Knowledge, Attitude, and Practices on Antimicrobial Use and Antimicrobial Resistance among Poultry Drug and Feed Sellers in Bangladesh

High prevalence of low-concentration antimicrobial residues in commercial fish: A public health concern in Bangladesh

Antibiotics are widely used in commercial fish farms in Bangladesh for therapeutic and prophylactic purpose, raising concerns about antimicrobial resistance (AMR) and environmental contamination. This study used Thin Layer Chromatography to detect antimicrobial residues in four commercially available fish species- Tilapia (Oreochromis aureus), Stinging catfish (Heteropneustes fossilis), Climbing perch (Anabas testudineus), and Pabda (Ompok pabda)-with 100 samples per species. Ultra High-Performance Liquid Chromatography quantified residues in a subset of 25 samples per species. The prevalence of Ciprofloxacin, Oxytetracycline, and Chlortetracycline residues varied significantly among fish species, with the highest prevalence observed for Ciprofloxacin in Tilapia (42%), Oxytetracycline in Pabda (41%), and Chlortetracycline in Tilapia (49%). Additionally, the prevalence of Levofloxacin and Chlortetracycline differed by sampling location, with the highest levels found in Jhawtala market, 27.5% for Levofloxacin and 53.8% for Chlortetracycline. Furthermore, residue concentrations were highest for Enrofloxacin in Climbing perch (69.32 µg/Kg) and Oxytetracycline in Pabda (88.73 µg/Kg). The highest Hazard Quotient (HQ) was for Enrofloxacin in Climbing perch (0.480), followed by Pabda (0.460), Stinging catfish (0.420), and Tilapia (0.387). While the HQ values were below 1.0, indicating no immediate toxicological risk, residues raise public health concerns due to the chance of potential AMR development. Further research is needed on antimicrobial bioaccumulation, indirect exposure sources, environmental contamination, and antimicrobial resistance in aquaculture and wild fish.

Epidemiology and molecular characterisation of multidrug-resistant Escherichia coli isolated from chicken meat

Ensuring the safety of poultry products is critical for public health, particularly due to the rising concern of antimicrobial resistance (AMR) in foodborne pathogens. This study aimed to investigate the prevalence and antimicrobial resistance (AMR) patterns of Escherichia coli (E. coli) isolated from broiler chicken meat samples collected from live bird markets (LBMs) and supermarkets (SMs) in the Chattogram Metropolitan Area (CMA), Bangladesh. A total of 430 samples, comprising 215 liver and 215 muscle samples, were collected between October 2020 and February 2021 from nine LBMs and five SMs. Samples were processed and cultured, and E. coli was isolated and identified through phenotypic and molecular techniques, including PCR targeting the uidA and uspA genes. Antimicrobial susceptibility testing (AST) was conducted using the Kirby-Bauer disk diffusion techniques with seven antibiotics from six distinct antimicrobial classes. The study found an overall prevalence of 56.28% (95% CI: 51.56-60.89) for E. coli. The prevalence in LBMs (58.33%) was higher than in SMs (54.80%), with liver samples showing a slightly higher rate of contamination (63.33% in LBMs, 55.20% in SMs) compared to muscle samples. AMR profiling revealed high resistance rates to sulfamethoxazole-trimethoprim (88.84%), tetracycline (86.78%), and ampicillin (82.23%). Conversely, cephalexin (63.64%) and gentamicin (57.02%) had the highest susceptibility rates. A significant proportion (84.71%) of isolates were multidrug-resistant (MDR), with some isolates resistant to up to six classes of antimicrobial. The multiple antibiotic resistance (MAR) index ranged from 0.14 to 1.00, indicating substantial antimicrobial exposure. PCR analysis confirmed the presence of the blaTEM gene in all ampicillin-resistant isolates, while 75.35% of sulfamethoxazole-resistant isolates carried the sul2 gene. Correlation analysis revealed a strong association between phenotypic resistance to ampicillin and the presence of the blaTEM gene (r = 1), along with a moderate correlation between sul2 and resistance to sulfamethoxazole (r = 0.5). These findings highlight the widespread presence of multidrug-resistant (MDR) E. coli in broiler meat, posing a significant public health concern.

