Persistence of Staphylococcus spp. in milk from cows undergoing homeopathy to control subclinical mastitis.

BACKGROUND: Mastitis is one of the major diseases in dairy cattle, as it causes great economic losses to producers due to the reduction of milk production and changes in the quality of the product. The disease is mainly caused by bacteria of the genus Staphylococcus spp., these microorganisms can express various virulence factors, such as biofilms for example. In herds with organic management, producers and technicians use unconventional ways to treat and control the disease, such as homeopathy. However, it is not known if this type of treatment is able to control pathogenic bacteria such as those of the genus Staphylococcus, of relevance to animal and human health. Thus, the objective of this study was to investigate the production of biofilm in vitro and its genes by Staphylococcus spp. isolated in the milk of cows treated with homeopathy, as well as the persistence of microorganisms in animals. METHODS: Ninety-nine isolates of Staphylococcus spp. from cows treated and not treated with homeopathy were identified by internal transcribed space-polymerase chain reaction and investigated for the presence of the icaABCD, bap, aap, atlE, and bhp genes and in vitro biofilm production using the adhesion method on polystyrene plates. The enzyme restriction profile was determined by Pulsed-Field Gel Electrophoresis. Clusters of S. aureus and S. epidermidis with three or more isolates had an isolate selected for Multilocus Sequence Typing. RESULTS: The frequency of S. aureus isolations was similar in treated and untreated cows, while 71.4% of the coagulase-negative identified were isolated in cows treated with homeopathy. The distribution of the operon ica genes was similar in animals with and without treatment, except for the icaD gene, more frequent in treated cows. Production of biofilm was associated with presence of one or more genes from the icaADBC operon. S. aureus revealed a greater diversity and greater dissemination in cows treated and not treated with homeopathy. Sequence Types ST1, ST5, and ST126 were identified in S. aureus. CONCLUSIONS: The presence of biofilm-associated genes and the in vitro production of biofilms, combined with the persistence of clonal profiles of Staphylococcus spp. demonstrate other forms of control for bovine mastitis should be researched for organic production herds.

Invited review: A systematic review and qualitative analysis of treatments other than conventional antimicrobials for clinical mastitis in dairy cows.

Clinical mastitis is an important disease in dairies. Its treatment is mainly based on the use of antimicrobial drugs. Numerous non-antimicrobial drugs and treatment strategies have already been reported for clinical mastitis treatment, but data on their efficacy have never been collated in a systematic way. The objective of this systematic review was to identify treatments other than conventional antimicrobials for the treatment of clinical mastitis in lactating dairy cows. A systematic review was performed with studies written in English or French selected from CAB Abstracts, PubMed, and Web of Science from January 1970 to June 2014. Controlled clinical trials, observational studies, and experimental challenges were retained. Lactating dairy cows with clinical mastitis were the participant of interest. All treatments other than conventional antimicrobials for clinical mastitis during lactation were retained. Only studies comparing the treatment under investigation to a negative or positive control, or both, were included. Outcomes evaluated were clinical and bacteriological cure rates and milk production. Selection of the study, data extraction, and assessment of risk of bias was performed by 3 reviewers. Assessment of risk of bias was evaluated using the Cochrane Collaboration tool for systematic review of interventions. A total of 2,451 manuscripts were first identified and 39 manuscripts corresponding to 41 studies were included. Among these, 22 were clinical trials, 18 were experimental studies, and 1 was an observational study. The treatments evaluated were conventional anti-inflammatory drugs (n = 14), oxytocin with or without frequent milk out (n = 5), biologics (n = 9), homeopathy (n = 5), botanicals (n = 4), probiotics (n = 2), and other alternative products (n = 2). All trials had at least one unclear or high risk of bias. Most trials (n = 13) did not observe significant differences in clinical or bacteriological cure rates in comparison with negative or positive controls. Few studies evaluated the effect of treatment on milk yield. In general, the power of the different studies was very low, thus precluding conclusions on noninferiority or nonsuperiority of the treatments investigated. No evidence-based recommendations could be given for the use of an alternative or non-antimicrobial conventional treatment for clinical mastitis. However, probiotics and oxytocin with or without frequent milk out should not be recommended. We concluded that homeopathic treatments are not efficient for management of clinical mastitis.

Randomized, blinded, controlled clinical trial shows no benefit of homeopathic mastitis treatment in dairy cows.

