Burden assessment of antimicrobial use and resistance in livestock in data-scarce contexts.

Misuse and overuse of antimicrobials in livestock production are identified as drivers for antimicrobial resistance (AMR). To improve decision-making concerning livestock health, it is important to understand the impact of AMR in livestock and aquaculture, within and beyond farm level, as well as expenditure on antimicrobial use (AMU). Such understanding provides grounds for systematic disease prioritisation and establishes a baseline for understanding the value of different strategies to mitigate animal health problems and for the monitoring and evaluation of the impact of those strategies. Yet limited data availability and quality surrounding AMU and AMR create barriers to furthering the knowledge of such impact. These data constraints are also more prevalent in contexts that lack the necessary resources to develop and maintain systematic and centralised data collection and collation systems. Even in regions with robust AMU and AMR monitoring systems in place, data limitations remain, such that the expenditure on antimicrobials and impacts of AMR remain unclear. Additionally, the current research funding strategies have been less focused on primary data collection, adding further barriers to filling the data void and reducing the global AMU/AMR knowledge gap. To work around the data scarcity and leverage previous and ongoing research efforts, it is vital to gain comprehensive knowledge of the people, projects and research consortia dedicated to the topic of AMU/AMR.

Les utilisations incorrecte et excessive d'agents antimicrobiens dans la production animale figurent parmi les facteurs connus de développement de résistances aux agents antimicrobiens (RAM). Pour améliorer la prise de décision relative à la santé des cheptels, il est essentiel de comprendre l'impact de la RAM chez les animaux d'élevage terrestres et aquatiques, aussi bien au niveau des élevages qu'au-delà, et de pouvoir quantifier les dépenses consacrées à l'utilisation d'agents antimicrobiens (UAM). Cette compréhension apporte les éléments d'information pour la priorisation systématique des maladies et établit un cadre de référence pour comprendre la valeur respective des différentes stratégies d'atténuation des problèmes de santé animale et pour assurer le suivi et l'évaluation d'impact de ces stratégies. Cependant, la disponibilité et la qualité limitées des données relatives à l'UAM et à la RAM font obstacle à une connaissance plus poussée de cet impact. Ces contraintes liées aux données sont plus répandues dans les contextes dépourvus des ressources nécessaires pour élaborer et entretenir des systèmes de collecte de données systématiques et centralisés. Même dans les régions où des systèmes robustes de suivi de l'UAM et de la RAM sont en place, le problème de l'insuffisance de données reste posé de sorte que la réalité des coûts induits par les agents antimicrobiens et l'impact de la RAM demeurent incertains. De plus, les stratégies actuelles de financement de la recherche ont été moins axées sur la collecte de données primaires, ce qui ajoute des obstacles supplémentaires pour l'obtention des données manquantes et compromet les efforts visant à réduire les écarts de connaissances sur l'UAM et la RAM à l'échelle mondiale. Afin de remédier à la pénurie de données et de mettre à profit les recherches antérieures et en cours, il est indispensable de savoir quels sont les acteurs, les projets et les consortiums de recherche qui travaillent sur l'UAM et la RAM.

El uso incorrecto y excesivo de antimicrobianos en la producción ganadera se considera un impulsor de la resistencia a los antimicrobianos (RAM). Para mejorar la toma de decisiones relativas a la sanidad del ganado, es importante comprender el impacto de la RAM en la ganadería y la acuicultura, a nivel de las granjas y más allá, así como el coste con el uso de antimicrobianos (UAM). Tal comprensión permite una priorización sistemática de enfermedades y establece una línea base para comprender el valor de las distintas estrategias destinadas a mitigar los problemas de sanidad animal, así como para supervisar y evaluar el impacto de esas estrategias. Sin embargo, la limitada disponibilidad y calidad de los datos en torno al UAM y a la RAM crean barreras que impiden ampliar la comprensión de dicho impacto. Estas limitaciones de datos también son más frecuentes en contextos que carecen de los recursos necesarios para desarrollar y mantener sistemas sistemáticos y centralizados de recopilación y cotejo de datos. Incluso en las regiones que cuentan con sistemas sólidos de seguimiento del UAM y la RAM, los datos siguen siendo limitados, de modo que los costes con antimicrobianos y las repercusiones de la resistencia a estos siguen sin estar claros. Además, las actuales estrategias de financiación de la investigación se han centrado menos en la recopilación de datos primarios, lo que añade más obstáculos a la hora de llenar el vacío de datos y reducir la brecha mundial de conocimientos sobre el UAM y la RAM. Para superar la escasez de datos y aprovechar las iniciativas de investigación previas y en curso, es fundamental adquirir un conocimiento detallado de las personas, los proyectos y los consorcios de investigación dedicados al tema del uso de antimicrobianos y la resistencia a estos.