Study Rapid, Quantitative, and Simultaneous Detection of Drug Residues and Immunoassay in Chickens

Different levels of residual drugs can be monitored within a relatively safe range without causing harm to human health if the appropriate dosing methodology is considered and the drug withdrawal period is controlled during poultry and livestock raising. Antimicrobials are factors that can suppress the growth of microorganisms, and antibiotic residues in livestock farming have been considered as a potential cause of antimicrobial resistance in animals and humans. Antimicrobial drug resistance is associated with the capability of a microorganism to survive the inhibitory effects of the antimicrobial components. Antibiotic residue presence in chicken is a human health concern due to its negative effects on consumer health. Neglected aspects related to the application of veterinary drugs may threaten the safety of both humans and animals, as well as their environment. The detection of chemical contaminants is essential to ensure food quality. The most important antibiotic families used in veterinary medicines are β-lactams (penicillins and cephalosporins), tetracyclines, chloramphenicols, macrolides, spectinomycin, lincosamide, sulphonamides, nitrofuranes, nitroimidazoles, trimethoprim, polymyxins, quinolones, and macrocyclics (glycopeptides, ansamycins, and aminoglycosides). Antibiotic residue presence is the main contributor to the development of antibiotic resistance, which is considered a chief concern for both human and animal health worldwide. The incorrect application and misuse of antibiotics carry the risk of the presence of residues in the edible tissues of the chicken, which can cause allergies and toxicity in hypersensitive consumers. The enforcement of the regulation of food safety depends on efficacious monitoring of antimicrobial residues in the foodstuff. In this review, we have explored the rapid detection of drug residues in broilers.

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.

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.

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.

Effect of knowledge of informal poultry drug prescribers on their attitude and practice toward antimicrobial use, residues, and resistance in Bangladesh

Background and Aim

Informal prescribers (IPs) significantly contribute to the development of antimicrobial resistance and in disseminating pathogens from poultry to humans and other animals through the food chain, posing a serious global health threat. Therefore, this study aimed to assess whether the knowledge of IPs has an impact on their attitude and practice toward antimicrobial use, antibiotic residues, and antimicrobial resistance.

Materials and Methods

In this cross-sectional study, we conducted a pre-tested and questionnaire-based survey to investigate the knowledge, attitude, and practice of IPs in selected parts of the Mymensingh division, Bangladesh. Then, we used the linear regression model test with R-squared (R2) to measure the association between the study variables.

Results

Our investigation revealed that 70% of the IPs knew about antibiotics and 75% had good knowledge about antibiotic resistance, whereas only 50% were aware of withdrawal periods. Informal prescribers also displayed good attitudes toward the use and sale of antibiotics with withdrawal periods and completion of medication (50%). Analysis of their practice on the sale and prescription of antibiotics showed that 70% and 30% of IPs use antibiotics against bacterial infections and other conditions, respectively. Most of them do not consult a veterinarian before selling or prescribing antibiotics, although 80% claim to do so. This is because 75% of IPs gave other options regarding their consultations. However, 95% of IPs uses antibiotics only for therapeutic purposes. Furthermore, only 10% sell antibiotics based on a veterinarian's recommendation. Approximately 45% of IPs use single antibiotics at a time, while the rest use multiple antibiotics, individually or combined. Approximately 15% use antibiotics monthly, while 85% use them whenever the need arises. The knowledge and attitude of IPs are significantly affected by their age (p ≤ 0.025). The district of domicile also impacted their knowledge. Surprisingly, IPs from Jamalpur had significantly better knowledge compared to those from Mymensingh and Sherpur (p ≤ 0.01). The attitude of IPs from Jamalpur and Netrokona also differed significantly (p ≤ 0.001) from that of Mymensingh and Sherpur. The knowledge of IPs influenced their attitude up to 80.5% (r2 = 0.628) and their practice up to 75.4% (r2 = 0.545).

Conclusion

The knowledge of IPs greatly influenced their attitude and practice, while sociodemographics also influenced their knowledge and attitude toward antimicrobial use, antibiotic residues, and antimicrobial resistance.

