The Evidentiary Value of Challenge Trials for Three Pre-harvest Food Safety Topics: A Systematic Assessment

Novel feed additive delivers antimicrobial copper and influences fecal microbiota in pigs

Dehydrated alginate beads formulated with copper were synthesized and tested as a feed additive to influence the microbiota in finishing pigs and potentially use them as a preharvest intervention to reduce fecal pathogen shedding. The efficacy of the copper beads was tested in vitro and in vivo. In vitro, Salmonella was significantly (P < 0.05) reduced when in contact with the copper beads solution for up to 6 h, with a 5.4 log CFU/mL reduction over the first hour. Chemical analysis of the soak solutions demonstrated the beads delivered their copper payload gradually over the same period the bactericidal effect was observed. For the in vivo experiments, pigs (n = 48) supplemented with the copper beads experienced significant shifts in their microbiota. Enterobacteriaceae (EB) increased by 1.07 log CFU/g (P < 0.05), while lactic acid bacteria (LAB) decreased by 1.22 log CFU/g (P < 0.05) during the treatment period. When beads were removed from the feed, EB and LAB concentrations returned to baseline, indicating copper beads led to measurable and significant changes in microbial loads. Fecal microbiome analysis conducted to explore additional changes by copper bead supplementation demonstrated that, at the phylum level, there was an increase in Firmicutes, Euryarchaeota, and Acidobacteriota, while at the genus level, an increase in Methanosphaera and Pseudomonas was observed. Measures of copper in swine feces showed values ~20 times higher in the treatment group than in the control group during the treatment period, suggesting that dehydrated alginate copper beads were effective in delivering antimicrobial copper to the animal hindgut.IMPORTANCECopper has long been known to have antimicrobial properties. However, when water-soluble salts are fed to livestock, the copper may rapidly dissolve in gastric contents and fail to reach the gut. Here, specially formulated copper beads are seamlessly incorporated into feed and allow copper to remain longer in the gastrointestinal tract of animals, reach deep into both the foregut and hindgut, and shift microbial populations. The technology delivers antimicrobial copper to the animal hindgut and potentially reduces pathogenic microorganisms before animal slaughter.

Salmonella in Animal Feeds: A Scoping Review

The objective of this study was to describe the volume and nature of published literature on Salmonella in animal feeds using a formal scoping review methodology. A structured search followed by eligibility screening resulted in the identification of 547 relevant studies, encompassing studies conducted in the fields in which animal feeds are grown (15 studies), the manufacturing sector (106), during transportation (11), in the retail sector (15), and on-farm (226), with the sector not described for 204 studies. The most common study purposes were to estimate the prevalence of Salmonella in animal feeds (372 studies) and to identify serovars (195). The serovars that were found in animal feeds included serovars associated with human illness, with animal illness, and with serovars identified in food (livestock and poultry) intended for human consumption. There were 120 intervention studies and 83 studies conducted to evaluate potential risk factors. Within intervention and risk factor studies, there may be sufficient depth to warrant synthesis research in the areas of heat interventions, fermentation and ensiling, organic acids, season, and geographic region. Some deficiencies were identified in the completeness of reporting of key features in the relevant studies.

Dynamics of Microbial Shedding in Market Pigs during Fasting and the Influence of Alginate Hydrogel Bead Supplementation during Transportation

The shedding of foodborne pathogenic bacteria by food-animals can be affected by multiple factors, such as animal health, diet, stress, and environmental conditions. The practices that come with transport involve fasting, handling, mixing with unfamiliar pigs, and fluctuating temperatures. These practices, especially fasting and transport, can increase the microbial load in the feces of animals. The use of alginate hydrogels is a novel delivery system that can be a potential food safety intervention during transport to induce satiety and provide electrolytes to the animal’s system. This study sought to observe microbial shedding as affected by fasting and hydrogel bead supplementation during transport. Sixty market pigs were subjected to a 12 h fasting period and an additional 4 h transport period, in which a treatment group was fed hydrogel beads and a control group was not. Sampling points were before fast (BF), before transport (BT), and after transport (AT). Fecal samples were collected from every animal at each sampling point. Results from this study showed a significant increase in the concentrations of both Enterobacteriaceae and Escherichia coli between the before fast (BF) and after transport (AT) sampling points. However, no difference (p > 0.05) was found between the treatment (hydrogel) and control (no hydrogel) during transport. Moreover, no significant difference was found in the prevalence of Salmonella and E. coli O157:H7 at the three different sampling points, or between the treatment and control groups.

