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The presence of antibiotics in surface waters is a potential driver of antibiotic resistance and thus of concern to human and environmental health. Key factors driving the potential impact of antibiotics are their persistence and transport in rivers and lakes. The goal of this study was to describe the peer-reviewed published literature on the photolysis (direct and indirect), sorption, and biodegradation of a selected group of antibiotic compounds following a scoping review methodology. Primary research from 2000 to 2021 was surveyed to compile information on these processes for 25 antibiotics from 6 classes. After compilation and assessment of the available parameters, the results indicate that information is present to predict the rates of direct photolysis and reaction with hydroxyl radical (an indirect photolysis process) for most of the selected antibiotics. There is insufficient or inconsistent information for including other indirect photolysis processes, biodegradation, or removal via sorption to settling particles for most of the targeted antibiotic compounds. Future research should focus on collecting fundamental parameters such as quantum yields, second-order rate constants, normalized biodegradation rates, and organic carbon or surface area normalized sorption coefficients rather than pseudo-first order rate constants or sorption equilibrium constants that apply only to specific conditions/sites.
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Antibacterianos , Contaminantes Químicos del Agua , Humanos , Fotólisis , Contaminantes Químicos del Agua/análisis , Biodegradación AmbientalRESUMEN
The objective of this systematic review was to compare the efficacy of antibiotic and non-antibiotic alternatives in the prevention and treatment of necrotic enteritis (NE) in broiler chickens. In vivo experimental and observational studies that compared the administration of non-antibiotic compounds with antibiotics to prevent or treat NE in broiler chickens and that evaluated mortality and/or clinical or subclinical NE outcome measures were eligible. Four electronic databases were searched in December 2019 and updated in October 2021. Retrieved studies were evaluated in two phases: abstract and design screening. Data were then extracted from included studies. Risk of bias was assessed by outcome following the Cochrane Risk of Bias 2.0 tool. A meta-analysis was not conducted due to heterogeneity across interventions and outcomes. The non-antibiotic and antibiotic groups were compared at the outcome level for individual studies using the mean difference and 95% confidence interval (CI) calculated post hoc from raw data. In total, 1282 studies were originally identified, and 40 were included in the final review. The overall risk of bias for the 89 outcomes was either "high" (n = 34) or "some concerns" (n = 55). Individual study comparisons showed a beneficial trend toward the antibiotic group for reduced mortality, NE lesion scores (overall, jejunum, and ileum), Clostridium perfringens counts, and for most histologic measurements (duodenum, jejunum, and ileum villi height, and jejunum and ileum crypt depth). The non-antibiotic groups showed a beneficial trend for NE duodenum lesion scores and duodenum crypt depth measurements. Based on this review, there is a trend that mostly favors antibiotic compounds in preventing and/or treating NE, but the evidence also suggests no difference when comparing them with non-antibiotic alternatives. Studies assessing this research question were heterogeneous in their intervention conditions and outcomes measured, and there were key aspects of the experimental design not reported in some of the studies.
Eficacia de las intervenciones con antibióticos y compuestos no antibióticos para prevenir y tratar la enteritis necrótica en pollos de engorde: Una revisión sistemática El objetivo de esta revisión sistemática fue comparar la eficacia de antibióticos y alternativas a los antibióticos en la prevención y tratamiento de la enteritis necrótica (NE) en pollos de engorde. Se incluyeron estudios experimentales in vivo y estudios observacionales que compararon la administración de compuestos no considerados antibióticos con compuestos antibióticos usados para prevenir o tratar la enteritis necrótica en pollos de engorde, y que evaluaran mortalidad, signos clínicos, u otros resultados subclínicos. Se buscaron referencias en cuatro bases de datos bibliográficos en Diciembre de 2019 y por segunda vez en Octubre de 2021. Los estudios que se encontraron se evaluaron en dos fases: resumen y diseño del estudio de escrutinio. Posteriormente se extrajeron los datos de aquellos estudios que se incluyeron después del escrutinio. Se evaluó el riesgo de sesgos siguiendo la herramienta de Cochrane Risk of Bias 2.0. No se pudo realizar un meta-análisis debido a la heterogeneidad de las intervenciones y de los resultados de los estudios incluidos. Los grupos de compuestos no antibióticos y de antibióticos se compararon con base a los resultados individuales de cada estudio usando la diferencia entre medias e intervalos de confianza al 95%, calculados post-hoc usando los datos originales. Se identificaron un total de 1282 estudios, y 40 fueron finalmente incluidos en la revisión. El riesgo de sesgos para el total de los 89 resultados individuales fue alto (n = 34) o con "ciertos problemas" (n = 55). Las comparaciones individuales entre estudios mostraron una tendencia beneficiosa hacia el grupo de antibióticos en términos de mortalidad reducida, puntaje de lesiones de enteritis necrótica (total, yeyuno e íleo), conteos de Clostridium perfringens, así como para la mayoría de las medidas histológicas (altura de las vellosidades del duodeno, yeyuno e íleo, y profundidad de la cripta del yeyuno e íleo). El grupo de no antibióticos mostró una tendencia beneficiosa para el puntaje de lesiones de enteritis necrótica del duodeno y para las medidas de profundidad de la cripta del duodeno. Según esta revisión, hay una tendencia que favorece al grupo de antibióticos en la prevención y/o tratamiento de enteritis necrótica, pero la evidencia también sugiere que no hay diferencia entre los grupos. Los estudios incluidos en la comparación eran muy heterogéneos en cuanto a las condiciones de las intervenciones y a los resultados que se midieron, además de que algunos aspectos importantes del diseño experimental en algunos de los estudios no se reportaron.
