Knowledge, Attitude, and Practices on Antimicrobial Use and Antimicrobial Resistance among Commercial Poultry Farmers in Bangladesh

Perspective on Antibiotic Resistance in Bangladesh: A Critical Yet Overlooked Public Health Crisis

Background and Aims

This article explores antibiotic resistance as a critical public health issue in Bangladesh, emphasizing its growing threat to the nation's healthcare system. As a developing country, Bangladesh faces unique challenges in managing this crisis, with antibiotic resistance posing significant risks due to its multidimensional problems to both individual health and the broader population.

Methods

We searched for relevant pieces of literature that discuss the antibiotic resistance problem both from a global and national perspective. Based on the importance and our objectives we selected the relevant articles. The perspective was written using the evidence and information available in those articles.

Results

Key factors contributing to the rise of antibiotic resistance include the irrational use and prescription of antibiotics in both healthcare settings and agriculture, incomplete doses of antibiotics, and insufficient public awareness. The article also discusses potential policy recommendations, such as the implementation of stricter antimicrobial stewardship programs, enhanced surveillance systems, and public education campaigns to reduce the misuse of antibiotics.

Conclusion

In conclusion, antibiotic resistance in Bangladesh requires urgent attention and coordinated efforts from all sectors of society to prevent further deterioration of public health and safeguard future generations.

An application of COM-b model to explore factors influencing veterinarians' antimicrobial prescription behaviors: Findings from a qualitative study in Bangladesh

The integration of behavioral theories in designing antimicrobial stewardship (AMS) interventions aimed at optimizing the antimicrobial prescription in veterinary practice is highly recommended. However, little is known about the factors that influence veterinarians' antimicrobial behavior for food-producing animals in lower- and middle-income settings like Bangladesh. There is a large body of research on the factors that influence veterinarian behavior of prescribing antimicrobials, however, there is a need for more studies that use comprehensive behavior change models to develop and evaluate interventions. Applying the Capability, Opportunity, and Motivation for Behavior (COM-B) model, this qualitative study attempted to address this gap by conducting 32 one-on-one semi-structured interviews with registered veterinarians in Bangladesh. In alignment with COM-B constructs and the theoretical domain framework (TDF), thematic analysis (both inductive and deductive inferences) was performed to analyze the data and identify underlying factors that influence veterinarians' antimicrobial prescription behavior. We found that under "Capability," factors such as knowledge of antimicrobial resistance (AMR); ability to handle complex disease conditions; ability to identify the appropriate antimicrobial type, routes of administration, and potential side effects influence prescription behavior by veterinarians. Under "Opportunity," veterinarians' prescription behavior was influenced by lack of laboratory testing facilities, poor farm biosecurity, farm management and location, farming conditions, impacts of climate change, the clinical history of animals and social influence from different actors including senior figures, peers, farmers, and other informal stakeholders. Under "Motivation," national laws and guidelines serve as catalysts in reducing antimicrobial prescriptions. However, perceived consequences such as fear of treatment failure, losing clients, farmers' reliance on informal service providers, and economic losses demotivate veterinarians from reducing the prescription of antimicrobials. Additionally, veterinarians feel that reducing the burden of AMR is a shared responsibility since many informal stakeholders are involved in the administration and purchase of these medicines. Based on our results, this study recommends incorporating the factors we identified into existing or novel AMS interventions. The behavior change wheel can be used as the guiding principle while designing AMS interventions to increase capability, opportunity and motivation to reduce antimicrobial over-prescription.

Quantification of Antimicrobial Use on Commercial Broiler Farms in Pakistan

Pakistan has a large, intensive broiler production industry, where antimicrobials are extensively used for both therapeutic and prophylactic purposes. Monitoring antimicrobial use (AMU) at the farm level is crucial to guide interventions for antimicrobial stewardship. The objective of this study was to comprehensively quantify AMU on commercial broiler farms in Pakistan using different metrics. Data on on-farm AMU (both therapeutic and prophylactic) were collected from intensive commercial broiler farms in Punjab, Pakistan. AMU was quantified using four different metrics: treatment incidence (TI) based on defined daily dose (TIDDDvetPK), TI based on defined course dose (TIDCDvetPK), TI based on used daily dose (TIUDDvetPK), and mg/kg biomass. The median TIDDDvetPK, TIDCDvetPK, TIUDDvetPK, and mg/kg biomass values were 57.7 (7.5-257.9), 13.3 (1.8-52.5), 75.3 (21.1-182.9), and 301 (46.8-1009.6), respectively, based on 741 group treatments given at 100 participating farms with 225 flocks. About 34% treatments were administered for therapeutic purposes, with 66% administered as prophylaxis. A total of 41 active substances, distributed across 17 antimicrobial classes, were identified from 139 commercial antimicrobial products used. The most commonly used active substances (AS), out of total 741 group treatments, were colistin (polymyxins) at 17%, enrofloxacin (quinolones) at 8%, neomycin (aminoglycosides) and amoxicillin (aminopenicillins) at 7% each, and procaine penicillin (NS penicillins) and streptomycin (aminoglycosides) at 6% each. According to the WHO categorization, 57% of the used AS were found to be critically important antimicrobials (CIAs) for human medicine. As many as 30% of treatments were administered in the first week (13% on the first day of production), and the main indication was prophylaxis for early chick mortality, followed by 21% in week 5, with main indication being feed supplements for necrotic enteritis. The average weight at slaughtering was 2.25 kg, gained after an average of 44 days of the production cycle. The alarmingly high AMU in Pakistani broiler production emphasizes the urgent need to reduce AMU, particularly involving CIAs and the prophylactic use of antimicrobials. This can be achieved by improving farm management practices and strengthening regulatory oversight to enable prudent antimicrobial use, eventually reducing the risk of AMR.

Detection and characterization of multidrug resistant Escherichia coli carrying virulence gene isolated from broilers in Bangladesh

BACKGROUND

The emergence and dissemination of multidrug resistant (MDR) bacteria pose a severe threat to public health by limiting clinical treatment and prophylactic options.

OBJECTIVES

This study investigates the prevalence of Escherichia coli in broilers, their phenotypic antimicrobial resistance (AMR) profiles and the presence of virulence-associated genes (VAGs) and antimicrobial resistance genes (ARGs) using polymerase chain reaction (PCR).

MATERIALS AND METHODS

A total of 216 pooled cloacal samples were collected from 1080 broilers across six districts of Bangladesh. Each pooled sample comprised randomly selected cloacal swabs from five birds per farm. E. coli isolates were identified using standard bacteriological approach, followed by biochemical assays and PCR. Antimicrobial susceptibility was assessed using the Kirby-Bauer disc diffusion method, and the presence of ARGs and VAGs was determined via PCR. Five selected isolates were partially sequenced for five VAGs using Sanger sequencing.

RESULTS

A total of 177 E. coli isolates (81.94%, 95% confidence interval: 76.24%-86.53%) were identified. The isolates showed the highest resistance to ampicillin (93.79%), followed by tetracycline (91.53%), erythromycin (89.27%) and ciprofloxacin (87%). Conversely, ceftriaxone (80.79%) showed highest susceptibility, followed by gentamicin (37.29%) and neomycin (31.07%). All isolates were MDR, with a multiple antibiotic resistance indexes were <0.3. A significant percentage (16.38%) of E. coli isolates were MDR to five antimicrobial classes and harboured blaTEM, sul1, ere (A), tetA, tetB and tetC genes. The highest prevalent ARGs were blaTEM (88.14%) followed by ere (A) (83.62%) and sul 1 (72.32%). The prevalence of VAGs was astA (56.50%), iucD (31.07%), iss (21.47%), irp2 (15.82%) and cva/cvi (3.39%), respectively.

CONCLUSIONS

This study highlights the presence of ARGs contributing to the development of MDR in E. coli carrying VAGs in broilers. Effective monitoring and surveillance of antimicrobial usage in poultry production systems are urgently required to prevent emergence and dissemination of AMR.

Evaluation of the Knowledge, Attitudes and Practice of Veterinary Professionals and Senior Animal Health Students in Central Gondar Zone, Gondar, Ethiopia: Antimicrobial Use and Resistance Perspectives

BACKGROUND

Antimicrobial resistance (AMR) poses a worldwide challenge to the well-being of animals and humans. The emergence of AMR is largely attributed to the improper utilization and overuse of antimicrobials. In order to combat this issue and promote responsible antimicrobial use (AMU), it is imperative for veterinary professionals and graduating students to possess extensive knowledge, maintain positive attitudes, and adhere to good practices regarding AMU and AMR.

OBJECTIVE

To assess the knowledge, attitude and practices (KAPs) of veterinary professionals and senior animal health students' towards veterinary AMU and AMR.

METHODS

A cross-sectional study design was conducted on purposefully selected 200 participants (60 of them were veterinary professionals from the districts and towns, and the remaining 140 were senior animal health university students). A self-administered, structured questionnaire was used to collect the necessary data, and descriptive statistics were used to summarize the data.