Collecting Multi-country Retrospective Antimicrobial Consumption and Use Data: Challenges and Experience.

Excessive or inappropriate antimicrobial use contributes to antimicrobial resistance, emphasizing the need to monitor and document the types and quantities of antibiotics used. Thus, data on antimicrobial consumption (AMC) and antimicrobial usage (AMU) are key in informing and promoting judicious use. Our study, conducted during 2019-2023, as part of the CAPTURA project, aimed to understand the state of data availability and quality for AMC and AMU monitoring in Asia. In this article, we describe the challenges and opportunities faced and provide examples of AMU and AMC analysis. World Health Organization (WHO) and country-tailored methodologies and tools were applied to collect retrospective data from 2016 to 2019 in Bangladesh, Bhutan, Laos, Nepal, Pakistan, Papua New Guinea, Sri Lanka, and Timor-Leste. The primary indicator for national AMC was total level of consumption, expressed as total defined daily doses (DDD) per 1000 inhabitants per day for the year or period of data collected. For facility AMC and AMU, the primary indicator was total DDD per admissions per day for the year or period of data collected. Although many countries faced infrastructural challenges in data collection and storage, we managed to collect and analyze AMC data from 6 countries and AMU data from 5. The primary indicators, and additional findings, were visualized to facilitate dissemination and promote the development of action plans. Looking ahead, it is crucial that future initiatives empower each country to establish surveillance infrastructures tailored to their unique contexts, ensuring sustainable progress in the fight against antimicrobial resistance.

Antimicrobial use and antimicrobial resistance monitoring in pig production in the United States of America.

Monitoring antimicrobial use (AMU) and antimicrobial resistance (AMR) on farms is recognised as an important component of antimicrobial stewardship, yet the process can be resource intensive. This paper describes a subset of findings from the first year of a collaboration across government, academia and a private sector veterinary practice focused on swine production in the Midwestern United States. The work is supported by participating farmers and the greater swine industry. Twice-annual collection of samples from pigs along with AMU monitoring occurred on 138 swine farms. Detection and resistance of Escherichia coli from pig tissues was assessed, and associations between AMU and AMR were evaluated. This paper describes the methods utilised and the first-year E. coli-related results from this project. Higher minimum inhibitory concentrations (MIC) for enrofloxacin and danofloxacin in E. coli from swine tissues were associated with the purchase of fluoroquinolones. There were no other significant associations between MIC and AMU combinations in E. coli isolated from pig tissues. This project represents one of the first attempts to monitor AMU as well as AMR in E. coli in a large-scale commercial swine system in the United States of America.

Alors même que la surveillance exercée sur l'utilisation des agents antimicrobiens (UAM) et sur la résistance aux agents antimicrobiens (RAM) dans les élevages est une composante majeure reconnue de la gestion des antimicrobiens, le processus en lui-même exige une mobilisation intensive de ressources. Les auteurs décrivent un sous-ensemble de résultats obtenus au cours de la première année d'une collaboration entre les pouvoirs publics, les universités et une clinique vétérinaire privée, axée sur la production porcine dans le Midwest des états-Unis d'Amérique. Ce travail est soutenu par les éleveurs participants et par le secteur porcin au sens large. Une collecte d'échantillons porcins a été effectuée deux fois par an, parallèlement à la surveillance de l'UAM dans 138 élevages. Il a été procédé à une recherche des Escherichia coli présents dans les tissus porcins prélevés puis à la détermination de la résistance aux antimicrobiens chez les microorganismes détectés ; les corrélations éventuelles entre l'UAM et la RAM ont ensuite été évaluées. Les auteurs décrivent les méthodes utilisées dans la cadre de ce projet ainsi que les résultats en lien avec les E. coli obtenus au cours de la première année. Une corrélation a été constatée entre l'augmentation des concentrations minimales inhibitrices (CMI) recueillies pour l'enrofloxacine et la danofloxacine vis-à-vis d'E. coli dans les tissus porcins analysés, d'une part, et l'achat de fluoroquinolones, d'autre part. Aucune autre corrélation significative n'a été décelée entre les CMI recueillies et les profils d'UAM concernant les E. coli isolés à partir des tissus porcins. Ce projet représente l'une des premières tentatives conduites aux états-Unis d'Amérique pour surveiller parallèlement l'UAM et la RAM chez les E. coli dans un système commercial de production porcine à grande échelle.

