New York State dairy farmers' perceptions of antibiotic use and resistance: A qualitative interview study

From Herd Health to Public Health: Digital Tools for Combating Antibiotic Resistance in Dairy Farms

The emergence of antimicrobial resistance (AMR) is a significant threat to global food security, human health, and the future of livestock production. Higher rates of antimicrobial use in dairy farming and the sheer lack of new antimicrobials available for use focused attention on the question of how the dairy production sector contributed to the development of AMR and paved the path toward taking action to curtail it on the targeted type of farms. This paper aims to provide an introduction to a phenomenon that has gained considerable attention in the recent past due to its ever-increasing impact, the use of antimicrobial drugs, the emergence of antimicrobial resistance (AMR) on dairy farms, and seeks to discuss the possibilities of approaches such as digital health monitoring and precision livestock farming. Using sensors, data, knowledge, automation, etc., digital health monitoring, as well as Precision Livestock Farming (PLF), is expected to enhance health control and minimize disease and antimicrobial usage. The work presents a literature review on the current status and trends of AMR in dairy farms, an understanding of the concept of digital health monitoring and PLF, and the presentation and usefulness of digital health monitoring and PLF in preventing AMR. The study also analyses the strengths and weaknesses of adopting and incorporating digital technologies and artificial intelligence for dairy farming and presents areas for further study and level of use.

Recording antimicrobial use on Irish dairy farms: Barriers and facilitators to using technology and sharing data

Antimicrobial use (AMU) data are essential to monitor the effect of AMU reduction strategies in animal health. The use of technology and herd recording software to record AMU will be vital to scale the collation of these data in the future. The aim of this study was to determine the barriers and facilitators to Irish dairy farmers recording their AMU using a herd recording software and sharing AMU data. Thirty-three Irish dairy farmers involved in a study on AMU monitoring were asked to record their AMU using a herd recording software over a 12-mo period. At the end of the 12-mo period, 10 of these farmers were selected to take part in semi-structured interviews exploring their opinions on recording AMU, the use of herd recording software, and sharing AMU data. Interviews were transcribed and qualitatively analyzed using inductive thematic analysis. Several barriers and facilitators to farmers recording their AMU using a herd recording software and sharing AMU data were identified. Barriers included the age and generation of the farmer, farm infrastructure, a lack of training and education, a lack of knowledge around the benefits of digital data, a lack of incentive to digitize records, and a fear of repercussions. Facilitators identified by the farmers included the benefits of having instantly available data for making herd management decisions, reduced paperwork, increased organization for inspections, and a potential positive effect on the image of the dairy industry. To increase the uptake of new technology to record AMU at farm-level, farmers will need support in terms of education and training around the software available to them and reassurance around the perceived risks of repercussions with sharing data in a digital format.

Knowledge, Attitude, and Practice of Thai Dairy Farmers on the Use of Antibiotics

Antibiotics have been used regularly in dairy farms by veterinarians; however, they were also used occasionally by farmers without any veterinary prescriptions. Because knowledge, attitude, and practice are important for sustainable antibiotic use, the levels of these aspects among farmers and associated factors should be determined to improve antibiotic use in dairy farming. The study was carried out in 89 Thai dairy farmers, using a structured questionnaire. Data were analyzed using descriptive statistics. The questions were scored and the total scores were calculated for each aspect. Factors associated with knowledge, attitude, and practice scores were identified using the multivariate linear regression. The mean scores for knowledge, attitude, and practice were 62%, 86%, and 78%, respectively. Higher education, participation in a training related to antibiotic use, and being supervised by the Veterinary Teaching Hospital Nong Pho were associated with a higher knowledge score (p < 0.050). Farmers with less experience received a higher attitude score (p = 0.020). Acquiring antibiotic knowledge from other farmers was associated with a lower practice score (p = 0.005). A positive association was found between knowledge and attitude scores (p = 0.021) and practice and attitude score (p < 0.001). Due to the insufficient knowledge on antibiotic use, there is a need to fill the gap to ensure prudent antibiotic use by farmers. Recommendations including training farmers by veterinarian to perceive the prudent antibiotic uses, encouraging young generation with higher education to participate in dairy farming, providing antibiotic use protocols, and decreasing the availability of antibiotics should be implemented to limit overuse by farmers.

Understanding barriers to reducing antimicrobials on Australian dairy farms: A qualitative analysis

INTRODUCTION

Reducing antibiotic use in production animal systems is one strategy which may help to limit the development of antimicrobial resistance. To reduce antimicrobial use in food-producing animals, it is important to first understand how antibiotics are used on farm and what barriers exist to decreasing their use. In dairy production systems, mastitis is one of the most common reasons for administering antimicrobials. Therefore, it is important to understand the motivations and behaviours of dairy farmers in relation to the diagnosis, treatment and prevention of mastitis.

MATERIALS AND METHODS

In this study, we interviewed a sample of dairy farmers and dairy industry professionals from the major dairying regions of eastern Australia regarding their current practices used to diagnose, treat, and control subclinical and clinical mastitis. Inductive thematic analysis was used to code interview transcripts and identify the recurrent themes.

RESULTS

Four overarching themes were identified: (1) the challenges associated with the detection and diagnosis of clinical mastitis, including with laboratory culture, (2) the motivations behind treatment decisions for different cases, (3) decisions around dry cow therapy and the role of herd recording, and (4) concerns regarding the development of antimicrobial resistance.

DISCUSSION

This study identifies several challenges which may limit the ability of Australian dairy farmers to reduce antimicrobial use on farm, such as the need for rapid and reliable diagnostic tests capable of identifying the pathogenic causes of mastitis and the difficulties associated with conducting herd recording for the implementation of selective dry cow therapy. Industry professionals were concerned that farmers were not using individual cow records to aid in treatment decisions, which could result in unnecessary antimicrobial use. The results of this study can act as the basis for future research aimed at assessing these issues across the broader Australian dairy industry.