RESULTS

The study revealed that, overall, study participants' KAP were not satisfactory. From veterinary professionals, about 56.7% of respondents scored average knowledge, whereas 66.7% and 61.66% of them had negative attitudes and poor practices, respectively, on AMU and AMR. The study found that 56% of the participants' think the previous knowledge they acquired regarding AMU and AMR was not sufficient, and the internet was used as a source of drug information by the majority of participants. The majority (72%) of them were not taking special training on AMU and AMR. Regarding senior animal health students, this study indicated that 52% and 69.2% of the respondents had poor knowledge and a negative attitude, respectively, towards AMU and AMR.

CONCLUSION

Overall, veterinary professionals in the central Gondar zone have average knowledge, a negative attitude and poor practices. Poor knowledge and a negative attitude were also observed among senior animal health students towards AMU and AMR. Therefore, to fill the observed gaps, activities that enhance the skills of veterinary professionals and students should be implemented. Ingreted measures with animicrobial stewardship program and Nationwide studies are highly suggested to evaluate the overall status of veterinary professionals towards AMU and AMR.

A review of antimicrobial usage practice in livestock and poultry production and its consequences on human and animal health

Antimicrobials are employed in the control of contagious illnesses in humans and animals and are also utilized as growth enhancers in livestock and poultry. Improper application of antibiotics results in the development of multi-drug-resistant (MDR) bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant S. aureus (VRSA), colistin-resistant, extended-spectrum beta-lactamase (ESBL)-producing E. coli, and fluoroquinolone-resistant Salmonella. Transmission of MDR bacteria happens among animals, from human to animal, and vice versa, resulting in treatment failure, increased treatment cost, and high morality. In this article, we analyzed the recent publications of the current antimicrobial application practices in livestock and poultry farms and the development of antimicrobial resistant (AMR) bacteria in livestock and poultry and its adverse effects on human and animal health using PubMed, Google Scholar, and Google. Citations from published articles were also analyzed. Several drug-resistant bacteria, including MRSA, VRSA, colistin-resistant strains, ESBL-producing E. coli, and fluoroquinolone-resistant Salmonella, have emerged due to heavy antibiotic application in cattle and poultry, according to the analysis. Transmission happens between people and animals as well as throughout the production chain, which raises the chance of failure of antibiotic therapy and fatality. To stop the proliferation of drug-resistant bacteria, it is important to ensure the proper use of antibiotics in livestock and poultry. Especially in developing nations, strict control and implementation of antimicrobial rules are necessary. To successfully address antimicrobial resistance and lessen dependency on antibiotics, alternative disease management strategies in livestock and poultry must be developed.

Understanding the awareness of antimicrobial resistance amongst commercial poultry farmers in northwestern Nigeria

The emergence of antimicrobial resistance (AMR) in both humans and animals is a growing health threat worldwide. Significant quantities of antibiotics are used in the livestock production sector, particularly in poultry farming to enhance growth and productivity. A cross-sectional study was conducted in three states of northwestern Nigeria to understand the level of knowledge, attitude, and practice of commercial poultry farmers on antimicrobial resistance. A total of 247 poultry farmers enrolled in the study comprising 100 (40.5 %) from Sokoto, 68 from Kebbi (27.5 %) and 79 (32.0 %) from Zamfara States. A significant number of the farmers have good knowledge of antimicrobial use (94.74 %), and the potential emergence of antimicrobial resistant bacteria due to irrational administration of antibiotics (83.0 %). Kruskal-Wallis test showed a significant difference in farmers' knowledge of AMR based on their educational qualification (p < 0.001) as farmers with bachelor's degree (BSc) being more knowledgeable than those with Ordinary National Diploma (OND) and those who only completed primary or secondary education. A statistically significant difference was also observed in the attitude of the participants based on State (p < 0.001) and educational qualification (p = 0.013). The study provided valuable insight into the understanding of antimicrobial resistance amongst commercial poultry farmers in the region. The findings necessitate the need for educational interventions and initiatives through enlightenment campaigns and deployment of extension workers to reach farmers with low level of education to further improve their attitudes and practice towards responsible use of antibiotics.

Assessment of knowledge, attitudes, and practices on vaccine usage among small ruminant farmers in the Northern Region of Bangladesh

Background and Aim

Small ruminants require vaccines to prevent and manage diseases. Unfortunately, no studies have been conducted in Bangladesh to assess the knowledge, attitudes, and practices (KAP) of small ruminant farmers (SRF) regarding vaccine use against infectious diseases, affecting the success of vaccination campaigns. The present study aims to assess SRF's KAP regarding vaccines, revealing gaps and barriers to efficient vaccination.

Materials and Methods

Two hundred and twenty-eight SRF in northern Bangladesh were surveyed in a cross-sectional study. Data were collected from random participants through face-to-face interviews using a structured questionnaire. KAP levels were categorized as "good" or "poor" and "positive" or "negative" using a scoring method with a 60% cutoff. The analysis comprised the utilization of descriptive statistics as well as logistic regression models.

Results

Results showed that most participants were female (60.5%), aged 31-40 (34.2%), with secondary education (28.1%), and vaccination training (22.8%). While 75% knew about vaccines, only 37.3% understood their role in preventing infectious diseases, and 63.6% in reducing antibiotic use 68.4% of farmers were aware of negative drawbacks, and 61.8% reported vaccinating their herds. About 42.1% of the farmers had good knowledge, 52.6% had a positive attitude, and 22.8% followed good practices. Female farmers with graduate degrees and 6-10 years of goat farming experience, but not those with vaccination training, demonstrated stronger knowledge. Female farmers with a graduate degree and 6-10 years of goat farming experience displayed positive attitudes. Female goat farmers from Thakurgaon had a higher likelihood of following good vaccination practices than those with vaccination training.

Conclusion

The study unearths disparities in KAP scores among farmers. To effectively address KAP gaps concerning vaccine usage and prevent potential infectious diseases, it is essential to design focused educational and training programs. About 52.6% of SRF hold a positive view toward vaccines.

Understanding veterinary drug shop workers' knowledge and practices to identify drivers of antibiotic use in Vietnamese livestock farms

BACKGROUND

Antimicrobial resistance (AMR) is a One Health issue and a major threat to animal and human health. Antibiotic use (ABU) drives AMR development, and several hotspots for ABU, and AMR, in livestock have been identified in Southeast Asia, including Vietnam. There are often multiple drivers of ABU at farms, and to identify all of them there is a need to look beyond farm level.

OBJECTIVES

The overall aim of this study was to identify routines and/or competencies, related to antibiotic sales, among veterinary drug shop workers that may be improved in order to decrease the medically non-rational use of antibiotics in livestock production.

METHODS

A questionnaire-based survey was conducted at 50 veterinary drug shops in northern Vietnam.

RESULTS

Results showed high education and knowledge levels. According to the respondents, antibiotic treatment advice was almost always provided to the farmers, and the recommended treatment was most commonly based on recommendations for the specific disease. However, farmers had almost never had their animals properly diagnosed. Antibiotics were the most sold drug category, penicillins being the most common. Several broad-spectrum antibiotics were also quite frequently sold. Further, >50% of respondents recommended antibiotics for disease prevention.

CONCLUSIONS

Even though education and knowledge levels might be high, several challenges can prevent drug shop workers from contributing to more prudent ABU at farms, for example, lack of proper diagnosis, commercial interests and individual farmer motives, often in combination with poor compliance to regulations.

Knowledge, Attitudes, and Practices of Antibiotic Use among Small-, Medium-, and Large-Scale Fish Farmers of the Stratum II of the Volta Lake of Ghana

BACKGROUND

Antibiotic residue in food products and the resulting antibiotic-resistant bacteria represent a significant global public health threat. The misuse of antibiotics is a primary contributor to this issue. This study investigated the knowledge, attitudes, and practices (KAP) regarding antibiotic use among cage fish farmers on Ghana's Volta Lake.

METHOD

We conducted a cross-sectional survey with 91 cage fish farmers across three scales: small, medium, and large. A semi-structured questionnaire complemented by personal observations provided comprehensive data. We used several statistical methods for analysis: Pearson Chi-Square and Spearman correlation tests to examine relationships and trends among variables, logistic regression to analyze variable interactions, and Cronbach's alpha to check internal consistency. Additionally, Kendall's coefficient was used to rank challenges, utilizing STATA and SPSS for these calculations.

RESULTS

The survey revealed that 58.55% of cage fish farmers earn an average of 10,000 USD annually, with 35.16% having over 16 years of experience. From the survey, all sampled populations admitted to antibiotic applications in their farming operation. Knowledge of antibiotic types was mainly influenced by peers (46.15%), with tetracycline being the most recognized and used. There was a significant reliance on the empirical use of antibiotics, with 52.75% of farmers using them based on personal experience and 40.66% without a prescription. When initial treatments failed, 41.76% of the farmers would change or combine drugs. Older farmers (over 51 years) and those with tertiary education demonstrated significantly better KAP scores regarding antibiotic use. Strong correlations were also found among knowledge, attitudes, and practices in antibiotic usage.

