Factors associated with the effectiveness of antibiotic treatment for ovine virulent footrot

Network meta-analysis of the therapeutic effects of various antibiotics on footrot in sheep and cattle

The present network meta-analysis was performed to compare the effects of antibiotics used in treating footrot in some ruminants and to rank these antibiotics based on their efficacy. Data of 14 eligible studies consisting of 5622 affected animals was included in the analysis. A Bayesian method and Markov Chain Monte Carlo (MCMC) simulations were utilized to analyze data. The estimated results were reported in the form of odds ratios (ORs) with 95% credible intervals (CrI). The Surface Under the Cumulative Ranking Curve (SUCRA) was used to rank antibiotics. Network meta-regressions (NMRs) were conducted to examine the influence of sample sizes, treatment duration, route of administration, and species of animals (sheep and cattle) on the overall outcome. The results indicated that gamithromycin impact on curing footrot was superior to other antibiotics and Lincomycin and oxytetracycline were ranked second and third. The difference between the impact of gamithromycin and amoxicillin (OR = 14.76, CrI: 1.07-193.49) and enrofloxacin (OR = 20.21, CrI: 1.57-229.25) on footrot was significant. There was a significant difference between the effect of oxytetracycline and enrofloxacin (OR = 5.24, CrI: 1.14-23.74) on footrot. The NMR performed based on species of animals fitted data better than network meta-analysis, suggesting erythromycin as the best third antibiotic instead of oxytetracycline. Egger's regression test and the shape of the funnel plot showed no publication bias among included studies. In conclusion, gamithromycin was associated with the highest curing rate benefit when used to treat footrot, followed by lincomycin and oxytetracycline/erythromycin. Among all evaluated antibiotics, enrofloxacin showed the lowest effects on footrot.

Field Validation of a Non-carcinogenic and Eco-Friendly Disinfectant in a Stand-In Footbath for Treatment of Footrot Associated With aprV2-Positive Strains of Dichelobacter nodosus in Swiss Sheep Flocks

A national control program for virulent footrot is currently planned in Switzerland. Since commonly used disinfectants either contain heavy metals or are carcinogenic, the aim of this study was to verify the effectiveness of an eco-friendly and non-carcinogenic candidate disinfectant against aprV2-positive strains of Dichelobacter nodosus. Additionally, the effect of the selective use of long-acting oxytetracyclines was evaluated. A total of 18 farms with confirmed footrot infection, randomly allocated to two treatment groups: (1) with antibiotics (AB; n = 9) and, (2) no antibiotics (NAB; n = 9), were included. Claws were carefully trimmed and scored using a scale from 0 (clinically healthy) to 5 (complete loss of the horn capsule) and a prewash waterbath was implemented on 11 farms. Twice-weekly, repeated whole-flock stand-in footbaths with the candidate disinfectant (6%) were performed. Additionally, animals of group AB with a score ≥ 3 were administered oxytetracyclines by injection. On all farms, 10 days after last treatment, aprV2-positive strains could not be detected by risk-based sampling for real-time PCR analysis after 7–21 (median = 12) footbaths with a minimal culling rate of non-responders on nine farms. Farms without contact to other sheep remained without clinical signs of footrot for a minimum of 245 days (mean ± standard deviation: 293.6 ± 23.6). Antibiotic treatment did not reduce the number of footbaths needed. In contrast, a mean of 3.3 disinfecting footbaths could be saved by implementing a prewash waterbath. At animal level, individual and selective use of oxytetracyclines lead to a higher chance (odds ratio = 9.95; 95% CI: 3.54–27.95; p < 0.001) for a lesion score ≥ 3 to improve to a lesion score < 3 within 2 weeks compared to treatment without antibiotics. The test disinfectant is an effective and eco-friendly alternative for the planned Swiss footrot control program and selective use of oxytetracycline has a beneficial impact on the recovery of animals with lesion scores ≥ 3.

A Trifecta of New Insights into Ovine Footrot for Infection Drivers, Immune Response, and Host-Pathogen Interactions

Footrot is a polymicrobial infectious disease in sheep causing severe lameness, leading to one of the industry's largest welfare problems. The complex etiology of footrot makes in situ or in vitro investigations difficult. Computational methods offer a solution to understanding the bacteria involved and how they may interact with the host, ultimately providing a way to identify targets for future hypothesis-driven investigative work. Here, we present the first combined global analysis of bacterial community transcripts together with the host immune response in healthy and diseased ovine feet during a natural polymicrobial infection state using metatranscriptomics. The intratissue and surface bacterial populations and the most abundant bacterial transcriptomes were analyzed, demonstrating that footrot-affected skin has reduced diversity and increased abundances of not only the causative bacterium Dichelobacter nodosus but also other species such as Mycoplasma fermentans and Porphyromonas asaccharolytica. Host transcriptomics reveals the suppression of biological processes related to skin barrier function, vascular functions, and immunosurveillance in unhealthy interdigital skin, supported by histological findings that type I collagen (associated with scar tissue formation) is significantly increased in footrot-affected interdigital skin compared to outwardly healthy skin. Finally, we provide some interesting indications of host and pathogen interactions associated with virulence genes and the host spliceosome, which could lead to the identification of future therapeutic targets.