A qualitative analysis of the unwritten rules influencing antibiotic prescribing practices among French poultry veterinarians

Background

It is now recognized that a better understanding of prescriber behaviour is needed to improve antimicrobial stewardship programmes. Most studies conducted in the livestock sector have focused on farmers' perspectives, while the prescribing habits of veterinarians have remained overlooked.

Objective

Our study explored the psychosocial determinants associated with antibiotic prescribing practices in the French poultry sector by analysing the informal norms and unwritten rules that influence veterinarians' prescribing decisions.

Methods

A qualitative study was conducted in four French regions in February 2021. Using the biographical narrative interpretive method, semi-structured interviews were conducted with 16 poultry veterinarians with varying professional experience. Three main themes were retained for data analysis: (i) compliance with and deviations from prescribing recommendations, (ii) the influence of fellow veterinarians on antibiotic decisions and (iii) the key role of veterinary corporate groups.

Results

When prescribing antibiotics, junior veterinarians were strongly influenced by senior veterinarians who acted as role models driving clinical practices. Prescribing habits were shared through peer networks in which veterinarians participated throughout their careers. Finally, veterinary corporate groups helped to shape veterinarians' prescribing habits by promoting existing guidelines and even producing in-house recommendations.

Conclusions

We show that, in parallel with official guidelines, prescribing habits circulate among veterinarians and are shared in professional circles. Therefore, antimicrobial stewardship interventions should focus not only on official guidelines and communication channels, but also unwritten professional rules and organizations influencing veterinarians' prescribing practices.

Invited review: Qualitative research in dairy science-A narrative review

The use of qualitative research in dairy science has increased considerably in recent years, providing the opportunity to inform research and practice. This review aims to enhance the accessibility of qualitative research among a range of audiences and specifically: (1) provide an overview of what qualitative research is and the value it can bring to scientific inquiries in the dairy context, (2) illustrate the emergence of qualitative dairy science research in the past 15 to 20 years, (3) outline the role of the researcher and key philosophical assumptions underlying qualitative research, (4) describe qualitative research approaches and methods used in dairy science research, and (5) highlight key aspects of qualitative inquiry used to ensure research trustworthiness. Qualitative approaches in dairy science enable researchers to understand myriad topics including stakeholder relationships, decision-making, and behaviors regarding dairy cattle management, animal welfare, and disease prevention and control measures. Approaches that were used often for qualitative data collection were individual interviews and focus groups, and variations of thematic analysis were common analytical frameworks. To assess public values, attitudes, and perceptions, mixed methods questionnaires that combined quantitative data with qualitative data from open-ended questions were used regularly. Although still used infrequently, action research and participatory approaches have the potential to bridge the research-implementation gap by facilitating group-based learning and on-farm changes. Some publications described the philosophical assumptions inherent to qualitative research, and many authors included reflexivity and positionality statements. Although a comprehensive description of strategies to meet trustworthiness criteria for qualitative research was uncommon, many publications mentioned certain aspects of trustworthiness, such as member checking, researcher triangulation, and the recording of reflexive notes. Qualitative research has been used to deepen our understanding of phenomena relevant to the dairy sector and has opened the door for a broad array of new opportunities. In addition to having merit on its own, qualitative research can guide, inform, and expand on quantitative research, and an understanding of the core pillars of qualitative research can foster interdisciplinary collaborations.

Individual drivers and barriers to adoption of disease control and welfare practices in dairy and beef cattle production: a scoping review

The implementation of disease control and welfare practices is an essential part of limiting disease exposure in livestock, however successful adoption of these practices seem to be low in both the beef and dairy cattle industries. The main objectives of this scoping review were to characterize literature published exploring beef and dairy cattle producers' perceptions on the implementation of various disease control and welfare practices, identify major themes of drivers and barriers that influence producers' adoption of these practices, and identify current gaps in knowledge. A total of 2,486 articles were obtained from two database literature searches and screened, from which 48 articles published between 2010 and 2021 were deemed eligible and charted. Europe was the most common region for articles (58%). A majority of articles focused solely on dairy producers (52%). A wide range of barriers and drivers which were categorized into 4 and 5 key themes, respectively. The most commonly mentioned driver was animal health, welfare, and safety, while the most common barrier was costs. Potential gaps in literature were identified, including the underrepresentation of beef producer perceptions relative to dairy producers in current literature.

Invited review: Selective treatment of clinical mastitis in dairy cattle

Treatment of clinical mastitis (CM) and use of antimicrobials for dry cow therapy are responsible for the majority of animal-defined daily doses of antimicrobial use (AMU) on dairy farms. However, advancements made in the last decade have enabled excluding nonsevere CM cases from antimicrobial treatment that have a high probability of cure without antimicrobials (no bacterial causes or gram-negative, excluding Klebsiella spp.) and cases with a low bacteriological cure rate (chronic cases). These advancements include availability of rapid diagnostic tests and improved udder health management practices, which reduced the incidence and infection pressure of contagious CM pathogens. This review informed an evidence-based protocol for selective CM treatment decisions based on a combination of rapid diagnostic test results, review of somatic cell count and CM records, and elucidated consequences in terms of udder health, AMU, and farm economics. Relatively fast identification of the causative agent is the most important factor in selective CM treatment protocols. Many reported studies did not indicate detrimental udder health consequences (e.g., reduced clinical or bacteriological cures, increased somatic cell count, increased culling rate, or increased recurrence of CM later in lactation) after initiating selective CM treatment protocols using on-farm testing. The magnitude of AMU reduction following a selective CM treatment protocol implementation depended on the causal pathogen distribution and protocol characteristics. Uptake of selective treatment of nonsevere CM cases differs across regions and is dependent on management systems and adoption of udder health programs. No economic losses or animal welfare issues are expected when adopting a selective versus blanket CM treatment protocol. Therefore, selective CM treatment of nonsevere cases can be a practical tool to aid AMU reduction on dairy farms.