CONCLUSIONS

The findings indicate a need for improved education on antibiotic use among fish farmers to reduce misuse and enhance awareness of the potential consequences. This study provides foundational data for designing interventions to address these issues in the context of cage fish farming on Volta Lake.

Genomic characterisation of Escherichia coli isolated from poultry at retail through Sink Surveillance in Dhaka, Bangladesh reveals high levels of multi-drug resistance

The surveillance of antimicrobial resistance (AMR) in commensal Escherichia coli from livestock at slaughter is widely employed to assess the potential for risk to humans. There is currently a limited understanding of AMR in Bangladesh poultry at retail in live bird markets, with studies focussing solely on phenotypic characterisation of resistance. To address this evidence gap we performed antimicrobial susceptibility testing and whole genome sequencing on E. coli obtained from chickens from live bird markets in Dhaka in 2018 (n = 38) and 2020 (n = 45). E. coli were isolated from caeca samples following ISO guidelines and sequenced using short and long read methods. Multidrug resistance was extremely common (n = 77) and there was excellent concordance between AMR phenotype and the presence of corresponding AMR genes or mutations. There was considerable genomic diversity, with 43 different sequence types detected. Public health considerations included the high occurrence of resistance to ciprofloxacin (n = 75) associated with plasmid-residing qnrS or mutations in the gyrA and parC chromosomal genes; and the detection of a tigecycline resistant isolate harbouring tet(X4) on an IncHI1A/B-IncFIA mosaic plasmid. Thirty-nine isolates were resistant to azithromycin and harboured mphA, with a significant increase in the incidence of resistance between 2018 and 2020. Although azithromycin is banned for veterinary use in Bangladesh it remains an important treatment option for humans. Interestingly, mphA confers high-level resistance to azithromycin and erythromycin, and the latter is commonly used on poultry farms in Bangladesh. Seven isolates were colistin resistant and carried mcr1. For two isolates hybrid assemblies revealed that mcr1 resided on a highly conserved IncHI2 plasmid that had 93% nucleotide identity to a plasmid from the published genome of an E. coli isolate of Bangladeshi human origin. Six isolates had resistance to third generation cephalosporins, associated with plasmid-residing bla CTX-M-55, bla CTX-M-65, or bla DHA-1. By employing phenotypic and genomic approaches for AMR surveillance we have provided new insights into the potential for One Health AMR linkages in Bangladesh. Employing similar approaches in human and environmental sectors will help inform the One Health approach to addressing AMR, and generate evidence to support mitigation measures such as improved antimicrobial stewardship.

Evaluation of cattle farmers' knowledge, attitudes, and practices regarding antimicrobial use and antimicrobial resistance in Rwanda

The misuse of antimicrobials in livestock may lead to the emergence and spread of resistant pathogens harmful to human, animal, and environmental health. Therefore, determining the behavior and practices of farmers regarding antimicrobial use (AMU) and antimicrobial resistance (AMR) is crucial for addressing the growing threat of AMR. This cross-sectional study was conducted in the Eastern Province of Rwanda on 441 participants using a structured questionnaire to determine the knowledge, attitudes, and practices (KAP) towards AMU and AMR. Frequency distributions, chi-square test of association and logistic regression model were used to analyze the data. This study showed poor biosecurity measures at the farm level with various antimicrobials used here; 83.9% of participants obtained them from friends and neighbors and 61.9% used them for growth promotion. Our assessment revealed a low level of KAP towards AMR among cattle farmers from the study districts. Our data showed that at a 69% cutoff, only 52.6% of farmers had correct knowledge, whereas 56% had good attitudes (47% cutoff). Finally, 52.8% had correct practices toward AMR based on a calculated cutoff of 50%. Positive attitudes, correct knowledge, and practices regarding AMU and AMR were associated with higher educational levels. Sex was correlated with knowledge and attitudes, whereas farm location was associated with attitudes and practices. Farmers expressed a need for more access to veterinary services and AMR-related training for themselves, the community animal health workers, and veterinarians. This study highlighted the low levels of KAP associated with using antimicrobials, which may lead to the misuse of antimicrobials and the spread of AMR. It is imperative to develop and implement cross-cutting measures to minimize antibiotic usage and reduce the risk of antibiotic resistance.

Understanding Vietnamese chicken farmers' knowledge and practices related to antimicrobial resistance using an item response theory approach

Introduction

Antimicrobial resistance (AMR) poses a threat to animal and human health, as well as food security and nutrition. Development of AMR is accelerated by over- and misuse of antimicrobials as seen in many livestock systems, including poultry production. In Vietnam, high AMR levels have been reported previously within poultry production, a sector which is dominated by small-scale farming, even though it is intensifying. This study focuses on understanding small- and medium-scale chicken farmers' knowledge and practices related to AMR by applying an item response theory (IRT) approach, which has several advantages over simpler statistical methods.

Methods

Farmers representing 305 farms in Thai Nguyen province were interviewed from November 2021 to January 2022, using a structured questionnaire. Results generated with IRT were used in regression models to find associations between farm characteristics, and knowledge and practice levels.

Results

Descriptive results showed that almost all farmers could buy veterinary drugs without prescription in the local community, that only one third of the farmers received veterinary professional advice or services, and that the majority of farmers gave antibiotics as a disease preventive measure. Regression analysis showed that multiple farm characteristics were significantly associated to farmers' knowledge and practice scores.

Conclusion

The study highlights the complexity when tailoring interventions to move towards more medically rational antibiotic use at farms in a setting with high access to over-the-counter veterinary drugs and low access to veterinary services, since many on-farm factors relevant for the specific context need to be considered.

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.

Assessment of Knowledge, Attitude and Practice (KAP) Regarding Antimicrobial Usage and Resistance Among Animal Health Professionals of East Wallaga Zone, Oromiya, Ethiopia

Background

Antimicrobial resistance (AMR) is one of the top global public health and economic threats. The use of antimicrobials (AMs) in animal production is a major contributor to the development of AMR globally. Animal health professionals (AHPs) play a key role in ensuring judicious use of AMs.

Objective

To assess the knowledge, attitude and practice (KAP) of antimicrobial usage (AMU) and AMR among healthcare professionals in Nekemte town, Leka Dulecha and Sibu Sire districts.

Methods

A cross-sectional study was conducted with 120 purposively chosen AHPs residing in the districts and the town. A semi-structured questionnaire consisting of 49 questions was used to ascertain the KAP. The chi-square test (X2) was used to analyze the association between the knowledge score and demographic profile of the study participants.

Results

In the study the overall knowledge of the participants was moderately appreciable, and all participants had positive attitudes toward AMR and appropriate usage. In terms of knowledge of antibiotic use, the majority (93.33%) of the participants correctly answered the statement that antibiotics can kill viruses. About 84.17% of the participants correctly knew that antibiotics killed or stopped the growth of both bad and good bacteria. The majority of the participants (74.17%) always or (25.83%) sometimes rely on usage of antibiotics without a doctor's prescription. It was shown that comparing respondents from Sibu Sire, Leka Dulecha and Nekemte town, the scores of knowledge of AMU were significantly (X2=14.13, p=0.007) different. Most animal healthcare professionals from the Sibu sire have a good knowledge of AMU, and contribute to AMR development.

Conclusion

The study revealed that there was moderate knowledge and positive attitude toward AMU and resistance. This warrants continuing capacity building programs for the professionals on AM usage and resistance, and development of field-friendly disease diagnosis and management tools is essential in the need to reduce AMR.

Assessment of the Implementation of Pakistan's National Action Plan on Antimicrobial Resistance in the Agriculture and Food Sectors

The agriculture and food (agrifood) sectors play key roles in the emergence, spread, and containment of antimicrobial resistance (AMR). Pakistan's first National Action Plan (NAP) on AMR was developed to guide One Health interventions to combat AMR through 2017-2022. To improve subsequent iterations, we assessed the implementation of Pakistan's NAP in the agrifood sectors (NAPag) in October 2022, using the Progressive Management Pathway on AMR tool developed by the Food and Agriculture Organization of the United Nations (FAO). The assessment tool addressed four crucial focus areas of the NAPag: governance, awareness, evidence, and practices. Each focus area contains multiple topics, which involve four sequential stages of activities to progressively achieve systematic management of AMR risk in the agrifood sectors. High-level representatives of the NAPag stakeholders provided information for the assessment through pre-event documentary review and workshop discussions. The assessment results showed that Pakistan's NAPag had an overall moderate coverage (59%) of the anticipated activities. Gaps were particularly notable in strengthening governance, good practices, and interventions in non-livestock sectors. Furthermore, only 12% of the evaluated activities were fully executed and documented, consistently remaining at the planning and piloting stages in the livestock sector across all the examined topics. Insufficient attention to non-livestock sectors, inadequate regulation and enforcement capacity, and resource constraints have hindered scalable and sustainable interventions under the current plan. This assessment provides valuable insights to strengthen the inclusiveness and contribution of the agrifood sectors in the next NAP iteration. In the short-to-medium term, strategic prioritization is necessary to optimize the use of limited resources and target the most critical gaps, such as improving awareness among key stakeholders and fortifying regulations for prudent antimicrobial use. In the long term, integration of AMR into the country's broader health, development, and agricultural transformation agendas will be needed to generate sustainable benefits.

