The use of antibiotics on small dairy farms in rural Peru

Attitudes and practices on antibiotic use and its emerging threats among Lebanese dairy veterinarians: a case study from a developing country

Introduction

This study aimed to explore how veterinarians (vets) rationalized their prescribing decisions for antimicrobial (AM) uses, the barriers they perceived to implement proper farm management in Lebanon, and the consecutive threats that might arise concerning the emergent spread of antimicrobial resistance in animals and the population.

Methods

Amid the COVID-19 pandemic, phone call interviews were conducted with 34 veterinarians working in different demographic regions across the country. Data were analyzed qualitatively using an inductive thematic analysis.

Results and discussion

The majority of veterinarians called for responsible antibiotic use. The prescribing decision of veterinarians was based mainly on suspected disease from field examination, farmer's reports via phone calls, and the ability of the farmer to cover antibiotic costs. Very few veterinarians referred to laboratory diagnosis before prescribing a specific AM due to many obstacles. This study uncovered the absence of a trust relationship between veterinarians and farmers in Lebanon. Veterinarians provided different insights into farming practices, reflecting that farmers, in general, lack proper knowledge and implementation of farm management and that they mainly treat the herd on their own, especially in light of the current unprecedented economic crisis that Lebanon has been facing in the last three years. Above all, veterinarians revealed that AM resistance in Lebanon is markedly spreading, which calls for a serious and instantaneous set of governmental policies and regulations.

Prevalence of Multidrug-Resistant CTX-M Extended Spectrum Beta-Lactamase-Producing Escherichia coli From Different Bovine Faeces in China

CTX-M extended spectrum beta-lactamase-producing Escherichia coli cause severe health hazards in livestock breeding. To date, little is known about antibiotic resistance differences among bacterial isolates from yaks, cows, and beef cattle; therefore, the aims of this study were to analyse the prevalence of CTX-M-producing E. coli in yak, beef cattle, and dairy cattle feces from different provinces in China. A total of 790 fecal samples from yaks, beef cattle, and dairy cows were used. Among all the samples, 523 non duplicate E. coli isolates were identified, and 29.6% of samples harbored CTX-M producers. The results showed that these E. coli strains harbored 15 clusters of CTX-M genes: CTX-M-79, CTX-M-55, CTX-M-15, CTX-M-14, CTX-M-28, CTX-M-179, CTX-M-65, CTX-M-24, CTX-M-27, CTX-M-102, CTX-M-105, CTX-M-173, CTX-M-238, CTX-M-196, and CTX-M-10. The dominant resistance genes were CTX-M-15, CTX-M-14, and CTX-M-55. Moreover, the distribution of CTX-M genes was related to geographical region. Based on the above findings, we reasoned that bovines are potential reservoirs of antibiotic resistance, and this problem should be given adequate attention.

Long-term maintenance of multidrug-resistant Escherichia coli carried by vampire bats and shared with livestock in Peru

Extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-E. coli) have been reported in wildlife worldwide. Whether wildlife is a transient host of ESBL-E. coli or comprises an independently maintained reservoir is unknown. We investigated this question by longitudinally monitoring ESBL-E. coli in common vampire bats and nearby livestock in Peru. Among 388 bats from five vampire bat colonies collected over three years, ESBL-E. coli were detected at a low prevalence (10% in 2015, 4% in 2017 and 2018) compared to a high prevalence (48%) from 134 livestock sampled in 2017. All ESBL-E. coli were multidrug-resistant, and whole genome sequencing of 33 randomly selected ESBL-E. coli isolates (18 recovered from bats) detected 46 genes conferring resistance to antibiotics including third-generation cephalosporins (e.g., bla_CTX-M-55, bla_CTX-M-15, bla_CTX-M-65, bla_CTX-M-3, bla_CTX-M-14), aminoglycosides, fluoroquinolones, and colistin (mcr-1). The mcr-1 gene is reported for the first time on a wild bat in Latin America. ESBL-E. coli also carried 31 plasmid replicon types and 16 virulence genes. Twenty-three E. coli sequence types (STs) were detected, including STs involved in clinical infections worldwide (e.g., ST 167, ST 117, ST 10, ST 156 and ST 648). ESBL-E. coli with identical cgMLST (ST 167) were detected in the same bat roost in 2015 and 2017, and several ESBL-E. coli from different bat roosts clustered together in the cgMLST reconstruction, suggesting long-term maintenance of ESBL-E. coli within bats. Most antibiotic resistance and virulence genes were detected in E. coli from both host populations, while ESBL-E. coli ST 744 was found in a bat and a pig from the same locality, suggesting possible cross-species exchanges of genetic material and/or bacteria between bats and livestock. This study suggests that wild mammals can maintain multidrug-resistant bacteria and share them with livestock.