Aunque se tiene por sabido que la vigilancia en las explotaciones del uso de agentes antimicrobianos (UAM) y de la resistencia a los antimicrobianos (RAM) es un importante componente de la gestión de estos fármacos, no es menos cierto que el proceso puede consumir cuantiosos recursos. Los autores exponen un ubconjunto de observaciones realizadas durante el primer año de un proyecto de colaboración entre la administración pública, el mundo universitario y una clínica veterinaria privada que tenía por objeto de estudio la producción porcina en la zona del medio oeste de los Estados Unidos de América. Respaldaban el proyecto los productores que participaban en él y el sector de la industria porcina en general. Dos veces al año se obtuvieron muestras en 138 explotaciones porcinas, en las que también se seguía de cerca el UAM. Tras realizar pruebas de detección de Escherichia coli en tejidos porcinos y analizar la resistencia de esos microorganismos a antimicrobianos, se buscaron correlaciones entre el uso de estos fármacos y la presencia de eventuales resistencias. Los autores describen los métodos empleados y los resultados obtenidos el primer año del proyecto en relación con E. coli. Se observó una correlación entre la compra de fluoroquinolonas y el aumento de la concentración inhibitoria mínima (MIC) de enrofloxacina y de danofloxacina en los E. coli analizados. No se constató ninguna otra asociación significativa entre las MIC y el uso de diferentes antimicrobianos en los E. coli aislados a partir de tejido porcino. Este proyecto constituye una de las primeras tentativas de hacer seguimiento y balance del uso de agentes antimicrobianos y de la resistencia de E. coli a estos fármacos en el sistema de producción porcina industrial de los Estados Unidos de América.

Microplastic transport during desertification in drylands: Abundance and characterization of soil microplastics in the Amu Darya-Aral Sea basin, Central Asia.

Desertification and microplastic pollution are major environmental issues that impact the function of the ecosystem and human well-being of drylands. Land desertification may influence soil microplastics' abundance, transport, and distribution, but their distribution in the dryland deserts of Central Asia's Amu Darya-Aral Sea basin is unknown. Here, we investigated the abundance and distribution of microplastics in dryland desert soils from the Amu Darya River to the Aral Sea basin in Central Asia at a spatial scale of 1000 km and soil depths ranging from 0 to 50 cm. Microplastics were found in soils from all sample locations, with abundances ranging from 182 to 17841 items kg-1 and a median of 3369. Twenty-four polymers were identified, with polyurethane (PU, 37.3%), silicone resin (SR, 17.0%), and chlorinated polyethylene (CPE, 9.8%) accounting for 64.1% of all polymer types. The abundance of microplastics was significantly higher in deep (20-50 cm) soils than in surface (0-5, 5-20 cm) soils. The main morphological characteristics of the observed microplastics were small size (20-50 µm) and irregular particles with no round edges (mean eccentricity 0.65). The abundance was significantly and positively related to soil EC and TP. According to the findings, desertification processes increase the abundance of microplastic particles in soils and promote migration to deeper soil layers. Human activities, mainly grazing, may be the region's primary cause of desertification and microplastic pollution. Our findings provide new information on the diffusion of microplastics in drylands during desertification; these findings are critical for understanding and promoting dryland plastic pollution prevention and control.

Occurrence, sources and spatial distribution of n-alkanes in surface soils from the Amu Darya Delta, Uzbekistan, arid Central Asia.

