[Intramammary use of antibiotics in dairy farms in the canton of Ticino before, during and after Staphylococcus aureus genotype B elimination]. / Intramammärer Antibiotikaeinsatz vor, während und nach einer Staphylococcus aureus Genotyp B Sanierung in Milchkuhbetrieben im Kanton Tessin.

INTRODUCTION: The aim of the study was to evaluate the use of intramammary antibiotics before, during and after the elimination of Staphylococcus aureus genotype B (SAGTB). Data on intramammary antibiotic use was collected in 65 dairy farms as part of a pilot project for SAGTB elimination in the canton of Ticino from 2017 to 2019. The investigated farms were divided into 46 affected farms (with at least one SAGTB-positive animal) and 19 control farms (SAGTB-free farms). Data on antibiotic use were requested from veterinarians and treatment incidence, as a measure of antibiotic use, was calculated based on medical records and veterinary prescriptions. In addition, the treatment incidence was calculated for 47 farms during alpine farming period. In 2018 (elimination year), the mean incidence of treatment during lactation in the SAGTB-positive farms was significantly higher than in the control farms (p=0,003). In 2019 no significantly lower antibiotic use during lactation or dry period was detected between 2017 (before elimination) and 2019 (after elimination). Alpine farming places where only S. aureus genotype B-negative animals had access to had a significantly lower antibiotic use during lactation (p=0,004). The new federal database (Antibiotics Information System in Veterinary Medicine, IS ABV) should allow continuous monitoring and to confirm the reduction of antibiotic use in the coming years.

INTRODUCTION: L'objectif de l'étude était d'évaluer la consommation d'antibiotiques intramammaires avant, pendant et après l'assainissement de Staphylococcus aureus génotype B (SAGTB). Dans le cadre d'un projet pilote d'assainissement SAGTB dans le canton du Tessin, l'étude a recueilli des données sur la consommation d'antibiotiques intramammaires de 2017 à 2019 dans 65 exploitations laitières réparties en 46 exploitations test (avec au moins un animal positif au SAGTB) et 19 exploitations témoins (exploitations exemptes de SAGTB). Les données relatives à la consommation d'antibiotiques ont été demandées aux vétérinaires et, grâce aux enregistrements et aux prescriptions des vétérinaires, il a été possible de calculer l'incidence du traitement en tant que mesure de la consommation d'antibiotiques. En outre, l'incidence des traitements pendant l'alpage a également pu être calculée pour 47 exploitations. En 2018 (année d'assainissement), l'incidence des traitements pendant la lactation était en moyenne significativement plus élevée dans les exploitations SAGTB-positives que pour les exploitations de contrôle (p=0,003). En comparant 2017 (avant l'assainissement) et 2019 (après l'assainissement), il n'y a pas eu de baisse significative de la consommation d'antibiotiques pendant la lactation et le tarissement en 2019. Dans les exploitations d'estivage, on a constaté l'année suivant l'assainissement (2019) une consommation d'antibiotiques significativement plus faible pendant la lactation pour les alpages qui n'accueillaient que des animaux négatifs à S. aureus génotype B (p=0,004). Il faut espérer qu'avec l'aide de la nouvelle base de données fédérale (Système d'information sur les antibiotiques en médecine vétérinaire, IS ABV), le monitoring pourra être poursuivi dans les années à venir et que la réduction de la consommation d'antibiotiques sera confirmée dans les années suivantes.

The ecological importance of habitat complexity to the Caribbean coral reef herbivore Diadema antillarum: three lines of evidence.

When Caribbean long-spined sea urchins, Diadema antillarum, are stable at high population densities, their grazing facilitates scleractinian coral dominance. Today, populations remain suppressed after a mass mortality in 1983-1984 caused a loss of their ecosystem functions, and led to widespread declines in ecosystem health. This study provides three lines of evidence to support the assertion that a lack of habitat complexity on Caribbean coral reefs contributes to their recovery failure. Firstly, we extracted fractal dimension (D) measurements, used as a proxy for habitat complexity, from 3D models to demonstrate that urchins preferentially inhabit areas of above average complexity at ecologically relevant spatial scales. Secondly, controlled behaviour experiments showed that an energetically expensive predator avoidance behaviour is reduced by 52% in complex habitats, potentially enabling increased resource allocation to reproduction. Thirdly, we deployed a network of simple and cost-effective artificial structures on a heavily degraded reef system in Honduras. Over a 24-month period the adult D. antillarum population around the artificial reefs increased by 320% from 0.05 ± 0.01 to 0.21 ± 0.04 m-2 and the juvenile D. antillarum population increased by 750% from 0.08 ± 0.02 to 0.68 ± 0.07 m-2. This study emphasises the important role of habitat structure in the ecology of D. antillarum and as a barrier to its widespread recovery.

[Survey among livestock veterinarians from the Canton of Fribourg investigating the topics of herd-health management, counselling and the use of antimicrobial drugs]. / Umfrage bei Freiburger Nutztierärzten zu den Themen Bestandesmedizin, Beratung und Antibiotikaeinsatz.