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.

Determinants of Knowledge, Attitude, and Practices of Veterinary Drug Dispensers toward Antimicrobial Use and Resistance in Main Cities of Malawi: A Concern on Antibiotic Stewardship

Antimicrobial resistance (AMR) is an emerging challenge to global public health. The use of antibiotics in the veterinary field is one of the contributing factors to AMR mostly due to poor knowledge, attitudes, and practices (KAP) of dispensers. Veterinary drug dispensers are expected to guide clients on indications, contraindications, and withdrawal periods of veterinary drugs. This study assessed veterinary drug dispensers' KAP toward AMR and associated potential contributing factors. A cross-sectional study, using a structured questionnaire, was conducted in three main cities of Malawi, namely Mzuzu, Lilongwe, and Blantyre. A total of 68 agrovet shops were selected using a simple random sampling technique. The KAP level was presented descriptively. Bivariate and multivariable analyses were run to investigate the relationships between the independent and outcome variable. Overall, the KAP score for knowledge, attitude, and practices was 46.7%, 49.2%, and 41.6%, respectively. The significant determinants of the knowledge were the practice of asking for a written prescription (OR: 16.291, 95% CI: 11.6-24.2) (p = 0.024), female (OR: 0.609, 95% CI: 0.3-0.9) (p = 0.001), and old age (≥35) (OR: 0.227, 95% CI: 0.1-0.5) (p = 0.04). Poor knowledge, negative attitude, and poor practices were observed among most of the participants. Sensitization and training on AMR and antimicrobial stewardship are recommended to address the KAP score gaps and the observed determinants among veterinary drug dispensers.

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.

Knowledge, attitudes and practices regarding antimicrobial usage, spread and resistance emergence in commercial poultry farms of Rajshahi district in Bangladesh

Background

Inappropriate and injudicious use of antimicrobials in broiler and layer farms has become a common practice in lower and middle-income countries including Bangladesh. This study aimed to assess poultry farmers’ knowledge, attitude, and practices regarding antimicrobial usage (AMU), and their beliefs in factors that affect antimicrobial resistance (AMR) spread and emergence in humans through commercial poultry farms in Bangladesh.

Methods

A cross-sectional study was conducted among 204 farmers (95.6% male; mean_age = 35.14 ± 10.25 years) in the Rajshahi district of Bangladesh who were recruited from three upazilas (sub-districts) through a multistage sampling technique. Data were collected from June to November 2021 via face-to-face interviews using a semi-structured questionnaire.

Results

The proportion of farmers who reported having received information regarding AMU from veterinarians was higher in layer compared to broiler farms (65.9% vs. 44.9%, p < 0.001). A higher proportion of layer compared to broiler farmers believed that antimicrobial residues and pathogens in poultry can pass to humans through the consumption of contaminated eggs (28.1% vs. 5.8%, p < 0.05). The mean score of the farmers’ attitude towards addressing AMU was 4.49 (SD = 1.37) out of 7, with the higher score indicating a better attitude. The mean score of better attitudes towards addressing AMU was significantly higher among educated participants (bachelor’s or higher levels of education (p = 0.006). A higher proportion of layer (56.3%) farmers did not keep a record of AMU when compared to broiler farmers (37.7%) (p = 0.012). More broiler (50.7%) compared to layer (38.5%) farmers continued using the full dose of antimicrobials (p = 0.042). The most frequently used antimicrobials in broiler and layer poultry farms were Colistin (broiler vs layer: 73.9% vs. 86.75%; p = 0.024), and Ciprofloxacin (broiler vs. layer: 95.7% vs. 84.4%; p = 0.021). Farmers’ beliefs were significantly associated with the spread of AMR pathogens from contaminated eggs to humans (p < 0.001).

Conclusions

The findings reflected that majority of farmers had inadequate knowledge of AMU, less knowledgeable beliefs aboutAMU, and inappropriate AMU (e.g., poor record keeping, incomplete doses) in chicken production systems. The government should ensure education or advisory services for poultry farmers on proper AMU, enforce current veterinary laws and regulations on antimicrobials, and implement AMU surveillance systems.