Central Asia (CA) has attracted global attention because of either water scarcity or ecosystem degradation. The Amu Darya Delta (ADD), one of the most important oases in CA, is endowed with valuable wetlands and biological resources that provide good ecosystem services to inhabitants. However, the region has experienced climate warming and large-scale anthropogenic changes since the last century. To assess the influences of anthropogenic interventions on the soil environment in this area, surface soil samples collected from the ADD were analysed for aliphatic hydrocarbon fractions and five heavy metals (HMs; including Cd, Zn, Cu, Ni and V). The results indicated that the n-alkanes extracted from surface soils were composed of homologous series from C14 to C35. Relatively high abundances of short-chain n-alkanes (n-C33) occurred in most surface soils, which might be a sign of a hot and arid climatic environment. Notably, almost all samples presented a clear even carbon dominance of short-chain n-alkanes, especially for cluster 1, which possibly represented the influence of hydrocarbon contamination and highly saline carbonate environments in addition to bacterial degradation. The biomarker indices and HM enrichment index indicated greater effects of crude oil pollution on cluster 1 (specifically samples 2, 4, 5, 6, 13, 16 and 34) and anthropogenic activities such as traffic emissions and agricultural drainage on cluster 3 samples. The results of this study provide evidence that the n-alkane composition and abundance in surface soils respond sensitively to anthropogenic interventions, arid climate and petroleum hydrocarbon pollution.

A novel disk-based detection method with superior sensitivity for ß-lactamase production in third-generation cephalosporin-resistant Enterobacteriaceae.

OBJECTIVE: Current phenotypic methods for extended-spectrum ß-lactamase (ESBL), AmpC ß-lactamase (AmpC), and carbapenemases fail to detect isolates that co-produce other classes of ß-lactamases. In this study, we have developed a novel assay (Applied Multiplex Disk Method: AMU-DM) for the phenotypic detection and identification of ß-lactamases produced by Enterobacteriaceae. METHODS: We evaluated the performance of the method by comparison with PCR results for 78 Enterobacteriaceae clinical isolates that were positive by the ESBL screening test and negative by the ESBL confirmation test. Additionally, one NCTC strain and four ATCC strains were also included in the test population for the study as reference. RESULTS: For 79/83 (95%) isolates tested, the AMU-DM results matched those obtained by PCR. The concordance rates were 31/31 (100%), 11/11 (100%), 3/3 (100%), 0/1 (0%), 15/15 (100%), 16/19 (84%), and 3/3 (100%) for AmpC, ESBL and AmpC co-production, Klebsiella pneumoniae carbapenemase (KPC), KPC and ESBL co-production, metallo ß-lactamase (MBL), MBL and ESBL co-production, and MBL and AmpC co-production, respectively. CONCLUSION: The AMU-DM is convenient to perform, economical, and highly sensitive in identifying ESBLs, AmpCs, and carbapenemases. Our method may be useful in clinical settings for the implementation of relevant infection control measures and for surveillance purposes.

An Integrated Analysis of Abattoir Lung Lesion Scores and Antimicrobial Use in Italian Heavy Pig Finishing Farms.

Respiratory diseases significantly affect intensive pig finishing farms, causing production losses and increased antimicrobial use (AMU). Lesion scoring at slaughter has been recognized as a beneficial practice to evaluate herd management. The integrated analysis of abattoir lesion scores and AMU data could improve decision-making by providing feedback to veterinarians and farmers on the effectiveness of antimicrobial treatments, thus rationalizing their use. This study compared lung and pleural lesion scores collected at Italian pig slaughterhouses with on-farm AMU, estimated through a treatment index per 100 days (TI100). Overall, 24,752 pig carcasses, belonging to 236 batches from 113 finishing farms, were inspected. Bronchopneumonia and chronic pleuritis were detected in 55% and 48% of the examined pigs, respectively. Antimicrobials were administered in 97% of the farms during the six months prior to slaughter (median TI100 = 5.2), notwithstanding compliance with the mandatory withdrawal period. EMA category B (critical) antimicrobials were administered in 15.2% of cases (median TI100 = 0.06). The lung score was not associated with the total AMU, but significant, positive associations were found with the past use of critical antimicrobials (p = 0.041) and macrolides (p = 0.044). This result highlights the potential of abattoir lung lesion monitoring to rationalize antimicrobial stewardship efforts, contributing to AMU reduction.