INTRODUCTION: The work of veterinarians is continuously undergoing structural changes. A shift from purely curative individual animal care towards herd-health management is observed worldwide in the livestock sector. To illustrate the practical implementation with all its advantages and disadvantages, an online survey was conducted among all practicing livestock veterinarians in the Canton of Fribourg. A link to the survey was sent by email, it was voluntary and possible to complete the questionnaire anonymously. The survey focused on four topics: Demographic data, herd-health management, billing of counselling and use of antimicrobial drugs. Forty veterinarians from at least 79.2% (n = 19) of all veterinary practices located in the canton of Fribourg (n = 24) responded. Of these, 67.5% were practice owners or partner (n = 27) and 32.5% were employed veterinarians (n = 13). In Fribourg, only herd fertility management is included in the herd-health management on a regular basis. The quality and quantity of advanced trainings in herd-health management for veterinarians was assessed as moderate to poor. There are various options for charging herd-health management services. The amount charged was variable. The most frequently used options were hourly rates (100-300 CHF/h), "rate per cow per year excl. visit rate" (22-75 CHF/cow/year) or "rate per cow per year incl. visit rate" (85-98 CHF/ cow/year). Only one veterinarian (2.5%) charges for advisory activities not included in the the herd-health management service, which was asked for separately. However, the time required for counselling (excluding herd-health management) was estimated to be between 5.0-70.0% of the total working time (median 15.0%, interquartile range = 10.0-32.5%). Veterinarians in Fribourg are reHauptluctant to follow the international trend towards a regular, integrated herd-health management. The majority of them do not charge for consultancy outside the herdhealth management service. A nationwide survey should be considered to better assess the situation all over Switzerland.

INTRODUCTION: Les vétérinaires sont soumis à un changement structurel permanent dans leur travail et cette évolution va dans la direction de la médecine de troupeau pour le secteur des animaux de rente. Pour pouvoir décrire les avantages et les inconvénients, une enquête en ligne a été effectuée auprès de tous les vétérinaires praticiens ruraux du canton de Fribourg et des régions limitrophes. Un lien vers l'enquête a été envoyé par courriel. La participation était sur une base volontaire et les données pouvaient être anonymisées, si souhaité. L'enquête portait sur les quatre thématiques principales suivantes: données démographiques, médecine de troupeau, facturation des prestations de conseil et administration d'antibiotiques. Quarante vétérinaires, soit 79.2% (n = 19) de toutes les pratiques vétérinaires rurales fribourgeoises (n = 24), ont répondu. De ceux-ci, 67.5% étaient propriétaires ou associés ( n= 27) et 32.5 % employés (n = 13). Dans le canton de Fribourg, le suivi de fertilité est effectué seulement de manière généralisée et intégré régulièrement dans le suivi de troupeau (100%). L'offre en formation continue aux vétérinaires sur la thématique médecine de troupeau est évaluée de moyenne à médiocre. La facturation des prestations de médecine de troupeau se déroule auprès des participants à l'étude de manière différenciée, avec même de très grandes différences: le plus souvent un barème horaire (100-300 CHF/h), à la seconde place «par vache et année sans le tarif de la visite¼ (22-75 CHF/vache/an) et en troisième position «par vache et année avec le tarif de la visite inclus¼ (85-98 CHF/Vache/an). Seul un vétérinaire (2.5%) a indiqué facturer des prestations de conseil en dehors du suivi de troupeau. Cependant, l'investissement en temps pour le conseil (sans le suivi de troupeau) est estimé de 5.0 à 70% du temps total de travail (moyenne: 15.0%, écart interquartile = 10.0­32.5%). La corporation vétérinaire fribourgeoise suit la tendance internationale à l'introduction d'un suivi de troupeau intégré et régulier, avec un peu de retard. Une enquête au niveau suisse devrait permettre d'évaluer la situation au niveau national.

[Staphylococcus aureus and its genotypes as a mastitis pathogen in dairy cattles - a review]. / Staphylococcus aureus und seine Genotypen als Mastitiserreger der Milchkuh ­ eine Übersicht.

INTRODUCTION: In the last decade the knowledge on Staphylococcus aureus as the etiologic agent of chronic mastitis in dairy cattle has increased. Molecular biology and increasingly whole genome sequencing provide an advanced technology far beyond the classical, phenotypic bacteriology. Staphylococcus aureus has different characteristics, thus clinical and epidemiological properties are massively dependent on the genotypes. In Switzerland, Staphylococcus aureus genotype B (GTB) is a common genotype that causes infectious mastitis. Often, half and more cows of the herd are infected. Conversely, genotype C (GTC) and some of the other Staphylococcus aureus genotypes are classified less problematic because they affect individual cows and only one mammary gland quarter. Since Staphylococcus aureus GTB causes herd problems, the associated costs are high in the dairy industry. This applies in particular in the alpine region, because GTB-positive and -negative cows are not separated during milking and the infectious pathogen can spread rapidly. The pathogen is transferred by contaminated milking liners. Staphylococcus aureus GTB is highly associated with the mammary gland. In contrast, the skin and the udder are identified as the reservoir for Staphylococcus aureus GTC and the other genotypes. Staphylococcus aureus GTC is a classic infectious pathogen in wounds and occasionally in mammary glands.

