Estimating antimicrobial usage based on sales to beef and dairy farms from UK veterinary practices

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.

Validation of a multiplex-tandem RT-PCR for the detection of bovine respiratory disease complex using Scottish bovine lung samples

The welfare and economic impact of bovine respiratory disease complex (BRDC), and its associated antibiotic usage, are major challenges to cattle rearing and beef cattle finishing industries. Accurate pathogen diagnosis is important to undertake appropriate treatment and long-term management strategies, such as vaccine selection. Conventional diagnostic approaches have several limitations including high costs, long turnaround times and difficulty in test interpretation, which could delay treatment decisions and lead to unnecessary animal losses. We describe the validation of a multiplex-tandem (MT) reverse transcription-polymerase chain reaction (RT-PCR) for the detection of seven common pathogens associated with BRDC. This test has the potential to advance pathogen identification and to overcome many of the limitations of current testing methods. It requires a single sample and results are obtained quickly and not influenced by prior antimicrobial therapy or overgrowth of contaminating organisms. We demonstrated a test specificity of 100% and sensitivity ranging from 93.5% to 100% for these seven common pathogens. This test will be a useful addition to advance BRDC investigation and diagnosis.

Phylogenetic relationship and virulence composition of Escherichia coli O26:H11 cattle and human strain collections in Scotland; 2002-2020

O26 is the commonest non-O157 Shiga toxin (stx)-producing Escherichia coli serogroup reported in human infections worldwide. Ruminants, particularly cattle, are the primary reservoir source for human infection. In this study, we compared the whole genomes and virulence profiles of O26:H11 strains (n = 99) isolated from Scottish cattle with strains from human infections (n = 96) held by the Scottish Escherichia coli O157/STEC Reference Laboratory, isolated between 2002 and 2020. Bovine strains were from two national cross-sectional cattle surveys conducted between 2002-2004 and 2014-2015. A maximum likelihood phylogeny was constructed from a core-genome alignment with the O26:H11 strain 11368 reference genome. Genomes were screened against a panel of 2,710 virulence genes using the Virulence Finder Database. All stx-positive bovine O26:H11 strains belonged to the ST21 lineage and were grouped into three main clades. Bovine and human source strains were interspersed, and the stx subtype was relatively clade-specific. Highly pathogenic stx2a-only ST21 strains were identified in two herds sampled in the second cattle survey and in human clinical infections from 2010 onwards. The closest pairwise distance was 9 single-nucleotide polymorphisms (SNPs) between Scottish bovine and human strains and 69 SNPs between the two cattle surveys. Bovine O26:H11 was compared to public EnteroBase ST29 complex genomes and found to have the greatest commonality with O26:H11 strains from the rest of the UK, followed by France, Italy, and Belgium. Virulence profiles of stx-positive bovine and human strains were similar but more conserved for the stx2a subtype. O26:H11 stx-negative ST29 (n = 17) and ST396 strains (n = 5) were isolated from 19 cattle herds; all were eae-positive, and 10 of these herds yielded strains positive for ehxA, espK, and Z2098, gene markers suggestive of enterohaemorrhagic potential. There was a significant association (p < 0.001) between nucleotide sequence percent identity and stx status for the bacteriophage insertion site genes yecE for stx2 and yehV for stx1. Acquired antimicrobial resistance genes were identified in silico in 12.1% of bovine and 17.7% of human O26:H11 strains, with sul2, tet, aph(3″), and aph(6″) being most common. This study describes the diversity among Scottish bovine O26:H11 strains and investigates their relationship to human STEC infections.

Antimicrobial usage and resistance in scottish dairy herds: a survey of farmers' knowledge, behaviours and attitudes