Knowledge, attitudes, and perceptions of dairy farmers regarding antibiotic use: Lessons from a developing country

In lower- and middle-income countries, uncontrolled use of antibiotics is causing antimicrobial resistance, affecting both animal welfare and public health. Meanwhile, studies on antibiotic use in these countries are limited. A crucial step to limit the spread of antimicrobial resistance (AMR) is to examine the use of these drugs and identify its determinants. The aim of our study, the first of its kind in Lebanon, was to assess dairy farmers' knowledge and awareness of antimicrobial use (AMU) and AMR. For this, 18 farmers from different regions, educational backgrounds, experience levels, and herd sizes were interviewed. Results showed that owners of larger farms were more aware of AMU and AMR, and trying to implement preventive actions, whereas nonsystematic antimicrobial use was prevalent among the smaller farms. Mastitis and laminitis were the most treated diseases, and antibiotics used were oxytetracycline, penicillin, streptomycin, and florfenicol. Overall, antibiotic use was found as a preventive measure and a treatment of nonbacterial diseases. Irregular uses were linked to easy access of farmers to antibiotics, interrupted relations with veterinary authorities, and lack of self-assessment and inspection. Lebanese dairy farmers and owners reported feeling disadvantaged in their local trade field, facing illegal competition and unauthorized farms and industries, and lacking support from the government. Training and awareness programs must be implemented, and policies and regulations must be set, to reduce antibiotic use and hinder the spread of AMR in Lebanon.

Antimicrobial usage in cattle and poultry production in Dar es Salaam, Tanzania: pattern and quantity

Background

Antimicrobials are extensively used in cattle and poultry production in Tanzania. However, there is dearth of information on its quantitative use. A questionnaire-based cross-sectional study was conducted from August to September 2019 in randomly selected poultry and small-scale dairy farms, in three districts of Dar es Salaam City eastern, Tanzania, to assess the practice and quantify antimicrobial use. Descriptive and statistical analyses were performed at a confidence interval of 95%. The ratio of Used Daily Dose (UDD) and Defined Daily Dose (DDD) were used to determine whether the antimicrobial was overdosed or under dosed.

Results

A total of 51 poultry and 65 small-scale dairy farms were involved in the study. The route of antimicrobial administration was 98% orally via drinking water and 2% in feeds for poultry and for small-scale dairy farms, all through parenteral route. Seventeen types of antimicrobials comprising seven classes were recorded in poultry farms while nine belonging to six classes in the small dairy farms. Majority of the farms (poultry, 87.7% and small scale dairy, 84.3%) used antimicrobials for therapeutic purposes. About 41% of the poultry and one third (34%) of the dairy farmers’ were not compliant to the drug withdrawal periods. Beta-lactams, fluoroquinolones, sulphonamides, tetracyclines and macrolides were the commonly used antimicrobials on these farms. In the poultry farms both those with records and those which relied on recall, antimicrobials were overdosed whereas in the small dairy farms, sulfadimidine, oxytetracycline and neomycin were within the appropriate dosing range (0.8–1.2). The majority (58.6%) of farmers had adequate level of practices (favorable) regarding antimicrobial use in cattle and poultry production. This was associated with the age and level of education of the cattle and poultry farmers.

Conclusion

The study revealed a widespread misuse of antimicrobials of different types and classes in both poultry and small-scale dairy farming in Dar es Salaam, Tanzania. This result gives insight into the antimicrobial use practices and its quantification. The information obtained can guide and promote prudent use of antimicrobials among the farmers by developing mitigate strategies that reduce antimicrobial resistance risk potentials.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12917-021-03056-9.

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.

In Silico Detection of Antimicrobial Resistance Integrons in Salmonella enterica Isolates from Countries of the Andean Community

Antimicrobial resistance genes are often associated with integrons, which promote their movement between and within DNA molecules. IntFinder 1.0 and I-VIP v1.2 were used for the detection of integrons and their associated resistance genes in assembled sequences and raw reads. A dataset comprising 1688 sequenced Salmonella enterica isolates from countries of the Andean Community was developed. A total of 749 and 680 integrons were identified by IntFinder 1.0 and I-VIP v1.2, respectively; class 2 integrons were the most abundant followed by class 1, whereas no class 3 integrons were detected. These elements were mainly associated with isolates from animal sources. S. Infantis ST32 contained the majority of integrons. Trimethoprim resistance genes (dfrA) were found in greater numbers than others, including aadA and bla genes. The presence of these resistance integrons may come as a response to antibiotic misuse, especially of co-trimoxazole. This represents a public health risk as novel resistant strains might appear due to gene dissemination. The information gathered from in silico studies not only contributes to our understanding of integron dynamics in pathogenic Salmonella, but also helps identify potential emergent patterns of resistance in the region, which is fundamental for developing pertinent antibiotic surveillance programs.

Association between antimicrobial use and antimicrobial resistance of Streptococcus uberis causing clinical mastitis