INTRODUCTION: Ces dernières années, de nombreuses nouvelles connaissances sur Staphylococcus aureus en tant que pathogène de la mammite chez la vache laitière ont été développées. Ceci est principalement dû au fait qu'avec la biologie moléculaire et de plus en plus avec le séquençage complet du génome et la bio-informatique, on dispose de méthodes analytiques totalement nouvelles qui vont bien au-delà de celles de la bactériologie phénotypique classique. Staphylococcus aureus n'est plus une bactérie présentant toujours les mêmes caractéristiques, mais ses particularités cliniques et épidémiologiques dépendent énormément des génotypes de Staphylococcus aureus. En Suisse, le génotype B du Staphylococcus aureus (GTB) est le seul génotype responsable de la mammite infectieuse chez la vache. Souvent, la moitié et plus des vaches d'une exploitation sont infectées. En revanche, le génotype C (GTC) et tous les autres génotypes provoquent des quartiers uniques chez les vaches isolées et ne sont donc pas aussi problématiques. Étant donné que Staphylococcus aureus GTB pose des problèmes de troupeau, les coûts associés sont élevés pour l'industrie laitière. Cela vaut en particulier pour les régions de Suisse où les vaches sont montées à l'alpage, car cet alpage représente en soi le plus grand risque d'infection : ici, l'agent pathogène très agressif peut se propager rapidement, car les vaches négatives et négatives pour le GTB sont mélangées pour la traite. L'agent pathogène est transféré à d'autres vaches par les manchons de machine à traire contaminés. Le Staphylococcus aureus GTB est fortement associé à la mamelle, alors que le GTC et les autres génotypes colonisent la peau. Staphylococcus aureus GTC est un germe cutané qui provoque parfois aussi une mammite. Des recherches menées ces dernières années ont montré que Staphylococcus aureus en tant que pathogène de la mammite n'était plus simplement Staphylococcus aureus.

[Analysis of udder health in relation to antimicrobial usage in Swiss dairy farms]. / Analyse der Eutergesundheit in Zusammenhang mit dem Antibiotika­verbrauch in Schweizer Milchvieh­betrieben.

INTRODUCTION: In Switzerland, standards for milk quality are high. This requires a high level of udder health in dairy cows. Previous studies have shown that mastitis and antibiotic dry cow treatments are the most common causes of antimicrobial consumption in dairy cows. This raises the question of whether a high use of antibiotics is necessary to maintain good udder health. The aim of this study was to analyze the relationship between udder health and antimicrobial usage in Swiss dairy farms. A total of 84 participating farms were evaluated over a period of 18 months. Udder health was assessed using the yield corrected bulk milk somatic cell count from the monthly milk yield data and the number of lactating cows over 150'000 cells/ml per month. Data on antimicrobial consumption were also collected on a monthly basis. In a hierarchical regression model, a significant association between udder health and intramammary antibiotics used during lactation was found. The month of Measurement of the Somatic Cell Count and the veterinarian also had a statistically significant influence on udder health. The consumption of antibiotics for dry cow treatments was not associated with udder health. Antibiotics administered systemically and the production label of the farms was also not statistically associated with udder health in our models. The study was able to show that good udder health is possible with low antimicrobial usage.

INTRODUCTION: En Suisse, les exigences en matière de qualité du lait et, partant, de la santé de la mamelle dans les exploitations laitières sont élevées. Des études antérieures ont montré que les maladies de la mamelle et les tarissements aux antibiotiques sont la principale cause de l'usage d'antibiotiques chez les vaches laitières. Par conséquent, la question s'est posée de savoir si une utilisation importante d'antibiotiques est nécessaire au maintien d'une bonne santé de la mamelle. Le but de cette étude était d'analyser la relation entre la santé de la mamelle et la consommation d'antibiotiques. La santé de la mamelle a été évaluée au moyen du nombre théorique de cellules dans le tank à lait à partir des données du contrôle laitier mensuel et du nombre d'animaux présentant plus de 150 000 cellules/ml par mois. Des données sur la consommation d'antibiotiques ont également été collectées mensuellement. Les données totales de 84 exploitations sur une période de 18 mois ont pu être évaluées. Dans un modèle de régression hiérarchique, une corrélation significative entre la santé de la mamelle et les antibiotiques appliqués en intra mammaires pendant la lactation a été constatée. Le mois de pesée ainsi que le vétérinaire traitant ont également eu un impact significatif sur la santé de la mamelle. La quantité de préparations antibiotiques utilisées pour la phase de tarissement ne correspondait pas à la santé de la mamelle dans les exploitations. Les antibiotiques administrés par voie systémique de même que le label de production des exploitations ne sont pas non plus significatifs. L'étude a montré qu'une bonne santé de la mamelle est possible même avec une faible utilisation d'antibiotiques.

Sanitation of Staphylococcus aureus genotype B-positive dairy herds: A field study.

