Antimicrobial Resistance in Escherichia coli and Its Correlation with Antimicrobial Use on Commercial Poultry Farms in Bangladesh.

Antimicrobial resistance is a global concern, posing risks to human and animal health. This research quantified antimicrobial resistance (AMR) in E. coli isolates from poultry fecal and environmental samples in Bangladesh and explored their association with antimicrobial use (AMU). We screened 725 fecal and 250 environmental samples from 94 conventional broilers and 51 Sonali farms for E. coli presence using MALDI-TOF mass spectrometry. AMU data were collected at flock levels, expressed as treatment incidence (TI), while minimum inhibitory concentrations (MIC) for 14 antibiotics were determined on five fecal E. coli isolates per farm and on all environmental isolates. MIC results were interpreted using human clinical breakpoints and EUCAST epidemiological cut-off values (ECOFFs). Acquired resistance against commonly used antimicrobial agents such as ciprofloxacin, tetracycline and ampicillin, was extremely high and predominantly clinically relevant. There was a moderate correlation between fecal and environmental antibiotic resistance index (ARI), but there was no significant correlation between AMU and AMR, suggesting that the observed AMR prevalence is unrelated to current AMU in poultry, but may be due to high historical AMU. A high level of multidrug resistance, including against critically important antimicrobials, was found in both farm types. Therefore, an AMR/AMU surveillance program is urgently needed in the poultry production sector of Bangladesh.

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.

Establishing the Most Important Clinical Skills for New Graduate Veterinarians by Comparing Published Lists with Regional Stakeholder Expectations: A Bangladesh Experience.

Veterinary clinical skills training is evolving rapidly around the world and there is increasing interest in Bangladesh in opening clinical skills laboratories and using models in teaching. The first clinical skills laboratory was opened at Chattogram Veterinary and Animal Sciences University in 2019. The current study aimed to identify the most important clinical skills for veterinarians in Bangladesh to inform the further development of clinical skills laboratories and ensure resources are deployed effectively and efficiently. Lists of clinical skills were collated from the literature, national and international accreditation standards, and regional syllabi. The list was refined through local consultation, focused on farm and pet animals, and was disseminated via an online survey to veterinarians and final-year students who were asked to rate the level of importance of each skill for a new graduate. The survey was completed by 215 veterinarians and 115 students. A ranked list was generated with injection techniques, animal handling, clinical examination, and basic surgical skills among the most important. Some techniques requiring specific equipment and some advanced surgical procedures were considered less important. As a result of the study, the most important clinical skills for a new graduate in Bangladesh have been identified for the first time. The results will inform the development of models, the use of clinical skills laboratories, and the design of clinical skills courses for veterinary training. Our approach of drawing upon existing lists followed by local stakeholders consultation is recommended to others to ensure clinical skills teaching is regionally relevant.

Factors Influencing Effective Communication between Stakeholder Groups during DVM Work-Based Learning Program in Bangladesh.

This study aimed to review the existing communication systems between the universities, placement providers, and students during the DVM final year work-based learning (WBL) program in Bangladesh. The intention was to identify what factors impact the effectiveness of the communication system and to explore ways to enhance communication to better support the program. A questionnaire was used to collect details about the WBL program and the communication systems from all universities in Bangladesh. The questionnaire was completed on paper at a meeting of the National Veterinary Dean Council and online with a member of each university's WBL coordination team. A summary of the current WBL programs in Bangladesh was produced. Focus group discussions were used to collect more detailed information about the communication systems and were held via Zoom with recent graduates (n = 16) and placement providers (n = 7). Effective means of communication between all stakeholders were identified as an initial letter, phone calls, and spot visits by teachers. However, the frequency of formal communication before and during placements was variable and the ways of providing feedback on the communication systems were insufficient. These issues sometimes undermined the student learning experience. Suggestions for improvements included increased resourcing, greater use of online communication systems, and a national committee to oversee WBL. Other ways to motivate placement providers included a better honorarium and continuing education courses. The results suggest that existing communication systems for veterinary WBL in Bangladesh are not completely satisfactory. Measures are needed to improve communication to optimize the student learning experience and capitalize on the many benefits of the WBL program for all stakeholders.

Measures, Gaps, and Mitigation Strategies in Bangladesh's COVID-19 Response.

The Coronavirus Disease 2019 (COVID-19) spread rapidly from China to most other countries around the world in early 2020 killing millions of people. To prevent virus spread, world governments implemented a variety of response measures. This paper's objectives were to discuss the country's adopted measures to combat the virus through June 2020, identify gaps in the measures' effectiveness, and offer possible mitigations to those gaps. The measures taken included screening device deployment across international air and land ports, flight suspensions and closures from COVID-19 affected countries, and declaration and extension of a national public holiday (equivalent to lockdowns in other countries). Identified gaps were test kit, PPE, ICU beds, and ventilator shortages, limited public awareness, and insufficient coordination and collaboration among national and international partners. Proper and timely risk mapping, preparedness, communication, coordination, and collaboration among governments and organizations, and public awareness and engagement would have provided sufficient COVID-19 mitigation in Bangladesh.

Prevalence and risk factors of Avian Influenza Viruses among household ducks in Chattogram, Bangladesh.

Avian influenza viruses (AIV) increase commercial and backyard poultry mortality and morbidity, reduces egg production, and elevates public health risk. Household ducks propagate and transmit HPAI and LPAI viruses between domesticated and wild birds in Southeast Asian countries, including Bangladesh. This study was conducted to identify epidemiological factors associated with AIV infection among household ducks at Chattogram, Bangladesh. We randomly selected and collected blood and oropharyngeal swab samples from 281 households ducks. We evaluated the serum for AIV antibody using cELISA and tested for H5 and H9 subtypes using the HI test. We tested the swabs with real-time reverse transcriptase PCR (rRT-PCR) for M gene, and H5, H9 subtypes. In the duck populations, the household level AIV sero-prevalence was 57.7% (95% CI: 51.6-63.3) and RNA prevalence was 2.4% (95% CI: 1.0-5.0). H5 and H9 subtype sero-prevalence was 31.5% (95% CI: 22.2-42.0) and 23.9% (95% CI: 15.6-33.9). H5 and H9 subtype RNA prevalence were 0% (95% CI: 0.0-1.3) and 2.4% (95% CI: 1.0-5.0). We determined household-level OR (Odds Ratios) for the "combined (mixed materials-mud and concrete or metallic)" category was 2.2 (95% CI: 1.1-4.2) compared with "wooden/bamboo" category (p = 0.02); 2.8 (95% CI: 1.2-6.6) in households with duck plague vaccine coverage compared with no coverage (p = 0.01); and 2.4 (95% CI: 0.6-9.7) in households that threw dead birds in bushes and the roadside compared with households that buried or threw dead birds in garbage pits (p = 0.21). M gene phylogenetic analysis compared M gene sequences to previously reported Bangladeshi H9N2 isolates. The evidence presented here shows AIV circulation in the Chattogram, Bangladesh study areas. AIV reduction can be achieved through farmer education of proper farm management practices.