Mastitis is one of the most common diseases in dairy production, and homeopathic remedies have been used increasingly in recent years to treat it. Clinical trials evaluating homeopathy have often been criticized for their inadequate scientific approach. The objective of this triple-blind, randomized controlled trial was to assess the efficacy of homeopathic treatment in bovine clinical mastitis. The study was conducted on a conventionally managed dairy farm between June 2013 and May 2014. Dairy cows with acute mastitis were randomly allocated to homeopathy (n = 70) or placebo (n = 92), for a total of 162 animals. The homeopathic treatment was selected based on clinical symptoms but most commonly consisted of a combination of nosodes with Streptococcinum, Staphylococcinum, Pyrogenium, and Escherichia coli at a potency of 200c. Treatment was administered to cows in the homeopathy group at least once per day for an average of 5 d. The cows in the placebo group were treated similarly, using a placebo preparation instead (lactose globules without active ingredients). If necessary, we also used allopathic drugs (e.g., antibiotics, udder creams, and anti-inflammatory drugs) in both groups. We recorded data relating to the clinical signs of mastitis, treatment, time to recovery, milk yield, somatic cell count at first milk recording after mastitis, and culling. We observed cows for up to 200 d after clinical recovery. Base-level data did not differ between the homeopathy and placebo groups. Mastitis lasted for an average of 6 d in both groups. We observed no significant differences in time to recovery, somatic cell count, risk of clinical cure within 14 d after disease occurrence, mastitis recurrence risk, or culling risk. The results indicated no additional effect of homeopathic treatment compared with placebo. The advantages or disadvantages of homeopathy should be carefully assessed for individual farms.

Mastitis prevention and control practices and mastitis treatment strategies associated with the consumption of (critically important) antimicrobials on dairy herds in Flanders, Belgium.

The main objectives of this study were to evaluate to what extent variations in herd-level antimicrobial consumption (AMC) can be explained by differences in management practices that are consistently effective in the prevention of (sub)clinical mastitis, on the one hand, and by differences in mastitis treatment strategies, on the other hand. Antimicrobial consumption data were obtained during 2012 and 2013 by "garbage can audits" and expressed as antimicrobial treatment incidences (ATI) for all compounds combined (total ATI) and for the critically important antimicrobials for human health separately. Data on mastitis prevention and control practices were obtained via face-to-face interviews performed during herd visits in March 2013. Some management practices and treatment strategies related to udder health were associated with the total AMC. However, the results demonstrated that implementing effective udder health management practices does not necessarily imply a low AMC and vice versa. Herds participating in a veterinary herd health management program and herds selectively drying off cows used fewer antimicrobials compared with herds not participating in such a program or applying blanket dry-cow therapy. Moreover, herds treating (some) (sub)clinical mastitis cases with intramammary homeopathic substances consumed fewer antimicrobials than herds not applying such homeopathic treatments. Besides these factors, no other direct association was found between effective udder health management practices on the one hand and AMC on the other hand. Also, the use of critically important antimicrobials was only associated with the way in which subclinical mastitis cases were treated. The latter indicates that the AMC of critically important antimicrobials is potentially driven by factors other than those included in this study such as those related to the "mindset" of the veterinarians and their farmers. Future research should therefore aim to unravel the reasoning of vets and their farmers behind the use of those critically important antimicrobials for the treatment of mastitis and other diseases.

Comparative effectiveness of individualised homeopathy and antibiotics in the treatment of bovine clinical mastitis: randomised controlled trial.

Based on the widespread use of homeopathy in dairy farm practice when treating mastitis, a blind randomised controlled trial (RCT) was conducted to assess the effectiveness of homeopathic treatment of clinical mastitis on four dairy farms. The study considered specific guidelines for RCTs as well as the basic principles of individualised homeopathy and involved 180 lactating dairy cows. Evaluation of cure rates was based on clinical investigation of the udder and on laboratory analysis of milk samples. In culture-positive cases, the antibiotic treatment provided suboptimal bacteriological cures (60-81 per cent) but was more effective than individualised homeopathy (33-43 per cent) whose effects appeared little different to those of placebos (45-47 per cent) (P≤0.05). On the cytological cure level, all three treatment methods were similarly ineffective: antibiotic being 2-21 per cent, individualised homeopathy 0-8 per cent and placebo 3-13 per cent (P≤0.05; P=0.13). Antibiotics, individualised homeopathy and placebo had similar effects on bacteriological and cytological cure in cases of culture-negative milk samples (P>0.4) and Escherichia coli infections (P=1.0). The study results implied that the effectiveness of individualised homeopathy does not go beyond a placebo effect and successful treatment is highly dependent on the specific mastitis pathogen. Thus, antimicrobial or alternative remedies used should be based on the bacterial culture of the milk sample. TRIAL REGISTRATION NUMBER: NTP-ID: 00008011-1-9, Pre-results.