Non-antibiotic Approaches for Disease Prevention and Control in Nursery Pigs: A Scoping Review

Swine producers are encouraged to practice antibiotic stewardship by reducing their use of antibiotics belonging to classes of medical importance to humans. We conducted a scoping review of non-antibiotic approaches in the form of products or management practices that might prevent or control disease and thus reduce the need for antibiotics in nursery pigs. Our objectives were to systematically describe the research on this broad topic for the North American context, identify specific topics that could feasibly support systematic reviews, and identify knowledge gaps. A search of multiple databases identified 11,316 articles and proceedings for relevance screening. From these, 441 eligible clinical trials and observational studies were charted. The majority were clinical trials (94%). Study results from EU countries were mostly communicated through journal articles, whereas study results from the USA were mostly communicated through conference proceedings. Interventions and health outcomes were diverse. The two most frequent intervention categories were feed additives and piglet vaccines. The three most frequent outcomes reported were diarrhea, mortality, and indices of vaccine immunity. There were 13 specific topics comprising various feed additives and vaccines that might feasibly support systematic reviews. There were relatively few studies in which interventions were compared with antibiotic comparison groups and relatively few studies evaluating management practices.

National Safety Survey of Animal-use Commercial Probiotics and Their Spillover Effects From Farm to Humans: An Emerging Threat to Public Health

BACKGROUND

Human-use probiotics have recently been associated with clinical infections and antibiotic resistance transfer, raising public concern over their safety. However, despite their extensive application in aquaculture and animal husbandry, the safety of animal-use probiotics remains poorly described.

METHODS

We evaluated the safety of 92 animal-use probiotics from China. The pattern of spread of pathogens from probiotics and the consequent public health implications were also examined by conducting in-field genomic surveillance at 2 farms.

RESULTS

A total of 123 probiotic Bacillus species isolates were obtained from 92 brands of probiotics, of which 45 isolates were resistant to antibiotics. Notably, 33.7% of probiotic products were contaminated with life-threatening pathogens such as Klebsiella pneumoniae. Genomic surveillance at a chicken farm identified an anthrax toxin-positive Bacillus cereus strain in a probiotic product used as a feed supplement, which was transferred into the groundwater and to a nearby fish farm. Following up retrospective analysis of the surveillance data during 2015-2018 in 3 provinces retrieved 2 B. cereus strains from human with intestinal anthrax symptoms and confirmed the transmission of B. cereus from farm to human. Surveillance of anthrax toxin revealed that cya was detected in 8 of 31 farms.

CONCLUSIONS

This study provides the first national safety survey of animal-use probiotics in China and confirms the spillover effects of probiotics from the farms to human. These results suggest that the large-scale application of pathogen-containing probiotics leads to the transfer of pathogens, with worrisome implications for public health. Good Manufacturing Practice should be implemented during the production of all probiotics.Animal-use probiotic products are frequently contaminated with viable pathogenic bacteria. This study revealed that virulent probiotic organisms and contaminating pathogens were colonized with farm animals and shed into the environment, which facilitated the transfer of pathogens to humans.

Evaluating farm-level livestock interventions in low-income countries: a scoping review of what works, how, and why

Livestock interventions can improve nutrition, health, and economic well-being of communities. The objectives of this review were to identify and characterize livestock interventions in developing countries and to assess their effectiveness in achieving development outcomes. A scoping review, guided by a search strategy, was conducted. Papers needed to be written in English, published in peer-reviewed journals, and describe interventions in animal health and production. Out of 2739 publications systematically screened at the title, abstract, and full publication levels, 70 met our inclusion criteria and were considered in the study. Eight relatively high-quality papers were identified and added, resulting in 78 reviewed publications. Only 15 studies used randomized controlled trial designs making it possible to confidently link interventions with the resulting outcomes. Eight studies had human nutrition or health as outcomes, 11 focused on disease control, and four were on livestock production. Eight interventions were considered successful, but only four were scalable. We found good evidence that livestock-transfer programs, leveraging livestock products for nutrition, and helping farmers manage priority diseases, can improve human well-being. Our report highlights challenges in garnering evidence for livestock interventions in developing countries and provides suggestions on how to improve the quantity and quality of future evaluations.