Antibiotic usage practices and its drivers in commercial chicken production in Bangladesh

Irrational and inappropriate use of antibiotics in commercial chicken production can contribute to the development of antimicrobial resistance. We aimed to assess antibiotic usage in commercial chicken production in Bangladesh, and identify factors associated with this practice. We conducted a large-scale cross-sectional study to collect information on antibiotic usage in commercial chickens from January to May 2021. Structured interviews were conducted with 288 broiler, 288 layer and 192 Sonali (locally-produced cross-bred) farmers in 20 sub-districts across Bangladesh. The frequency of antibiotic usage, the types of antibiotics and purpose of usage were estimated for each production type. Adjusted odds ratios (aOR) were calculated to measure the association between antibiotic usage and factors related to the characteristics of the farms and farmers using multivariable logistic regression models. The proportion of farms, irrespective of their production type, reporting usage of antibiotics in the 24 hours preceding the interview was 41% (n = 314, 95% CI: 37–44%). Forty-five percent (n = 344, 41–48%) reported antibiotic usage in the last 72 hours, 86% (n = 658, 83–88%) in the last 14 days, and almost all farms, 98% (n = 753, 97–99%), had used antibiotics since the start of their production cycle. Use of antibiotics in the 24 hours preceding an interview was more frequently reported in broiler (OR 1.91, 95% CI: 1.36–2.69) and Sonali (OR 1.94, 95% CI: 1.33–2.33) than layer farms. Oxytetracycline (23–31%, depending on production type), doxycycline (18–25%), ciprofloxacin (16–26%) and amoxicillin (16–44%) were the most frequently used antibiotics. Antibiotics were reported to be used for both treatment and prophylactic purposes on most farms (57–67%). Usage of antibiotics in the 24h preceding an interview was significantly associated with the occurrence of any illnesses in chickens (aOR broiler: 41.22 [95% CI:13.63–124.62], layer: aOR 36.45[9.52–139.43], Sonali: aOR 28.47[4.97–162.97]). Antibiotic usage was mainly advised by veterinary practitioners (45–71%, depending on production type), followed by feed dealers (21–40%) and farmers (7–13%). Improvement of chicken health through good farming practices along with changes in key stakeholders (feed dealers and practitioners) attitudes towards antibiotic recommendations to farmers, may help to reduce the levels of antibiotic usage and thus contribute to mitigate antimicrobial resistance.

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.

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.

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.

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

Antimicrobial resistance (AMR) has become an emerging health issue globally, posing a threat to zoonotic pathogens and foodborne diseases. In Bangladesh, the poultry sector supplies the majority of the demand for animal-source protein. The irrational and excessive use of antimicrobials (AMU) has been observed in the poultry sector. The development of AMR is associated with many factors, including the knowledge and attitudes of poultry farmers. Therefore, AMR reduction requires intervention from all the stockholders, including the farmers who are considered as end users of antimicrobials. This current research conducted a cross-sectional study to assess the knowledge, attitudes, and practices (KAP) of poultry farmers on AMU and AMR in Bangladesh. We determined the KAP of poultry farmers (broiler and layer farmers) of some selected districts of the country using a tested and paper-based questionnaire. The results demonstrated that most of the respondents have insufficient KAP regarding AMU and AMR. The respondents used a variety of antimicrobials primarily in the treatment of various diseases in poultry. One-third of the farmers did not seek antimicrobials from registered vets. Instead, they depended on others or themselves. The factor score analysis further revealed that the farmers’ demographic and socioeconomic variables were significant factors influencing the KAP. An adjusted logistic regression analysis showed that older farmers with 9–12 years of farming experience and graduate-level education, engaging in medium-sized layer farming, were more likely to have correct KAP on AMU and AMR. Further, farmers from the Cox’s Bazar region showed correct knowledge, whereas farmers of the Chattogram region showed a correct attitude towards AMU and AMR. A Spearman’s rank-order correlation revealed a positive association between knowledge–attitudes and knowledge–practices. The findings of the current investigation provide baseline evidence about the KAP of poultry farmers from low-income resources and offer insights into designing interventions and policies for the use of AMU and AMR in Bangladesh.