Application of a bacteriological on-farm test to reduce antimicrobial usage in dairy cows with purulent vaginal discharge

Comparison between intrauterine application of an antibiotic and an herbal product to treat clinical endometritis in dairy cattle - A randomized multicentre field study

Uterine diseases are main indications for antibiotic use in dairy cows. To test a non-antibiotic treatment option, we compared the effect of an intrauterine cephapirin (Metricure®; cefapirin benzathin 500 mg per dosis; CEPH) with an intrauterine applied herbal product (25 ml of EucaComp® PlantaVet containing alcoholic extracts of Calendula officinalis L., Mellissa officinalis L., Origanum majorana L. and Eucalyptus globulus Labill. (EUC)) on the clinical cure of endometritis. Examinations of 816 cows between 21 and 35 days after calving were performed and cases of clinical endometritis (n = 169) were included. Diagnosis based on a scoring system for vaginal discharge. Study animals were randomly assigned to one of two treatment groups and treated immediately. After excluding animals with incomplete datasets, 136 cows (EUC: n = 61; CEPH: n = 75) remained for the final analysis. In total, 64% (EUC: 61%, CEPH: 67%) of analysed endometritis cases were considered as clinically cured 14 ± 2 days after the first treatment, 15% stayed uncured after the application of a maximum of two consecutive treatments, leading to an overall clinical cure rate of 85% (EUC: 82%, CEPH: 88%). No statistically difference in clinical cure rates could be observed between both treatment groups nor 14 ± 2 days after the first treatment (p = 0.956) neither regarding the overall cure rate (p = 0.923). In conclusion, the clinical cure of dairy cows' endometritis after the intrauterine application of the herbal product was non-inferior to the intrauterine application of the antibiotic cephapirin. These results could contribute to reduce the antimicrobial use in the daily veterinary routine treatment of endometritis.

Oxytetracycline Persistence in Uterine Secretion after Intrauterine Administration in Cows with Metritis

Simple Summary

Puerperal metritis in cows involves the acute inflammation of the uterus, which is often treated with antibacterial drugs. Restrictions on the use of antibiotics in veterinary medicine require the very precise selection of an antibiotic based on its pharmacokinetics and on sensitivity tests of pathogenic bacteria. This study aimed to evaluate the changes in oxytetracycline levels in uterine secretion over time after intrauterine administration in cows with metritis in relation to the sensitivity of pathogenic bacterial isolates. The concentrations of oxytetracycline in the uterine secretions were higher than the minimum inhibitory concentrations against pathogenic bacteria, provoking the infection of the uterus. Higher concentrations were measured in milk rather than in plasma. The intrauterine infusion of oxytetracycline for three consecutive days led to the alleviation of the inflammation and the restoration of the estrus cycle in cows. The local intrauterine administration of oxytetracycline requires the monitoring of the withdrawal time of milk to ensure consumer safety.

Abstract

Puerperal metritis in cows is often treated with antibacterial drugs. The prudent use of antibiotics in farm animals requires state-of-the-art knowledge of their pharmacokinetics and data from sensitivity tests of pathogenic bacteria. Changes in oxytetracycline levels in the uterine secretion over time after intrauterine administration in cows with metritis were evaluated in relation to the sensitivity of pathogenic bacterial isolates. Oxytetracycline levels in plasma, milk and uterine secretion were determined via LC–MS/MS analysis. Pathogenic bacteria were isolated and their sensitivity to oxytetracycline was determined. The concentrations of oxytetracycline in the uterine secretion were 433.79 (39.17–1668.76) µg·mL⁻¹ six hours after the third application at a dose of 8 mg/kg and 84.33 (1.58–467.55) µg·mL⁻¹ 96 h after the last treatment. These levels were higher than the minimum inhibitory concentrations—namely, between 4 and 64 µg·mL⁻¹—against pathogenic isolates Trueperella pyogenes, Streptococcus intermedius, Escherichia coli and Bacillus pumilis. Higher concentrations over time were measured in milk rather than in plasma, indicating the need to monitor the withdrawal time for milk. The intrauterine infusion of oxytetracycline for three consecutive days resulted in the successful treatment of metritis in terms alleviating inflammation and restoring the estrus cycle in cows.