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Infecciones por Clostridium , Enteritis , Enfermedades de las Aves de Corral , Animales , Enteritis/tratamiento farmacológico , Enteritis/prevención & control , Enteritis/veterinaria , Infecciones por Clostridium/tratamiento farmacológico , Infecciones por Clostridium/prevención & control , Infecciones por Clostridium/veterinaria , Pollos , Antibacterianos/uso terapéutico , Enfermedades de las Aves de Corral/tratamiento farmacológico , Enfermedades de las Aves de Corral/prevención & control , Enfermedades de las Aves de Corral/patología , Clostridium perfringens , Necrosis/veterinariaRESUMEN
Third generation cephalosporins and carbapenems are considered critically important antimicrobials in human medicine. Food animals such as swine can act as reservoirs of antimicrobial resistance (AMR) genes/bacteria resistant to these antimicrobial classes, and potential dissemination of AMR genes or resistant bacteria from pigs to humans is an ongoing public health threat. The objectives of this systematic review and meta-analysis were to: (1) estimate global proportion and animal-level prevalence of swine E. coli phenotypically resistant to third generation cephalosporins (3GCs) and carbapenems at a country level; and (2) measure abundances and global distribution of the genetic mechanisms that confer resistance to these antimicrobial classes in these E. coli isolates. Articles from four databases (CAB Abstracts, PubMed/MEDLINE, PubAg, and Web of Science) were screened to extract relevant data. Overall, proportion of E. coli resistant to 3GCs was lower in Australia, Europe, and North America compared to Asian countries. Globally, <5% of all E. coli were carbapenem-resistant. Fecal carriage rates (animal-level prevalence) were consistently manifold higher as compared to pooled proportion of resistance in E. coli isolates. bla CTX-M were the most common 3GC resistance genes globally, with the exception of North America where bla CMY were the predominant 3GC resistance genes. There was not a single dominant bla CTX-M gene subtype globally and several bla CTX-M subtypes were dominant depending on the continent. A wide variety of carbapenem-resistance genes (bla NDM-, VIM-, IMP-, OXA-48, and KPC-) were identified to be circulating in pig populations globally, albeit at very-low frequencies. However, great statistical heterogeneity and a critical lack of metadata hinders the true estimation of prevalence of phenotypic and genotypic resistance to these antimicrobials. Comparatively frequent occurrence of 3GC resistance and emergence of carbapenem resistance in certain countries underline the urgent need for improved AMR surveillance in swine production systems in these countries.
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Background: Fluoroquinolones and polymyxins (colistin) are considered as critical drugs for human medicine. Antimicrobials of these classes are also used in swine production worldwide and this usage can contribute to selection of antimicrobial resistance (AMR), which is a threat to both human and animal health. Given the dynamic epidemiology of AMR, updating our knowledge regarding distribution and trends in the proportion of resistant bacteria is of critical importance. Objectives: The aim of this systematic review and meta-analysis was to describe the global prevalence of phenotypic and genotypic resistance to fluoroquinolones and colistin in Escherichia coli collected from swine. Results: Four databases (PubMed, PubAg, Web of Science, and CAB abstracts) and reports of national surveillance programs were scanned and 360 articles were included in the analysis. We identified higher prevalence levels of fluoroquinolone and colistin resistance in isolates from pig populations in Asia compared to Europe. The heterogeneity of pooled estimates was also higher in Asian countries suggesting that prevalence of AMR is still not fully characterized. There was a major knowledge gap about the situation of AMR in South American and African countries. We also identified key deficiencies in how AMR data was reported in the studies. A meta-analysis using 6,167 publicly available genomes of swine E. coli established the prevalence and global distribution of genetic determinants that can lead to fluoroquinolone and colistin resistance. Conclusion: This study provides the most comprehensive information on prevalence of phenotypic and genotypic resistance to key antimicrobials in pig populations globally. There is a need to establish national surveillance programs and effective policies, particularly in certain world regions, to curtail the threat of evolution of resistant isolates in swine production that can potentially contribute to public health detrimentally.