Efficacy of bacterial vaccines to prevent respiratory disease in swine: a systematic review and network meta-analysis

A systematic review and network meta-analysis (MA) was conducted to address the question, 'What is the efficacy of bacterial vaccines to prevent respiratory disease in swine?' Four electronic databases and the grey literature were searched to identify clinical trials in healthy swine where at least one intervention arm was a commercially available vaccine for one or more bacterial pathogens associated with respiratory disease in swine, including Mycoplasma hyopneumoniae, Actinobacillus pleuropneumonia, Actinobacillus suis, Bordetella bronchiseptica, Pasteurella multocida, Stretococcus suis, Haemophils parasuis, and Mycoplasma hyorhinis. To be eligible, trials had to measure at least one of the following outcomes: incidence of clinical morbidity, mortality, lung lesions, or total antibiotic use. There were 179 eligible trials identified in 146 publications. Network MA was undertaken for morbidity, mortality, and the presence or absence of non-specific lung lesions. However, there was not a sufficient body of research evaluating the same interventions and outcomes to allow a meaningful synthesis of the comparative efficacy of the vaccines. To build this body of research, additional rigor in trial design and analysis, and detailed reporting of trial methods and results are warranted.

Non-antibiotic approaches for disease prevention and control in beef and veal production: a scoping review

Livestock producers are encouraged to reduce the use of antibiotics belonging to classes of medical importance to humans. We conducted a scoping review on non-antibiotic interventions in the form of products or management practices that could potentially reduce the need for antibiotics in beef and veal animals living under intensive production conditions. Our objectives were to systematically describe the research on this broad topic, identify specific topics that could feasibly support systematic reviews, and identify knowledge gaps. Multiple databases were searched. Two reviewers independently screened and charted the data. From the 13,598 articles screened, 722 relevant articles were charted. The number of relevant articles increased steadily from 1990. The Western European research was dominated by veal production studies whereas the North American research was dominated by beef production studies. The interventions and outcomes measured were diverse. The four most frequent interventions included non-antibiotic feed additives, vaccinations, breed type, and feed type. The four most frequent outcomes were indices of immunity, non-specific morbidity, respiratory disease, and mortality. There were seven topic areas evaluated in clinical trials that may share enough commonality to support systemic reviews. There was a dearth of studies in which interventions were compared to antibiotic comparison groups.

The efficacy of antibiotics to control colibacillosis in broiler poultry: a systematic review

The objective of this systematic review was to evaluate the efficacy of antibiotics to prevent or control colibacillosis in broilers. Studies found eligible were conducted controlled trials in broilers that evaluated an antibiotic intervention, with at least one of the following outcomes: mortality, feed conversion ratio (FCR), condemnations at slaughter, or total antibiotic use. Four electronic databases plus the gray literature were searched. Abstracts were screened for eligibility and data were extracted from eligible trials. Risk of bias was evaluated.Seven trials reported eligible outcomes in a format that allowed data extraction; all reported results for FCR and one also reported mortality. Due to the heterogeneity in the interventions and outcomes evaluated, it was not feasible to conduct meta-analysis.Qualitatively, for FCR, comparisons between an antibiotic and an alternative product did not show a significant benefit for either. Some of the comparisons between an antibiotic and a no-treatment placebo showed a numerical benefit to antibiotics, but with wide confidence intervals. The risk-of-bias assessment revealed concerns with reporting of key trial features.The results of this review do not provide compelling evidence for or against the efficacy of antibiotics for the control of colibacillosis.