The effect of pre-calving injection of trace mineral supplements on periparturient disease incidence in pasture based dairy cows

Trace minerals, have a role in immune function and a trace mineral supplement (TMS) can improve animal health in dairy herds. This prospective randomised clinical study assessed whether subcutaneous injection of 5.5 mL of TMS (40 mg zinc, 10 mg manganese, 5 mg selenium, 15 mg copper per mL), 14-28 days before planned start of calving (PSC) reduced clinical mastitis (CM), subclinical mastitis (SCM) and purulent vaginal discharge (PVD). From four farms, half of 1700 cows stratified on somatic cell count, age and breed were randomly allocated to treatment or no treatment. Occurrence of CM from - 7 to PSC + 100 days, SCM at PSC + 60 days and PVD at PSC + 24 days was analysed using survival analysis and Bayesian generalised mixed multivariable models. From -7 to PSC +30 days, TMS reduced the adjusted hazard ratio (HR) for CM at quarter and cow level (P < 0.001), with no evidence for an effect beyond 30 days. The adjusted OR (and 95% highest density interval, HDI) for the effect of TMS on CM from -7 to PSC +30 days was 0.40 (95% HDI, 0.26-0.63) at quarter level, 0.51 (95% HDI, 0.38-0.69) at cow level and for SCM, 0.72 (95% HDI, 0.54-0.95). The difference in CM incidence from TMS at the cow level was -2.0% (95% HDI, -3.4 to -1.1%) and -1.2% (95% HDI, -3.2 to - 0.6%) at quarter level. No clear effect was identified of TMS on cumulative incidence of PVD.

Evaluación de la administración de medicamentos veterinarios en hatos lecheros de quince municipios de Cundinamarca, Colombia

Objetivo Evaluar el conocimiento en el uso de Medicamentos de Uso Veterinario (MUV) de los productores ganaderos y personal involucrado en Bogotá y municipios aledaños. Métodos Se realizó un estudio de corte transversal a través de entrevistas a operarios y productores ganaderos de una muestra de 30 hatos lecheros localizados en 15 municipios cerca de Bogotá, Cundinamarca. Resultados Se identificó la implementación de prácticas para la administración de MUV, incluyendo parámetros que influencian su administración y conocimientos en las personas que los prescriben y administran. Se encontró que los medicamentos de mayor frecuencia fueron los antimicrobianos con 60,7%, entre los cuales se destaca el uso de penicilina y oxitetraciclina. Los MUV inyectables (parenterales) fueron las formas más frecuentes de aplicación con un 64,7%. Se identificaron 251 MUV en los hatos lecheros, de los cuales el 81,3% están compuestos por principios activos que requieren tiempo de retiro en leche y carne. Se destaca el rol del mayordomo en el cuidado animal a nivel diagnóstico y administración del tratamiento. Conclusión El presente estudio sugiere que el uso de MUV es implementado empíricamente en producciones lecheras y podría contribuir a mediano y largo plazo a la emergencia de cepas con resistencia a MUV.

Validation of On-Farm Bacteriological Systems for Endometritis Diagnosis in Postpartum Dairy Cows

Simple Summary

Endometritis is a disease affecting reproductive performance in dairy cows. Considering the modern issues concerning the use of antibiotics in animal production, it is important to refine our criteria for diagnosing this disease. As such, confirming the presence of bacteria in the uterus before implementing an intrauterine antibiotic treatment is critical. To be able to achieve this on dairy farms, the accuracy of currently available on-farm bacteriological culture systems (Tri-plate and Petrifilm) needs to be validated. This study used data from 189 dairy cows to assess this objective. Uterine samples were collected on cows between 30 and 43 days in milk and were submitted for bacteriological culture using three different approaches: standard laboratory and two on-farm systems (Tri-plate and Petrifilm). Our results showed that the optimal criteria for using the Tri-plate and Petrifilm on-farm systems were >90 and >100 colonies, respectively, when compared with the results from the standard laboratory. These results support the possibility of using the Tri-plate on-farm bacteriological culture system to diagnose endometritis.