Staphylococcus aureus is one of the most widespread mastitis pathogens infecting dairy cattle worldwide. In Switzerland, different bovine genotypes of Staph. aureus have been identified, and genotype B (GTB) was demonstrated to be a highly contagious subtype, causing herd problems in cattle. As the efficacy of antibiotic therapy against Staph. aureus is not satisfactory, the most promising strategy for controlling this udder pathogen is the implementation of specific sanitation programs for affected farms. The aim of the present longitudinal study was the field evaluation of 2 analytical approaches for the sanitation of Staph. aureus GTB-positive dairy herds. We compared a new real-time quantitative PCR (qPCR) assay based on the detection of the unique target gene adlb with classical bacteriology. Sanitation was successfully achieved using both analytical methods, but the qPCR approach showed some main advantages, namely the use of clean (instead of aseptically collected) milk samples facilitates sample collection in terms of time and costs, enabling the sampling of entire herds during a regular milking procedure and by the farm staff. The high inclusivity and exclusivity of the new target gene adlb enable very specific detection of only the genotype of interest. Because of the very high diagnostic sensitivity of qPCR, each GTB-positive cow can be correctly identified at any time point during lactation, allowing farmers to continuously update milking groups to prevent transmission during milking. Milk sample analysis becomes more objective, faster, less expensive, and more suitable for routine application, enabling the sanitation of even big herds in short time.

[AntibioticScout.ch: Decision support for the prudent use of antimicrobials: Application in cattle]. / AntibioticScout.ch: Entscheidungshilfe für den umsichtigen Einsatz von antimikrobiellen Wirkstoffen: Anwendung beim Rind.

INTRODUCTION: The administration of antibiotics in livestock has been criticized for many years, in particular because of an inappropriate use and the appearance of antibiotic residues in the environment, which can promote the emergence and spread of resistant bacteria. However, antibiotics are essential for the successful and sustainable control of bacterial pathogens. With the aim of optimizing the use of antibiotics in food animals and minimizing the prevalence of resistant bacteria, AntibioticScout. ch provides a decision aid for the prudent use of antimicrobial drugs. This approach emphasizes the importance of supportive therapy and the hallmarks of preventive concepts. Procedures to improve animal health and animal welfare in accordance with the principles of good veterinary practice are primary and effective tools to reduce the use of antimicrobial drugs. The necessary reduction in the use of antibiotics must, therefore, be accompanied by appropriate management strategies in animal husbandry. In particular, hygiene, animal welfare and biosecurity measures are crucial to ensure an optimal health status in farm animals.

INTRODUCTION: On discute depuis des années de l'usage des antibiotiques dans l'élevage des animaux de rente, en particulier en ce qui concerne leur utilisation incorrecte et la charge environnementale liée à des résidus d'antibiotiques susceptibles de favoriser l'apparition et la propagation de résistances. Toutefois les antibiotiques sont essentiels pour assurer une lutte efficace et durable contre les maladies d'origine bactérienne. Dans le but d'optimiser l'usage des antibiotiques dans l'élevage des animaux de rente et, par conséquence, de réduire le développement de résistances, AntibioticScout.ch propose une aide à la décision pour un usage prudent de ces substances ("prudent use"). Parallèlement, on attire l'attention sur les traitements adjuvants et sur les mesures de prévention. Des mesures visant à améliorer la santé et le bien-être des animaux en tenant compte des fondements d'une bonne pratique vétérinaire sont des instruments efficaces pour réduire l'usage des antibiotiques. Cette réduction indispensable doit donc être combinée avec des mesures de gestion adéquates dans les élevages. Ce sont en particulier l'hygiène et les conditions d'élevage correctes ainsi que la mise en place de mesures de biosécurité qui sont décisives pour l'optimisation de la santé des troupeaux.

Apparent prevalence of and risk factors for infection with Ostertagia ostertagi, Fasciola hepatica and Dictyocaulus viviparus in Swiss dairy herds.

Infections with helminth parasites can negatively affect performance of dairy cows. Knowledge on infection intensity, spatial distributions and risk factors are key to develop targeted treatment strategies. Canada and most EU countries have conducted large investigations, but respective data for Switzerland were missing. We now performed a bulk tank milk serosurvey for Ostertagia ostertagi, Fasciola hepatica, and Dictyocaulus viviparus on a total of 1036 voluntarily participating dairy herds that were sampled at confinement periods, i.e. in winter 2014/15 or 2015/16, respectively. All samples were analyzed with commercial ELISAs for antibodies (AB) against O. ostertagi and F. hepatica, and those of the first sampling period additionally with an in-house ELISA for AB against D. viviparus. Testing for the latter parasite was not done in the second year of the study, as the sampling period might have missed infections due to the short lived nature of specific antibodies. The possible influence of geographic, climatic, and farm management variables on AB levels were assessed for each parasite using scanning cluster and multiple regression analysis. Overall seroprevalence for O. ostertagi was 95.5% (95% C.I.: 94.0-96.6), with a mean optical density ratio (ODR) of 0.83, for F. hepatica 41.3% (95% C.I.: 38.3-44.4), and for D. viviparus 2.9% (95% C.I.: 1.6-4.7). There were no significant differences between the two sampling periods. For all parasites, significant geographic clusters of higher AB levels could be established. Furthermore, AB levels against all three parasites were positively correlated with each other, indicating either cross-reactions or co-infections. For O. ostertagi, herd size and percentage of pasture in the ration were positively correlated with AB levels. For F. hepatica, altitude above sea level (a.s.l.) positively, and milk production per cow and year was negatively correlated with AB levels. This work provides baseline data for further studies performing in-depth risk factor analysis and investigating management as well as targeted treatment options to control the parasites.

Quarter- and cow-level risk factors for intramammary infection with coagulase-negative staphylococci species in Swiss dairy cows.