A systematic review of the efficacy of antibiotics for the prevention of swine respiratory disease

Prevention and control of respiratory disease is a major contributor to antibiotic use in swine. A systematic review was conducted to address the question, 'What is the comparative efficacy of antimicrobials for the prevention of swine respiratory disease?' Eligible studies were controlled trials published in English evaluating prophylactic antibiotics in swine, where clinical morbidity, mortality, or total antibiotic use was assessed. Four databases and the gray literature were searched for relevant articles. Two reviewers working independently screened titles and abstracts for eligibility followed by full-text articles, and then extracted data and evaluated risk of bias for eligible trials. There were 44 eligible trials from 36 publications. Clinical morbidity was evaluated in eight trials where antibiotics were used in nursery pigs and 10 trials where antibiotics were used in grower pigs. Mortality was measured in 22 trials in nursery pigs and 12 trials in grower pigs. There was heterogeneity in the antibiotic interventions and comparisons published in the literature; thus, there was insufficient evidence to allow quantification of the efficacy, or relative efficacy, of antibiotic interventions. Concerns related to statistical non-independence and quality of reporting were noted in the included trials.

Comparative efficacy of antimicrobials for treatment of clinical mastitis in lactating dairy cattle: a systematic review and network meta-analysis

A systematic review and network meta-analysis were conducted to assess the relative efficacy of antimicrobial therapy for clinical mastitis in lactating dairy cattle. Controlled trials in lactating dairy cattle with natural disease exposure were eligible if they compared an antimicrobial treatment to a non-treated control, placebo, or a different antimicrobial, for the treatment of clinical mastitis, and assessed clinical or bacteriologic cure. Potential for bias was assessed using a modified Cochrane Risk of Bias 2.0 tool. From 14775 initially identified records, 54 trials were assessed as eligible. Networks were established for bacteriologic cure by bacterial species group, and clinical cure. Disparate networks among bacteriologic cures precluded meta-analysis. Network meta-analysis was conducted for trials assessing clinical cure, but lack of precision of point estimates resulted in wide credibility intervals for all treatments, with no definitive conclusions regarding relative efficacy. Consideration of network geometry can inform future research to increase the utility of current and previous work. Replication of intervention arms and consideration of connection to existing networks would improve the future ability to determine relative efficacy. Challenges in the evaluation of bias in primary research stemmed from a lack of reporting. Consideration of reporting guidelines would also improve the utility of future research.

Scoping Reviews, Systematic Reviews, and Meta-Analysis: Applications in Veterinary Medicine

Evidence-based decision making is a hallmark of effective veterinary clinical practice. Scoping reviews, systematic reviews, and meta-analyses all are methods intended to provide transparent and replicable ways of summarizing a body of research to address an important clinical or public health issue. As these methods increasingly are being used by researchers and read by practitioners, it is important to understand the distinction between these techniques and to understand what research questions they can, and cannot, address. This review provides an overview of scoping reviews, systematic reviews, and meta-analysis, including a discussion of the method and uses. A sample dataset and coding to conduct a simple meta-analysis in the statistical program R also are provided. Scoping reviews are a descriptive approach, designed to chart the literature around a particular topic. The approach involves an extensive literature search, following by a structured mapping, or charting, of the literature. The results of scoping reviews can help to inform future research by identifying gaps in the existing literature and also can be used to identify areas where there may be a sufficient depth of literature to warrant a systematic review. Systematic reviews are intended to address a specific question by identifying and summarizing all of the available research that has addressed the review question. Questions types that can be addressed by a systematic review include prevalence/incidence questions, and questions related to etiology, intervention efficacy, and diagnostic test accuracy. The systematic review process follows structured steps with multiple reviewers working in parallel to reduce the potential for bias. An extensive literature search is undertaken and, for each relevant study identified by the search, a formal extraction of data, including the effect size, and assessment of the risk of bias is performed. The results from multiple studies can be combined using meta-analysis. Meta-analysis provides a summary effect size, and allows heterogeneity of effect among studies to be quantified and explored. These evidence synthesis approaches can provide scientific input to evidence-based clinical decision-making for veterinarians and regulatory bodies, and also can be useful for identifying gaps in the literature to enhance the efficiency of future research in a topic area.

