Feedlot Cattle Antimicrobial Use Surveillance Network: A Canadian Journey

Variation in Pen-Level Prevalence of BRD Bacterial Pathogens and Antimicrobial Resistance Following Feedlot Arrival in Beef Calves

Antimicrobials are crucial for treating bovine respiratory disease (BRD) in beef feedlots. Evidence is needed to support antimicrobial use (AMU) decisions, particularly in the early part of the feeding period when BRD risk is highest. The study objective was to describe changes in prevalence and antimicrobial susceptibility of BRD bacterial pathogens at feedlot processing (1 day on feed (1DOF)), 12 days later (13DOF), and for a subset at 36DOF following metaphylactic antimicrobial treatment. Mixed-origin steer calves (n = 1599) from Western Canada were managed as 16 pens of 100 calves, receiving either tulathromycin (n = 1199) or oxytetracycline (n = 400) at arrival. Deep nasopharyngeal swabs collected at all time points underwent culture and antimicrobial susceptibility testing (AST). Variability in the pen-level prevalence of bacteria and antimicrobial susceptibility profiles were observed over time, between years, and metaphylaxis options. Susceptibility to most antimicrobials was high, but resistance increased from 1DOF to 13DOF, especially for tetracyclines and macrolides. Simulation results suggested that sampling 20 to 30 calves per pen of 200 reflected the relative pen-level prevalence of the culture and AST outcomes of interest. Pen-level assessment of antimicrobial resistance early in the feeding period can inform the evaluation of AMU protocols and surveillance efforts and support antimicrobial stewardship in animal agriculture.

Strengthening antimicrobial resistance surveillance systems: a scoping review

BACKGROUND

Antimicrobial resistance (AMR) is an emerging global public health crisis. Surveillance is a fundamental component in the monitoring and evaluation of AMR mitigation endeavours. The primary aim of the scoping review is to identify successes, barriers, and gaps in implementing AMR surveillance systems and utilising data from them.

METHODS

PubMed, Web of Science, SCOPUS, and EMBASE databases were searched systematically to identify literature pertaining to implementation, monitoring, and evaluation of AMR surveillance systems. A thematic analysis was conducted where themes within the literature were inductively grouped based on the described content.

RESULTS

The systematic search yielded 639 journal articles for screening. Following deduplication and screening, 46 articles were determined to be appropriate for inclusion. Generally, most studies focused on human AMR surveillance (n = 38, 82.6%). Regionally, there was equal focus on low- and middle-income countries (n = 7, 15.2%) and trans-national contexts (n = 7, 14.5%). All included articles (n = 46, 100.0%) discussed barriers to either implementing or utilising AMR surveillance systems. From the scoping review, 6 themes emerged: capacity for surveillance, data infrastructure, policy, representativeness, stakeholder engagement, and sustainability. Data infrastructure was most frequently discussed as problematic in evaluation of surveillance systems (n = 36, 75.0%). The most frequent success to surveillance system implementation was stakeholder engagement (n = 30, 65.2%).

CONCLUSIONS

Experiences of AMR surveillance systems are diverse across contexts. There is a distinct separation of experiences between systems with emerging surveillance systems and those with established systems. Surveillance systems require extensive refinement to become representative and meet surveillance objectives.

Bovine Respiratory Disease: Conventional to Culture-Independent Approaches to Studying Antimicrobial Resistance in North America