A Survey of knowledge, attitude, and practices surrounding antimicrobial use by family dairy farmers to mastitis control

This study determined the family dairy farmers' knowledge, attitudes, and practices regarding the management strategy of mastitis, antibiotic use, and antimicrobial resistance in dairy farms in Türkiye. A total of 455 dairy farmers participated in face-to-face surveys from the villages of Çanakkale in Türkiye. A total of 62 questions that were divided into 5 categories were asked of the participants. Farmers (252/455; 55.4%) noted that they had not heard of any term about the expression of microbial resistance. They believe that antibiotic residues (156/455; 34,3%) do not pass into the soil and environment with animal wastes, and diseases such as mastitis (173/455; 38%) cannot be cured without antibiotics. Farmers indicated that they used antibiotic therapy in the treatment of udder diseases such as mastitis at a rate of 44.8%. Moreover, most dairy farmers (78.2%) decided to start antibiotic treatment with the decision of the veterinarian. Farmers believe that the barn environment is not as clean as necessary at a rate of 23.5%, and the necessary hygiene conditions are not followed in animal care 23.4% as the cause of mastitis. They highlighted that they detected mastitis from the redness or swelling of the udder at a rate of 38.2%. 55.8% of the farmers participating in the study had undergone analysis for the diagnosis of mastitis disease. On the other hand, 57.4% of farmers tried natural products such as olive oil, soft soap, vinegar, clay soil, honey, soapy, and yogurt, instead of antibiotics treatment for mastitis diseases. They have been relying mostly on veterinarian recommendations for AU. The use of culture and susceptibility test results for antimicrobial selection should be expanded among veterinarians. All stakeholders should be included in periodic training programs on topics such as AU, AR, preventive treatments for mastitis, vaccination, public health, and environmental health. Surveillance systems are needed to monitor AU and AR in animals, as in human medicine.

Metagenomic insights into the antibiotic resistomes of typical Chinese dairy farm environments

Antibiotic resistance genes (ARGs) in the environment pose a threat to human and animal health. Dairy cows are important livestock in China; however, a comprehensive understanding of antibiotic resistance in their production environment has not been well clarified. In this study, we used metagenomic methods to analyze the resistomes, microbiomes, and potential ARG bacterial hosts in typical dairy farm environments (including feces, wastewater, and soil). The ARGs resistant to tetracyclines, MLS, β-lactams, aminoglycoside, and multidrug was dominant in the dairy farm ecosystem. The abundance and diversity of total ARGs in dairy feces and wastewater were significantly higher than in soil (P &lt; 0.05). The same environmental samples from different dairy have similar resistomes and microbiomes. A high detection rate of tet(X) in wastewater and feces (100% and 71.4%, respectively), high abundance (range from 5.74 to 68.99 copies/Gb), and the finding of tet(X5) challenged the clinical application of the last antibiotics resort of tigecycline. Network analysis identified Bacteroides as the dominant genus in feces and wastewater, which harbored the greatest abundance of their respective total ARG coverage and shared ARGs. These results improved our understanding of ARG profiles and their bacterial hosts in dairy farm environments and provided a basis for further surveillance.

Emotive Themes from Tennessee Cattle Producers Regarding Responsible Antibiotic Use

To improve judicious antimicrobial use (AMU) in food animals in the United States, all feed additives that were medically important antimicrobials were moved from over the counter to Veterinary Feed Directive in 2017. This action required a change in behavior of producers’ AMU practices. Because emotions are important aspects of behavior, several behavioral interventions have targeted people’s emotions as means of effecting change. Hence, understanding and incorporating the emotional experiences of producers towards current AMU practices can be a starting point to making future behavioral changes that could reduce the emergence of antimicrobial resistance challenge. Between June 2017 and March 2018, seven focus group meetings of Tennessee (TN) beef and dairy cattle producers were conducted to evaluate producers’ emotional views regarding responsible AMU in TN cattle. Sixty-two TN cattle producers participated and emotively expressed the following: (1) deep connections to animals in ways that improve animal and public health; (2) pride in their quality of products; (3) distress that consumers misconceive their AMU practices as indiscriminate; and (4) recommended that producers be more transparent about their AMU practices and the public improve their awareness for detecting marketers’ deceptive product labels that take advantage of public ignorance. Knowledge of these producers’ emotions would help educators target more successful behavioral change campaigns, improving stewardship in AMU practices among producers.

Managing organic dairy herd health: Current roles and possible future roles for veterinarians with organic dairy clientele

This study aimed to understand the veterinary-client relationship and perspectives in organic dairy production systems. Twenty-three organic dairy producers and 12 veterinarians were interviewed using semi-structured, one-on-one interviews. Consultation with local veterinarians was typically infrequent, as there was greater reliance on other producers and organic industry professionals for advice on dairy herd health management, perhaps due to a shared focus on organic farming principles. Organic producers generally consulted local veterinarians most frequently to develop vaccine protocols, address animal health emergencies, and gain reproductive services. Common reasons organic producers cited for not regularly consulting a local veterinarian included the cost of veterinary services and a perception that local veterinarians have limited experience with organic systems and products. Some producers also expressed the idea that infrequent veterinarian usage is indicative of a healthy herd. Meanwhile, local veterinarians reported that organic dairy producers often delayed consulting them about individual cases until animal health problems were severe. Local veterinarians also identified challenges in servicing organic herds, such as the lack of standardized regulations between different organic certifiers and limited safety and efficacy data for many herd health products used by organic producers. In addition, their formal training generally did not include organic herd health strategies. Organic dairy clients were typically a small fraction of the overall workload for local veterinarians, which precluded their ability to accumulate experience. In contrast, a handful of specialized veterinarians in the organic milk processing industry work more frequently with organic producers and have published most of the available resource materials on organic dairy herd health. Veterinary-client partnerships could be improved through more open communication and discussion of the challenges identified in this study and through participatory research and outreach engagement that includes local veterinarians, organic certifiers, organic industry veterinarians, and producers.