Antimicrobial Use Survey and Detection of ESBL-Escherichia coli in Commercial and Medium-/Small-Scale Poultry Farms in Selected Districts of Zambia.

Antimicrobial resistance (AMR) among Escherichia coli from food animals is a rising problem, and heavy antimicrobial use in poultry is a contributing factor. In Zambia, studies linking poultry-associated AMR and antibiotic use (AMU) are rare. This study aimed to investigate commercial and medium-/small-scale poultry farmers' usage of antimicrobials based on a questionnaire survey in ten districts of Zambia. In addition, the study characterized extended-spectrum ß-lactamase (ESBL)-producing E. coli isolates obtained from poultry in the same districts. Data regarding knowledge and usage of antimicrobials were collected from commercial and medium-/small-scale poultry farmers using a pre-tested structured questionnaire. At the same time, cloacal samples were collected and analyzed. One hundred and fifty E. coli isolates were tested for antimicrobial susceptibility using eight antibiotic classes. The isolates were further screened for ESBL production by streaking them on cefotaxime (CTX)-supplemented MacConkey agar, then subjecting them to sequencing on a NextSeq. The questionnaire survey showed that more medium-/small-scale than commercial poultry farmers used antimicrobials (OR = 7.70, 95% CI = 2.88-20.61) but less prescriptions (OR = 0.02, 95% CI = 0.00-0.08). Susceptibility testing revealed that resistance was highest to ampicillin (128/148, 86.5%) and tetracycline (101/136, 74.3%) and that the prevalence of multidrug resistance (MDR) (28/30, 93.3%) was high. Whole-genome sequencing (WGS) of eight (8/30, 26.7%) isolates with CTX Minimum Inhibitory Concentration (MIC) ≥ 4 µg/mL revealed the presence of ESBL-encoding genes blaCTX-M-14, blaCTX-M-55, and blaTEM. WGS also detected other AMR genes for quinolones, aminoglycosides, phenicols, tetracycline, macrolides, and folate-pathway antagonists. Altogether, the questionnaire survey results showed a higher proportion of AMU and lower prescription usage among medium-/small-scale farmers. In addition, our results emphasize the circulation of ESBL-producing E. coli strains with associated MDR. It is critical to educate farmers about AMR risks and to encourage responsible usage of antimicrobials. Furthermore, there is a need to strengthen regulations limiting access to antimicrobials. Finally, there is a need to establish a one health system to guide public health response.

Accessing the behavior and awareness of veterinary professionals towards antimicrobials use and antimicrobial resistance in Indian district.

Introduction: Antimicrobial resistance (AMR) poses a significant public health threat, and understanding the awareness and practices of healthcare professionals is crucial for its mitigation. Since the animal sector plays a key role in India's economy, we decided to explore the understanding of Antimicrobial Use (AMU) and AMR among veterinary professionals. Methods: The study aimed to evaluate the awareness and behavior of veterinarians and para-veterinarians working in the Jhunjhunu district, Rajasthan, India, concerning AMU and AMR. Questionnaire surveys were administered to them with closed-ended questions. The data was collected and subjected to statistical analysis to derive meaningful insights. The key findings highlight notable differences in certain behavioral aspects of antibiotic prescription among the two groups. Results and Discussion: It appears that 53.8% of veterinarians as compared to 25.8% para-veterinarians do not surely inform farmers about the importance of adhering to antibiotic withdrawal periods, thereby failing to raise awareness about proper antibiotic use. Moreover, para-veterinarians (46.6%) tend to engage less in evidence-based antibiotic prescription than veterinarians (81%). Furthermore, both groups exhibit a lower frequency of advice on Antimicrobial Susceptibility Testing (ABST), essential for informed prescribing decisions. Most significantly, both groups show a tendency to prefer critically important antibiotics for prescription, raising concerns about the escalating threat of AMR. This study thus emphasizes the areas that need targeted interventions to enhance responsible antimicrobial usage and curb the growth of AMR in the region.