Bacteriological status, evaluation of udder symmetry, udder hygiene, and teat end scores of 92 dairy cows were assessed on 3 Swiss dairy farms in a longitudinal 1-yr study to determine risk factors for intramammary infection (IMI) with coagulase-negative staphylococci (CNS) species. Farm visits were performed monthly including sterile quarter milk sampling and udder evaluation of all lactating cows. Milk samples were evaluated for the presence of staphylococci using selective agar plates. Species identification was performed using MALDI-TOF mass spectrometry. Intramammary infection was defined as milk samples having ≥100 cfu per mL of milk according to culture results. Overall, 3,151 quarter samples were included in the statistical analysis. Staphylococcus chromogenes, Staphylococcus haemolyticus, Staphylococcus xylosus, and a Staphylococcus warneri-like species were the 4 most prevalent CNS species found. Hierarchical multivariable logistic regression models were built to evaluate risk factors for species-specific CNS IMI. Risk factors for Staph. chromogenes IMI were presence in herd B, the period from June 2014 to August 2014 and December 2014 to February 2015, and presence of udder edema. For Staph. haemolyticus, the relevant risk factor included coinfection with Staph. xylosus coinfection with other than the above-mentioned CNS species ("others") and the period from June 2014 to November 2014. Coinfection with Staph. haemolyticus and "others," the periods from June 2014 to August 2014 and December 2014 to February 2015, early phase of lactation (1-60 d in milk), and belonging to herd B were significantly associated with Staph. xylosus IMI. Mid and late lactation, coinfection with Staph. xylosus, and the period September 2014 to May 2015 were identified as significant risk factors for Staph. warneri-like IMI. For Staph. chromogenes, 60.6 and 26% of the variance was observed at the quarter and cow level, respectively, whereas for the other investigated species the highest variance was observed at the sample level. The predominant species within herds differed and was most pronounced for the Staph. warneri-like species.

The influence of the rearing period on intramammary infections in Swiss dairy heifers: A cross-sectional study.

Healthy replacement heifers are one of the foundations of a healthy dairy herd. Farm management and rearing systems in Switzerland provide a wide variety of factors that could potentially be associated with intramammary infections (IMI) in early lactating dairy heifers. In this study, IMI with minor mastitis pathogens such as coagulase-negative staphylococci (CNS), contagious pathogens, and environmental major pathogens were identified. Fifty-four dairy farms were enrolled in the study. A questionnaire was used to collect herd level data on housing, management and welfare of young stock during farm visits and interviews with the farmers. Cow-level data such as breed, age at first calving, udder condition and swelling, and calving ease were also recorded. Data was also collected about young stock that spent a period of at least 3 months on an external rearing farm or on a seasonal alpine farm. At the quarter level, teat conditions such as teat lesions, teat dysfunction, presence of a papilloma and teat length were recorded. Within 24h after parturition, samples of colostral milk from 1564 quarters (391 heifers) were collected aseptically for bacterial culture. Positive bacteriological culture results were found in 49% of quarter samples. Potential risk factors for IMI were identified at the quarter, animal and herd level using multivariable and multilevel logistic regression analysis. At the herd level tie-stalls, and at cow-level the breed category "Brown cattle" were risk factors for IMI caused by contagious major pathogens such as Staphylococcus aureus (S. aureus). At the quarter-level, teat swelling and teat lesions were highly associated with IMI caused by environmental major pathogens. At the herd level heifer rearing at external farms was associated with less IMI caused by major environmental pathogens. Keeping pregnant heifers in a separate group was negatively associated with IMI caused by CNS. The odds of IMI with coagulase-negative staphylococci increased if weaning age was less than 4 months and if concentrates were fed to calves younger than 2 weeks. This study identified herd, cow- and quarter-level risk factors that may be important for IMI prevention in the future.

A new predilection site of Mycoplasma bovis: Postsurgical seromas in beef cattle.

Mycoplasma bovis is a highly contagious bacterium, which predominantly causes chronic pneumonia, otitis and arthritis in calves and mastitis in adult cattle. In humans, Mycoplasma species have been associated with post-surgical infections. The present study aimed to identify the bacteria associated with three outbreaks of infected seromas after caesarian section in Belgian Blue beef cattle. A total of 10 cases occurred in three herds which were in close proximity of each other and shared the same veterinary practice. M. bovis could be cultured from seroma fluid in five of the six referred animals, mostly in pure culture and was isolated from multiple chronic sites of infection (arthritis and mastitis) as well. DNA fingerprinting of the isolates targeting two insertion sequence elements suggested spread of M. bovis from chronic sites of infection (udder and joints) to the postsurgical seromas. Identical genetic profiles were demonstrated in two animals from two separate farms, suggesting spread between farms. Mortality rate in the referred animals positive for M. bovis in a seroma was 80% (4/5), despite intensive treatment. A massive increase in antimicrobial use was observed in every affected farm. These observations demonstrate involvement of mycoplasmas in outbreaks of postsurgical seromas in cattle.

Short communication: Role of Streptococcus pluranimalium in Mediterranean buffaloes (Bubalus bubalis) with different udder health statuses.