Realities, Challenges and Benefits of Antimicrobial Stewardship in Dairy Practice in the United States

The use of antimicrobials for the treatment of food-producing animals is increasingly scrutinized and regulated based on concerns about maintaining the efficacy of antimicrobials used to treat important human diseases. Consumers are skeptical about the use of antibiotics in dairy cows, while dairy producers and veterinarians demonstrate ambivalence about maintaining animal welfare with reduced antimicrobial usage. Antimicrobial stewardship refers to proactive actions taken to preserve the efficacy of antimicrobials and emphasizes the prevention of bacterial diseases and use of evidence-based treatment protocols. The ability to broadly implement antimicrobial stewardship in the dairy industry is based on the recognition of appropriate antimicrobial usage as well as an understanding of the benefits of participating in such programs. The most common reason for the use of antimicrobials on dairy farms is the intramammary treatment of cows affected with clinical mastitis or at dry off. Based on national sales data, intramammary treatments comprise < 1% of overall antimicrobial use for food-producing animals, but a large proportion of that usage is a third-generation cephalosporin, which is classified as a highest-priority, critically important antimicrobial. Opportunities exist to improve the use of antimicrobials in dairy practice. While there are barriers to the increased adoption of antimicrobial stewardship principles, the structured nature of dairy practice and existing emphasis on disease prevention provides an opportunity to easily integrate principles of antimicrobial stewardship into daily veterinary practice. The purpose of this paper is to define elements of antimicrobial stewardship in dairy practice and discuss the challenges and potential benefits associated with these concepts.

Understanding Antibiotic Resistance as a Perceived Threat towards Dairy Cattle through Beliefs and Practices: A Survey-Based Study of Dairy Farmers

Antibiotic use is an important component in dairy herd management both to treat bacterial diseases and to maximize animal welfare. However, there is concern among scientists that antibiotic misuse and/or overuse by farmers might promote the emergence of resistant pathogens. We conducted a cross-sectional web-based questionnaire study with dairy farmers/managers in New York, USA to evaluate their (i) level of concern about antibiotic resistance and (ii) interest in adopting new judicious antibiotic use practices regarding mastitis treatment. A total of 118 responses were subjected to statistical analysis. The findings revealed that nearly half (45%) of study participants were undecided or disagreed that antibiotic resistance due to antibiotic use in dairy farming may negatively impact the health of dairy cattle. In contrast, the majority (78%) of participants self-reported that they do not treat with antibiotics at the first sign of mastitis, and the majority (66%) have either fully or partially implemented culture-based mastitis treatment on their farm. The self-reported adoption of culture-based mastitis treatment practices was statistically significantly associated with higher numbers of injectable and intramammary doses of antibiotics used on the participants' farms. These findings will aid future research investigations on how to promote sustainable antibiotic use practices in dairy cattle.

Ontario Dairy Producers’ Perceived Barriers and Motivations to the Use of Pain Control for Disbudding and Dehorning Calves: A Qualitative Study

Simple Summary

This study aimed to understand influences on producer behaviour towards the use of pain mitigation for disbudding and dehorning. Calf comfort, post-operative performance, and better farmer experiences were common motivators for pain control use. Barriers included cost, education, and producer attitude. Quality assurance requirements for disbudding and dehorning practices were received well by participants; however, there were requests for more education surrounding the application of pain control for these procedures. Veterinarians were highly influential for participants and were mentioned as an avenue for the reduction of pain control barriers via producer education.

Abstract

Canadian dairy farmers are required to use a local anesthetic and analgesic prior to all disbudding and dehorning procedures. This study was done to investigate the opinions of Ontario dairy farmers on the use of pain control for disbudding and dehorning calves and their perspectives on the current requirements of the quality assurance program. Interviews were conducted with 29 dairy farmers across Ontario. All participants used a cautery iron to disbud or dehorn their calves and some form of pain control (i.e., NSAID and/or local anesthetic). Of the 29 producers that were interviewed, 22 (76%) were in compliance with the proAction requirements for pain control. Many participants felt positive about the use of pain control for these practices. Education from veterinarians was one of the most commonly listed resources to reduce barriers to pain control use by producers. A farmer’s attitude was highly referenced as an influence on producer behaviour. Although participants had positive views of pain control use, full compliance with national quality assurance requirements for disbudding and dehorning was not met by all. Producer education through veterinarians is a potential avenue to encourage the adoption of pain control use for disbudding and dehorning practices.

Antibiotic use by backyard food animal producers in Ecuador: a qualitative study

Background

Antibiotics are increasingly used throughout the world in food animal production for controlling and preventing disease and for promoting growth. But this trend also has the potential for promoting antibiotic resistance, which represents a threat to human, animal, and environmental health. The use of antibiotics and the potential effects of antibiotic dependence has often been associated with large-scale food animal production. But rural households also engage in small-scale production, often operating literally in backyards. While some small-scale producers use veterinary antibiotics, many do not. This paper examines knowledge, attitudes, beliefs, and agricultural practices (KAP) that represent an alternative to dependence on antibiotics.

Methods

Qualitative field research was based on four focus group discussions (FGDs) with non-indigenous backyard food animal producers in four communities near Quito, Ecuador and two FGDs with veterinarians. FGDs were supplemented by structured observations and key informant interviews. They were recorded with digital audio devices and transcriptions were analyzed independently by two researchers using a three-stage coding procedure. Open coding identifies underlying concepts, while axial coding develops categories and properties, and selective coding integrates the information in order to identify the key dimensions of the collective qualitative data.