Participatory identification of the causes of antimicrobial use and how they may vary according to differences in sector structure: The case of the Flemish pork and veal sectors.

The increasing threat of antimicrobial resistance (AMR) to human health has prompted many countries to adopt national action plans to reduce antimicrobial use (AMU) in farm animals. To achieve this goal, it is necessary to gain a deeper understanding of the factors driving AMU in farm animals. While previous research has focused on gaining a better understanding of AMU from the perspective of farmers and veterinarians, less emphasis has been placed on examining the systemic and contextual factors that influence AMU from multiple viewpoints within the food supply chain. To this end, this paper describes a participatory approach involving multiple stakeholders from two distinct livestock sectors to identify the underlying drivers of AMU and explore their case-specificity. For each sector, we identified causes of AMU during four online focus groups, by co-creating a "problem tree", which resulted in the identification of over 50 technical, economic, regulatory, and sociocultural causes per sector and exploration of causal links. Following this, we analysed the focus group discussion through a content analysis and clustered causes of AMU that were related into 17 categories (i.e. main drivers of AMU), that we then classified as drivers of AMU at sector level or drivers of AMU at farm level. Finally, we compared the two sectors by assessing whether the generated categories (i.e. main drivers for AMU) had been discussed for both sectors and, if so, whether they involved the same causes and had the same implications. Through our analysis, we gained a better understanding of several main drivers of AMU at sector level, that result from systemic and/or contextual causes. As these cannot always be addressed by farmers and/or their veterinarian, we suggest that interventions should also target other actors related to these causes or consider them to help implement certain strategies. Furthermore, based on the results of our comparative analysis, we suggest that systemic structural differences, such as size and level of supply chain integration/fragmentation, may lead to differences in how animal health management is approached. This in turn may influence AMU's decision-making and the effectiveness of interventions, if they are generic and not tailored to the specificities of the sector.

The burden of cancer on the acute medical unit.

The burden of cancer is increasing, with a significant increase in cancer-related emergencies and patients with known malignancy presenting to the acute medical unit (AMU). We performed a retrospective analysis at a university hospital in the north west of England in May 2011. We examined 300 consecutive admissions to determine the number of, and reason for, cancer patients presenting to the AMU. Patients with cancer had a statistically significantly longer average length of inpatient stay than patients without cancer (8.8 days vs 7.2 days, p<0.01). As the incidence and prevalence of cancer increases, the challenge of improving the experience, safety and outcomes of patients with cancer becomes more important. Development of successful acute oncology services with close working with acute physicians will be essential in order to achieve this.

Case Study: Using a Shared International Database to Document Veterinary Consumption of Antibiotics in Pakistan.

In this paper, we present a case study of Pakistan documenting the use of antimicrobial drugs in poultry flocks in the VetCAb-ID database. Unlike other databases, this system allows international users to upload their data directly. Based on expert interviews and a review of the latest publications on the topic, we provide an alternative approach to harmonizing data collection among countries. This paper will provide impetus to formulate joint requirement documentation for an AMU database on a global level that international users can adapt for their own purposes and projects.

Quantitative and qualitative analysis of antimicrobial usage and biosecurity on broiler and Sonali farms in Bangladesh.