Challenges in the profitability of small-scale broiler farming by avoiding injudicious use of drugs and additives

The aim of the current study was to determine the present scenario of injudicious use of drugs and additives in small-scale broiler operations and whether broilers can be produced successfully and profitably without the injudicious use of drugs and additives. First, a survey was undertaken in relation to farmers' basic information and general management methods in commercial broilers, with special attention given to the usage of medications and additives in drinking water. Second, based on the survey data, an experimental trial was carried out to compare the growth performance and economic profitability of rearing broilers with and without the use of said drugs and additives. A total of 540 broiler DOCs were allotted into three treatments: T1 = self-formulated feed (SFF) with judicious use of drugs and additives; T2 = commercial feed with judicious use of drugs and additives (JUDA) and T3 = commercial feed with injudicious use of drugs and additives (InJUDA), with six replications (30 birds/replication) in each. The results showed that the farmers used a variety of drugs and additives in 35 days of broiler rearing; however, the farmers usually did not consult with veterinary practitioners, instead relying on and being instructed by local dealers and medicine company representatives. Although the medications and additives account for almost 6-8% of total production costs, the experimental trial clearly demonstrated that the broilers kept with either JUDA or InJUDA showed statistically (p < 0.05) similar BW (2181.93 g & 2222.53 g/bird), BWG (2110.0 g & 2129.91 g/bird), and FCR (1.62 & 1.57, respectively), whereas broilers in the SFF group showed significantly lower growth performances (BW = 1799.31 g/bird, BWG = 1746.19 g/bird, and FCR = 1.93, respectively). The net profit per kg bird in the JUDA group was substantially (p < 0.05) greater (BDT- 27.34/-), followed by the SFF group (BDT- 25.56/) and the InJUDA group (BDT- 24.49/-). Taken together, these findings suggest that profitable broiler farming is possible without the injudicious use of drugs and additives.

Knowledge, attitudes, and practices regarding antibiotic use in Bangladesh: Findings from a cross-sectional study

BACKGROUND

Escalating antibiotic resistance presents a notable worldwide dilemma, pointing a large involvement of general population. The objective of this study was to assess knowledge, attitudes, and practices regarding the utilization of antibiotics among Bangladeshi residents.

METHODS

A cross-sectional study, conducted from January 01 to April 25, 2022, included 1,947 Bangladeshi adults with a history of antibiotic use, via online surveys and face-to-face interviews using a pretested semi-structured questionnaire. Descriptive statistics, Chi-square tests, and multivariate linear regression models were employed.

RESULTS

Mean scores for knowledge, attitudes, and practices were 6.59±1.20, 8.34±1.19, and 12.74±2.59, with correct rates of 73.22%, 92.67%, and 57.91%. Positive predictors for knowledge included being unmarried (β = 0.10, p = 0.001), higher education (College: β = 0.09, p = 0.025; Bachelor: β = 0.22, p<0.001; Master or above: β = 0.14, p<0.001), various professions (student: β = 0.57, p<0.001; housewife: β = 0.33, p<0.001; employee: β = 0.53, p<0.001; businessman: β = 0.31, p<0.001; unemployed: β = 0.15, p<0.001), and residing in semi-urban (β = 0.32, p<0.001) or urban areas (β = 0.15, p<0.001). Positive predictors for attitudes included being married (β = 0.18, p<0.001), specific professions (student: β = 1.06, p<0.001; housewife: β = 0.33, p<0.001; employee: β = 0.86, p<0.001; businessman: β = 0.37, p<0.001; unemployed: β = 0.47, p<0.001), higher SES (Lower-middle: β = 0.22, p<0.001; Middle: β = 0.26, p<0.001), and residing in semi-urban areas (β = 0.18, p<0.001); negative predictors included higher education (College: β = -0.12, p = 0.001; Master or above: β = -0.09, p = 0.008) and being rich (β = -0.13, p<0.001). Positive predictors for practices included being married (β = 0.18, p<0.001), specific professions (student: β = 0.32, p<0.001; employee: β = 0.43, p<0.001; businessman: β = 10, p = 0.034; unemployed: β = 0.11, p = 0.009), and higher SES (Lower-middle: β = 0.14, p = 0.009; Middle: β = 0.38, p<0.001; Higher-middle: β = 0.15, p = 0.008); negative predictors included higher education (College: β = -0.21, p<0.001), being rich (β = -0.12, p<0.001), residing in semi-urban (β = -0.14, p<0.001) or urban areas (β = -0.16, p<0.001).

CONCLUSIONS

Participants exhibited adequate knowledge and positive attitudes but lagged behind in proper practice of antibiotic use. Proper initiatives should be tailored to enhance prudent antibiotic use and mitigate the risk of antimicrobial resistance.

Identification of terpenoids as dihydropteroate synthase and dihydrofolate reductase inhibitors through structure-based virtual screening and molecular dynamic simulations

Bacterial infections are rising, and antimicrobial resistance (AMR) in bacteria has worsened the scenario, requiring extensive research to find alternative therapeutic agents. Terpenoids play an essential role in protecting plants from herbivores and pathogens. The present study was designed to focus on in silico evaluation of terpenoids for their affinity towards two necessary enzymes, i.e. DHFR and DHPS, which are involved in forming 5, 6, 7, 8-tetrahydrofolate, a key component in bacterial DNA synthesis proteins. Additionally, to account for activity against resistant bacteria, their affinity towards the L28R mutant of DHFR was also assessed in the study. The structure-based drug design approach was used to screen the compound library of terpenes for their interaction with active sites of DHFR and DHPS. Further, compounds were screened based on their dock score, pharmacokinetic properties, and binding affinities. A total of five compounds for each target protein were screened, having dock scores better than their respective standard drug molecules. CNP0169378 (-8.4 kcal/mol) and CNP0309455 (-6.5 kcal/mol) have been identified as molecules with a higher affinity toward the targets of DHFR and DHPS, respectively. At the same time, one molecule CNP0298407 (-5.8 kcal/mol for DHPS, -7.6 kcal/mol for DHFR, -6.1 kcal/mol for the L28R variant), has affinity for both proteins (6XG5 and 6XG4). All the molecules have good pharmacokinetic properties. We further validated the docking study by binding free energy calculations using the MM/GBSA approach and molecular dynamics simulations.Communicated by Ramaswamy H. Sarma.

Mapping of dressed and processed poultry products in Bangladesh: Identifying the food safety risks for policy intervention

Bangladesh's commercial poultry production is growing rapidly, including the commercial processing of poultry. This expansion of poultry processing plants is fueled by the belief that this sub-sector provides safer food and has less food-borne disease risks compared to traditional live bird markets (LBMs). The purpose of this study is to describe Bangladesh's dressed and processed poultry production and distribution network (PDN), identify what and where quality control occurs, and suggest where improvements could be made. Engaging with PDN for dressed and processed poultry, we used in-depth interviews with key informants to identify the stakeholders involved and their connections with other poultry PDNs. In addition, we mapped out the supply and distribution of dressed and processed poultry and quality control processes occurring throughout the network. We argue that dressed and processed poultry PDNs are closely connected with traditional PDNs such as LBMs, with multiple crossover points between them. Also, there is a lack of consistency in quality control testing and a lack of meat traceability. Consequently, perceptions of dressed and processed poultry being safer than birds from LBMs needs to be treated with caution. Otherwise, unsubstantiated consumer confidence in dressed poultry may inadvertently increase the risk of food-borne diseases from these products.

Colistin Resistance in Multidrug-Resistant Escherichia coli Isolated from Retail Broiler Meat in Bangladesh

The emergence of colistin resistance in Escherichia coli is a global public health concern. Contaminated food can accelerate the spread of colistin-resistant E. coli to humans. This study aimed to detect and characterize colistin-resistant E. coli from broiler meat in Bangladesh. We analyzed 136 pooled broiler meat samples from 240 carcasses collected from 40 live bird markets in urban and rural areas and 8 metropolitan supermarkets. The mean count of E. coli in broiler meat samples collected from rural retail shops, metropolitan supermarkets, and urban retail shops was 5.3 ± 1.1, 4.1 ± 1.4, and 3.9 ± 0.8 log10 colony-forming unit per gram, respectively. Colistin-resistant E. coli (minimum inhibitory concentration >2 mg/L) was found in 78% (95% confidence interval 70.2-84.1%) of the samples. All colistin-resistant isolates harbored the mcr-1 gene, while the rest of the mcr genes (mcr-2 to mcr-9) were not detected. Most colistin-resistant E. coli isolates (98%) showed coresistance to tetracycline, sulfamethoxazole/trimethoprim followed by ciprofloxacin (95%). Alarmingly, all of the colistin-resistant isolates were found to be multidrug resistant. Phylogenetic analysis showed close similarities of the mcr-1 gene sequences of this study with many strains of Enterobacterales isolated from humans, animals, and the environment. This study detected colistin-resistant E. coli contamination in broiler meat, which can pose a serious public health threat.