Numerous antimicrobial resistance (AMR) surveillance studies have been conducted in North American feedlot cattle to investigate the major bacterial pathogens of the bovine respiratory disease (BRD) complex, specifically: Mannheimia haemolytica, Pasteurella multocida, Histophilus somni, and Mycoplasma bovis. While most bacterial isolates recovered from healthy cattle are susceptible to a repertoire of antimicrobials, multidrug resistance is common in isolates recovered from cattle suffering from BRD. Integrative and conjugative elements (ICE) have gained increasing notoriety in BRD-Pasteurellaceae as they appear to play a key role in the concentration and dissemination of antimicrobial resistant genes. Likewise, low macrolide susceptibility has been described in feedlot isolates of M. bovis. Horizontal gene transfer has also been implicated in the spread of AMR within mycoplasmas, and in-vitro experiments have shown that exposure to antimicrobials can generate high levels of resistance in mycoplasmas via a single conjugative event. Consequently, antimicrobial use (AMU) could be accelerating AMR horizontal transfer within all members of the bacterial BRD complex. While metagenomics has been applied to the study of AMR in the microbiota of the respiratory tract, the potential role of the respiratory tract microbiome as an AMR reservoir remains uncertain. Current and prospective molecular tools to survey and characterize AMR need to be adapted as point-of-care technologies to enhance prudent AMU in the beef industry.

Integrated surveillance of antimicrobial resistance and antimicrobial use: Evaluation of the status in Canada (2014-2019)

OBJECTIVE

Integrated surveillance of antimicrobial resistance (AMR) and antimicrobial use (AMU) across One Health sectors is critically important for effective, evidence-based policy, stewardship, and control of AMR. Our objective was to evaluate progress towards achieving comprehensive, integrated AMR/AMU surveillance in Canada.

MATERIALS AND METHODS

Based on an environmental scan, interviews of subject matter experts, and reports from the 2014 National Collaborating Centre for Infectious Diseases and the 2016 Canadian Council of Chief Veterinary Officers, we identified 8 core surveillance requirements and their specific components; the latter were assessed using a 2-way classification matrix, with 7 common elements ranked according to development stage.

RESULTS

Components that mapped to requirements of a comprehensive, fully integrated AMR/AMU surveillance system were mostly in the lowest stages of development (Exploration or Program Adoption). However, both the establishment of the Canadian AMR Surveillance System integrated reporting and expansion of existing components under the Canadian Nosocomial Infection Surveillance Program and the Canadian Integrated Program for AMR Surveillance are improvements. Regardless, obvious gaps in Canadian AMR/AMU surveillance prevent this from being a comprehensive and integrated One Health program.

CONCLUSION

Action is needed in 3 crucial areas: i) development of a complete, integrated AMR/AMU surveillance program, based on current success; ii) changes in Federal/Provincial/Territorial policies to require standardized AMR/AMU reporting; and iii) more resources for AMR/AMU surveillance (dedicated persons, funding, and enabling structures and policy). There is an urgent need for prioritization by Federal/Provincial/Territorial governments to address governance, leadership, and funding to create surveillance systems that inform stewardship and policy.

Integrated surveillance of antimicrobial resistance and antimicrobial use: Evaluation of the status in Canada (2014-2019)

OBJECTIVE

Integrated surveillance of antimicrobial resistance (AMR) and antimicrobial use (AMU) across One Health sectors is critically important for effective, evidence-based policy, stewardship, and control of AMR. Our objective was to evaluate progress towards achieving comprehensive, integrated AMR/AMU surveillance in Canada.

MATERIALS AND METHODS

Based on an environmental scan, interviews of subject matter experts, and reports from the 2014 National Collaborating Centre for Infectious Diseases and the 2016 Canadian Council of Chief Veterinary Officers, we identified 8 core surveillance requirements and their specific components; the latter were assessed using a 2-way classification matrix, with 7 common elements ranked according to development stage.

RESULTS

Components that mapped to requirements of a comprehensive, fully integrated AMR/AMU surveillance system were mostly in the lowest stages of development (Exploration or Program Adoption). However, both the establishment of the Canadian AMR Surveillance System integrated reporting and expansion of existing components under the Canadian Nosocomial Infection Surveillance Program and the Canadian Integrated Program for AMR Surveillance are improvements. Regardless, obvious gaps in Canadian AMR/AMU surveillance prevent this from being a comprehensive and integrated One Health program.