Randomized control trial to test the effect of a feed additive on Campylobacter contamination in commercial broiler flocks up to slaughter

A randomized controlled trial (RCT) was carried to evaluate the effect of a feed additive on Campylobacter contamination of broilers reared in commercial conditions. Twenty-four broiler flocks naturally contaminated with Campylobacter were enrolled in the RCT: 12 were assigned to a control group (C) fed with a conventional finishing feed from 4 weeks of age to slaughter (around 35 days), and the other group of 12 flocks (S) was fed with a finishing feed supplemented with 250 ppm of a patented feed additive (an ion-exchanged clay compound) previously proven to reduce Campylobacter contamination in broiler caeca under experimental conditions. Enumeration of Campylobacter colonies in caeca (8 per flock) was carried out following ISO standards before feed distribution and at slaughter. Before treatment, the caecal Campylobacter load tended to be lower in C flocks (7.1 ± 1.9 log CFU/g, CI_95% [6.6-7.5]) than in S flocks (7.7 ± 1.0 log UFC/g, CI_95% [7.5-7.9]) (p = .05). At slaughter, the bacterial load was similar in the S (7.7 ± 1.0 log CFU/g, CI_95% [7.5-7.9]) and C groups (7.5 ± 1.2 log CFU/g, CI_95% [7.2-7.8]) (p = .73). Therefore, the feed additive had no significant effect on the caecal Campylobacter load at slaughter under the tested conditions. The logistical constraints inherent in field trials and the natural variability of Campylobacter contamination in naturally infected broiler flocks make it difficult to reproduce experimental results in in situ farm conditions. RCT testing of an intervention strategy in commercial situation is therefore a key step in evaluating pre-harvest interventions against food-borne pathogens.

Current Status of the Preharvest Application of Pro- and Prebiotics to Farm Animals to Enhance the Microbial Safety of Animal Products

The selection of microorganisms that act as probiotics and feed additives that act as prebiotics is an ongoing research effort, but a sizable range of commercial pro-, pre- and synbiotic (combining pro- and prebiotics) products are already available and being used on farms. A survey of the composition of commercial products available in the United States revealed that Lactobacillus acidophilus, Enterococcus faecium, and Bacillus subtilis were the three most common species in probiotic products. Of the nearly 130 probiotic products (also called direct-fed microbials) for which information was available, about 50 also contained yeasts or molds. The focus on these particular bacteria and eukaryotes is due to long-standing ideas about the benefits of such strains, research data on effectiveness primarily in laboratory or research farm settings, and regulations that dictate which microorganisms or feed additives can be administered to farm animals. Of the direct-fed microbials, only six made a claim relating to food safety or competitive exclusion of pathogens. None of the approximately 50 prebiotic products mentioned food safety in their descriptions. The remainder emphasized enhancement of animal performance such as weight gain or overall animal health. The reason why so few products carry food safety-related claims is the difficulties in establishing unambiguous cause and effect relationships between the application of such products in varied and constantly changing farm environments and improved food safety of the end product.

Vaccination as a control strategy against Salmonella infection in pigs: A systematic review and meta-analysis of the literature

Consumption or handling of improperly processed or cooked pork is considered one of the top sources for foodborne salmonellosis, a common cause of intestinal disease worldwide. Asymptomatic carrier pigs may contaminate pork at slaughtering; therefore, pre-harvest reduction of Salmonella load can contribute to reduce public health risk. Multiple studies have evaluated the impact of vaccination on controlling Salmonella in swine farms, but results are highly variable due to the heterogeneity in vaccines and vaccination protocols. Here, we report the results of an inclusive systematic review and a meta-analysis of the peer-reviewed scientific literature to provide updated knowledge on the potential effectiveness of Salmonella vaccination. A total of 126 articles describing the use of Salmonella vaccines in swine were identified, of which 44 fulfilled the inclusion criteria. Most of the studies (36/44) used live vaccines, and S. Typhimurium and S. Choleraesuis were the predominant serotypes evaluated. Vaccine efficacy was most often measured through bacteriological isolation, and pooled estimates of vaccine efficacy were obtained as the difference in the percentage of positive animals when available. Attenuated and inactivated vaccines had similar efficacy [Risk Difference=-26.8% (-33.8, -19.71) and -29.5% (-44.4, -14.5), respectively]. No serotype effect was observed on the efficacy recorded for attenuated vaccines; however, a higher efficacy of inactivated vaccines against S. Choleraesuis was observed, though in a reduced sample. Results from the meta-analysis here demonstrate the impact that vaccination may have on the control of Salmonella in swine farms and could help in the design of programs to minimize the risk of transmission of certain serotypes through the food chain.