It is unknown whether overuse of antimicrobials against clinical mastitis (CM) from Streptococcus uberis is associated with increased antimicrobial resistance (AMR). Therefore, the aim of this study was to evaluate the association between antimicrobial use (AMU) and AMR in relation to the Strep. uberis causing CM in dairy herds. A total of 83 Strep. uberis isolates were selected from a collection created during a previous study evaluating the epidemiology of CM in dairy herds (n = 17) of southeastern Brazil. For each case of CM identified on farm, the following information was recorded: cow's identification number, affected mammary quarter, date of CM diagnosis, antimicrobial commercial names, number of administrations, and descriptions of protocol changes during the treatment. Streptococcus uberis isolates were confirmed by conventional culture, MALDI-TOF mass spectrometry, and quantitative multiplex PCR analyses. Thus, a total of 8 antimicrobials commonly used for CM treatment were evaluated for antimicrobial activity against Strep. uberis isolates. The minimum inhibitory levels of antimicrobials were determined at the lowest concentrations able to inhibit 50 and 90%, respectively, of Strep. uberis isolates. Data related to the antibiotics used for treatment of CM was used to calculate the frequency of administered antimicrobials as the number of defined daily doses (DDD). The highest frequencies of resistant Strep. uberis were observed for erythromycin (80.7% resistant, R), tetracycline (R = 59%), and penicillin G (R = 57.8%), whereas against ceftiofur only 10.8% of Strep. uberis isolates were resistant, and only 1.2% of the Strep. uberis isolates were resistant to enrofloxacin. Regarding the evaluation of resistance for antimicrobial classes, the highest frequency was observed for macrolides (R = 80.7%; 19.3% susceptible, S). Additionally, a frequency of 18.7% of Strep. uberis isolates were resistant to cephalosporins (S = 81.3%), respectively. Further, 94% of Strep. uberis isolates were multiresistant; all these isolates presented resistance to at least 3 different antimicrobial classes. The overall monthly average of antimicrobial treatment incidence (ATI) among the 17 herds enrolled in the study was 23.7 DDD per 1,000 lactating dairy cows [standard deviation (SD) = 13.9], ranging from 5.0 to 55.4 DDD per 1,000 cows in lactation-day. Cephalosporins and penicillins were the most commonly used antimicrobial classes among the evaluated herds (n = 16; 94.1%), followed by tetracyclines (n = 15 herds; 88.2%), fluoroquinolones (n = 14; 82.3%), and sulfonamides (n = 14; 82.3%). The tetracycline class had the highest ATI mean (5.0 DDD per 1,000 lactating cow-days, SD = 5.8), followed by fluoroquinolones (4.7 DDD per 1,000 lactating cow-days, SD = 6.0) and cephalosporins (3.8 DDD per 1,000 lactating cow-days, SD = 6.0). The overall use of antimicrobials was associated with the resistance of Strep. uberis to the antimicrobial tetracycline.

Clostridioides difficile on dairy farms and potential risk to dairy farm workers

Clostridioides difficile causes severe colitis in people and is a significant enteric pathogen in many species of animals, including swine, horses, and potentially cattle. C. difficile is shed in feces, and transmission occurs horizontally via the fecal-oral route. Livestock has been suggested as a potential reservoir for C. difficile, and while studies have shown that swine and farm workers can be colonized with identical clones of C. difficile, the zoonotic transmission of C. difficile from livestock to people has not been definitively demonstrated. The goal of this study was to determine whether dairy calves and dairy farm workers harbored genetically similar isolates of C. difficile. First, we validated a glove juice protocol for detecting C. difficile on farm workers' hands. We then visited 23 farms and collected 1) fecal samples from 92 dairy calves, 2) hand rinsates from 38 dairy farm workers, and 3) fecal samples from five of the dairy farm workers who were willing to submit them. All samples underwent anaerobic culture and qPCR to detect C. difficile. C. difficile was detected on 15 of the farms (65.2%, 95% confidence interval (CI) 42.7%-83.6%) and in 28 calves (30.4%, 95% CI 21.2-40.9%) but in none of the hand rinsates or human fecal samples. Thus, the zoonotic transmission of C. difficile on dairy farms could not be demonstrated, and dairy farmers did not appear to be at increased risk of acquiring C. difficile via the fecal-oral route.

Understanding farmers' and veterinarians' behavior in relation to antimicrobial use and resistance in dairy cattle: A systematic review

To tackle antimicrobial resistance, it is vital that farmers' and veterinarians' antimicrobial use behaviors and attitudes toward resistance are understood so that we can identify how beliefs and motives influence practices. Current literature details qualitative and quantitative research that explores the knowledge, attitudes and perceptions of dairy farmers and veterinarians with respect to antimicrobial resistance and antimicrobial practices, and the reported findings are varied and conflicting. Our objective was to conduct a systematic review to assess the evidence and knowledge gaps in the published literature. We identified articles via database searches of Embase, Medline, PubMed, Scopus, and Web of Science; we limited findings to published articles available in English with no publication year restrictions. Article screening was conducted at 3 levels: title, abstract, and full text. Of the 349 articles identified, 35 were retained for systematic review. Transparency of reporting was assessed for each study using the Consolidated Criteria for Reporting Qualitative Research (COREQ) framework. Quality was assessed using the Critical Appraisal Skills Programme qualitative checklist. Findings relating to dairy farmers' and veterinarians' knowledge, attitudes, and perceptions on antimicrobial resistance and practices were thematically analyzed. The comprehensiveness of reporting was variable: studies reported 5 to 26 of the 32 COREQ checklist items. Five key themes emerged from the data: knowledge and awareness of antimicrobial resistance; factors influencing farmer and veterinarian decision-making; perceived barriers and facilitators to reduced antimicrobial use; perceived responsibility for antimicrobial resistance; and the role of the farmer and veterinarian relationship in reducing antimicrobial use. Awareness of prudent antimicrobial use was not uniform between studies. Many factors influence farmers' and veterinarians' decisions to use antimicrobials, including animal welfare and available resources. The farmer-veterinarian relationship is a potential barrier or facilitator of reduced antimicrobial use, depending on the perceived relationship dynamic. Encouraging collaboration between farmers and veterinarians could lead to shared responsibility for reducing antimicrobial use. This review provided a coherent picture of what is currently known and identified gaps in the current knowledge to inform future behavioral intervention research. Increased knowledge, skill development, resources, engagement, and further research to address the gaps we identified are the main recommendations to effectively overcome barriers, elicit appropriate behavior change, and achieve reduced antimicrobial use in dairy cattle.