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OBJECTIVE: To evaluate the evidence for the conservative and surgical management of pericardial effusions for neoplastic and idiopathic etiologies in dogs. STUDY DESIGN: Systematic review. SAMPLE POPULATION: Peer-reviewed English-language articles describing the treatment and outcome of naturally occurring pericardial effusion in domestic dogs. METHODS: A literature search was performed with PubMed, Cab Abstracts, Scopus, and Agricola in August 2019 for articles describing pericardial effusion treatment in dogs. Inclusion criteria were applied, and articles were evaluated for reported outcome and level of evidence by using The Oxford 2011 Levels of Evidence, a previously described hierarchical system, and GRADE (Grading of Recommendations, Assessment, Development and Evaluation). RESULTS: One hundred eight of the 641 unique articles that were identified and evaluated met inclusion criteria. Most articles included were case studies (68.2%) or retrospective case series (25.2%), with all articles providing a low level of evidence. The articles had inconsistent inclusion criteria, outcome measures, and follow-up, making comparison of outcomes difficult. CONCLUSION: Because of the low quality of evidence of the studies included in this systematic review and the variability of the outcomes, there is not sufficient evidence to recommend one treatment option rather than another. CLINICAL SIGNIFICANCE: There is a requirement for higher quality evidence such as randomized controlled trials and prospective comparative cohort studies. Standardization of outcome measures reported for each treatment option and disease process studied will allow for better comparison of outcomes between studies.
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Enfermedades de los Perros/terapia , Derrame Pericárdico/veterinaria , Animales , Enfermedades de los Perros/cirugía , Perros , Derrame Pericárdico/cirugía , Derrame Pericárdico/terapiaRESUMEN
The natural progression of observation through inquiry to scholarship that is common to scientists is not well demonstrated among veterinary educators. One possible institutional barrier to promotion of education-related research among faculty is lack of a mechanism to demonstrate productivity and impact of scholarship of teaching and learning (SoTL) and hypothesis-driven research related to education. The h-index is one measure of research productivity. The h-index was calculated for individuals at one veterinary college and was compared between select North American schools of veterinary medicine to demonstrate baseline values for this kind of scholarship in this discipline. Use of standard search techniques using Google Scholar for citation count generated a slightly lower score than a more labor-intensive search and review of curricula vitae. The h-index across institutions ranged from 1 to 11, with a mean score of 6.0 (SD = 2.8). Five hundred forty-four education-related articles were published in 45 different journals; the primary sites of publication were the Journal of Veterinary Medical Education (JVME) and the Journal of the American Veterinary Medical Association.
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Educación en Veterinaria , Animales , Docentes , Becas , Humanos , Aprendizaje , UniversidadesRESUMEN
There is a growing concern about the role of the environment in the dissemination of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARG). In this systematic review, we summarize evidence for increases of ARG in the natural environment associated with potential sources of ARB and ARG such as agricultural facilities and wastewater treatment plants. A total of 5247 citations were identified, including studies that ascertained both ARG and ARB outcomes. All studies were screened for relevance to the question and methodology. This paper summarizes the evidence only for those studies with ARG outcomes (n = 24). Sixteen studies were at high (n = 3) or at unclear (n = 13) risk of bias in the estimation of source effects due to lack of information or failure to control for confounders. Statistical methods were used in nine studies; three studies assessed the effect of multiple sources using modeling approaches, and none reported effect measures. Most studies reported higher ARG concentration downstream/near the source, but heterogeneous findings hindered making any sound conclusions. To quantify increases of ARG in the environment due to specific point sources, there is a need for studies that emphasize analytic or design control of confounding, and that provide effect measure estimates.
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Farmacorresistencia Bacteriana , Farmacorresistencia Microbiana/genética , Microbiología Ambiental , Agricultura , Animales , Aguas Residuales/microbiologíaRESUMEN
Herein we describe a protocol for a systematic review of the evidence on whether point sources of anthropogenic effluent are associated with an increase in antibiotic resistance in the adjacent environment. The review question was based on the Population, Exposure, Comparator, Outcome, Study Design (PECOS) framework as follows: Is the prevalence or concentration of antibiotic resistant bacteria or resistance genes (O) in soil, water, air or free-living wildlife (P) higher in close proximity to, or downstream from, known or suspected sources of anthropogenic effluent (E) compared to areas more distant from or upstream from these sources (C)? A comprehensive search strategy was created to capture all relevant, published literature. Criteria for two stages of eligibility screening were developed to exclude publications that were not relevant to the question, and determine if the study used a design that permitted estimation of an association between a source and levels of resistance. A decision matrix was created for assessment of risk of bias to internal validity due to sample selection bias, information bias, and confounding. The goal of this protocol is to provide a method for determining the state of knowledge about the effect of point sources on antibiotic resistance in the environment.