Public knowledge, attitudes, and practices (KAP) regarding antibiotics use and antimicrobial resistance (AMR) in Bangladesh

Background

Antibiotic resistance is a global public health concern that requires an understanding of public knowledge, attitudes, and practices (KAP) towards antibiotics. This study aimed to assess the KAP regarding antibiotic use and AMR among the general population in Bangladesh.

Methods

A cross-sectional survey was conducted among 656 respondents in Bangladesh. Data on socio-demographic characteristics, knowledge, attitudes, and practices regarding antibiotics use and AMR were collected through a structured questionnaire. Descriptive statistics and ordered logit regression analysis were performed to analyze the data.

Results

The study involved participants, with 52.44 % aged 18 to 30, 77.29 % males, and 92.53 % having primary education or higher. Urban residents were 80 %, and students formed the largest occupational group (29.57 %), followed by businessmen (25 %), service holders (24.7 %), housewives (10.52 %), and day laborers (8.84 %). The majority of respondents demonstrated average knowledge (52.29 %), moderate attitudes (67.84 %), and good practices (50.61 %) regarding antibiotic use and AMR. Socioeconomic factors such as education, media exposure, and urban residence significantly (1 % level of significance) influenced KAP. The findings revealed knowledge gaps and misconceptions among the respondents, including incorrect beliefs about antibiotic resistance (42%), and inadequate awareness of the importance of completing full antibiotic courses (54.88 %).

Conclusion

This study sheds light on the existing KAP related to antibiotic use and AMR within the general population of Bangladesh. The findings reveal varying levels of knowledge, attitudes, and practices among the participants. The results underscore the importance of addressing knowledge gaps, and misconceptions for awareness building through educational campaigns utilizing social media platforms and newspapers. These insights provide a foundation for informed strategies to ensure the continued efficacy of antibiotics.

"It's a habit. They've been doing it for decades and they feel good and safe.": A qualitative study of barriers and opportunities to changing antimicrobial use in the Indonesian poultry sector

Interventions to change antimicrobial use (AMU) practices can help mitigate the risk of antimicrobial resistance (AMR) development. However, changing AMU practices can be challenging due to the complex nature of the factors influencing AMU-related behaviours. This study used a qualitative approach to explore the factors that influenced decision-making on AMU by farmers and other actors in the Indonesian poultry sector. Thirty-five semi-structured interviews were conducted with farmers, technical services staff from the private sector, and representatives of associations, universities, and international organisations in Central Java, West Java, and East Java. Thematic analysis identified three patterns of influence on AMU: how farmers used information to make AMU-related decisions, the importance of farmers' social and advisory networks, and the motivations driving changes in AMU behaviours. Key barriers identified included a lack of shared understanding around when to use antibiotics, financial pressures in the poultry sector, and a lack of engagement with government veterinary services. Potential opportunities identified included high farmer awareness of AMU, identification of private sector actors and peer networks as the stakeholders with established relationships of trust with farmers, and the importance of farmers' conceptions of good farming practices, which could be engaged with to improve AMU practices.

Knowledge and practice of antimicrobial usage and resistance among poultry farmers: A systematic review, meta-analysis, and meta-regression

A systematic review was conducted to summarize and synthesize the existing research on poultry farmers' knowledge, practices, and awareness regarding antimicrobial use (AMU) and antimicrobial resistance (AMR). It was undertaken by systematically searching databases, screening and characterizing relevant studies, extracting data, and evaluating the risk of bias. The outcomes were stratified into several subgroups, and pooled prevalence of each subgroup was calculated using a random-effect meta-analysis. Meta-regression was used for selected outcomes to further investigate the potential sources of heterogeneity across studies. Poultry farmers had knowledge and practice gaps on antimicrobial use. While most (65%; 95% CI: 50%-80%) used antimicrobials on poultry for therapeutic purposes, a portion used them to prevent disease (45%; 95% CI: 34%-55%) or boost growth (29%; 95% CI: 13%-46%) and productivity (20%; 95% CI: 6%-34%). 60% (95% CI: 50%-69%) of farmers approached veterinarians for antimicrobial advice, although many consulted drug sellers and fellow farmers. Insufficient antimicrobial residue knowledge (45%; 95% CI: 29%-62%), as well as inadequate awareness and faulty practice on withdrawal periods, were identified. Only 43% (95% CI: 34%-53%) were knowledgeable about AMR. Around half of farmers understood AMR's impacts on poultry, human health, and the environment. Meta-regression demonstrated that the source of heterogeneity for therapeutic antimicrobial use was the type of poultry farmers sampled and their educational qualifications; geographical region was significantly associated with antimicrobial usage based on farmers' experience; and the country's economic state was correlated with farmers' understanding of antimicrobial residue. This study recommends implementing legislation for judicious antimicrobial use, and farmer awareness campaigns to reinforce knowledge about prudent AMU and AMR.

Drivers of antimicrobial resistance in layer poultry farming: Evidence from high prevalence of multidrug-resistant Escherichia coli and enterococci in Zambia

Background and Aim

Inappropriate use of antimicrobials exacerbates antimicrobial resistance (AMR) in the poultry sector. Information on factors driving AMR in the layer poultry sector is scarce in Zambia. This study examined the drivers of AMR in the layer poultry sector in the Lusaka and Copperbelt Provinces of Zambia.

Materials and Methods

This cross-sectional study employed a structured questionnaire in 77 layer poultry farms in the provinces of Lusaka and Copperbelt, Zambia, from September 2020 to April 2021. Data analysis was conducted using Stata version 16.1. Antimicrobial resistance was defined as the presence of multidrug resistance (MDR) isolates. Multivariable regression analysis was used to identify drivers of AMR.

Results

In total, 365 samples were collected, from which 339 (92.9%) Escherichia coli and 308 (84.4%) Enterococcus spp. were isolated. Multidrug resistance was identified in 39% of the E. coli and 86% of the Enterococcus spp. The overall prevalence of AMR in layer poultry farms was 51.7% (95% confidence interval [CI]: 40.3%-63.5%). Large-scale farmers (Adjusted odds ratio [AOR] = 0.20, 95% CI: 0.04%-0.99%) than small-scale and farmers who were aware of AMR than those who were unaware (AOR = 0.26, 95% CI: 0.08%-0.86%) were less likely to experience AMR problems.

Conclusion

This study found a high prevalence of AMR in layer poultry farming linked to the type of farm management practices and lack of AMR awareness. Evidence of high MDR in our study is of public health concern and requires urgent attention. Educational interventions must increase AMR awareness, especially among small- and medium-scale poultry farmers.

Knowledge, Attitude, and Practice of Antibiotic Use and Resistance among Poultry Farmers in Nepal

The abuse and misuse of antibiotics is one of the main drivers of antimicrobial resistance (AMR). Globally, AMR in food-producing animals is a significant public health concern. This study, therefore, assessed the knowledge, attitudes, and practices related to antibiotic usage (AMU) and AMR among poultry farmers in Nepal. We conducted a cross-sectional survey of 605 poultry farmers from six districts of Nepal from May to June 2022 to assess the status of knowledge, attitude, as well as practices toward prudent antibiotic usage (AMU) and AMR. The majority of the participants in our study were from the Chitwan district (31.6%; n = 191/605), aged 30-44 (54.2%; n = 328/605), males (70.4%; n = 426/605), and farmers with a higher secondary (28.76%; n = 174/605) level of education. The tetracyclines (28%, n = 228/828), aminoglycosides (23%, n = 188/828), and fluoroquinolones (15%, n = 126/828) were the most used antibiotics classes among poultry farmers. Although 87.8% (n = 531/605) of poultry farmers used antibiotics, 49.8% (n = 301/605) of them were aware of AMR, and 55.7% (n = 337/605) knew that the misuse of antimicrobials could affect human and environmental health. There were significant differences in the knowledge, attitude, and practices toward prudent AMU and AMR among farmers who reared different birds. The mean knowledge, attitude, and practice score of the respondents were 7.81 ± 3.26, 5.8 ± 2.32, and 7.59 ± 3.38 when measured on a scale of 12, 10, and 15, respectively. Based on a cut-off of 75% of the maximum score, 49.4% (n = 299/605), 62.8% (n = 380/605), and 12.73% (n = 77/605) of the respondents had good knowledge, attitude, and practices toward prudent AMU and AMR, respectively. The multivariable logistic regression analyses revealed that the positive predictors of good knowledge and attitude were male gender, higher level of education, district, and the types of birds (layers). Similarly, those of the male gender (OR: 3.36; 95% CI: 1.38-8.20; p = 0.008) and those that rear layers (OR: 4.63; 95% CI: 1.75-12.25; p = 0.003) were more likely to practice prudent usage of antimicrobials. The findings of this study show poor practice toward prudent antibiotic usage despite good knowledge of AMR. This study provides essential baseline data on the knowledge, attitudes, and practices of poultry farmers in Nepal and offers valuable insights that could help in the design of interventions and policies aimed at addressing illicit AMU and AMR in poultry in Nepal.