Knowledge and use of antibiotics among low-income small-scale farmers of Peru

The extensive use and misuse of antibiotics in the livestock sector is one of the main drivers of the emergence and spread of antimicrobial resistance. Although small-scale farms constitute most of the livestock production in low and middle-income countries, knowledge and use of antibiotics among these populations is sparse. We conducted 201 questionnaires to estimate the use and knowledge of antibiotics by small-scale farmers located in the coastal area of the Lima region of Peru. Our results show that farmers had a small number of livestock (e.g. average of 11 cows, 7 pigs and 19 chickens per farm) and 80 % earned less than minimum wage. More than half of farmers reported at least one episode of respiratory disease, diarrhea, mastitis, skin lesion or post-parturition infection in their animals during the previous year, and 40 % of these episodes were treated with antibiotics. Farmers reported using 14 different antibiotics, most commonly oxytetracycline (31 % of episodes treated with antibiotics), penicillin (21 %), gentamicin (19 %) and trimethoprim-sulfamethazine (18 %). The third-generation cephalosporin ceftiofur was occasionally used to treat mastitis. Most farmers relied on veterinarians to prescribe (95 % of respondents) and administer (59 %) antibiotics. Only half of farmers knew what micro-organisms can be treated with antibiotics and the degree of knowledge of antibiotics (based on a 5-question metric) was positively correlated with respondents’ educational level, monthly income, knowledge of the animal health authority, farm area, number of cows and knowledge of an antiparasitic drug. In contrast, knowledge of antibiotics was not correlated with respondents’ age, gender, main occupation, knowledge of a veterinarian or household size. Potential misuse of antibiotics was reported, including 21 % of framers reporting stopping the treatment when clinical signs disappear and infrequent use of antibiotics to treat parasites or animals not eating. Our study highlights poor knowledge and potential misuse of antibiotics among small-scale farmers in coastal Peru, but high reliance on veterinarians for prescription and administration. Strengthening farmers' relationships with veterinarians and improving the diagnostic capacity of the veterinary sector could result in more judicious antibiotic use on these farms.

Antimicrobial use practices and resistance in indicator bacteria in communal cattle in the Mnisi community, Mpumalanga, South Africa

Surveillance of antimicrobial use and antimicrobial resistance is a critical component of the “Global Action Plan” to tackle antimicrobial resistance. However, there is a paucity of such surveillance in communal farming areas in South Africa. This study investigated knowledge and antimicrobial use practices by cattle farmers and antimicrobial resistance levels of indicator bacteria in cattle in a rural communal farming area in South Africa. Seventy (70) farmers were interviewed at five cattle inspection sites using structured questionnaires. Rectal swabs were collected from apparently healthy cattle (n = 100) for culture of Escherichia coli and Enterococcus species, and antimicrobial susceptibility testing using broth microdilution. The farmers indicated predominantly using tetracyclines. Although 42% of the farmers indicated hearing about antimicrobial resistance, none of them clearly understood what it involves. Seventy‐nine (79) E. coli and 71 Enterococcus species were isolated with E. faecium being the dominant species among the Enterococcus isolates. E. coli isolates were resistant to colistin (16%; 13/79), chlortetracycline (8%; 6/79) and amoxicillin (8%; 6/79). Enterococcus isolates were resistant to enrofloxacin (55%; 39/71) and amoxycillin (3%; 2/71). We observed knowledge gaps in prudent antimicrobial use practices and antimicrobial resistance among the farmers. Farmer tailored education programmes on primary animal health care and prudent antimicrobial use practices must be developed and implemented to improve antimicrobial stewardship among farmers with limited veterinary supervision. The level of colistin resistance detected among E. coli isolates from rural communal cattle in this study was unexpected and warrants further molecular investigation to check if the resistance is plasmid mediated.

Antimicrobial use for treatment of clinical mastitis in dairy herds from Brazil and its association with herd-level descriptors

The aims of this prospective and descriptive study were to: (a) characterize treatment profile and quantify antimicrobial consumption for treatment of clinical mastitis (CM) in dairy herds of Brazil; and, (b) determine the association of antimicrobial use (AMU) for treatment of CM and herd-level descriptors, such as herd size, average milk yield, bulk milk somatic cell count (BMSCC), bulk milk total bacterial count (BMTBC), season and housing type. Data on treatment practices were obtained from 19 of 20 dairy herds selected for the study for a period of 12 months per herd. Treatment protocols were recorded in each case of CM by the farm personnel using a form that included information at the cow- and treatment-level. The frequency of antimicrobial consumption for treatment of CM was determined monthly in units of defined daily dose (DDD) and expressed as antimicrobial treatment incidence (ATI; the number of DDD per 1,000 lactating cow-days). Mixed linear regression models were used to determine the association between log-transformed ATI and herd level descriptors. The overall monthly mean ATI was 21.9 DDD per 1,000 lactating cow-days (15.4 DDD per 1,000 lactating cow-days for intramammary compounds, and 6.4 DDD per 1,000 lactating cow-days for systemically administered antimicrobials). Among intramammary drugs, aminoglycosides had the highest ATI (11.7 DDD per 1,000 lactating cow-days), followed by a treatment with a combination of tetracycline, aminoglycoside and polypeptide (10.3 DDD per 1,000 lactating cow-days). For systemically administrated antimicrobials, fluoroquinolones (6.1 DDD per 1,000 lactating cow-days), penicillin combinations (3.9 DDD per 1,000 lactating cow-days), and the combination of sulfonamide and pyrimidine (3.6 DDD per 1,000 cows per day) were the most frequently used antimicrobials. The use of combination therapy (i.e., association of intramammary and systemically administered antimicrobials) was reported for 64.3 % of treatments at the cow-level. The AMU tended to be higher in herds with highest BMSCC. In addition, a higher AMU for treatment of CM was observed during the rainy season compared to the dry season in Brazil. This seasonal effect was mostly characteristic in herds housing cows in outdoor housing systems (i.e., paddocks).