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Farmacorresistencia Microbiana , Contaminación Ambiental/efectos adversos , Animales , Sesgo , Protocolos Clínicos , Factores de Confusión Epidemiológicos , Estudios Transversales , Farmacorresistencia Microbiana/genética , Actividades Humanas , Humanos , Estudios Observacionales como Asunto/normas , Reproducibilidad de los Resultados , Factores de Riesgo , Sesgo de Selección , Revisiones Sistemáticas como AsuntoRESUMEN
There are a variety of biologics, vaccines, antibiotics, and hormones used in animal agriculture. Depending upon the procedure or pharmaceutical used, accidental injections or product exposures can result in mild to severe injuries. Needlestick injury (NSI) prevention, research, and education for veterinarians and agriculture workers is limited. The objective of this study was to collect and review published case reports and case series/surveys on human needlestick exposure to veterinary biologics and to summarize needlestick prevention strategies for agricultural workers/veterinarians. A search was conducted of PubMed and Centre for Agriculture Bioscience International (CABI) databases. References were reviewed to identify additional articles. NSI among agricultural workers were primarily included in this review. Thirty articles were applicable to exposures in agricultural settings. Relevant literature consisted of case reports, survey/case series articles, prevention documents, and background articles. Fifty-nine case patients were identified. Most of these cases were associated with exposures to specific vaccines or veterinary products. Injury location was identified from 36 individuals: 24 (67%) NSI to the hands, 10 (28%) injuries to the legs, and 2 to other body locations. Of the 59 cases, 20 (34%) involved oil-adjuvant vaccines. Evidence of hospitalization was recorded for 30 case patients. The length of hospitalization was available from 11 case patients. Median length of hospitalization was 3 days (range: 1-4). Surgical intervention was reported in 25 case patients. Outcome information was available on 30 case patients. Fifteen made a complete recovery within 2 weeks of treatment, 14 had residual sequelae attributed to the injury, and there was 1 reported death. Of the 13 survey/case series articles: 2 focused on oil-adjuvant products, 1 on Brucellosis RB-51 vaccine, 3 on tilmicosin, 1 on Salmonella enteritidis vaccine, 1 on high-pressure injection, and 5 were nonspecific. NSI in agriculture workers and veterinarians can result in significant bodily injury and loss of work. There is a need for varied and comprehensive educational programs for agricultural workers and veterinarians to prevent NSI on livestock operations.
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Accidentes de Trabajo/prevención & control , Enfermedades de los Trabajadores Agrícolas/prevención & control , Lesiones por Pinchazo de Aguja/prevención & control , Accidentes de Trabajo/estadística & datos numéricos , Enfermedades de los Trabajadores Agrícolas/epidemiología , Enfermedades de los Trabajadores Agrícolas/etiología , Traumatismos de la Mano/epidemiología , Traumatismos de la Mano/prevención & control , Humanos , Lesiones por Pinchazo de Aguja/epidemiología , Lesiones por Pinchazo de Aguja/terapia , VeterinariosRESUMEN
The free availability of full-text veterinary publications in MEDLINE-indexed journals by US and Canadian veterinary faculty from 2006-7 was determined. Additionally, publishing databases were searched to obtain general statistics on veterinary publishing. A survey of institutional initiatives to promote open-access journals and institutional repositories was also performed. Veterinary faculty published a total of 4,872 articles indexed by MEDLINE in 679 different journals. Of these articles, 1,334 (27%) were available as free full text and were published in 245 different journals. Although 51 veterinary-specific journals offering immediate and free full-text access were identified, few articles in this study appeared in these titles. Rather, most free scholarly articles by veterinary faculty appeared in journals with an embargo period. Academic veterinary institutions may want to recommend acceptance of alternate forms of information dissemination (such as open-access journals and journals published only digitally) to encourage greater global dissemination of their research findings. The promotion and use of digital institutional repositories is also an area for future investment and warrants additional research.
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Acceso a la Información , Bibliometría , Publicaciones Periódicas como Asunto/estadística & datos numéricos , Medicina Veterinaria , Canadá , Educación en Veterinaria , Docentes , Humanos , MEDLINE , Facultades de Medicina Veterinaria/estadística & datos numéricos , Estados Unidos , Medicina Veterinaria/estadística & datos numéricosRESUMEN
Veterinary education has traditionally focused on clinical skills. Success as a practicing veterinarian, however, also depends on good communication skills, emotional intelligence, and other "soft" skills that can lead to greater employee and employer satisfaction and increased practice revenue. The University of Minnesota has approached this curricular need by convening a task force and creating a series of courses aimed at improving leadership skills, teamwork, and verbal and written communication; managing conflict; and understanding ethics and personal finance. This article describes the evolution and structure of these soft-skill classes and the challenges in securing faculty and student buy-in essential for success.