Antimicrobial Resistance in Clostridium and Brachyspira spp. and Other Anaerobes

This article describes the antimicrobial resistance to date of the most frequently encountered anaerobic bacterial pathogens of animals. The different sections show that antimicrobial resistance can vary depending on the antimicrobial, the anaerobe, and the resistance mechanism. The variability in antimicrobial resistance patterns is also associated with other factors such as geographic region and local antimicrobial usage. On occasion, the same resistance gene was observed in many anaerobes, whereas some were limited to certain anaerobes. This article focuses on antimicrobial resistance data of veterinary origin.

How does reviewing the evidence change veterinary surgeons' beliefs regarding the treatment of ovine footrot? A quantitative and qualitative study

Footrot is a widespread, infectious cause of lameness in sheep, with major economic and welfare costs. The aims of this research were: (i) to quantify how veterinary surgeons' beliefs regarding the efficacy of two treatments for footrot changed following a review of the evidence (ii) to obtain a consensus opinion following group discussions (iii) to capture complementary qualitative data to place their beliefs within a broader clinical context. Grounded in a Bayesian statistical framework, probabilistic elicitation (roulette method) was used to quantify the beliefs of eleven veterinary surgeons during two one-day workshops. There was considerable heterogeneity in veterinary surgeons' beliefs before they listened to a review of the evidence. After hearing the evidence, seven participants quantifiably changed their beliefs. In particular, two participants who initially believed that foot trimming with topical oxytetracycline was the better treatment, changed to entirely favour systemic and topical oxytetracycline instead. The results suggest that a substantial amount of the variation in beliefs related to differences in veterinary surgeons' knowledge of the evidence. Although considerable differences in opinion still remained after the evidence review, with several participants having non-overlapping 95% credible intervals, both groups did achieve a consensus opinion. Two key findings from the qualitative data were: (i) veterinary surgeons believed that farmers are unlikely to actively seek advice on lameness, suggesting a proactive veterinary approach is required (ii) more attention could be given to improving the way in which veterinary advice is delivered to farmers. In summary this study has: (i) demonstrated a practical method for probabilistically quantifying how veterinary surgeons' beliefs change (ii) revealed that the evidence that currently exists is capable of changing veterinary opinion (iii) suggested that improved transfer of research knowledge into veterinary practice is needed (iv) identified some potential obstacles to the implementation of veterinary advice by farmers.

A clinical trial comparing parenteral oxytetracyline and enrofloxacin on time to recovery in sheep lame with acute or chronic footrot in Kashmir, India

BACKGROUND

No clinical trials have been conducted in India on the efficacy of parenteral antibacterials to treat footrot in sheep. In addition, there are no studies worldwide on the efficacy of parenteral antibacterials to treat chronic footrot. Sixty two sheep with acute footrot and 30 sheep with chronic footrot from 7 villages in Kashmir, India were recruited into two separate trials. Sheep with acute footrot were allocated to one of three treatments using stratified random sampling: long acting parenteral oxytetracycline, long acting parenteral enrofloxacin and topical application of potassium permanganate solution (a traditional treatment used by sheep farmers in India). In a quasi pre-post intervention design, sheep with chronic footrot that had not responded to treatment with potassium permanaganate were randomly allocated to treatment with one of the two parenteral antibacterials mentioned above. Sheep with acute footrot were treated on day 0 and those with chronic footrot on days 0, 3, 6 and 9. Sheep were monitored for up to 28 days after treatment. Time to recovery from lameness and initial healing of lesions was assessed using Kaplan-Meier survival curves, nonparametric log-rank and Wilcoxon sign-rank tests.

RESULTS

There was significant correlation in recovery from lameness and presence of healing lesions in sheep with acute (r = 0.94) or chronic (r = 0.98) footrot. Sheep with acute footrot which were treated with parenteral antibacterials had a significantly more rapid recovery from lameness and had healing lesions (median = 7 days) compared with those treated with topical potassium permanganate solution (less than 50% recovered in 28 days). The median time to recovery in sheep with chronic footrot treated with either antibacterial was 17 days; this was significantly lower than the median of 75 days lame before treatment with antibacterials. The median time to recovery for both acute and chronic footrot increased as the severity of lesions increased. There was no difference in time to recovery by age, body condition score, duration lame, or presence of pus in the foot within acute and chronically affected sheep.

CONCLUSIONS

We conclude that use of parenteral antibacterials to treat sheep lame with either acute or chronic footrot in India is highly effective. This is likely to improve welfare and give economic benefits to the farmers.

