaller herd size than lowland farms, provide cows with access to pasture, and limit concentrates in the diet. These management practices and the use of local/dual-purpose breeds could reduce the risk of production diseases and the consequent need for antimicrobial use.

Abstract

The quantitative assessment of antimicrobial use (AMU) in food-producing animals contributes to the provision of essential information for developing relevant and effective policies to reduce use and to control antimicrobial resistance. Information on AMU is available mainly for intensive dairy farming systems and specialized high-yielding breeds. The aim of this study is to investigate AMU in different dairy farming systems by comparing the treatment incidence in mountain farms with specialized high-yield dairy breeds or with dual-purpose breeds raised for milk production to the treatment incidence in lowland farms with specialized high-yield dairy breeds or with dual-purpose breeds raised for milk production. Significant differences were found only between the overall treatment incidence, as well as the treatment incidence of highest-priority critically important antimicrobials for human medicine, in lowland farms with high-yielding breeds and mountain farms with dual-purpose breeds. Mountain farms have a generally lower milk production and smaller herd size than lowland farms, provide cows with access to pasture, and limit concentrates in the diet. These management practices and the use of local/dual-purpose breeds could reduce the risk of production diseases and the consequent need for AMU.

How Input Parameters and Calculation Rules Influence On-Farm Antimicrobial Use Indicators in Animals

A variety of indicators of antimicrobial use are available in veterinary medicine, their choice should depend on the study objective as none has been recognized as the most appropriate metric. Calculation of indicators of antimicrobial use is based on a number of parameters (e.g., treatment dose or weight at treatment) that can be informed using theoretical (also called "standard") or actual (also called "used") values. Although few studies compare the application of several indicators to the same antimicrobial data, the obtained results lead to apparent discrepancies or contradictions. This study aimed to investigate antimicrobial use at the weaning stage in French pig farms and, more specifically, the impact the sources of information regarding doses, body weight at treatment and treatment length, had on the indicators results. A cross-sectional survey was conducted, and data collected from 70 farms made it possible to calculate four indicators at the weaning stage using different input values. The indicator values did not show significant differences when calculated based on the theoretical dose and length of treatment (as recommended by the summary of product characteristics) or when calculated based on the dose used and treatment length as applied by the farmer. However, all of the indicators showed significant differences when calculated using the standard theoretical weight (15 kg) or actual weight (P < 0.05). It appears that if data collection plans cannot be harmonized, clarification of indicator calculations in the literature is needed to allow comparisons between studies.

Used Daily Dose vs. Defined Daily Dose-Contrasting Two Different Methods to Measure Antibiotic Consumption at the Farm Level

Tackling the problem of rising antibiotic resistance requires valid and comparable data on the use of antimicrobial drugs in livestock. To date, no harmonized monitoring of antimicrobial usage in animals is available, and there is no system to assess usage data throughout Europe, thus hampering a direct comparison between different European countries. Most of the currently applied monitoring systems are based on sales data. Placement of sales data in relation to the population at risk requires overall assumptions about the weights of the animals treated and the doses applied. Only a few monitoring systems collect data in which the number of treated animals is reported exactly and does not need to be estimated. To evaluate the influence of different calculation methods on the standardizing procedure of antibiotic usage and benchmarking of farms, the treatment frequency for several farms (broiler, suckling piglets, and fattening pigs) was calculated in the following two different ways: first, based on the Used Daily Dose (TF_UDD), and second, based on the Defined Daily Dose (TF_DDD). To support this evaluation, consumption data from the Veterinary Consumption of Antibiotics Sentinel (VetCAb-S) project in Germany were used as example data. The results show discrepancies between both outcomes depending on the calculation method applied. In broiler holdings, the median values of TF_DDD were 20.89% lower than the median values of TF_UDD. In suckling piglets and fattening pig holdings, the median values of TF_DDD were increased 77.14% and 16.33%, respectively, which may have serious implications for the benchmarking of farms. Furthermore, this finding reflects that the calculation procedure also has an impact on the comparison between populations. Therefore, UDD-based calculations should be preferred to run monitoring systems with a benchmark mission. If, in contrast, the DDD approach is chosen to compare antimicrobial usage between populations, additional considerations should be made to adjust for the addressed discrepancies.

Prevalence and risk factors for carriage of antimicrobial-resistant Escherichia coli on household and small-scale chicken farms in the Mekong Delta of Vietnam

OBJECTIVES

To describe the prevalence of antimicrobial resistance among commensal Escherichia coli isolates on household and small-scale chicken farms, common in southern Vietnam, and to investigate the association of antimicrobial resistance with farming practices and antimicrobial usage.

METHODS

We collected data on farming and antimicrobial usage from 208 chicken farms. E. coli was isolated from boot swab samples using MacConkey agar (MA) and MA with ceftazidime, nalidixic acid or gentamicin. Isolates were tested for their susceptibility to 11 antimicrobials and for ESBL production. Risk factor analyses were carried out, using logistic regression, at both the bacterial population and farm levels.

RESULTS

E. coli resistant to gentamicin, ciprofloxacin and third-generation cephalosporins was detected on 201 (96.6%), 191 (91.8%) and 77 (37.0%) of the farms, respectively. Of the 895 E. coli isolates, resistance to gentamicin, ciprofloxacin and third-generation cephalosporins was detected in 178 (19.9%), 291 (32.5%) and 29 (3.2%) of the isolates, respectively. Ciprofloxacin resistance was significantly associated with quinolone usage (OR = 2.26) and tetracycline usage (OR = 1.70). ESBL-producing E. coli were associated with farms containing fish ponds (OR = 4.82).

CONCLUSIONS

Household and small farms showed frequent antimicrobial usage associated with a high prevalence of resistance to the most commonly used antimicrobials. Given the weak biocontainment, the high prevalence of resistant E. coli could represent a risk to the environment and to humans.