Assessment of Antimicrobial and Pesticide Residues in Food Products Sourced from Peasant Family Farming in Chile

The presence of antimicrobial and pesticide residues in products sourced from peasant family farms selected from eight regions of Chile was determined. A total of 204 samples were analyzed from family farm products, including honey, lettuce, tomato, strawberry, raspberry, lamb meat, and cow's milk. Pesticide residues were found in 43 of 107 samples tested for them, but only 4 samples had concentrations that exceeded the maximum residue limits (MRLs) set by Chilean regulations. As for animal products, 2 of 15 cow's milk samples tested positive for permethrin residues; however, these concentrations did not exceed Chilean MRLs. No pesticide residues were detected in honey samples. As for antimicrobial drugs, 4 of 14 lamb meat samples and 11 of 79 cow's milk samples tested positive for different classes of antimicrobial residues, such as tetracyclines, macrolides, aminoglycosides, and β-lactams. Among these, only three samples exceeded the MRLs for these matrices. Traces of tetracyclines and sulfonamides were detected in 7 of 29 honey samples. These findings show that these chemical contaminants are present in trace concentrations in foodstuffs produced by peasant family farms in Chile; however, most residues did not exceed the regulatory limits. This study is the first assessment of the presence of residues from antimicrobial drugs and pesticides in food products sourced from peasant family farms in Chile. Data about the current state of drug residues in this segment of food products provide a baseline for efforts to close possible gaps in current surveillance schemes.

Quantification of antibiotic use on dairy farms in Pennsylvania

Antibiotic use data are critical for drawing conclusions about the epidemiological connections between antibiotic use in farms animals, antibiotic resistance, animal health, and human health. The goal of this study was to quantitatively and qualitatively characterize antibiotic use on dairy farms in Pennsylvania, the state with second largest number of dairy farms nationally. A survey was sent to 10% of the 6,580 dairy farms registered in Pennsylvania and completed by 235 producers (response rate of 36%). Data on antibiotic use in the previous month and in the previous 6 mo were collected based on farmer self-report, using either recall or treatment records. Two metrics were used to quantify antibiotic consumption: animal-defined daily doses (ADD) and days of therapy (DOT), a metric used in human medicine for purposes of antimicrobial stewardship. Across all farms, 24,444 ADD and 19,029 DOT were reported, representing treatment incidences of 4.2 ADD/1,000 animal-days and 3.3 DOT/1,000 animal-days. These rates were generally lower than those found in other states and countries. The main indication for antibiotic use was mastitis, and first-generation cephalosporins were the most commonly used class of antibiotic for all indications, followed by penicillins and third-generation cephalosporins. Trends in use were similar for ADD and DOT, but the numbers of recorded DOT and associated treatment incidences were generally lower than the number of ADD and associated treatment incidences. Rates of treatment were significantly associated with herd size. This study is the first to quantify antibiotic use on dairy farms in Pennsylvania and the first to use the DOT metric in a dairy setting.

Ethnographic Decision Modeling to Understand Smallholder Antibiotic Use for Poultry in Guatemala

Widespread use of antibiotics is of concern due to the selection for resistant bacterial strains, which render life-saving antimicrobials ineffective. Smallholders in rural Guatemala rely on human antibiotics to treat their poultry, and in this article, I aim to understand why they do so. I incorporate Ethnographic Decision Modeling (EDM) to understand treatment behaviors. Results indicate that access and affordability in opportunity costs are barriers to seeking veterinary medicines for poultry. Access to veterinary medicine and education campaigns on poultry health are necessary to support the appropriate use of antimicrobials for backyard poultry.

Antimicrobial Usage in Animal Production: A Review of the Literature with a Focus on Low- and Middle-Income Countries

Antimicrobial use (AMU) in animal production is a key contributor to antimicrobial resistance (AMR) worldwide. As consumption of animal protein and associated animal production is forecast to increase markedly over coming years in low- and middle-income countries (LMICs), accurate monitoring of AMU has become imperative. We summarized data from 89 scientific studies reporting AMU data in animal production published in English since 1998, identified through the 'ISI Web of Knowledge' search engine. The aims were as follows: (a) to describe methodologies and metrics used to quantify AMU; (b) to summarize qualitative (on-farm prevalence of use) and quantitative (amounts of antimicrobial active principle) data, in order to identify food animal species at the highest risk of AMU; and (c) to highlight data gaps from LMICs. Only 17/89 (19.1%) studies were conducted in LMICs. Sixty (67.3%) reported quantitative data use, with 'daily doses per animal-time' being the most common metric. AMU was greatest in chickens (138 doses/1000 animal-days [inter quartile range (IQR) 91.1⁻438.3]), followed by swine (40.2 [IQR 8.5⁻120.4]), and dairy cattle (10.0 [IQR 5.5⁻13.6]). However, per kg of meat produced, AMU was highest in swine, followed by chickens and cattle. Our review highlights a large deficit of data from LMICs, and provides a reference for comparison with further surveillance and research initiatives aiming to reduce AMU in animal production globally.