CONCLUSION

Action is needed in 3 crucial areas: i) development of a complete, integrated AMR/AMU surveillance program, based on current success; ii) changes in Federal/Provincial/Territorial policies to require standardized AMR/AMU reporting; and iii) more resources for AMR/AMU surveillance (dedicated persons, funding, and enabling structures and policy). There is an urgent need for prioritization by Federal/Provincial/Territorial governments to address governance, leadership, and funding to create surveillance systems that inform stewardship and policy.

Canadian Dairy Network for Antimicrobial Stewardship and Resistance (CaDNetASR): An On-Farm Surveillance System

Canada has implemented on-farm antimicrobial resistance (AMR) surveillance systems for food-producing animals under the Canadian Integrated Program for Antimicrobial Resistance (CIPARS); however, dairy cattle have not been included in that program yet. The objective of this manuscript was to describe the development and implementation of the Canadian Dairy Network for Antimicrobial Stewardship and Resistance (CaDNetASR). An Expert Panel (EP) of researchers was created to lead the development of the dairy surveillance system. The EP initiated a draft document outlining the essential elements of the surveillance framework. This document was then circulated to a Steering Committee (SC), which provided recommendations used by the EP to finalize the framework. CaDNetASR has the following components: (1) a herd-level antimicrobial use quantification system; (2) annually administered risk factor questionnaires; and (3) methods for herd-level detection of AMR in three sentinel enteric pathogens (generic Escherichia coli, Campylobacter spp., and Salmonella spp.) recovered from pooled fecal samples collected from calves, heifers, cows, and the manure pit. A total of 144 dairy farms were recruited in five Canadian provinces (British-Columbia, Alberta, Ontario, Québec, and Nova-Scotia), with the help of local herd veterinarians and regional field workers, and in September 2019, the surveillance system was launched. 97.1 and 94.4% of samples were positive for E. coli, 63.8, and 49.1% of samples were positive for Campylobacter spp., and 5.0 and 7.7% of samples were positive for Salmonella spp., in 2019 and 2020, respectively. E. coli was equally distributed among all sample types. However, it was more likely that Campylobacter spp. were recovered from heifer and cow samples. On the other hand, it was more common to isolate Salmonella spp. from the manure pit compared to samples from calves, heifers, or cows. CaDNetASR will continue sampling until 2022 after which time this system will be integrated into CIPARS. CaDNetASR will provide online access to farmers and veterinarians interested in visualizing benchmarking metrics regarding AMU practices and their relationship to AMR and animal health in dairy herds. This will provide an opportunity to enhance antimicrobial stewardship practices on dairy farms in Canada.

Prevalence, Risk Factors, and Antimicrobial Resistance Profile of Respiratory Pathogens Isolated From Suckling Beef Calves to Reprocessing at the Feedlot: A Longitudinal Study

Here, we investigated the prevalence and risk factors for the presence of Histophilus somni, Mannheimia haemolytica, Mycoplasma bovis, and Pasteurella multocida in the respiratory tract of calves from the spring processing to the reprocessing at feedlots. Additionally, we characterized, phenotypically and genotypically, the antimicrobial resistance (AMR) profile of the four species. Calves from 22 cow-calf operations were enrolled in the study (n = 30 calves per operation) and sampled by deep nasopharyngeal swabs at three time points: spring processing, weaning, or induction into feedlots, and at reprocessing at the feedlot. Isolates were tested for susceptibility using the minimum inhibitory concentration (MIC) test against commonly administered antimicrobials. Additionally, a subset of isolates underwent whole-genome sequencing to infer presence of AMR genes and resistance determinants. Among studied pathogens, P. multocida was the most prevalent species, regardless of time point, followed by M. haemolytica, M. bovis, and H. somni. For M. bovis, a sharp increase in prevalence was detected at the reprocessing sampling, whereas for P. multocida, an increase in prevalence was observed at the weaning/induction sampling. Comingling and co-location of feedlots were not associated with prevalence of any respiratory pathogen. In terms of AMR, resistance against macrolides was prevalent in M. bovis, with most isolates resistant against tildipirosin, tilmicosin, and tylosin. In general, there was limited evidence to support an increase in resistance rates of respiratory bacteria from the spring processing to reprocessing at feedlots, with the exception of florfenicol resistance in M. bovis, which increased at reprocessing. Metaphylactic administration of tetracyclines at feedlot induction was not associated with the MIC of tetracyclines in any respiratory bacteria. Conversely, there were clear associations between the parenteral use of macrolides as metaphylaxis at the feedlot induction, and increased MIC against macrolides in P. multocida, M. haemolytica, and H. somni. Overall, the AMR phenotypes were corroborated by presence of AMR genes. We hypothesize that the administration of macrolides such as tulathromycin at feedlot induction contributes to historical changes in macrolides MIC data of respiratory bacteria of beef cattle.