Abstract

The objective of this study was to validate the accuracy of the results of on-farm bacteriological culture media (Tri-plate and Petrifilm) from endometrial samples compared with the ones from the diagnostic laboratory. A cross-sectional observational study was set up within two dairy herd clients of the Université de Montréal. A total of 189 cows in the postpartum period were systematically enrolled to collect two uterine samples from cytobrushes during the same examination. The first cytobrush was used to inoculate the Tri-plate medium directly and then was sent to the reference laboratory for aerobic bacterial culture. The second cytobrush was used to make a microscopic smear for cytological analysis (proportion of polymorphonuclear cells) and subsequently diluted in 1 mL of saline to inoculate the Petrifilm medium. From these data, statistical analyses were computed to optimize the summation of sensitivity and specificity of the two systems compared with the results of the reference laboratory. For the Tri-plate and Petrifilm media, the cutoffs of ˃90 and ˃100 colonies gave the maximum sum of sensitivity and specificity, respectively. In conclusion, Tri-plate media was best at reproducing the results obtained by laboratory analysis using a threshold of >90 colonies.

Analysis of puerperal metritis treatment records in a grazing dairy farm in Argentina

OBJECTIVE

To assess the efficacy of antibiotic usage for the treatment of puerperal metritis (PM) and its association with reproductive performance, a retrospective cohort study including a total of 9168 records of cows from a dairy farm in Argentina was run.

MATERIAL AND METHODS

Cows having a PM3 (metricheck, scale 0-3) and treated with ceftiofur (ceftiofur crystalline free acid, 6.6 mg/kg) at 0-21 days postpartum (p. p.) (n = 2688), and cows having a PM 1-2 and not treated with an antibiotic at 0-21 days p. p. (n = 6480) were included in the study. All cows were reexamined with metricheck to assess the clinical cure (vaginal discharge [VD] score 0), partial cure (VD score similar or lower than previous), no cure (VD score higher than previous). Cows with a metricheck VD1-3 after 0-21 days p. p. were diagnosed as clinical endometritis (CE) 1-3. The occurrence of PM1-3, cure rate, calving to conception interval, the hazard of pregnancy, odds for non-pregnancy, and odds for CE were analyzed using SAS software.

RESULTS

A total of 8876 PM1-3 records were included, 2435 records of PM3 treatments with ceftiofur (27.43 %), and 6441 records of PM1-2 (72.57 %) with no treatment. Cows having PM1 and PM2 became pregnant 14 and 12 days earlier than cows with PM3 (p < 0.001). The PM3 ceftiofur treated cows had a clinical cure of 24.85 % (PM0); 53.63 % had a partially cure; and 18.52 % no cure. Conversely, cows with PM1-2 had a 51.96 %, 20.70 %, and 24.53 % cure rate, respectively (p < 0.001). Cows having complete cure became pregnant 13 and 11 days earlier than cows having partial cure and no cure (p < 0.001). Cows that had PM3 during the first 21 days p. p. had twice the chances of developing CE compared to cows having PM1-2 (41.28 % vs. 24.14 %, p < 0.001). After 21 days p. p., less than 1 % of cows with clinical cure developed CE compared to 63.32 % that developed CE with partial cure, and 38.21 % with no cure (p < 0.001).

CONCLUSION AND CLINICAL RELEVANCE

After ceftiofur treatment, 78 % of cows were cured when measured by disappearance of fetid VD but only 25 % of cows had clinical cure when measured by appearance of a clear VD. The cows that remained with clinical metritis had more chances of having CE after 21 days p. p. and had more days open than cows with clear normal VD.