Lameness on Brazilian pasture based dairies-part 1: Farmers' awareness and actions

This cross-sectional survey aimed to verify farmers' awareness and knowledge about lameness in grazing dairy cows and to analyze their perspectives and actions intended to control this issue. Farms (n = 44, mean herd size: 42, SD = 11.2) located in southern Brazil were visited twice in 2015. On the first visit the farmers were requested to answer a questionnaire on lameness knowledge (relative importance as a health issue, aetiology, impacts on culling) and management (prevention, treatment and veterinary assistance) on their farms. Farmers were asked to estimate the number of lame cows present on their farms at each visit. All lactating cows on each farm were locomotion scored by a veterinarian to estimate lameness prevalence on both visits. Intra-class correlation coefficients (ICC) were used to test similarity between the veterinarian and farmer estimated lameness prevalence. Mixed-effects linear models were fitted to investigate the associations between veterinarian lameness estimated prevalence and farmers' answers regarding lameness importance and impacts on culling cows at the farms. On average, farmers underestimated lameness prevalence during both visits; however, when assessing only severe lameness, veterinarian and farmer prevalence lameness ratings were very similar on the second visit (ICC 0.8, 95% CI: 0.6-0.9, n = 43, P < 0.01). The veterinarian's estimated lameness prevalence was about 10% higher on herds where farmers identified lameness as a primary health issue (40.24%) or as a reason for culling (41.7%) versus farms where the farmer did not recognize lameness as a health concern or reason for culling. Farmers' most reported causes of lameness on their farms were categorized as hoof trauma, inadequate feeding practices associated with acidosis-laminitis, high moisture on walking surfaces, and individual features of cows. Farmers mentioned frequently that they made use of antibiotics and topical hoof products to treat lame cows; they also reported low use of anti-inflammatories/analgesics and hoof trimming as treatment remedies and no one mentioned adoption of regular preventative measures for lameness. Farmers reported having no training on lameness management, and cited an overall lack of veterinary support to control lameness on their farms. The farmers seemed unaware of the extent of lameness on their farms. Interventions aimed at reducing lameness in small scale herds in this region of Brazil should include a preventative veterinary assistance approach focused, initially, to increase farmers' knowledge and awareness on lameness.

Prevailing practices in the use of antibiotics by dairy farmers in Eastern Haryana region of India

AIM

The aim of the study was to assess the antibiotic use in dairy animals and to trace its usage pattern among the small, medium, and large dairy farmers in Eastern Haryana region of India.

MATERIALS AND METHODS

Karnal and Kurukshetra districts from Eastern region of Haryana state were purposively selected, and four villages from each district were selected randomly. From each village, 21 farmers were selected using stratified random sampling by categorizing into small, medium, and large farmers constituting a total of 168 farmers as respondents. An antibiotic usage index (AUI) was developed to assess usage of antibiotics by dairy farmers.

RESULTS

Frequency of veterinary consultancy was high among large dairy farmers, and they mostly preferred veterinarians over para-veterinarians for treatment of dairy animals. Small farmers demanded low-cost antibiotics from veterinarians whereas large farmers rarely went for it. Antibiotics were used maximum for therapeutic purposes by all categories of farmers. Completion of treatment schedules and follow-up were strictly practiced by the majority of large farmers. AUI revealed that large farmers were more consistent on decision-making about prudent use of antibiotics. Routine use of antibiotics after parturition to prevent disease and sale of milk without adhering to withdrawal period was responsible for aggravating the antibiotic resistance. The extent of antibiotic use by small farmers depended on the severity of disease. The large farmers opted for the prophylactic use of antibiotics at the herd level.

CONCLUSION

Antibiotic usage practices were judicious among large dairy farmers, moderately prudent by medium dairy farmers and faulty by small farmers. The frequency of veterinary consultancy promoted better veterinary-client relationship among large farmers.

The oxidative stress response of oxytetracycline in the ciliate Pseudocohnilembus persalinus

Oxytetracycline (OTC) is commonly employed in fish farms to prevent bacterial infections in China, and because of their widely and intensive use, the potential harmful effects on organisms in aquatic environment are of great concern. Ciliates play an important role in aquatic food webs as secondary producers, and Pseudocohnilembus persalinus, is one kind of them which are easily found in fish farms, surviving in polluted water. Therefore, using P. persalinus as experimental models, this study investigated the effects of oxytetracycline (OTC) on the growth, antioxidant system and morphological damage in pollution-resistant ciliates species. Our results showed that the 96-h EC₅₀ values for OTC of P. persalinus was 21.38mgL^-1. The increased level of SOD and GSH during 96h OTC stress was related to an adaptive response under oxidative stress induced in ciliates. Additionally, sod1, sod2 and sod3 exhibited a significant increased expression level compared to control group at 24h treatment, indicating a promoting of dense system in ciliates at this exposure time. However, only sod1 and sod2 showed raised expression level at 48h stress, showing the different sensitive of gene isoforms to some extent. With OTC treatment, damage of regular wrinkles, shrunk, twisted on the cell surface, even forming cyst of scuticociliatid ciliate cells were firstly observed by SEM (scanning electron microscope) in this study. Overall, physiological, molecular and morphological information on the toxicological studies of ciliates and more information on possibility of ciliates as indicators of contamination were provided in this study.