Results

Backyard food animal producers in the Ecuadorian highlands generally do not use antibiotics while rearing small batches of animals and poultry for predominantly non-commercial household consumption. Instead, they rely on low cost traditional veterinary remedies. These practices are informed by their Andean history of agriculture and a belief system whereby physical activity is a holistic lifestyle through which people maintain their health by participating in the physical and spiritual environment.

Conclusions

Backyard food animal producers in the Ecuadorian highlands implement complex strategies based on both economic calculations and sociocultural underpinnings that shape perceptions, attitudes, and practices. They use traditional veterinary remedies in lieu of antibiotics in most cases because limited production of food animals in small spaces contributes to a predictable household food supply, while at the same time conforming to traditional concepts of human and environmental health.

Swiss Dairy Farmers' Perceptions Surrounding the Disposal of Waste Milk Containing Antibiotic Residues and Antibiotic Resistance

The feeding of waste milk containing antibiotic residues (WMA) to calves has been associated with the shedding of antibiotic-resistant bacteria by calves. However, little is known regarding farmers' intrinsic factors affecting this practice, and on which it would be relevant to intervene in order to change this practice. The objectives of this study were (1) to describe the farmers' intrinsic factors, such as perceived benefits, risks, and social norms related to the feeding of WMA to calves, antibiotic resistance, and antibiotic use, and (2) to evaluate how the feeding of WMA to calves is related to farmers' personal values and perceptions related to WMA feeding and antibiotic resistance. Answers to an online survey were collected from 233 Swiss dairy producers (38.3% response rate). The proportion of respondents who fed WMA to calves was 48.3%. In a hierarchical logistic regression model, only perception factors extracted by factor analysis were associated with the feeding of WMA to calves, namely (in decreasing order of magnitude): farm-level benefits of WMA feeding, the interaction of farm-level benefits with support from governmental authorities, and causes and threats of antibiotic resistance. The results suggest that, in order to reduce the feeding of WMA to calves, communications to dairy producers should focus on changing the perceived benefits of this practice in comparison to those of alternative WMA disposal methods carrying a lower risk of antibiotic resistance. The involvement of veterinarians and governmental authorities in these communications and in supporting producers may increase the successful adoption of alternative WMA disposal methods.

Wisconsin dairy farm worker perceptions and practices related to antibiotic use, resistance, and infection prevention using a systems engineering framework

We studied farmworker practices and beliefs potentially contributing to transmission of bacteria and their associated antibiotic resistance genes (ARGs) among animals and farm workers to identify potential behavioral interventions to reduce the risk of bacterial transmission. Ten focus groups were conducted on eight Wisconsin dairy farms to assess potentially high-risk practices and farmworker knowledge and experiences with antibiotic use and resistance using the Systems Engineering in Patient Safety (SEIPS) framework. Farmworkers were asked to describe common on-farm tasks and the policies guiding these practices. We found workers demonstrated knowledge of the role of antibiotic stewardship in preventing the spread of ARGs. Worker knowledge of various forms of personal protective equipment was higher for workers who commonly reported glove-use. Additionally, workers knowledge regarding the importance of reducing ARG transmission varied but was higher than we had hypothesized. Programs to reduce ARG spread on dairy farms should focus on proper hand hygiene and personal protective equipment use at the level of knowledge, beliefs, and practices.

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.

Engaging with selective dry cow therapy: understanding the barriers and facilitators perceived by Irish farmers

BACKGROUND

Selective dry cow therapy (SDCT) is widely promoted in dairy farming as a method to reduce antimicrobial usage. New legislation introduced by the European Union will restrict and regulate the prophylactic and metaphylactic use of antibiotics from January 2022. Blanket dry cow therapy continues to be a practice engaged in by many farmers in Ireland and for many of these farmers, moving towards SDCT would require a significant infrastructural, behavioural and/or cultural change on their farm. Existing research has reported the important need to understand farmers' motivations to initiate any substantial behaviour change. However, it is currently unknown what farmers know, think and believe about SDCT in Ireland. The aim of this study was to use qualitative methods to explore what barriers and facilitators farmers perceived to exist with SDCT and explore if they had chosen to implement SDCT after voluntarily participating in a funded dry cow consult with a trained veterinarian, with the objective of maximising the dry period udder health performance and moving safely to SDCT.

RESULTS

In this study, 19 farmers were contacted, and telephone interviews were conducted regarding farmers' beliefs about the consequences of SDCT. Audio recordings were professionally transcribed verbatim and analysed qualitatively using an inductive thematic analysis. The analysis identified 6 barriers and 6 facilitators to implementing SDCT. A significant fear of increasing mastitis incidence was evident that caused reluctance towards SDCT and reliance on antibiotics. Mixed perceptions on SDCT, infrastructure limitations, a perceived lack of preventive advice as well as peer influence were presented as barriers to SDCT. Farmers can build confidence when a graded approach to SDCT is implemented, which could help overcome the fear of SDCT and reliance on antibiotics. Regulatory pressure, high standards of farm hygiene and use of targeted veterinary consults were found to facilitate SDCT. Education was suggested to motivate farmers in the future uptake of SDCT. Despite cited negative influences, peer influence can be utilised to encourage the farming community.

CONCLUSIONS

This study prioritises areas to facilitate the major behaviour change required as a dairy industry in order to move from blanket dry cow therapy to SDCT.

