Understanding the veterinary antibiotics supply chain to address antimicrobial resistance in Lao PDR: Roles and interactions of involved stakeholders.

In response to the global call to mitigate risks associated with antimicrobial resistance (AMR), new regulations on the access and use of veterinary antibiotics are currently being developed by the Lao government. This study aims to explore how the implementation of these new regulations might effectively reduce and adapt the sale, distribution and use of veterinary antibiotics in Lao PDR. To this end, we used the theory of change, framing the AMR issue within the context of the stakeholders involved in the veterinary antibiotics supply chain. Qualitative and quantitative methods were used to collect data, based on questionnaires (n=36 antibiotic suppliers, n=96 chicken farmers, n=96 pig farmers), and participatory tools such as a workshop (n=10 participants), semi-structured interviews (n=20), and focus group discussions (n=7 participants). The stakeholders' understanding of the AMR issue and potential challenges related to the implementation of new regulations regarding access and use of antibiotics, were also investigated. We mapped the veterinary antibiotic supply chain in Lao PDR, and analysed the roles and interactions of its stakeholders. Twenty-three stakeholders representing the private and the public sectors were identified. Many informal and formal links connected these stakeholder within this supply chain. The lack of veterinarian-farmer interaction and the evolving nature of the veterinary antibiotics supply chain accentuated the challenges of achieving behaviour change through regulations. Most of the antibiotics found on farms were categorized by the World Health Organisation's as critically important antibiotics used in human medicine. We argue that AMR risk mitigation strategy requires dialogue and engagement between private and public sectors stakeholders, involved in the importation, distribution, sale and use of veterinary antibiotics. This study further highlighted that AMR is a complex adaptive challenge requiring multi-sectoral approach. We believed that a sustainable approach to reduce and adapt veterinary antibiotics use should be prepared in collaboration with stakeholders from private and public sectors identified in this study, in addition to the new regulations. This collaboration should start with the co-construction of a common understanding of AMR issue and of the objectives of new regulations.

Prevalence and antimicrobial resistance among Escherichia coli and Salmonella in Ontario smallholder chicken flocks.

Surveillance is an important component of an overall strategy to address antimicrobial resistant bacteria in food animals and the food chain. The poultry market has many points of entry into the Canadian food chain, and some production practices are underrepresented in terms of surveillance. For example, pathogen carriage and antimicrobial resistance surveillance data are limited in smallholder chicken flocks raised for slaughter at provincially inspected abattoirs. In Canada, antimicrobial resistance in Escherichia coli and Salmonella isolated from commercial broiler chicken flocks, slaughtered at federally inspected abattoirs, is monitored by the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). The objective of this study was to establish baseline information of antimicrobial resistance presence in E. coli and Salmonella isolated from smallholder flocks in Ontario, utilizing CIPARS collection and isolation methodologies, and to compare findings with CIPARS federally inspected abattoir data from Ontario, Canada. Five chickens per flock were sampled from 205 smallholder flocks. Of 1,025 samples, the E. coli prevalence was 99% (1,022/1,025), and 47% (483/1,022) of positive E. coli isolates were resistant to one or more of the 14 antimicrobials. Furthermore, as compared to results reported for the CIPARS commercial flocks, E. coli isolates from smallholder flocks had significantly lower resistance prevalence to six of 14 individual antimicrobials. Recovery of E. coli did not differ between federally inspected and provincially inspected flocks. Salmonella prevalence at the bird level in smallholder flocks was 0.3% (3/1,025), significantly lower (p â‰ª 0.0001, 95% CI 0.080%-0.86%) than federally inspected commercial flocks. The overall differences found between the commercial and smallholder flocks may be explained by differences in poultry husbandry practices and hatchery sources.

Ciprofloxacin-resistant Campylobacter in broiler chicken in Canada.

This case study outlines the patterns of ciprofloxacin resistance in Campylobacter isolated from retail chicken meat in Canada. Campylobacter is the third most common cause of foodborne enteric illness in Canada; it usually causes a self-limited illness, but in some cases antimicrobials may be indicated. Ciprofloxacin (a fluoroquinolone) is an antimicrobial used to treat a number of infections in humans; other fluoroquinolones are used both therapeutically and prophylactically in livestock animals, including broiler chickens. The Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) has been testing retail chicken meat samples across Canada for the presence of Campylobacter and for resistant strains since 2003. At the end of 2010, CIPARS documented that retail chicken meat samples in Canada contaminated with Campylobacter ranged from 36% in the Maritimes to 42% in British Columbia. Furthermore, levels of ciprofloxacin-resistant Campylobacter varied across the country, with higher percentages in British Columbia (17% in 2010) and Saskatchewan (11%), in comparison with lower percentages in Ontario (5%), Québec (2%, and the Maritimes (4%). In 2011 and 2012, resistance declined in British Columbia and Saskatchewan, but began to rise in Québec and Ontario. Recently, the Canadian poultry industry developed a policy to eliminate the preventive use of third generation cephalosporins and fluoroquinolones in broiler chickens (meat chickens) and broiler breeder chickens (chickens that produce the eggs that will become the broilers). CIPARS will continue to monitor trends in antimicrobial use and resistance following this industry intervention. By following good food preparation and hygiene practices, Canadians can reduce the risks of developing a Campylobacter infection (resistant or susceptible) from retail chicken.