Antimicrobial Use and Veterinary Care among Agro-Pastoralists in Northern Tanzania

Frequent and unregulated use of antimicrobials (AM) in livestock requires public health attention as a likely selection pressure for resistant bacteria. Studies among small-holders, who own a large percentage of the world's livestock, are vital for understanding how practices involving AM use might influence resistance. We present a cultural-ecological mixed-methods analysis to explore sectors of veterinary care, loosely regulated AM use, and human exposure to AMs through meat and milk consumption across three rural to peri-urban Tanzanian ethnic groups (N = 415 households). Reported use of self-administered AMs varied by ethnic group (Maasai: 74%, Arusha: 21%, Chagga: 1%) as did consultation with professional veterinarians (Maasai: 36%, Arusha: 45%, Chagga: 96%) and observation of withdrawal of meat and milk from consumption during and following AM treatment (Maasai: 7%, Arusha: 72%, Chagga: 96%). The antibiotic oxytetracycline was by far the most common AM in this sample. Within ethnic groups, herd composition differences, particularly size of small-stock and cattle herds, were most strongly associated with differences in lay AM use. Among the Arusha, proxies for urbanization, including owning transportation and reliance on "zero-grazing" herds had the strongest positive associations with veterinarian consultation, while distance to urban centers was negatively associated. For Maasai, consultation was negatively associated with use of traditional healers or veterinary drug-shops. Observation of withdrawal was most strongly associated with owning technology among Maasai while Arusha observance displayed seasonal differences. This "One-Health" analysis suggests that livelihood and cultural niche factors, through their association with practices in smallholder populations, provide insight into the selection pressures that may contribute to the evolution and dissemination of antimicrobial resistance.

Ecological study on antimicrobial-resistant zoonotic bacteria transmitted by flies in cattle farms

Flies were qualitatively and quantitatively monitored on both livestock animals and the surrounding environment to investigate their role as a potential carrier for antimicrobial-resistant bacteria of zoonotic importance in cattle farms. This was done by the use of visual observations and animal photography; meanwhile, in the surrounding environment, flies were collected using sticky cards and then microscopically identified. Representative fly samples were cultured for bacterial isolation, biochemical identification, and then tested against common 12 antibiotics. The total average of dipterous flies in examined farms was 400.42 ± 6.2. Culicoides biting midges were the most common existing species (70.01 %) followed by house flies, stable flies, and mosquitoes (18.31, 7.74, and 3.91 %, respectively) at X (2) = 9.0, P < 0.05. The most predominant bacterial isolates were Escherichia coli (22.6 %), Staphylococcus aureus and Enterobacter (17.3 % each), coagulase-negative Staphylococci (CNS) (14.7 %), Klebsiella sp. (8 %), Salmonella spp. (6.7 %), and Shigella spp. and Proteus spp. (6.7 % each). The tested bacterial isolates were resistant to variant antibiotics used. S. aureus exhibited 100 % resistance to colistine. However, E. coli revealed 92.9 and 78.6 % resistance against tetracycline and colistine, respectively. Both Salmonella spp. and Shigella spp. were 100 % resistant to penicillin, and Klebsiella sp. had 100 % resistance to tetracycline. In conclusion, Culicoides biting midges and house flies could be considered as a potential carrier for multi-drug-resistant bacteria of zoonotic importance. Furthermore, cows' environment has an essential role in propagation and wide spread of antimicrobial-resistant bacterial pathogens.

Bacterial Density, Serotype Distribution and Antibiotic Resistance of Pneumococcal Strains from the Nasopharynx of Peruvian Children Before and After Pneumococcal Conjugate Vaccine 7

BACKGROUND

Pneumococcal conjugate vaccines (PCV) have decreased nasopharyngeal carriage of vaccine types but little data exist from rural areas. We investigated bacterial density, serotype distribution and antibiotic resistance of pneumococcal strains within the nasopharynx of young children in the Peruvian Andes, 2 years after PCV7 was introduced.

METHODS

Pneumococcal strains were isolated from a subset of 125 children from our Peruvian cohort, who entered the study in 2009 and had pneumococcus detected in the nasopharynx in both 2009 and during follow-up in 2011. Strains were Quellung serotyped and tested for susceptibility to antibiotics. Bacterial density was determined by quantitative polymerase chain reaction.

RESULTS

The prevalence of PCV7 strains decreased from 48% in 2009 to 28.8% in 2011, whereas non-PCV7 types increased from 52% to 71.2% (P = 0.002). There was a 3.5-fold increase in carriage of serotype 6C in 2011 (P = 0.026). Vaccination with PCV7 did not affect pneumococcal density in children colonized by a PCV7 type but did increase density in those colonized with a non-PCV7 type. Antibiotic resistance did not change after vaccine introduction; strains were nonsusceptible to tetracycline (97.2%), trimethoprim-sulfamethoxazole (56.4%), penicillin (34%), erythromycin (22.4%), chloramphenicol (18.8%) and clindamycin (12.4%).

CONCLUSIONS

Serotype replacement was observed post-PCV7 vaccination with a concomitant, not previously recognized, increased nasopharyngeal density.