Ovine footrot: new approaches to an old disease

Footrot is a bacterial disease that has substantial economic and welfare impacts in sheep and can be difficult to manage. Research is focussed on reducing the impact that footrot has on farmers and their flocks and better understanding the aetiology of the disease. Key areas of current research include, developing better vaccines, deploying tailored vaccines in a specific and targeted fashion on individual farms, analysing and developing better farm management practices to suit specific sheep farming environments, elucidating the virulence genes and bacterial population dynamics that drive footrot and using genetic testing in combination with selective breeding to produce stock that are more resilient to disease.

Randomized clinical trial of long-acting oxytetracycline, foot trimming, and flunixine meglumine on time to recovery in sheep with footrot

BACKGROUND

Internationally, foot trimming is used by most farmers, and parenteral antibacterials by some, to treat sheep with footrot. Nonsteroidal anti-inflammatory drugs (NSAID) are sometimes used. No clinical trials have compared these treatments.

OBJECTIVES

To investigate the above treatments on time to recovery from lameness and foot lesions in sheep with footrot.

ANIMALS

Fifty-three sheep with footrot on a commercial farm in England.

METHODS

In a randomized factorial design, the sheep were allocated to 6 treatment groups. The treatments were oxytetracycline spray to all sheep (positive control) and one or more of parenteral administration of long-acting oxytetracycline, flunixine meglumine, and foot trimming on day 1 or 6 of diagnosis. Follow-up was for 15 days. Time to recovery from lameness and lesions was investigated with discrete-time survival models.

RESULTS

There was significant association (P < .05) between recovery from lameness and lesions. Sheep receiving antibacterials parenterally recovered faster from lameness (odds ratio [OR]: 4.92 [1.20-20.10]) and lesions (OR: 5.11 [1.16-22.4]) than positive controls, whereas sheep foot trimmed on day 1 (lameness-OR: 0.05 [0.005-0.51]; lesions-OR: 0.06 [0.008-0.45]) or day 6 of diagnosis (lameness OR: 0.07 [0.01-0.72]; lesions OR: 0.07 [0.01-04).56]) recovered more slowly than positive controls. NSAID had no significant effect on recovery.

CONCLUSIONS AND CLINICAL IMPORTANCE

If foot trimming on day 1 or 6 of diagnosis was stopped and parenteral antibacterials were used, then over 1 million sheep/annum lame with footrot in the United Kingdom would recover more rapidly with benefits to productivity. Globally, this figure would be much higher.

Current approaches to the management of ovine footrot

Ovine footrot remains the most important cause of lameness in sheep flocks in the UK, despite the existence of proven methods for the control of the disease. Recent research suggests that sheep farmers may be unaware of these methods and may allocate greater resources to treatment of footrot rather than to its prevention. Foot paring, topical treatments, vaccination and parenteral antibiotic therapy all have a role in treating sheep with advanced footrot infections, but prevention of severe infections is best achieved by the timely implementation of control programmes. These are usually based on footbathing and vaccination. For control programmes to be effective it is essential that the pathogenesis and epidemiology of footrot is understood and that control methods are implemented at appropriate times in the season, depending on climatic and pasture conditions. This article reviews these strategies and makes recommendations for steps to reduce the spread of footrot between flocks and to reduce the incidence of footrot within UK flocks.

Effectiveness of small workshops for improving farmers' knowledge about ovine footrot

OBJECTIVE

To determine sheep farmers' attitudes to and beliefs about ovine footrot, and to improve their knowledge about the diagnosis, control and eradication of this disease.

METHOD

Eighteen workshops, involving 291 farmers, were conducted across Victoria in the spring of 1996. The workshops were designed as small-group discussions with a maximum attendance of 20 farmers to encourage active participation. All participants completed questionnaires before each workshop and 12 to 40 weeks after the last workshop.

RESULTS

Before the workshops the farmers had a poor understanding of the principles of diagnosis, control and eradication of footrot. For example, only 50% knew the footrot organism survived in soil for less than 7 days, over two-thirds did not know the reason for paring sheep's feet during an eradication program, and only 31% realised cattle were a potential source of footrot infection for sheep. After the workshops, understanding about footrot was significantly improved; 87% said Dichelobacter nodosus survived in soil less than 7 days, 71% knew the reason for paring sheep's feet and 64% realised that cattle were a potential source of footrot infection. As well as improved knowledge, change of attitude among farmers is fundamentally important if virulent footrot is to be successfully controlled and eradicated. The workshops successfully initiated this process; 40% of farmers thought the workshops changed their attitudes to footrot, while 37% said they gained an increased understanding of other people's opinions about the disease.

CONCLUSION

Farmers' poor understanding of ovine footrot is a constraint to the programs aimed at controlling this disease. Small group workshops may be an effective way to influence farmers' attitudes and beliefs, and could facilitate the effectiveness of regulatory disease control programs.