Antimicrobial use (AMU) is a major contributing factor to the rising threat of antimicrobial resistance (AMR) in human and animals. To control AMR, indiscriminate antibiotic use needs to be restricted, preventive measures such as biosecurity must be prioritized and proper action plans must be implemented. This study aimed to quantify and associate AMU and biosecurity status of broiler and Sonali farms in Bangladesh. Data on all antimicrobial treatments administered during a batch production cycle and antimicrobials purchased over a year were collected from 94 conventional broiler and 51 Sonali (cross-breed) farms from the northern and southeast regions of Bangladesh. Flock-level AMU was quantified using Treatment Incidence (TI) per 100 days based on the Defined Daily Dose (TIDDDvet) expressing the number of days per 100 animal-days at risk that the flock receives a standard dose of antimicrobials. The biosecurity status (external and internal) of these farms was assessed by means of the Biocheck.UGent scoring system and the correlation between biosecurity and TIDDDvet were assessed by Pearson's correlation coefficients. Median flock TIDDDvet was 60 and 58 for broilers and Sonali flocks, indicating that the birds were treated around 60% and 58% of their lifetime with an antimicrobial dose, respectively. Minimum and maximum values of TIDDDvet ranged from 18 -188 and 31-212 in broilers and Sonali, respectively. Fluoroquinolones, sulfonamides, tetracyclines and aminopenicillins were the most frequently used antimicrobial classes. The mean external and internal biosecurity scores were 39% and 61% for broilers and 44% and 61% for Sonali, respectively. There was a statistically significant difference in the external biosecurity score in broiler farms in the two regions (p ≤ 0.001), whereas, the internal biosecurity score was borderline not statistically significantly different (p = 0.065). The biosecurity score was negatively correlated with AMU in broiler and sonali farms both for external (R2 =-0.38; -0.36) and internal biosecurity (R2 =-0.33; -0.32), respectively. As most of the farmers treated their birds with antimicrobials for a very large part of the production, it could be concluded that there is a high overuse of antimicrobials both in broiler and Sonali poultry production in Bangladesh. This study also highlighted a low level of farm biosecurity practices. Overuse of antimicrobials and low level of biosecurity practice may be due to a lack of knowledge, ignorance, avoid loss and/or lack of monitoring by governmental agencies. Therefore, urgent action is required to increase awareness and biosecurity levels and to reduce AMU in these production systems.

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 Use in Canadian Cow-Calf Herds.

Despite growing concern surrounding antimicrobial use (AMU) and the importance of cow-calf herds to the Canadian livestock industry, surveillance of AMU in cow-calf herds to inform antimicrobial stewardship programs has been sporadic. Producers from the Canadian Cow-Calf Surveillance Network (87%, 146/168) provided data and almost all reported AMU in at least one animal (99%, 145/146 herds) in 2019-2020. The most common reasons for AMU were treatment of respiratory disease in nursing calves in 78% of herds and neonatal diarrhea in 67% of herds, as well as for lameness in cows in 83% of herds. However, most herds treated <5% of animals for these reasons. Less than 2.5% of herds treated more than 30% of calves for either bovine respiratory disease or neonatal diarrhea and no herds treated more than 30% of cows for lameness. The most frequently reported antimicrobial was oxytetracycline in 81% of herds, followed by florfenicol in 73% of herds. Antimicrobials with very high importance to human health, such as ceftiofur, were used at least once by 20% of herds but were only used in >30% of nursing calves from one herd. Similarly, while 56% of herds used macrolides at least once, within-herd use was the highest in nursing calves where <4% of herds reported use in >30% of animals. Herds using artificial insemination and calving in the winter were more likely (p = 0.05) to treat >5% of nursing calves for respiratory disease, suggesting the importance of vaccination programs for herds at risk. Overall, AMU was similar to previous Canadian studies; however, the percentage of herds using macrolides had increased from a comparable study in 2014.

Evaluating the contribution of antimicrobial use in farmed animals to global antimicrobial resistance in humans.

Antimicrobial resistance (AMR) is currently regarded by the World Health Organization (WHO) as one of the most significant risks to global public health. The most critical causes of AMR infections in humans are the misuse and overuse of antimicrobials in humans and farmed animals. The rising global demand for food of animal origin encourages the increase of animal production worldwide, especially in developing countries. Simultaneously, current farming practices often extensively use antimicrobials on animals, influencing bacterial AMR incidence. This study aims to evaluate the correlation between antimicrobial use (AMU) in farmed animals and the detection of AMR infections in humans, the effects of enforcing laws in animal farming in a country on AMR situation in the neighbors, and the potential of AMR to spread from one country to another. Using data from 30 largest animal-producing countries in different regions of the world, between 2010 and 2020, and a Spatial Durbin Model (SDM), we found that AMU in farmed animals increases AMR in humans and there is a spatial dependence between countries regarding AMR spreading. Such findings indicate that a globally coordinated strategy regulating AMU on farmed animals may reduce AMR emergence and worldwide spreading.

Quantifying antimicrobial use on Canadian dairy farms using garbage can audits.