Antimicrobial resistance (AMR) poses a major threat to global health. Understanding how antimicrobials are used on dairy farms and stakeholder beliefs relating to their use is essential to ensure responsible antimicrobial usage (AMU) to tackle the emergence of AMR. This study explored Scottish dairy farmers' knowledge about the meaning of AMR and antimicrobial activity, behaviour and practices related to farm AMU and attitudes towards AMR mitigation. An online survey was designed based on the findings of two focus groups and was completed by 61 respondents (7.3% of the total population of Scottish dairy farmers). Knowledge of antimicrobials and AMR was variable, and almost half of the participants believed that antimicrobials could have anti-inflammatory or analgesic activity. Veterinarians' opinions and advice about AMU were ranked significantly more important than other social referents or advisors. The majority of farmers (90%) reported having implemented practices to reduce reliance on antimicrobials (e.g., selective dry cow therapy, AMU treatment protocols) and having reduced farm AMU over recent years. Feeding waste milk to calves is still widespread, being reported by up to 30% of respondents. The main factors described to hinder responsible farm AMU were limited facilities (e.g., lack of isolation pens for sick animals) and knowledge of appropriate AMU recommendations, followed by time and financial constraints. Most farmers (89%) agreed that it is important to reduce AMU on dairy farms, but fewer (52%) acknowledged that AMU on UK dairy farms is currently too high, suggesting a mismatch between their intention to reduce antimicrobials and AMU behaviour. These results indicate that dairy farmers are aware of AMR, and their self-reported farm AMU has been reduced. However, some do not clearly comprehend the activity of antimicrobials and their correct usage. More work is needed to improve dairy farmers' knowledge of appropriate AMU and intentions to combat AMR. Farmers would benefit from more regular AMU discussions and advice from herd veterinarians, as they were described as highly trusted information resources. Training on how to reduce AMU should involve all farm staff administering antimicrobials and should be tailored to farm-specific barriers, such as limited facilities and workforce shortages.

Mastitis Control and Intramammary Antimicrobial Stewardship in Ireland: Challenges and Opportunities

The Veterinary Medicines Regulation (EU 2019/6) came into force in all EU member states on 28 January 2022. This regulation places particular emphasis on prudent and responsible antimicrobial use in food animal production. Key changes include restrictions on the prophylactic use of antimicrobials in animals, and the possibility to reserve certain antimicrobials for humans only. The Regulation presents challenges to the Irish dairy industry, particularly with respect to current approaches to dry cow therapy. In response, the CellCheck technical working group (TWG, a technical group working in support of CellCheck, the national mastitis control programme) have developed pragmatic national and farm-level recommendations in support of improved mastitis control and intramammary antimicrobial stewardship in the Irish dairy industry. This paper outlines these recommendations, and provides an overview of the evidence considered to inform the TWG during its work (including the Regulation, policy perspectives, international best-practice, international scientific reviews and specific Irish challenges). In many key areas of concern, the TWG recognises the challenges in seeking to shape recommendations in the absence of robust and practical scientific evidence. For this reason, some of the recommended actions are pragmatic in nature, informed by national and international experiences. Periodic programme review will be needed, informed by ongoing monitoring of key performance indicators, to identify those actions that are most effective in an Irish context.

Evaluation of the use of antibiotic waste bins and medicine records to quantify antibiotic use on sheep, beef, and mixed species farms: A mixed methods study

There is a lack of robust data on antibiotic use on sheep and beef farms in the UK, particularly for farms with mixed species. On mixed farms, quantification of antibiotic use is reliant on accurate farmers' records as veterinary prescription data does not provide information at the species level. Previous studies that have investigated multiple antibiotic use collection methods were conducted on single species farms and failed to collect data on the reasons why differences in methods may exist. This study aimed to evaluate sheep and beef farmers' antibiotic recording practices by comparing quantities of antibiotics measured from medicine records and empty antibiotic packaging collection bins, and identify barriers and facilitators of the antibiotic use collection methods. Thirty-five farms were followed for a year period. Farmers were asked to record their antibiotic treatments and deposit empty antibiotic packaging used in sheep or beef cattle into a bin. Semi-structured qualitative interviews were conducted to understand the experiences of farmers taking part in the study and explore the possible differences in methods. Bins and medicine records were collected and the mass of active ingredient (mg) was calculated. The level of agreement between the two antibiotic use collection methods was measured using rank parameters of Kendall's T_a. The bins were 67 % (CI = 29-87 %) more likely to measure more antibiotic use than the medicine records. The scale of variability of the measurements between two random farms was 33 % (CI = 6-56 %) larger for the antibiotic waste bins than the scale of variability between the medicine records. Sheep farmers often missed neonatal lamb treatments off their medicine records, with a median of 32.5 missing treatments per farm (IQR = 18-130). Of the mixed species farms, 28 % of treatment entries were missing the species the antibiotic was used in. Farmers reported that the bin was easy to use but they also reported that there was a tendency to under-report actual use where there were multiple workers on the farm or where treatments were administered by the veterinarian. The qualitative analysis identified contextual barriers to accurate medicine recording, such as difficulties with animal identification, with recording in the field, and with recording during lambing time. This study demonstrated that there were significant differences in antibiotic use measured by the bins and the medicine records. The mixed-methods approach provided an understanding of the contextual barriers that impacted farmers' medicine recording and use of the bin. This information on the contextual barriers can be used to inform the design of data collection methods to improve antibiotic consumption data in the sheep and beef sectors.