The aims of the current study were to describe presence and clinical role over time of Streptococcus pluranimalium isolated in milk samples of Mediterranean buffalo (MB). Two hundred composite milk samples originating from 40 primiparous MB were collected at 10, 30, 60, 90, and 150d in milk (DIM) and from 20 pluriparous MB at 77 to 120 DIM. Milk samples were used for analysis of somatic cell counts, bacteriological cultures, and identification (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry). Nine of 200 (4.5%) samples of primiparous MB and 3 of 20 (15%) samples of pluriparous MB were positive for Strep. pluranimalium. The prevalence of the bacterium in primipari was 0% (0/40) at 10, 30, and 150 DIM, whereas it was 5 (2/40) and 17.5% (7/40) at 60 and 90 DIM, respectively. Eight primipari were positive only once, whereas 1 was positive at 2 different samplings. Mono-infection was not detected in any of the age categories or udder health status. Infections were transient in primipari. Clinical mastitis was observed in primipari once at 90 DIM, subclinical mastitis detected twice in the same animals at 60 and 90 DIM, and intramammary infections were diagnosed 1 and 5 times at 60 and 90 DIM in primipari, respectively, whereas 3 infections were diagnosed in pluripari. The clinical reflections demonstrate for the first time the presence of Strep. pluranimalium in MB and its association with different udder health status. Nevertheless, it cannot be excluded that the bacterium may simply follow a pattern of commensal or opportunistic behavior, taking advantage of a preexisting bacterial udder infection.

A multiarm randomized field trial evaluating strategies for udder health improvement in Swiss dairy herds.

The aims of this study were to quantify the effectiveness of specialist advice about udder health in Swiss dairy herds and to compare 3 different udder health improvement strategies against a negative control group. In 2010, 100 Swiss dairy herds with a high (between 200,000 and 300,000 cells/mL) yield-corrected bulk milk somatic cell count (YCBMSCC) were recruited for a 1-yr multiarm randomized field trial. The herds were visited between September and December 2011 to evaluate udder health-management practices and then randomly allocated into 1 of 4 study arms containing 25 herds each. The negative control study arm received neither recommendations for improving udder health nor any active support. The remaining 75 farmers received a herd-specific report with recommendations to improve udder health management. The positive control study arm received no further active support during 2012. The veterinarian study arm received additional support in the form of monthly visits by their herd veterinarian. Finally, the study group study arm received support in the form of bimonthly study group meetings where different topics concerning udder health were discussed. One year later, implementation of recommendations and changes in udder health were assessed. Of the recommendations given, 44.3% were completely implemented, 23.1% partially, and 32.6% were not implemented. No differences in implementation of recommendations were noted between the 3 study arms. At study enrollment, farmers were asked for the study arm of their preference but were subsequently randomly assigned to 1 of the 4 study arms. Farmers that were assigned to the study arm of their preference implemented more recommendations than farmers assigned to a study arm not of their preference. No decrease in the within-herd prevalence of cows that had a high (≥200,000 cells/mL) composite somatic cell count was observed in herds that had a YCBMSCC ≥200,000 cells/mL at the start of intervention. However, the 3 study arms with intervention (positive control, the veterinarian, and the study groups) prevented an increase in the within-herd prevalence of cows that had a high somatic cell count in herds with a low YCBMSCC at the start of the intervention compared with the negative control study arm. In the year after sending the report, herds assigned to the study group study arm had a reduced incidence rate of treated mastitis cases in comparison with the year before sending the report.

[Diagnosis and therapy of retained fetal membranes, puerperal metritis and clinical endometritis in cattle: Results of the Online-survey among Swiss practitioners. I Retained fetal membranes]. / Diagnose und Therapie von Nachgeburtsverhalten, puerperaler Metritis und klinischer Endometritis beim Rind: Ergebnisse einer Online-Umfrage bei Schweizer Tierärzten. I Nachgeburtsverhalten.

The aim of this study was to obtain the diagnostic and therapeutic approach among Swiss practitioners in cows with retained fetal membranes (RFM) (part 1). All members of the Association for ruminant health were contacted per email via the newsletter. The survey was completed by 128 veterinarians, partially responded by 140 veterinarians. The manual removal of the fetal membranes is practiced by 129 of the responding veterinarians. Cows with/without fever are treated usually with intrauterine antibiotics. Cows with RFM with/without fever are most commonly treated parenterally with tetracycline or penicillin. The use of cephalosporins and quinolones in cows with fever is more common than in cows without fever. With the present results of the survey veterinarians should critically question the supposed benefits of the manual removal of the placenta and the use of antibiotics in cows with RFM.

[Diagnosis and therapy of retained fetal membranes, puerperal metritis and clinical endometritis in cattle: Results of the Online-survey among Swiss practitioners. II. Puerperal metritis and clinical endometritis]. / Diagnose und Therapie von Nachgeburtsverhalten, puerperaler Metritis und klinischer Endometritis beim Rind: Ergebnisse einer Online-Umfrage bei Schweizer Tierärzten. II. Puerperale Metritis und klinische Endometritis.