Rapid systematic review and meta-analysis of the evidence for effectiveness of primary production interventions to control Salmonella in beef and pork

Non-typhoidal Salmonella spp. (hereafter referred to as Salmonella) on beef and pork is an important cause of foodborne illness and death globally. A systematic review of the effectiveness of interventions to reduce Salmonella prevalence or concentration in beef and pork was undertaken. A broad search was conducted in Scopus and CAB abstracts. Each citation was appraised using screening tools tested a priori. Level 1 relevance screening excluded irrelevant citations; level 2 confirmed relevance and categorized studies. Data were then extracted, and intervention categories were descriptively summarized. Meta-analysis was performed to provide a summary estimate of treatment effect where two or more studies investigated the same intervention in comparable populations. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used to assess the confidence in the estimated measures of intervention effect for data subgroups.

Potential for Meta-Analysis in the Realm of Preharvest Food Safety

Meta-analysis, the statistical combination of results from multiple studies, can be used to summarize all of the available research on an intervention, etiology, descriptive, or diagnostic test accuracy question. Meta-analysis should be conducted as a component of a systematic review, to increase transparency in the selection of studies and to incorporate an evaluation of the risk of bias in the individual studies included in the meta-analysis. The process of meta-analysis may include a forest plot to graphically display the study results and the calculation of a weighted average summary effect size. Heterogeneity (differences in the effect size between studies) can be evaluated using formal statistics and the reasons for heterogeneity can be explored using sub-group analysis or meta-regression. Thus, meta-analysis may be a useful methodology for preharvest food safety research to aid in policy or clinical decision-making or to provide input to quantitative risk assessment or other models.

Application of a Rapid Knowledge Synthesis and Transfer Approach To Assess the Microbial Safety of Low-Moisture Foods

Low-moisture foods (LMF) are increasingly implicated in outbreaks of foodborne illness, resulting in a significant public health burden. To inform the development of a new Codex Alimentarius code of hygienic practice for LMF, we applied a rapid knowledge synthesis and transfer approach to review global research on the burden of illness, prevalence, and interventions to control nine selected microbial hazards in eight categories of LMF. Knowledge synthesis methods included an integrated scoping review (search strategy, relevance screening and confirmation, and evidence mapping), systematic review (detailed data extraction), and meta-analysis of prevalence data. Knowledge transfer of the results was achieved through multiple reporting formats, including evidence summary cards. We identified 214 unique outbreaks and 204 prevalence and 126 intervention studies. Cereals and grains (n = 142) and Salmonella (n = 278) were the most commonly investigated LMF and microbial hazard categories, respectively. Salmonella was implicated in the most outbreaks (n = 96, 45%), several of which were large and widespread, resulting in the most hospitalizations (n = 895, 89%) and deaths (n = 14, 74%). Salmonella had a consistently low prevalence across all LMF categories (0 to 3%), but the prevalence of other hazards (e.g., Bacillus cereus) was highly variable. A variety of interventions were investigated in small challenge trials. Key knowledge gaps included underreporting of LMF outbreaks, limited reporting of microbial levels in prevalence studies, and a lack of intervention efficacy research under commercial conditions. Summary cards were a useful knowledge transfer format to inform complementary risk ranking activities. This review builds upon previous work in this area by synthesizing a broad range of evidence using a structured, transparent, and integrated approach to provide timely evidence informed inputs into international guidelines.