One Health Evaluation of Antimicrobial Use and Resistance Surveillance: A Novel Tool for Evaluating Integrated, One Health Antimicrobial Resistance and Antimicrobial Use Surveillance Programs

We describe the development, application and utility of our novel, One Health Evaluation of Antimicrobial Use and Resistance Surveillance (OHE-AMURS) tool that we created to evaluate progress toward integrated, One Health surveillance of antimicrobial resistance (AMR) and antimicrobial use (AMU) as a complex system in Canada. We conducted a qualitative inquiry into the current state of policy and programs for integrated AMR/AMU surveillance using explicit and tacit knowledge. To assess the "messy" state of public health surveillance program development, we synthesized recommendations from previous reports by the National Collaborating Centre for Infectious Diseases and the Canadian Council of Chief Veterinary Officers; conducted an environmental scan to find all federal, provincial, and territorial AMR/AMU surveillance programs in Canada; and conducted semi-structured interviews with Canadian subject matter experts. To integrate evidence from these different sources we adapted two published tools to create a new evaluation matrix, deriving 36 components of the ideal integrated AMR/AMU surveillance system. Our two-way matrix tool allowed us to examine seven common, foundational elements of sustainable programs for each component, and assign a stage of development/sustainability ranking for each component according to the matrix definitions. Our adaptable novel tool allowed for granular and repeatable assessment of the many components of a complex surveillance system. The assessment proved robust and exacting to ensure transparency in our methods and results. The matrix allows flexible assignment of program components based on program principles, and stages can be adapted to evaluate any aspect of an AMR/AMU surveillance or other multi-faceted, multi-jurisdictional system. Future refinement should include an assessment of the scope of surveillance components.

Prevalence and Risk Factors Associated With Antimicrobial Resistance in Bacteria Related to Bovine Respiratory Disease-A Broad Cross-Sectional Study of Beef Cattle at Entry Into Canadian Feedlots

A broad, cross-sectional study of beef cattle at entry into Canadian feedlots investigated the prevalence and epidemiology of antimicrobial resistance (AMR) in Mannheimia haemolytica, Pasteurella multocida, Histophilus somni, and Mycoplasma bovis, bacterial members of the bovine respiratory disease (BRD) complex. Upon feedlot arrival and before antimicrobials were administered at the feedlot, deep nasopharyngeal swabs were collected from 2,824 feedlot cattle in southern and central Alberta, Canada. Data on the date of feedlot arrival, cattle type (beef, dairy), sex (heifer, bull, steer), weight (kg), age class (calf, yearling), source (ranch direct, auction barn, backgrounding operations), risk of developing BRD (high, low), and weather conditions at arrival (temperature, precipitation, and estimated wind speed) were obtained. Mannheimia haemolytica, P. multocida, and H. somni isolates with multidrug-resistant (MDR) profiles associated with the presence of integrative and conjugative elements were isolated more often from dairy-type than from beef-type cattle. Our results showed that beef-type cattle from backgrounding operations presented higher odds of AMR bacteria as compared to auction-derived calves. Oxytetracycline resistance was the most frequently observed resistance across all Pasteurellaceae species and cattle types. Mycoplasma bovis exhibited high macrolide minimum inhibitory concentrations in both cattle types. Whether these MDR isolates establish and persist within the feedlot environment, requires further evaluation.