Antimicrobial stewardship in veterinary medicine: a review of online resources

Background

An awareness of antimicrobial resistance and stewardship is important for all prescribers from a One-Health perspective. Educational resources have been created to help veterinary practitioners and encourage an optimized approach to their antimicrobial use.

Objectives

To support veterinarians to select the most appropriate educational resource to meet their personal learning goals in relation to veterinary antimicrobial stewardship (AMS).

Methods

Modular online platforms, developed to promote AMS in veterinary practice (farm and companion animal), were reviewed and key features highlighted, including the required time commitment, resource type, focus and source as well as a subjective evaluation of resource accessibility (according to prior knowledge base).

Results

Five different online courses are described in this educational resource review: Antimicrobial stewardship in veterinary practice; Farm Vet Champions; Farmed Animal Antimicrobial Stewardship Initiative (FAAST); the Pathway of antimicrobial resistance (AMR) for a veterinary services professional; and the VetAMS online learning program. Each of these tools introduces users to key themes of veterinary AMS. Upon completion of any of the courses practitioners should feel confident to assume an active role as proponents of rational antimicrobial use. Significant differences between resources, relating to the focus (companion or farm animal), scope and depth of material covered, are recognized reflecting their respective target audiences.

Conclusions

Several informative and accessible resources, centred on the core principles of veterinary AMS, were reviewed. Key features have been highlighted to inform and guide resource-users towards the most appropriate tool for them. Greater engagement with these educational resources will hopefully contribute to improved antimicrobial prescribing among veterinarians and greater awareness of the importance of stewardship for the profession.

Livestock producers' knowledge, attitude, and behavior (KAB) regarding antimicrobial use in Ethiopia

Introduction

Inappropriate antimicrobial use (AMU) in livestock production is an important aspect of the global burden of antimicrobial resistance (AMR). In Ethiopia, a low-income country with a large and increasing livestock population, AMU in food animals is not properly regulated. Hence, farmers are fully free to use antimicrobials to their (perceived) benefit. Therefore, understanding farmers' mindsets is important to improve antimicrobial stewardship in the livestock sector.

Methods

This cross-sectional study was conducted to assess livestock disease management practices and knowledge, attitude, and behavior (KAB) among livestock producers regarding AMU, residues, and resistance, as well as factors potentially explaining differences in KAB. We determined the KAB of livestock owners of three selected districts of central and western Ethiopia (n = 457), using a pretested questionnaire administered through face-to-face interviews. Logistic regression was used to evaluate the association between potential explanatory variables and the KAB scores of the respondents.

Results

The results showed that 44% of the farmers used antimicrobials in the past few years, where antibiotics (21%) and trypanocides (11%) were most widely used to manage livestock diseases. Furthermore, most farmers showed poor knowledge about AMU, residues, and AMR (94%) and unfavorable attitudes (<50% correct answers) toward contributing factors for AMR (97%). On the contrary, 80% of the respondents had overall good behavior scores (≥50% correct answers) related to AMU. Multivariate analysis results showed that having good knowledge, keeping ≥2 animal species, and the occurrence of ≥4 livestock diseases on the farm in a year were strong predictors of bad behavior scores (p < 0.05). The findings of the current investigation also revealed that the incidence of livestock diseases on the farm and a higher level of formal education significantly contributed to better knowledge and desirable attitudes but bad AMU behavior.

Conclusion

A low level of awareness about and undesirable attitudes toward AMU and AMR could potentially affect farmers' behavior toward judicious AMU, thus requiring awareness creation efforts on livestock disease management practices.

Molecular Detection of Tetracycline-Resistant Genes in Multi-Drug-Resistant Escherichia coli Isolated from Broiler Meat in Bangladesh

This study aimed to estimate the antimicrobial resistance (AMR) patterns and tetracycline-resistant gene profiles of Escherichia coli (E. coli) from broiler meat and livers sourced from live bird markets (LBMs) and supermarkets (SMs) in Chattogram, Bangladesh. In total, 405 samples were collected from SMs and LBMs, comprising muscle (n = 215) and liver (n = 190) samples. Disc diffusion tests were used to determine antimicrobial susceptibility profiles. PCR was used to identify E. coli and tetracycline-resistant genes. Over half (57%) of the chicken product samples were positive for E. coli. The AMR profiling of these isolates showed that the highest prevalence of resistance was against sulphamethoxazole-trimethoprim (89%), followed by tetracycline (87%), ampicillin (83%), and ciprofloxacin (61%). Among the antimicrobials listed by the World Health Organization as critically important, E. coli isolates were found to be resistant to cephalexin (37%), gentamicin (32%), and colistin sulfate (21%). A large proportion of E. coli demonstrated multi-drug resistance (MDR). Most (84%) of the tetracycline-resistant isolates encoded tetA. Of the remaining isolates, 0.5% encoded tetC, 6.0% encoded two genes, and 3.6% of isolates were tetD, which was newly identified by this study in Bangladesh. Broiler products in Bangladesh are frequently contaminated with multi-drug-resistant E. coli, with differential carriage of tetracycline genes. The prevalence of tetracycline resistance among E. coli indicates a concern for poultry health and welfare regarding the management of colibacillosis. It also indicates growing public health risks of AMR among broiler-associated pathogens, which can be transferred to humans via the food chain. Appropriate control measures should be developed and implemented, focused on the rational use of antimicrobials in poultry farming systems, to mitigate risk from this drug-resistant zoonotic pathogen from foods of animal origin and to protect public health.

A scoping review of antibiotic use practices and drivers of inappropriate antibiotic use in animal farms in WHO Southeast Asia region

Antibiotic use (ABU) plays an important role in the proliferation of antimicrobial resistance (AMR). Global antimicrobial consumption in food production is projected to rise by 67% from 2010 to 2030, but available estimates are limited by the scarcity of ABU data and absence of global surveillance systems. The WHO South-East Asia (WHO SEA) region is at high risk of emergence of AMR, likely driven by intensifying farm operations and worsening ABU hotspots. However, little is known about farm-level ABU practices in the region. To summarize emerging evidence and research gaps, we conducted a scoping review of ABU practices following the Arksey and O'Malley methodological framework. We included studies published between 2010 and 2021 on farm-level ABU/AMR in the 11 WHO SEA member states, and databases were last searched on 31 October 2021. Our search strategy identified 184 unique articles, and 25 publications underwent full-text eligibility assessment. Seventeen studies, reported in 18 publications, were included in the scoping review. We found heterogeneity in the categorizations, definitions, and ABU characterization methods used across studies and farm types. Most studies involved poultry, pig, and cattle farms, and only one study examined aquaculture. Most studies evaluated ABU prevalence by asking respondents about the presence or absence of ABU in the farm. Only two studies quantified antibiotic consumption, and sampling bias and lack of standardized data collection methods were identified as key limitations. Emerging evidence that farm workers had difficulty differentiating antibiotics from other substances contributed to the uncertainty about the reliability of self-reported data without other validation techniques. ABU for growth promotion and treatment were prevalent. We found a large overlap in the critically important antibiotics used in farm animals and humans. The ease of access to antibiotics compounded by the difficulties in accessing quality veterinary care and preventive services likely drive inappropriate ABU in complex ways.

Prevalence and antimicrobial resistance patterns of Enterococcus species isolated from laying hens in Lusaka and Copperbelt provinces of Zambia: a call for AMR surveillance in the poultry sector

Background

The use of antimicrobials in layer poultry production for improved production, growth promotion, prophylaxis and treatment purposes has contributed to the development of antimicrobial resistance (AMR) in poultry. In Zambia, there is a paucity of information on the prevalence and AMR patterns of Enterococcus species isolated from laying hens.

Objectives

This study investigated the prevalence and AMR patterns of enterococci isolated in layer hens in Lusaka and Copperbelt provinces of Zambia.

Methods

A cross-sectional study was conducted from September 2020 to April 2021. Three hundred and sixty-five pooled cloacal swab samples were collected from 77 layer poultry farms. Enterococci identification and confirmation were performed using Analytical Profile Index (API 20 STREP) and 16S rRNA sequencing, respectively. A panel of nine antibiotics was used for antibiotic susceptibility testing and interpreted according to the CLSI 2020 guidelines. Data were analysed using SPSS version 23 and WHONET 2020.