Investigations of the motivation underlying Norwegian dairy farmers' use of homoeopathy.

Eighteen Norwegian dairy farmers were interviewed to examine their reasons for using homoeopathic treatments in managing their herds' health. Overall, they chose the treatments on the basis of factors related to their personal experience, considerations of individual animals and the framework for dairy production. For individual animals homoeopathy was used as an alternative to conventional veterinary treatment, but at the herd level it was used to complement it. The farmers' use of homoeopathic treatment for personal health problems and the experience of their colleagues with its use in dairy production were important factors motivating their initial use of homoeopathy. Other factors included a desire to decrease the use of antibacterial drugs, reduce costs and find alternatives when conventional veterinary medicine provided no effective treatment. In individual cases, the severity of disease, previous experience and the farmers' personal knowledge and resources were important. These factors parallel those found to influence the use of complementary and alternative therapies in human medicine. The lack of understanding and documentation of the effects of homoeopathic remedies was not important to the farmers, and they valued personal experience more highly than scientific evidence or the opposition to homoeopathy encountered within the veterinary profession.

[Guidelines for prevention and therapy in ecological animal farms as in the example of bovine mastitis]. / Richtliniengemässe Prävention und Therapie in der Tierhaltung des Okolandbaus am Beispiel der Mastitis der Kuh.

In ecological farming mastitis is the dominating disease in dairy cattle. The regular prophylactic use of antibiotics in farm animals is forbidden, in therapy antibiosis is restricted. A solution of this problem could be a program of systematic homeopathic prophylaxis as well as a standardised homeopathic treatment. The example of chronic catarrhal staph.-aureus-mastitis shows that there is only a certain expectancy of success by homeopathy as well as by any other medication, if the medication is combined with necessary sanitation measures. The prognosis for a homeopathic treatment is less favourable if the sanitation measures are realised incompletely. The possible negative effects of a false homeopathic medication are described.

Management of mastitis on organic and conventional dairy farms.

This paper compares management of mastitis on organic dairy farms with that on conventional dairy farms. National standards for organic production vary by country. In the United States, usage of antimicrobials to treat dairy cattle results in permanent loss of organic status of the animal, effectively limiting treatment choices for animals experiencing bacterial diseases. There are no products approved by the US Food and Drug Administration that can be used for treatment of mastitis on organic dairy farms, and usage of unapproved products is contrary to Food and Drug Administration guidelines. In general, organic dairy farms tend to be smaller, produce less, and more likely to be housed and milked in traditional barns as compared with conventionally managed herds. It is difficult to compare disease rates between herds managed conventionally or organically because perception and detection of disease is influenced by management system. To date, no studies have been published with the defined objective of comparing animal health on organic dairy herds with that on conventional dairy herds in the United States. European studies have not documented significant differences in animal health based on adoption of organic management. Few differences in bulk tank somatic cell counts have been identified between organic and conventional herds. Farmers that have adopted organic management consistently report fewer cases of clinical mastitis, but organic farmers do not use the same criteria to detect clinical mastitis. European dairy farmers that adopt organic management report use of a variety of conventional and alternative therapies for treatment and control of mastitis. In the United States, organic farmers treat clinical mastitis using a variety of alternative therapies including whey-based products, botanicals, vitamin supplements, and homeopathy. Organic farmers in the United States use a variety of alternative products to treat cows at dry-off. Virtually no data are available that support the clinical efficacy of any of the alternative veterinary products used for treatment or prevention of mastitis. Some associations between organic management and antimicrobial susceptibility of gram-positive mastitis pathogens have been noted, but overall, few mastitis pathogens from both conventional and organic dairy herds demonstrate resistance to antibiotics commonly used for mastitis control.

Mastitis and related management factors in certified organic dairy herds in Sweden.