Oxytetracycline Pharmacokinetics After Intramuscular Administration in Cows with Clinical Metritis Associated with Trueperella Pyogenes Infection

Systemic therapy with oxytetracycline is often used for treatment of clinical metritis although data about its penetration into the uterus and uterine secretion are lacking. Uterine secretions and milk from six cows with clinical metritis were collected for microbiological assay. The animals were treated intramuscularly with long-acting oxytetracycline (20 mg/kg) and samples of plasma, milk and uterine secretions were collected for determination of the antibiotic concentrations by HPLC-PDA analysis. Pharmacokinetics of the antibiotic and in silico prediction of its penetration into the uterus were described. Trueperella pyogenes with MIC values of 16-64 µg mL-1 was isolated (n of cows = 4) from uterine secretions. Oxytetracycline showed fast absorption and penetration in the uterine secretions and milk. No change of withdrawal time for milk was necessitated in cows with clinical metritis. Maximum levels in uterine secretions and predicted concentrations of oxytetracycline in the uterus were lower than MIC values. Systemic administration of long-acting oxytetracycline did not guarantee clinical cure and was not a suitable choice for treatment of clinical metritis associated with Trueperella pyogenes. The appropriate approach to antibiotic treatment of uterine infections of cows requires knowledge on penetration of the antibiotics at the site of infection and sensitivity of pathogens.

Antimicrobial Stewardship in Veterinary Medicine

While antimicrobial resistance is already a public health crisis in human medicine, therapeutic failure in veterinary medicine due to antimicrobial resistance remains relatively uncommon. However, there are many pathways by which antimicrobial resistance determinants can travel between animals and humans: by close contact, through the food chain, or indirectly via the environment. Antimicrobial stewardship describes measures that can help mitigate the public health crisis and preserve the effectiveness of available antimicrobial agents. Antimicrobial stewardship programs have been principally developed, implemented, and studied in human hospitals but are beginning to be adapted for other applications in human medicine. Key learning from the experiences of antimicrobial stewardship programs in human medicine are summarized in this article-guiding the development of a stewardship framework suitable for adaptation and use in both companion animal and livestock practice. The antimicrobial stewardship program for veterinary use integrates infection prevention and control together with approaches emphasizing avoidance of antimicrobial agents. The 5R framework of continuous improvement that is described recognizes the importance of executive support; highly motivated organizations and teams (responsibility); the need to review the starting position, set objectives, and determine means of measuring progress and success; and a critical focus on reducing, replacing, and refining the use of antimicrobial agents. Significant issues that are currently the focus of intensive research include improved detection and diagnosis of infections, refined dosing regimens that are simultaneously effective while not selecting resistance, searches for alternatives to antimicrobial agents, and development of improved vaccines to enhance immunity and reduce disease.

Short communication: Meta-analysis on therapy of bovine endometritis with prostaglandin F2α-An update

The objective of the study was to update a prior meta-analysis on the efficacy of the treatment of bovine endometritis with PGF_2α. Clinical endometritis in cattle is defined as the presence of a purulent or mucopurulent vaginal discharge after 20 or 26 d, respectively, postpartum. Although the prevalence and impact of this disease are well known, the questions of whether and how to treat endometritis are still controversially discussed. Hence, to ensure timeliness of scientific results, we updated an existing meta-analysis published in 2013 that showed no treatment effect of PGF_2α in cases of bovine endometritis. As in the prior meta-analysis, a comprehensive literature search was conducted. After applying specific inclusion and exclusion criteria, 3 trials remained that could be added to the 6 trials in the initial meta-analysis. Data for each trial were analyzed using the meta-analysis software Review Manager (version 5.3; The Nordic Cochrane Centre, Copenhagen, Denmark). Estimated effect sizes of PGF_2α were calculated on calving to first service interval (CFSI) and calving to conception interval (CCI). As revealed by the initial meta-analysis, PGF_2α treatment still had no effect on both reproductive parameters. Heterogeneity remained substantial for CFSI and CCI and even increased for CCI compared with the initial meta-analysis. Subgroup analysis, however, did not reveal a source of heterogeneity. In updating the meta-analysis, publication bias for trials reporting CCI became even more pronounced, suggesting that studies with higher standard error (i.e., usually smaller studies) that reported a prolonging effect on CCI after a PGF_2α treatment were less likely to be published. Finally, although the number of trials published on the chosen topic and their comparability are still limited, this update of our meta-analysis now provides results that are based on approximately twice the number of included cows. The overall outcome, however, has not substantially changed and a positive effect of a PGF_2α treatment in case of clinical endometritis could not be shown. Therefore, we do not recommend a treatment of bovine endometritis with PGF_2α as a means to improve reproductive performance.