Results

A total of 308 (83%) single Enterococcus species isolates were obtained and showed resistance to tetracycline (80.5%), erythromycin (53.6%), quinupristin/dalfopristin (53.2%), ampicillin (36.72%), vancomycin (32.8%), linezolid (30.2%), ciprofloxacin (11.0%), nitrofurantoin (6.5%) and chloramphenicol (3.9%). The prevalence of enterococci resistant to at least one antibiotic was 99.4% (n = 306), of which 86% (n = 265) were MDR.

Conclusions

This study found a high prevalence of antimicrobial-resistant enterococci. The presence of MDR requires urgent intervention and implementation of AMR surveillance strategies and antimicrobial stewardship programmes in layer poultry production in Zambia.

Towards a One Health Food Safety Strategy for Palestine: A Mixed-Method Study

Introduction: Foodborne diseases, together with increasing antimicrobial resistance (AMR), pose a threat to public health in an era of huge challenges with climate change and the risks of zoonotic epidemics. A One Health approach to foster food safety is a key for improvement, particularly in complex socio-ecological systems such as in Palestine, to examine human-animal-environment interfaces and promote intersectoral action. Objectives: This study aimed to assess food safety from farm to public health toward an operational One Health strategy for Palestine. This study evaluates the food production (broiler production) and monitoring system to better understanding the zoonotic foodborne illnesses transmission and their resistance to antimicrobials. Methods: The transdisciplinary approach included multi-stakeholder discussion groups and field visits to broiler farms, slaughterhouses, and meat stores in the Ramallah and Al-Bireh and Jerusalem districts using a semi-structured observational tool. A survey with 337 poultry producers and workers in slaughterhouses and meat stores was conducted to assess hygiene knowledge, attitudes, and practices during broiler meat production. Results: The stakeholders point out various challenges along the food production chain in Palestine, such as a striking scarcity of public slaughterhouses, insufficient coordination between authorities, a gap between public and private sectors, and inconsistent application of the law. From observations, it appears that, unlike traditional broiler production, the public slaughterhouses and meat markets have effective hygiene, while large-scale farms implement biosecurity measures. Overall, surveyed participants reported that they are aware of zoonotic disease transmission routes and value hygiene standards. Semi-structured observations and survey results are contradictory. Observations indicate poor hygiene practices; however, the vast majority of broiler meat production chain workers claim that hygiene standards are met. Discussion and Conclusions: Our study found that the overuse of antimicrobials, system fragmentation, insufficient infrastructure, a lack of regulations and controls, and poor hygiene practices are among the main obstacles to improving food safety in Palestine. Considering the risk of an important human health burden of food-related illnesses, enhancing food safety in Palestine is required using an integrated One Health approach. It is crucial to develop an integrated quality control system for food production along with promoting on-farm biosecurity and antimicrobial stewardship. Infrastructure, especially slaughterhouses and laboratories, must be built, training and education provided, and consumer awareness raised. As an important added value within a One Health strategy for better food safety in Palestine, research should be reinforced and accompany any future development of the food production monitoring system.

Knowledge, Attitudes, and Practices of Community Pharmacy Professionals on Poultry Antibiotic Dispensing, Use, and Bacterial Antimicrobial Resistance in Zambia: Implications on Antibiotic Stewardship and WHO AWaRe Classification of Antibiotics

Globally, the inappropriate dispensing and use of antibiotics in animals has contributed to the development of bacterial antimicrobial resistance (AMR). In Zambia, there is insufficient information among community pharmacy professionals on antibiotic use (ABU) and AMR in food-producing animals. This study assessed community pharmacy professionals' knowledge, attitudes, and practices regarding poultry antibiotic dispensing, use, and bacterial AMR in the Lusaka district of Zambia. A cross-sectional study was conducted among 178 community pharmacy professionals between February and April 2022 using a semi-structured questionnaire. Data were analyzed using Stata version 17. Of the total participants (n = 178), 51.1% (n = 91) were pharmacists. The most dispensed antibiotic was oxytetracycline, a Watch antibiotic, mainly without prescriptions. Good knowledge of ABU and AMR was associated with work experience for more than one year (p = 0.016), while good practices were associated with male gender (p = 0.039) and work experience of more than one year (p = 0.011). The study found moderate knowledge, positive attitudes, and moderate practices of pharmacy professionals on poultry ABU and AMR. There was high dispensing of poultry antibiotics without prescriptions, which calls for strict implementation of antimicrobial stewardship and surveillance programs in poultry production in Zambia to reduce AMR.

A Survey on Knowledge, Attitude, and Practices of Large-Animal Farmers towards Antimicrobial Use, Resistance, and Residues in Mymensingh Division of Bangladesh

The widespread and indiscriminate use of antimicrobials in food animals is a key contributor to antimicrobial resistance and antimicrobial residue, which have become a growing public and animal health concern in developing countries such as Bangladesh. This study was aimed to assess the knowledge, attitude, and practices (KAP) of large-animal farmers towards antimicrobial use (AMU), antimicrobial resistance (AMR), and antimicrobial residue (AR) with their correlation. A cross-sectional survey was conducted with a structured and pretested questionnaire in the Mymensingh division of Bangladesh. A total of 212 large-animal farmers (dairy, beef fattening, buffalo, sheep, and goat farmers) were surveyed. Results showed that most of the farmers are male (85.8%) and belong to the 18-30 age group (37.3%). About 20.3% had no formal education, and nearly half of the participants (48.1%) received training regarding antibiotic use and resistance. Penicillin is the most common class of antibiotic used (61.8%) in the study area, followed by other antimicrobials. Only 37.7% of the farmers used antimicrobials on the recommendation of their veterinarian. Overall, 41.5%, 42.5%, and 21.7% of farmers possess adequate knowledge and a satisfactory attitude and perform desirable practices, respectively. Farmers in the 31-40 age group have adequate knowledge, attitude, and ability to implement desired practices compared to farmers in the 18-30 age group. Farmers having a graduate or post-graduate degree scored better in relation to knowledge, attitude, and practice than other farmers. Analysis revealed that farmers who received training on AMU and AMR had 10.014 times (OR = 10.014, 95% CIs: 5.252-19.094), 9.409 times (OR = 9.409, 95% CIs: 4.972-17.806), and 25.994 times (OR = 25.994, 95% CIs: 7.73-87.414) better knowledge, attitude, and performance, respectively, compared to their counterparts. A significant proportion of farmers (97.2%) dispose of leftover antibiotics inappropriately. The findings of the present study will be used to intervene in the education and training of the farmers, which will help to limit the indiscriminate and irrational use of antimicrobials, leading to reducing the chances of developing AMR.

Awareness of Antimicrobial Resistance and Associated Factors among Layer Poultry Farmers in Zambia: Implications for Surveillance and Antimicrobial Stewardship Programs

Antimicrobial resistance (AMR) is a global public health problem affecting animal and human medicine. Poultry production is among the primary sources of income for many Zambians. However, the increased demand for poultry products has led to a subsequent increase in antimicrobial use. This study assessed the awareness of AMR and associated factors among layer poultry farmers in Zambia. A cross-sectional study was conducted among 77 participants from September 2020 to April 2021. Data was analysed using Stata version 16.1. The overall awareness of AMR among the farmers was 47% (n = 36). The usage of antibiotics in layer poultry production was high at 86% (n = 66). Most antibiotics were accessed from agrovets (31%, n = 24) and pharmacies (21%, n = 16) without prescriptions. Commercial farmers were more likely to be aware of AMR compared to medium-scale farmers (OR = 14.07, 95% CI: 2.09–94.70), as were farmers who used prescriptions to access antibiotics compared to those who did not (OR = 99.66, 95% CI: 7.14–1391.65), and farmers who did not treat market-ready birds with antibiotics compared to those who did (OR = 41.92, 95% CI: 1.26–1396.36). The awareness of AMR among some layer farmers was low. Therefore, policies that promote the rational use of antibiotics need to be implemented together with heightened surveillance activities aimed at curbing AMR.

Antibiotic Use and Resistance Knowledge Assessment of Personnel on Chicken Farms with High Levels of Antimicrobial Resistance: A Cross-Sectional Survey in Ica, Peru

Poultry farming represents Peru’s primary food animal production industry, where antimicrobial growth promoters are still commonly used, exerting selective pressure on intestinal microbial populations. Consumption and direct animal-to-human transmission have been reported, and farmworkers are at high risk of colonization with resistant bacteria. We conducted a cross-sectional survey among 54 farmworkers to understand their current antimicrobial resistance (AMR) awareness in Ica, Peru. To gain insight into the potential work-related risk of exposure to bacteria, we also measured the AMR rates in Escherichia coli isolated among 50 broiler chickens. Farmworkers were unaware of antimicrobial resistance (31.5%) or antibiotic resistance (16.7%) terms. Almost two-thirds (61%) consumed antibiotics during the previous month, and only 42.6% received a prescription from a healthcare professional. A total of 107 E. coli chicken isolates were obtained, showing a high frequency of multidrug-resistant (89.7%) and extended-spectrum beta-lactamase (ESBL) production (71.9%). Among ESBL-producer isolates, 84.4% carried the bla_CTX-M gene. Results identified gaps in knowledge that reflect the need for interventions to increase antimicrobial awareness among poultry farmworkers. The high AMR rates among E. coli isolates highlight the need to reduce antimicrobial use in poultry farms. Our findings reveal a critical need for effective policy development and antimicrobial stewardship interventions in poultry production in Ica, Peru.