The aim of the study was to obtain the diagnostic and therapeutic approach among Swiss practitioners in cows with puerperal metritis and clinical endometritis (part 2). All members of the Association for ruminant health were contacted per email via the newsletter. The survey was completed by 128 veterinarians, partially responded by 140 veterinarians. The following main symptoms of puerperal metritis were stated by the practitioners: purulent vaginal discharge, fever and reduced appetite. A vaginal and rectal examination was performed to diagnose the disease. Usually, an intrauterine treatment with tetracycline or cefapirin was done. Parenteral administration of tetracycline or penicillin was often combined with PGF(2α), NSAIDS or cortisone. Clinical endometritis was also diagnosed by vaginal and rectal examination and the main symptom indicated was purulent vaginal discharge. The therapy consisted of the administration of PGF(2α), uterine infusions predominantly with cefapirin, and rarely with parenteral administration of antibiotics. Further diagnostic tools were not used and normally cows were not rechecked. The success of the therapy of puerperal metritis and clinical endometritis was judged to be satisfactory to excellent.

Management of patients during hunger strike and refeeding phase.

OBJECTIVE: Hunger strikers resuming nutritional intake may develop a life-threatening refeeding syndrome (RFS). Consequently, hunger strikers represent a core challenge for the medical staff. The objective of the study was to test the effectiveness and safety of evidence-based recommendations for prevention and management of RFS during the refeeding phase. METHODS: This was a retrospective, observational data analysis of 37 consecutive, unselected cases of prisoners on a hunger strike during a 5-y period. The sample consisted of 37 cases representing 33 individual patients. RESULTS: In seven cases (18.9%), the hunger strike was continued during the hospital stay, in 16 episodes (43.2%) cessation of the hunger strike occurred immediately after admission to the security ward, and in 14 episodes (37.9%) during hospital stay. In the refeed cases (n = 30), nutritional replenishment occurred orally, and in 25 (83.3%) micronutrients substitutions were made based on the recommendations. The gradual refeeding with fluid restriction occurred over 10 d. Uncomplicated dyselectrolytemia was documented in 12 cases (40%) within the refeeding phase. One case (3.3%) presented bilateral ankle edemas as a clinical manifestation of moderate RFS. Intensive medical treatment was not necessary and none of the patients died. Seven episodes of continued hunger strike were observed during the entire hospital stay without medical complications. CONCLUSIONS: Our data suggested that seriousness and rate of medical complications during the refeeding phase can be kept at a minimum in a hunger strike population. This study supported use of recommendations to optimize risk management and to improve treatment quality and patient safety in this vulnerable population.

Metformin and the risk of head and neck cancer: a case-control analysis.

AIMS: Metformin use has been associated with a decreased risk of some cancers, although data on head and neck cancer (HNC) are scarce. We explored the relation between the use of antidiabetic drugs and the risk of HNC. METHODS: We conducted a case-control analysis in the UK-based Clinical Practice Research Datalink (CPRD) of people with incident HNC between 1995 and 2013 below the age of 90 years. Six controls per case were matched on age, sex, calendar time, general practice and number of years of active history in the CPRD prior to the index date. Other potential confounders including body mass index (BMI), smoking, alcohol consumption and comorbidities were also evaluated. The final analyses were adjusted for BMI, smoking and diabetes mellitus (or diabetes duration in a sensitivity analysis). Results are presented as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Use of metformin was neither associated with a statistically significant altered risk of HNC overall (1-29 prescriptions: adjusted OR 0.87, 95% CI 0.61-1.24 and ≥ 30 prescriptions adjusted OR 0.80, 95% CI 0.53-1.22), nor was long-term use of sulphonylureas (adjusted OR 0.87, 95% CI 0.59-1.30), or any insulin use (adjusted OR 0.92, 95% CI 0.63-1.35). However, we found a (statistically non-significant) decreased risk of laryngeal cancer associated with long-term metformin use (adjusted OR 0.41, 95% CI 0.17-1.03). CONCLUSIONS: In this population-based study, the use of antidiabetic drugs was not associated with a materially altered risk of HNC. Our data suggest a protective effect of long-term metformin use for laryngeal cancer.

Genotype-specific risk factors for Staphylococcus aureus in Swiss dairy herds with an elevated yield-corrected herd somatic cell count.

Bovine mastitis is a frequent problem in Swiss dairy herds. One of the main pathogens causing significant economic loss is Staphylococcus aureus. Various Staph. aureus genotypes with different biological properties have been described. Genotype B (GTB) of Staph. aureus was identified as the most contagious and one of the most prevalent strains in Switzerland. The aim of this study was to identify risk factors associated with the herd-level presence of Staph. aureus GTB and Staph. aureus non-GTB in Swiss dairy herds with an elevated yield-corrected herd somatic cell count (YCHSCC). One hundred dairy herds with a mean YCHSCC between 200,000 and 300,000cells/mL in 2010 were recruited and each farm was visited once during milking. A standardized protocol investigating demography, mastitis management, cow husbandry, milking system, and milking routine was completed during the visit. A bulk tank milk (BTM) sample was analyzed by real-time PCR for the presence of Staph. aureus GTB to classify the herds into 2 groups: Staph. aureus GTB-positive and Staph. aureus GTB-negative. Moreover, quarter milk samples were aseptically collected for bacteriological culture from cows with a somatic cell count ≥150,000cells/mL on the last test-day before the visit. The culture results allowed us to allocate the Staph. aureus GTB-negative farms to Staph. aureus non-GTB and Staph. aureus-free groups. Multivariable multinomial logistic regression models were built to identify risk factors associated with the herd-level presence of Staph. aureus GTB and Staph. aureus non-GTB. The prevalence of Staph. aureus GTB herds was 16% (n=16), whereas that of Staph. aureus non-GTB herds was 38% (n=38). Herds that sent lactating cows to seasonal communal pastures had significantly higher odds of being infected with Staph. aureus GTB (odds ratio: 10.2, 95% CI: 1.9-56.6), compared with herds without communal pasturing. Herds that purchased heifers had significantly higher odds of being infected with Staph. aureus GTB (rather than Staph. aureus non-GTB) compared with herds without purchase of heifers. Furthermore, herds that did not use udder ointment as supportive therapy for acute mastitis had significantly higher odds of being infected with Staph. aureus GTB (odds ratio: 8.5, 95% CI: 1.6-58.4) or Staph. aureus non-GTB (odds ratio: 6.1, 95% CI: 1.3-27.8) than herds that used udder ointment occasionally or regularly. Herds in which the milker performed unrelated activities during milking had significantly higher odds of being infected with Staph. aureus GTB (rather than Staph. aureus non-GTB) compared with herds in which the milker did not perform unrelated activities at milking. Awareness of 4 potential risk factors identified in this study guides implementation of intervention strategies to improve udder health in both Staph. aureus GTB and Staph. aureus non-GTB herds.