Educational interventions to address misconceptions about antibiotic residues in milk can alter consumer perceptions and may affect purchasing habits

The industrialization of the agri-food industry and resultant decrease in the number of people employed on farms has contributed to a knowledge gap among consumers about food production processes. A commonly reported concern of dairy consumers is the use of antibiotics in dairy animals, even though these drugs are an important tool for promoting animal health and welfare and food safety. The extent to which consumers are aware of antibiotic residue avoidance practices in dairy production is unknown, and it is unclear whether acquisition of such knowledge could affect purchasing behavior and perceptions of dairy farming. The objectives of this study were to assess consumers' perceptions about the quality and production of dairy products in the United States and determine whether educational materials on processes that limit the occurrence of antibiotic residues in milk can change consumers' perceptions of dairy products and purchasing behaviors. We surveyed 804 consumers and assigned them to 1 of 3 interventions: (1) a control arm (reading the content of the Dairy page of the USDA's myplate.gov website); (2) an educational brochure on the processes that prevent antibiotic residues in milk; and (3) a video on the same processes. We found that a majority (86.1%) of participants believe that the quality of dairy products in the United States is high, although many had concerns about the treatment of dairy animals and chemicals (pesticides, antibiotics, hormones) in dairy products. Compared with the control intervention, the brochure was associated with a significant decrease in the level of concern consumers had about chemicals in their milk [-0.20 points on a Likert scale, 95% confidence interval (CI), -0.32 to -0.08] and a significantly increased comfort in purchasing conventional dairy products (odds ratio 2.43, 95% CI, 1.62 to 3.66). The video was associated with even stronger effects: a 0.29-unit decrease in the level of concern about chemicals in milk (95% CI, -0.42 to -0.016) and 2.94 times greater odds of purchasing conventional dairy products (95%, CI 1.92 to 4.49). Although consumer food decision making is complex and driven by multiple factors, it appears that education about the processes that promote food safety can reassure consumers about their concerns and potentially affect purchasing habits.

The antimicrobial landscape as outlined by Danish dairy farmers

Limiting antimicrobial use (AMU) in dairy farming is an important step toward reducing antimicrobial resistance (AMR). Therefore, it is relevant to understand dairy farmers' choices and the potential for change in relation to AMU, even in countries with low usage. Furthermore, there is an increasing recognition of the need to focus on both the individual farmer's behavior as well as the context surrounding and influencing the farmer's decisions in relation to AMU if the goal is further reduction. To date, no studies have taken into account both the individual farmer and their context in both conventional and organic dairy farms under Danish conditions. For this study, 15 Danish dairy farmers were interviewed using qualitative semi-structured research interviews, and the notion of landscape was used to describe the context of their AMU. We found that AMR was considered a distant element of the farmers' antimicrobial landscape. Daily challenges such as acutely diseased animals and poor housing conditions seemed more urgent and overruled the threat of AMR. We also found that interviewed farmers had differing opinions on farm management, partly shaped by changes in legislation and ways of farming over time. At one end of the scale, some organic farmers had rethought the current way of farming; keeping robust animals in a natural setting was expected to prevent disease. They were positive about legislation, and the numerous restrictions on AMU over time were thought to contribute to ensuring quality for consumers. At the other end of the scale, some conventional farmers perceived disease as something that should be controlled through treatment, and the currently eased legislation and intensification of farming have legitimatized AMU for this purpose, leading to an expectation among these farmers of certain rights to handle medicines themselves. These contrasting views might lead to inspiration and competition in terms of reducing AMU, as the farmers appeared to value the opinions of other farmers, and they were found to continuously assess each other. Through such ongoing assessment, pioneers of AMU reduction-whether organic or conventional-might motivate their colleagues to change their AMU. Future research should address the potential of experience- and attitude-sharing among farmers as motivation to reduce AMU.

2019 Survey of Antimicrobial Drug Use and Stewardship Practices in Adult Cows on California Dairies: Post Senate Bill 27

Antimicrobial resistance (AMR) is a global issue for both human and animal health. Antimicrobial drug (AMD) use in animals can contribute to the emergence of AMR. In January 2018, California (CA) implemented legislation (Senate Bill 27; SB 27) requiring veterinary prescriptions for medically important AMD use in food animals. The objective of our survey was to characterize AMD use, health management, and AMD stewardship practices of adult cows on CA dairies since the implementation of SB 27. In 2019, we mailed a questionnaire to 1282 California dairies. We received a total of 131 (10.2%) survey responses from 19 counties in CA. Our results showed that 45.6% of respondents included a veterinarian in their decision on which injectable AMD to purchase. Additionally, 48.8% of dairy producers included a veterinarian in their decision on which AMDs were used to treat sick cows. The majority (96.8%) of dairy producers were aware that all uses of medically important AMDs require a prescription. Approximately 49% of respondents agreed or strongly agreed that AMD use in livestock does not cause problems in humans. The survey documents antimicrobial use and stewardship practices in CA's dairy industry and focus areas for future research and education.

A Focus Group Study of Canadian Dairy Farmers' Attitudes and Social Referents on Antimicrobial Use and Antimicrobial Resistance

As part of broader actions to combat antimicrobial resistance (AMR), health authorities have promoted the reduction of antimicrobial use (AMU) in food animals. Farmers' attitudes and receptivity to reduction of AMU appear to be variable and context specific. Our research objectives were to gain insight into Canadian dairy farmers' attitudes toward AMU, AMR, and AMU-reduction in the dairy industry, and to explore drivers and barriers to change AMU, including the influence of social referents. We conducted seven focus groups with 42 farmers in two provinces of Canada (New Brunswick and Ontario) and used thematic analysis to identify, analyze, and report patterns in the data. Our results indicate that farmers usually rely on their previous experience and judgement of individual cases of disease when making decisions related to AMU. External referents included other farmers, family members, and veterinarians. However, veterinarians were generally only consulted for unusual cases. Participants in this study expressed that maintaining cattle welfare is their responsibility, and that they were not willing to jeopardize animal welfare in order to reduce AMU. In addition, farmers regarded the cost of investment in improved facilities to prevent disease as an important barrier to reduce AMU. Finally, the majority of participants considered themselves to be low users of antimicrobials and perceived a small role of AMU on dairy farms in AMR. In conclusion, farmers from this study showed self-reliance to decide about AMU on their farms and considered animal-related and economic factors in these decisions. There was a general lack of knowledge of how to reduce AMU without investing in facilities, and there is an opportunity to motivate increased involvement of the veterinarian in AMU-related decisions. These results should be considered to design and refine antimicrobial stewardship programs for dairy farms.