Diversity of bacterial pathogens and their antimicrobial resistance profile among commensal rodents in Qatar

Rodents are sources of many zoonotic pathogens that are of public health concern. This study investigated bacterial pathogens and assessed their antimicrobial resistance (AMR) patterns in commensal rodents in Qatar. A total of 148 rodents were captured between August 2019 and February 2020, and blood, ectoparasites, and visceral samples were collected. Gram-negative bacteria were isolated from the intestines, and blood plasma samples were used to detect antibodies against Brucella spp., Chlamydophila abortus, and Coxiella burnetii. PCR assays were performed to detect C. burnetii, Leptospira spp., Rickettsia spp., and Yersinia pestis in rodent tissues and ectoparasite samples. Antimicrobial resistance by the isolated intestinal bacteria was performed using an automated VITEK analyzer. A total of 13 bacterial species were isolated from the intestine samples, namely Acinetobacter baumannii, Aeromonas salmonicida, Citrobacter freundii, Citrobacter koseri, Enterobacter aerogenes, Enterobacter cloacae, Escherichia coli, Hafnia alvei, Klebsiella pneumoniae, Providencia stuartii, Proteus mirabilis, Pseudomonas aeruginosa, and Salmonella enterica. The majority of them were E. coli (54.63%), followed by P. mirabilis (17.59%) and K. pneumoniae (8.33%). Most of the pathogens were isolated from rodents obtained from livestock farms (50.46%), followed by agricultural farms (26.61%) and other sources (22.94%). No antibodies (0/148) were detected against Brucella spp., C. abortus, or C. burnetii. In addition, 31.58% (6/19) of the flea pools and one (1/1) mite pool was positive for Rickettsia spp., and no sample was positive for C. burnetii, Leptospira spp., and Y. pestis by PCR. A total of 43 (38%) bacterial isolates were identified as multidrug resistant (MDR), whereas A. salmonicida (n = 1) did not show resistance to any tested antimicrobials. Over 50% of bacterial MDR isolates were resistant to ampicillin, cefalotin, doxycycline, nitrofurantoin, and tetracycline. The presence of MDR pathogens was not correlated with rodent species or the location of rodent trapping. Seven (11.86%) E. coli and 2 (22.2%) K. pneumoniae were extended-spectrum beta-lactamases (ESBL) producers. These findings suggest that rodents can be a source of opportunistic bacteria for human and animal transmission in Qatar. Further studies are needed for the molecular characterization of the identified bacteria in this study.

Knowledge, Attitudes, and Common Practices of Livestock and Poultry Veterinary Practitioners Regarding the AMU and AMR in Bangladesh

Current evidence indicates that more than half of all antimicrobials are used in the animal food-producing sector, which is considered a significant risk factor for the development, spread, and existence of antimicrobial resistance (AMR) pathogens in animals, humans, and the environment. Among other factors, clinical etiology and the level of knowledge, attitudes, and practices (KAP) of veterinarians are thought to be responsible for inappropriate prescriptions in the animal-source protein production sector in lower-resource settings like Bangladesh. We performed this cross-sectional study to assess factors associated with veterinarians' antimicrobial prescription behavior and their KAP on antimicrobial use (AMU) and AMR in Bangladesh. Exploratory and multivariate logistic models were used to describe an association between knowledge, attitudes, and practices of AMU and AMR and demographic characteristics of veterinarians. The results demonstrated that when selecting an antimicrobial, there was no to minimal influence of culture and susceptibility tests and patients' AMU history but moderate to high influence of the farmer's economic condition and drug instructions among the veterinarians. The results also demonstrated that more than half of the veterinarians had correct KAP regarding AMU and AMR, while the rest had moderate or lower levels of KAP. The factor score analysis revealed that age, level of education, years of experience, gender, and previous training on AMU and AMR were the key influencing factors in their level of KAP. Adjusted logistic regression analysis showed that respondents' age, current workplace, and previous training on AMU and AMR had a positive association with increased KAP. Considering the results, it is imperative to include AMR issues on vet curricula, and to provide post-education training, awareness campaigns, easy access to, and dissemination of AMR resources. Increasing the veterinary services to the outreach areas of the country and motivating veterinarians to follow the national AMR guidelines could be some other potential solutions to tackle the over-prescriptions of antimicrobials.

Occurrence and multidrug resistance of Campylobacter spp. at duck farms and associated environmental and anthropogenic risk factors in Bangladesh

Background

The alarming rise in multi-drug resistant (MDR) zoonotic pathogens, including Campylobacter spp., has been threatening the health sector globally. In Bangladesh, despite rapid growth in poultry sector little is known about the potential risks of zoonotic pathogens in homestead duck flocks. The aim of this study was to understand the occurrence, species diversity, and multi-drug resistance in Campylobacter spp., and identify the associated risk factors in duck farms in Bangladesh.

Methods

The study involved 20 duck farms at 6 sub-districts of Mymensingh, Bangladesh. Monthly occurrence of Campylobacter spp. in potential sources at the farms during February-September, 2018, was detected by culture and PCR-based methods. Campylobacter isolates were examined for resistance to different antimicrobials. Risk factors, concerning climatic and environmental disposition, farm management, and anthropogenic practices, of Campylobacter infection were estimated by participatory epidemiological tools.

Results

Occurrence of Campylobacter spp. was detected in overall 36.90% (155/420) samples, more frequently in drinking water (60%, 30/50), followed by cloacal swab (37.50%, 75/200), egg surface swab (35%, 35/100) and soil of the duck resting places (30%, 15/50) but was not detected in feed samples (n = 20). PCR assays distinguished the majority (61.30%, 95/155) of the isolates as C. coli, while the rest (38.70%, 60/155) were C. jejuni. Notably, 41.7% (25/60) and 31.6% (30/95) strains of C. jejuni and C. coli, respectively, were observed to be MDR. The dynamics of Campylobacter spp., distinctly showing higher abundance during summer and late-monsoon, correlated significantly with temperature, humidity, and rainfall, while sunshine hours had a negative influence. Anthropogenic management-related factors, including, inadequate hygiene practices, use of untreated river water, wet duck shed, flock age (1–6 months), and unscrupulous use of antimicrobials were identified to enhance the risk of MDR Campylobacter infection.

Conclusion

The present study clearly demonstrates that duck farms contribute to the enhanced occurrence and spread of potentially pathogenic and MDR C. coli and C. jejuni strains and the bacterial dynamics are governed by a combined interaction of environmental and anthropogenic factors. A long-term holistic research at the environment-animal-human interface would be integral to divulge health risk reduction approaches tackling the spread of Campylobacter spp. from duck farms.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-021-06834-w.

Epidemiology and antimicrobial resistance of Escherichia coli in broiler chickens, farmworkers, and farm sewage in Bangladesh

BACKGROUND

Antimicrobial resistance (AMR) has become an emerging threat worldwide, and developing countries such as Bangladesh are considered to be at greater risk of disseminating the resistant bacteria between human-animal interfaces.

OBJECTIVES

The present study was carried out to determine the prevalence and AMR profile of Escherichia coli isolated from broiler chickens, the environment, and farmworkers. This study also aimed to identify the risk factors associated with multidrug-resistant (MDR) E. coli infection in broiler chickens. In addition, the presence of carbapenem resistance gene (NDM-1) was assessed.

METHODS

A total of 114 E. coli isolates, recovered from 150 samples (cloacal swabs = 50, farm sewage = 50, and hand washed water of farmworkers = 50) collected from 50 broiler farms, were identified by biochemical examination and polymerase chain reaction (PCR) assay. Antimicrobial susceptibility test was performed for 10 antibiotics by disk diffusion test. Carbapenem resistance gene (NDM-1) was detected by PCR. Risk factors were identified through multivariable logistic regression.

RESULTS

The highest prevalence of E. coli was recorded in broiler chickens (86%) and the lowest in farmworkers (66%). For MDR E. coli infection, 'winter season', 'absence of specific shoes for staff', and 'use of antibiotics without veterinarian's prescription' were the significant risk factors. High resistance of the E. coli isolates was observed against levofloxacin (81.6%), doxycycline (78.1%), cefotaxime (78.1%), and ciprofloxacin (70.2%). About 76% of the isolates demonstrated MDR. None of the isolates were positive for the NDM-1 gene.

CONCLUSIONS

The high level and similar pattern of antibiotic resistance in E. coli isolates from broiler chickens, farmworkers, and sewage in poultry farms indicates a good possibility of spreading the antibiotic-resistant E. coli in such settings.