BACKGROUND: Mastitis is one of the major threats to animal health, in organic farming as well as conventional. Preliminary studies of organic dairy herds have indicated better udder health in such herds, as compared to conventional herds. The aim of this paper was to further study mastitis and management related factors in certified organic dairy herds. METHODS: An observational study of 26 certified organic dairy herds in mid-eastern Sweden was conducted during one year. A large-animal practitioner visited the herds three times and clinically examined and sampled cows, and collected information about general health and management routines. Data on milk production and disorders treated by a veterinarian in the 26 herds, as well as in 1102 conventional herds, were retrieved from official records. Multivariable logistic regression was used to assess associations between herd type (organic vs. conventional) and incidence of disorders. RESULTS: The organic herds that took part in the study ranged in size from 12 to 64 cows, in milk production from 3772 to 10,334 kg per cow and year, and in bulk milk somatic cell counts from 83,000 to 280,000 cells/ml. The organic herds were found to have a lower incidence of clinical mastitis, teat injuries, and a lower proportion of cows with a high somatic cell count (as indicated by the UDS, Udder Disease Score) compared to conventional herds. The spectrum of udder pathogenic bacteria was similar to that found in other Swedish studies. Treatment of mastitis was found to be similar to what is practised in conventional herds. Homeopathic remedies were not widely used in the treatment of clinical mastitis.The calves in most of these organic herds suckled their dams for only a few days, which were not considered to substantially affect the udder health. The main management factor that was different from conventional herds was the feeding strategy, where organic herds used a larger share of forage. CONCLUSION: Udder health in Swedish organic herds appears to be better than in conventional herds of comparable size and production. The major difference in management between the two types of farms is the proportion of concentrates fed. The mechanisms explaining the association between intensity of feeding and udder health in dairy cows require further research.

Aspectos produtivos e sanitários de vacas mestiças leiteiras tratadas com produtos homeopáticos / Productive and sanitary aspects of crossbred milking cows receiving homeopathic products

Nos dias de hoje, a população mundial exige o consumo de alimentos de qualidade, sem resíduos de produtos químicos. Desempenho (produção e qualidade do leite, peso e condição corporal) e sanidade (mastite e infestação por ecto e endoparasitas) foram acompanhados em oito vacas leiteiras mestiças de um rebanho de 40 (20%), que recebeu diariamente produtos homeopáticos comerciais no concentrado para o controle de endo e ectoparasitas e mastite. No período de nove meses, que correspondeu a toda uma lactação, não houve necessidade de medicar com produtos alopáticos nenhuma vaca do rebanho, o que demonstrou ser possível criar vacas leiteiras mestiças não utilizando produtos químicos para o combate a parasitas (carrapato, mosca-do-chifre e verminose), ou antibióticos para o controle de mastite, e sem interferir na produtividade dos animais.

Nowadays the world population demands food of good quality, without any residues from chemical products. Eight cows from a herd of 40, which were consuming commercial homeopathic medicines at the daily concentration for control of endoand ectoparasites, were monitored in terms of their performance (production and quality of milk, body score and body weight) and sanitary aspects (parasites infestation and mastitis) during the lactation period. It was not necessary to give any allopathic (conventional) medicines to control mastitis or parasites (ticks, horn-fly, verminosis) in any cow of the herd during the nine months of the lactation period. The results showed that it is possible to produce milk without using chemical products, and not interfering in the productivity of the crossbred animals.

Comparison of homeopathy, placebo and antibiotic treatment of clinical mastitis in dairy cows - methodological issues and results from a randomized-clinical trial.

Based on the widespread use of homeopathy in treatment of animal disease and the poor documentation of its possible effects and consequences, a clinical trial was carried out in order to evaluate the efficacy of homeopathy in treatment of clinical mastitis in dairy cows and a design for clinical studies on homeopathic treatment, taking into account the guidelines for randomized-clinical trials (RCT) as well as the basic principles of homeopathy. A three-armed, stratified, semi-crossover design comparing homeopathy, placebo and a standardized antibiotic treatment was used. Fifty-seven dairy cows were included. Evaluation was made by two score scales, with score I measuring acute symptoms and score II measuring chronic symptoms, and by recording the frequencies of responders to treatment based on four different responder definitions. Significant reductions in mastitis signs were observed in all treatment groups. Homeopathic treatment was not statistically different from either placebo or antibiotic treatment at day 7 (P = 0.56, P = 0.09) or at day 28 (P = 0.07, P = 0.35). The antibiotic treatment was significantly better than placebo measured by the reduction in score I (P < 0.01). Two-thirds of the cases both in the homeopathy and placebo groups responded clinically within 7 days. The outcome measured by frequencies of responders at day 28 was poor in all treatment groups. Evidence of efficacy of homeopathic treatment beyond placebo was not found in this study, but the design can be useful in subsequent larger trials on individualized homeopathic treatment.

Estudio comparativo de la eficacia de medicamentos homeopáticos y alopáticos en el control y prevención de mastitis clínica bovina / Comparative study of efficacy of homeopathic and alopathic therapy in control and prevention of bovine mastitis

Un estudio profiláctico y terapéutico fue desarrollado en un establo lechero. Dos grupos homogéneos con 17 animales cada uno fueron formados, asignando tanto los animales de los grupos, como los tratamientos por medio del método sistemático al azar. (AU)