How does public perception of antibiotic use on dairy farms contribute to self-reported purchasing of organic?

The United States regulates the use of antibiotics in agricultural settings to address the global antibiotic resistance problem. Conventional dairy cows treated with antibiotics are kept in the herd and after the withholding period milk is harvested. On organic farms, the US organic standard on antibiotic use requires sick dairy cows to be treated, but treated cows must be removed from the herd and their milk can never again be sold as certified organic. This study investigated the US public's perceptions of the organic dairy farming, antibiotic use on dairy farms, and whether these perceptions affect consumer's self‐reported purchasing behavior for organic. We used a nationally representative phone‐based survey of 1000 US adults and characterized participants’ self‐reported (i) knowledge of the legality of antibiotic use on dairy farms (conventional and organic) and (ii) frequency of purchasing organic instead of conventional dairy products, as well as several demographic and other variables. The results indicated that participants’ knowledge about antibiotic use practices in dairy farming have no effect on their self‐reported purchasing behavior for organic or conventional dairy products. However, respondents who were familiar with the regulations of antibiotic use on dairy farms were more likely to oppose the US organic standard on antibiotic use in dairy farming and thought that past antibiotic use should not permanently remove a cow's organic status. These findings contribute to understanding of public perceptions that shape the US dairy organic market.

Practical Application

Income, employment, health and political values, but not consumers’ knowledge about antibiotic use in dairy farming, affect self‐reported purchasing behavior for organic dairy products. However, consumers who are familiar with the regulations of antibiotic use on US dairy farms disagree with the US organic standard on antibiotic use mandating loss of organic status for any cattle treated with antibiotics. These findings may be useful to organic markets.

Farmer perceptions of dairy farm antibiotic use and transport pathways as determinants of contaminant loads to the environment

Agricultural antibiotic contamination into milk and beef products has been considered extensively, but antibiotic transport into soil and water environments is less regulated and studied. Farmer perceptions of these transport processes are critical to understanding how antibiotics reach soils and surface waters and what management strategies can be implemented to reduce environmental antibiotic loads. We have conducted semi-structured interviews with twenty-seven dairy farmers in central New York to understand farmer perceptions of environmental transport of antibiotics and decisions that reduce environmental antibiotic loads. Interviews were qualitatively analyzed and coded using thematic analysis. We found that farmers extensively considered transport of antibiotics into milk and beef, while consideration of antibiotic transport into manure was less common, and no farmers discussed antibiotic transport from carcasses into soil from on-farm animal mortality. Farmers highlighted decisions that reduce antibiotic environmental loads through disease prevention actions, usage of non-antibiotic treatments, and culturing bacterial samples before antibiotic treatment. Farmers did not cite reduction of environmental antibiotic loads as a driver of their waste management decisions. Farmers perceived antibiotic usage was already minimized on farms in the region, suggesting future environmental antibiotic contamination mitigation strategies should focus on waste management pathways.

Survey of perceptions and attitudes of an international group of veterinarians regarding antibiotic use and resistance on dairy cattle farms

Veterinarians are the main source of information for farmers regarding the responsible use of antibiotics in farm animals and how to reduce the risk of antibiotic resistance. Consequently, understanding how veterinarians perceive their clients' and colleagues' antibiotic use and their own beliefs about the development of antibiotic resistance is essential to determining areas in which antibiotic use practices can be improved to minimize the emergence of antibiotic resistance. An international cross-sectional study was carried out using a questionnaire designed to elucidate perceptions, attitudes, and concerns of dairy veterinarians regarding antibiotic use and the emergence of antibiotic resistance in dairy farming. The questionnaire was initially administered to veterinarians attending the International Bovine Mastitis Conference in Milano, Italy, 2018, followed by veterinarian members of the National Mastitis Council, and all conference registrants. A total of 71 participants from 21 countries participated in the survey, the majority were from the United States and member countries of the European Union. Logistic regression analysis was conducted to identify predictors of veterinarians' level of concern about the development of antibiotic resistance on their clients' farms. Associations were described with odds ratios (ORs) and the associated 95 % confidence intervals (95 % CIs). Free text responses where participants shared their views on the reason for overprescribing antibiotics by veterinarians were analyzed using thematic analysis. Participants perceived that nearly half of their clients overuse or inappropriately use antibiotics, and nearly half of their colleagues overprescribe or inappropriately prescribe antibiotics. After controlling for other factors, the odds of veterinarians being concerned about antibiotic resistance on dairy farms they served decreased by a factor of 0.91 for each additional year of participants' experience working with dairy cattle (OR = 0.91, 95 % CI = 0.84-0.99). Participants concerned about antibiotic resistance on clients' dairy farms were also more likely to consider better adherence to drug labelling as important for reducing farmers' antibiotic use (OR = 6.86, 95 % CI = 1.21-38.93). Thematic analysis revealed four themes surrounding the perceived reasons for veterinarians' overprescribing of antibiotics: (i) knowledge, (ii) attitudes, (iii) barriers, and (iv) rules and regulations. The study findings will aid in the development of strategies to improve antibiotic use in dairy farming and educational initiatives looking to enhance the communication between veterinarians and farmers about judicious use of antibiotics.