Prevalence and patterns of antimicrobial resistance among Escherichia coli isolated from Zambian dairy cattle across different production systems

This study focused on the use of antibiotics on small, medium and commercial-sized dairy farms in the central region of Zambia and its relationship to antibiotic resistance in Escherichia coli. A stratified random sample of 104 farms was studied, representing approximately 20% of all dairy farms in the region. On each farm, faecal samples were collected from a random sample of animals and a standardised questionnaire on the usage of antibiotics was completed. An E. coli isolate was obtained from 98.67% (371/376) of the sampled animals and tested for resistance to six classes of antibiotics. The estimated prevalence of resistance across the different farming systems was: tetracycline (10.61; 95%CI: 7.40–13.82), ampicillin (6.02; 95%CI: 3.31–8.73), sulfamethoxazole/ trimethoprim (4.49; 95%CI: 2.42–6.56), cefpodoxime (1.91; 95%CI: 0.46–3.36), gentamicin (0.89; 95%CI: 0.06–1.84) and ciprofloxacin (0%). Univariate analyses indicated certain diseases, exotic breeds, location, farm size and certain management practices as risk factors for detection of resistance, whereas multivariate analyses showed an association with lumpy skin disease and a protective effect for older animals (>25 months). This study has provided novel insights into the drivers of antibiotic use and their association with antibiotic resistance in an under-studied region of Southern Africa.

Molecular detection and sensitivity to antibiotics and bacteriocins of pathogens isolated from bovine mastitis in family dairy herds of central Mexico

Thirty-two farms (n = 535 cows) located in the state of Guanajuato, Mexico, were sampled. Pathogens from bovine subclinical mastitis (SCM) and clinical mastitis (CLM) were identified by 16S rDNA and the sensitivity to both antibiotics and bacteriocins of Bacillus thuringiensis was tested. Forty-six milk samples were selected for their positive California Mastitis Test (CMT) (≥3) and any abnormality in the udder or milk. The frequency of SCM and CLM was 39.1% and 9.3%, respectively. Averages for test day milk yield (MY), lactation number (LN), herd size (HS), and number of days in milk (DM) were 20.6 kg, 2.8 lactations, 16.7 animals, and 164.1 days, respectively. MY was dependent on dairy herd (DH), LN, HS, and DM (P < 0.01), and correlations between udder quarters from the CMT were around 0.49 (P < 0.01). Coagulase-negative staphylococci were mainly identified, as well as Staphylococcus aureus, Streptococcus uberis, Brevibacterium stationis, B. conglomeratum, and Staphylococcus agnetis. Bacterial isolates were resistant to penicillin, clindamycin, ampicillin, and cefotaxime. Bacteriocins synthesized by Bacillus thuringiensis inhibited the growth of multiantibiotic resistance bacteria such as S. agnetis, S. equorum, Streptococcus uberis, Brevibacterium stationis, and Brachybacterium conglomeratum, but they were not active against S. sciuri, a microorganism that showed an 84% resistance to antibiotics tested in this study.

Antibiotic residues in milk from small dairy farms in rural Peru

The use of antibiotics in livestock can pose a public health threat, especially if antibiotic residues remain in the food product. Understanding how often and why farmers sell products with antibiotic residues is critical to improving the quality of these products. To understand how often milk with antibiotic residues is sold on small farms in a major dairy-producing region of Peru and identify factors associated with selling milk with antibiotic residues, we tested milk samples for antibiotic residues from every provider on three routes of commercial milk companies and from bulk tanks of farmers currently treating cows with antibiotics. We also asked farmers if they sold milk from treated cows and examined factors associated with the tendency to do so. The prevalence of milk contamination with antibiotic residues on commercial routes was low (0-4.2%); however, 33/36 farmers treating their animals with antibiotics sold milk that tested positive for antibiotic residues. The self-reported sale of milk from treated cows had a sensitivity, specificity, and positive and negative predictive values of 75.8%, 100%, 100% and 27.2%, respectively (with testing of milk for residues as the gold standard). Finally, 69/156 randomly selected farmers reported selling milk from treated cows, and farmers' knowledge of antibiotics and the milk purchaser were significantly associated with a farmer's tendency to report doing so. Educating farmers on the risks associated with antibiotics and enforcement of penalties for selling contaminated milk by milk companies are needed to improve milk quality.

Comparison of two methods for collecting antibiotic use data on small dairy farms

Antibiotics are commonly used in animal agriculture; they can improve animal health and productivity, but their use may also represent a public health threat. Very little is known about antibiotic use on small farms in lower/middle income countries. To understand antibiotic use on these farms and promote the judicious use of these drugs, pharmacoepidemiologic data are necessary. However, acquiring such data can be difficult, as farmers are often illiterate (and therefore cannot participate in written surveys or keep treatment records), antibiotics can be obtained over-the-counter (in which case no prescriptions are generated) and monitoring and surveillance systems for drug use are often non-existent. The goal of this study was to compare two methods of acquiring pharmacoepidemiologic data pertaining to antibiotics that are well-adapted to farms in lower-middle income countries: self-report and the collection of discarded drug packaging. A convenience sample of 20 farmers in Cajamarca, Peru, participated in the study. Farmers placed discarded antibiotic packaging in bins for six months. At the end of the six-month period, farmers were interviewed and asked to recall the antibiotic usage that occurred on their farm over the past month and past six months; these self-reported data were quantitatively and qualitatively compared to the bin contents collected in the last month and previous six months. We found that the agreement between the bins and self-report was relatively poor for both the quantity and types of antibiotics used. The bins appeared to perform better than self-report when bottles and mLs of antibiotics were measured, while self-report appeared to perform better for intra-mammary infusions. The bins also appeared to perform better when data pertaining to an extended time period (six months) were collected. The results of this study will provide guidance to investigators seeking to collect pharmacoepidemiologic data in similar environments.