Antimicrobial resistance in pathogenic bacteria is one of the preeminent concerns for the future of global health. There is a dose-dependent relationship between antimicrobial use (AMU) and the prevalence of antimicrobial-resistant pathogens. As most AMU in Canada is related to animal agriculture, there is a need to reduce overall AMU, which could be accomplished through surveillance of AMU in animal agriculture, including the dairy industry. The objective of this study was to quantify AMU on dairy farms across Canada. This study had two parts: a description of data collected in 2019-2020, and a meta-analysis comparing this data to previous estimates of AMU in the Canadian dairy industry. The first included a garbage can audit (GCA) on 107 farms in four Canadian provinces (British Columbia, Alberta, Ontario, and Nova Scotia) in 2020; AMU data were converted to the dose-based metrics of defined course doses (DCD) and defined daily doses (DDD). Mixed-effect linear models were fit to determine the relationship between province and use of different classes of antimicrobials. On average, for every 100 animals on the farm, 117 DCD of antimicrobials were administered per year (IQR: 55, 158). These treatments amounted to 623 DDD / 100 animal-yr (IQR: 302, 677 DDD/100 animal-years). Penicillins were the most used class of antimicrobials, followed by first-and third-generation cephalosporins. Farms in Ontario used more third-generation cephalosporins than other provinces. The second part of this study compared AMU in 2020 to previously reported Canadian studies through a meta-analysis. A GCA was conducted in 2007-2008 in Alberta, Ontario, Québec, and the Maritime provinces (Prince Edward Island, New Brunswick and Nova Scotia); another GCA was conducted in Québec in 2018. Overall, AMU was lower in 2018-2020 than in 2007-2008, with the exception of third-generation cephalosporin use, which increased.

Complex interplay between PRRSV-1 genetic diversity, coinfections and antimicrobial use influences performance parameters in post-weaning pigs.

Porcine reproductive and respiratory syndrome (PRRS) is one of the main diseases of pigs, leading to large economic losses in swine production worldwide. PRRSV high mutation rate and low cross-protection between strains make PRRS control challenging. Through a semi-longitudinal approach, we analysed the relationships among performance parameters, PRRSV-1 genetic diversity, coinfections and antimicrobial use (AMU) in pig nurseries. We collected data over the course of five years in five PRRS-positive nurseries belonging to an Italian multisite operation, for a total of 86 batches and over 200,000 weaners involved. The farm experienced a severe PRRS outbreak in the farrowing unit at the onset of the study, but despite adopting vaccination of all sows, batch-level losses in nurseries in the following years remained constantly high (mean±SE: 11.3 ± 0.5 %). Consistently with previous studies, our phylogenetic analysis of ORF 7 sequences highlighted the peculiarity of strains circulating in Italy. Greater genetic distances between the strain circulating in a weaners' batch and strains from the farrowing unit and the previous batch were associated with increased mortality (p < 0.0001). All the respiratory and enteric coinfections contributed to an increase in losses (all p < 0.026), with secondary infections by Streptococcus suis and enteric bacteria also inducing an increase in AMU (both p < 0.041). Our findings highlight that relying solely on sows' vaccination is insufficient to contain PRRS losses, and the implementation of rigorous biosecurity measures is pivotal to limit PRRSV circulation among pig flows and consequently minimise the risk of exposure to genetically diverse strains that would increase production costs.

The ALEX algorithm - estimating average lifetime antimicrobial exposure of danish slaughter pigs in a fast, automated and robust way.

Calculating and estimating antimicrobial exposure at specific batch level is key to understanding consumption patterns of antimicrobials in the Danish pig sector. Understanding consumption and trading patterns can assist in developing treatment plans at national levels and might lead to reducing antimicrobial resistance levels. The ALEX algorithm is a fast, automated and robust algorithm developed to estimate the average lifetime antimicrobial exposure of Danish slaughter pigs. The algorithm estimates antimicrobial exposure in the different life stages of the pig (piglet, weaner and finisher) together with the type of production network (the number of farms within a network and ownership of these). We present the algorithm and give two examples of usage. Furthermore, we compare the ALEX algorithm with an acknowledged exposure estimation algorithm, and we present a sensitivity analysis.

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.