Integrated surveillance and potential sources of Salmonella enteritidis in human cases in Canada from 2003 to 2009.

Salmonella enteritidis has emerged as the most prevalent cause of human salmonellosis in Canada. Recent trends of S. enteritidis subtypes and their potential sources were described by integrating Salmonella data from several Canadian surveillance and monitoring programmes. A threefold increase in S. enteritidis cases from 2003 to 2009 was identified to be primarily associated with phage types 13, 8 and 13a. Other common phage types (4, 1, 6a) showed winter seasonality and were more likely to be associated with cases linked to international travel. Conversely, phage types 13, 8 and 13a had summer seasonal peaks and were associated with cases of domestically acquired infections. During agri-food surveillance, S. enteritidis was detected in various commodities, most frequently in chicken (with PT13, PT8 and PT13a predominating). Antimicrobial resistance was low in human and non-human isolates. Continued integrated surveillance and collaborative prevention and control efforts are required to mitigate future illness.

Effect of dietary beta1-4 mannobiose in the prevention of Salmonella enteritidis infection in broilers.

1. This study investigated the effects of beta1-4 Mannobiose (MNB)-supplemented feeds on the kinetics of Salmonella enterica serovar Enteritidis (SE) in broilers and the ensuing histopathological changes. D-Mannose (MAN) was used for comparison. The diets supplemented with MNB or MAN were fed during the first two weeks after hatching to investigate any protection against SE infection in growing birds and any immunomodulatory functions in the gut. 2. MNB-supplementation reduced SE organ colonisation, caecal carriage and faecal shedding in a time-dependent manner. The high concentrations and persistency of the SE-specific IgA response in those birds given rations supplemented with MNB or MAN were associated with a decline in SE shedding and caecal carriage in the later stages of infection. MNB was more effective against SE infection than MAN. 3. Histological examination of the caecal wall and caecal tonsils at 23 d post-infection indicated a lesser degree of intestinal pathology. An increased number of intra-epithelial mononuclear cells (mature lymphocytes and macrophages) in the lining epithelium of birds fed on the diet supplemented with MNB was accompanied by an increased number of lamina propria cells. 4. The present study indicates that feeding a diet supplemented with MNB during the first two weeks after hatching reduced susceptibility to SE infection. Supplementing the diet with MNB or MAN increased IgA production and improved SE clearance by acting as immunomodulatory agents that prevented intestinal pathology. Feeding a MNB-supplemented diet to broilers could be used as an alternative to antibiotics, because it has no adverse effects on mortality or weight gain.

Effects of nonimmunized egg yolk powder-supplemented feed on Salmonella enteritidis prevention and elimination in broilers.

Chicken consumption is a newly identified risk factor in Salmonella enterica serovar Enteritidis (SE) infection in humans. SE is widely distributed in commercial chicken flocks and high levels of cecal carriage and shedding may lead to broiler meat contamination. In the present study, the preventive and eliminative effect of nonimmunized freeze-dried egg yolk powder (EYP) on SE in broilers was investigated. In the prevention trial, reduced SE counts were observed in liver (P < or = 0.05), cecal contents, and fecal shedding (P < or = 0.05) in birds fed 10% or 5% EYP. Histological examination of cecal wall and cecal tonsils at 23 days postinfection indicated a lesser degree of intestinal pathology. In the elimination trial, a significantly lower (P < or = 0.05) number of SE reached the liver and spleen, and a reduction in cecal carriage and fecal shedding was observed. The histological changes in the cecal mucosa and cecal tonsils reflected an apparent inflammation and mucosal repair and also suggested that the infection had not completely resolved, confirming SE bacterial isolations in the cecal tissue. The present study indicates that supplementing the diets of broilers with 5% nonimmunized EYP, at the early stages of the growing period, reduces preharvest Salmonella load with a minimal degree of intestinal pathology.

Avian hepatitis E virus in an outbreak of hepatitis--splenomegaly syndrome and fatty liver haemorrhage syndrome in two flaxseed-fed layer flocks in Ontario.

Two commercial layer chicken flocks that were fed a flax-based diet beginning at 28 weeks of age for the production of omega-3 fatty-acid-enriched eggs experienced increased mortality when the birds reached 37 weeks. The average weekly mortality was 0.34% over a 20-week period, with peak mortality of 0.9% for 1 week. Reduced feed consumption, reduced body weight gain and poor peak production were noticed prior to the onset of increased mortality. A total of 245 birds were necropsied and 78% of these had lesions in the liver and spleen, with 44% of those necropsied having changes consistent with hepatitis-splenomegaly syndrome, with lesions ranging from acute periportal lymphoplasmacytic hepatitis to chronic severe cholangiohepatitis with haemorrhage, vasculitis and amyloidosis. A total of 11% of the birds had lesions typical of fatty liver haemorrhagic syndrome, and 22% had lesions found in both hepatitis-splenomegaly syndrome and fatty liver haemorrhagic syndrome. No significant bacteria or viruses were recovered from samples of the liver/bile or spleen but 11 of 21 bile samples contained avian hepatitis E virus RNA detectable with a reverse transcriptase-polymerase chain reaction assay. Comparative sequence analysis found identities of 82 to 92% and 78 to 80% between the helicase and capsid protein genes, respectively, of the virus detected in this outbreak and those of other avian hepatitis E virus isolates, suggesting extensive genetic heterogeneity in avian hepatitis E viruses in Ontario flocks.