A longitudinal study investigating the prevalence of Staphylococcus aureus genotype B in seasonally communal dairy herds.

Staphylococcus aureus is a major mastitis-causing pathogen. Various genotypes have been recently identified in Switzerland but Staph. aureus genotype B (GTB) was the only genotype associated with high within-herd prevalence. The risk of introducing this Staph. aureus genotype into a herd may be increased by frequent animal movements. This may also be the case when cows from different herds of origin are commingled and share their milking equipment for a limited period of time. The aim of the present study was to determine the prevalence of Staph. aureus GTB in seasonally communal dairy herds before and after a summer period when dairy farming is characterized by mixing cows from different herds of origin in 1 communal operation. In addition, the environment was investigated to identify potential Staph. aureus GTB reservoirs relevant for transmission of the disease. A total of 829 cows from 110 herds of origin in 9 communal operations were included in the study. Composite milk samples were collected from all cows during the first or second milking after arrival at the communal operation and again shortly before the end of the season. Swab samples from the environment, involved personnel, and herding dogs present were collected before the cows arrived. At the end of the season, sampling of personnel was repeated. All samples were analyzed for the presence of Staph. aureus GTB using an established quantitative PCR. At the beginning of the season, Staph. aureus GTB-positive cows were identified in 7 out of 9 communal operations and the within-communal operation prevalence ranged from 2.2 to 38.9%. At the second sampling, all communal operations were Staph. aureus GTB positive, showing within-communal operation prevalence from 1 to 72.1%. The between-herd of origin prevalence increased from 27.3 to 56.6% and the cow-level prevalence increased from 11.2% at the beginning of the season to 29.6% at the end of the season. On 3 different communal operations, Staph. aureus GTB-positive swabs from seasonally employed personnel were identified at the end of the season. The results indicate that Staph. aureus GTB can easily spread in communal operations when cows from different herds of origin are mixed during the summer season. Effective management measures need to be designed to prevent the spread of Staph. aureus GTB in seasonally communal herds.

Incidence of and risk factors for severe hypoglycaemia in treated type 2 diabetes mellitus patients in the UK--a nested case-control analysis.

AIMS: To assess incidence rates (IRs) of and identify risk factors for incident severe hypoglycaemia in patients with type 2 diabetes newly treated with antidiabetic drugs. METHODS: Using the UK-based General Practice Research Database, we performed a retrospective cohort study between 1994 and 2011 and a nested case-control analysis. Ten controls from the population at risk were matched to each case with a recorded severe hypoglycaemia during follow-up on general practice, years of history in the database and calendar time. Using multivariate conditional logistic regression analyses, we adjusted for potential confounders. RESULTS: Of 130,761 patients with newly treated type 2 diabetes (mean age 61.7 ± 13.0 years), 690 (0.5%) had an incident episode of severe hypoglycaemia recorded [estimated IR 11.97 (95% confidence interval, CI, 11.11-12.90) per 10,000 person-years (PYs)]. The IR was markedly higher in insulin users [49.64 (95% CI, 44.08-55.89) per 10,000 PYs] than in patients not using insulin [8.03 (95% CI, 7.30-8.84) per 10,000 PYs]. Based on results of the nested case-control analysis increasing age [≥ 75 vs. 20-59 years; adjusted odds ratio (OR), 2.27; 95% CI, 1.65-3.12], cognitive impairment/dementia (adjusted OR, 2.00; 95% CI, 1.37-2.91), renal failure (adjusted OR, 1.34; 95% CI, 1.04-1.71), current use of sulphonylureas (adjusted OR, 4.45; 95% CI, 3.53-5.60) and current insulin use (adjusted OR, 11.83; 95% CI, 9.00-15.54) were all associated with an increased risk of severe hypoglycaemia. CONCLUSIONS: Severe hypoglycaemia was recorded in 12 cases per 10,000 PYs. Risk factors for severe hypoglycaemia included increasing age, renal failure, cognitive impairment/dementia, and current use of insulin or sulphonylureas.