Antibiotics Use in Food Animal Production: Escalation of Antimicrobial Resistance: Where Are We Now in Combating AMR?

The use of antibiotics has been very beneficial to human health, animal wellbeing, and food production, however, there are no alternatives to antimicrobials in treating infectious diseases. Their use can contribute to the development of antimicrobial resistance, but the world has realized the need to combat antimicrobial resistance in recent decades due to the continued escalation of the problem jeopardizing human and veterinary medicine and food and environmental safety. Understanding the AMR and judicious use of antimicrobials are critical, and one health approach involving several sectors and multiple disciplines is important to tackle the problem. National, regional, and global action plans have been instigated to tackle the escalation of AMR. Antimicrobials are frequently used in food animal production. Therefore, food animal producers are important participants to prevent overuse and misuse of antimicrobials. Recent regulations to address the challenges have not been perceived well in animal farming communities. More awareness regarding these action plans and understanding the impact of AMR are needed. A nationwide survey of perceptions of food animal producers regarding AMR mitigation approaches should be conducted to evaluate the effectiveness of the current policies regarding antibiotics use and AMR. These outcomes should be incorporated in future policies and awareness campaigns targeting food animal producers.

Dairy farmer perceptions of antibiotic transport and usage in animal agriculture dataset

These data were from semi-structured interviews with dairy farmers. The content of the interviews focused on antibiotic transport and usage on dairy farms. Twenty-seven interviews were conducted in Central New York in 2019. Interviews were recorded and subsequently transcribed for qualitative thematic analysis. Qualitative coding analysis was preformed using ATLAS.ti and content filtered to ensure farmer anonymity. The dataset includes direct quotations from dairy farmers paired with farm and farmer characteristics. Quotations are subdivided thematically into the themes of disease prevention, antibiotic usage, non-antibiotic treatments, antibiotic transport, and environmental residue presence impacts, as structured in Georgakakos et al. [1]. Farm characteristics include management practice, farm size, and farm generation. Farm size was determined by number of lactating cows: small (0-50), medium-small (51-100), medium (101-500), medium-large (501-1000), and large (>1000). Farmer characteristics were farmer age categorized by birth year: Baby Boomer (1946-1964), Gen X (1965-1980), and Millennial (1981-1996). This dataset is particularly promising for longitudinal studies, incorporation of human behaviour into contaminant load models, or for recoding and analysis for themes other than those discussed by Georgakakos et al. [1].

Anti-pathogenic activity of graphene nanomaterials: A review

Graphene and its derivatives are promising candidates for a variety of biological applications, among which, their anti-pathogenic properties are highly attractive due to the outstanding physicochemical characteristics of these novel nanomaterials. The antibacterial, antiviral and antifungal performances of graphene are increasingly becoming more important due to the pathogen's resistance to existing drugs. Despite this, the factors influencing the antibacterial activity of graphene nanomaterials, and consequently, the mechanisms involved are still controversial. This review aims to systematically summarize the literature, discussing various factors that affect the antibacterial performance of graphene materials, including the shape, size, functional group and the electrical conductivity of graphene flakes, as well as the concentration, contact time and the pH value of the graphene suspensions used in related microbial tests. We discuss the possible surface and edge interactions between bacterial cells and graphene nanomaterials, which cause antibacterial effects such as membrane/oxidative/photothermal stresses, charge transfer, entrapment and self-killing phenomena. This article reviews the anti-pathogenic activity of graphene nanomaterials, comprising their antibacterial, antiviral, antifungal and biofilm-forming performance, with an emphasis on the antibacterial mechanisms involved.

Use of a systems engineering framework to assess perceptions and practices about antimicrobial resistance of workers on large dairy farms in Wisconsin

We studied farmworker practices potentially contributing to transmission of bacteria and antimicrobial resistant genes (ARGs) among animals and farm workers to identify human behavioral interventions to reduce exposure risk. Ten focus groups were conducted on eight farms to explore potentially high-risk practices and farmworker knowledge and experiences with antimicrobial use and resistance using the Systems Engineering in Patient Safety (SEIPS) framework. Farmworkers were asked to describe common tasks and the policies guiding these practices. We found workers demonstrated knowledge of the role of antibiotic stewardship in preventing the spread of ARGs. Knowledge of various forms of personal protective equipment was higher for workers who commonly reported glove-use. Knowledge regarding the importance of reducing ARG transmission varied but was greater than previously reported. Programs to reduce ARG spread on dairy farms should focus on proper hand hygiene and personal protective equipment use but at the level of knowledge, beliefs, and practices.

The Role of Innate Immune Response and Microbiome in Resilience of Dairy Cattle to Disease: The Mastitis Model

Animal health is affected by many factors such as metabolic stress, the immune system, and epidemiological features that interconnect. The immune system has evolved along with the phylogenetic evolution as a highly refined sensing and response system, poised to react against diverse infectious and non-infectious stressors for better survival and adaptation. It is now known that high genetic merit for milk yield is correlated with a defective control of the inflammatory response, underlying the occurrence of several production diseases. This is evident in the mastitis model where high-yielding dairy cows show high disease prevalence of the mammary gland with reduced effectiveness of the innate immune system and poor control over the inflammatory response to microbial agents. There is growing evidence of epigenetic effects on innate immunity genes underlying the response to common microbial agents. The aforementioned agents, along with other non-infectious stressors, can give rise to abnormal activation of the innate immune system, underlying serious disease conditions, and affecting milk yield. Furthermore, the microbiome also plays a role in shaping immune functions and disease resistance as a whole. Accordingly, proper modulation of the microbiome can be pivotal to successful disease control strategies. These strategies can benefit from a fundamental re-appraisal of native cattle breeds as models of disease resistance based on successful coping of both infectious and non-infectious stressors.