Increasing vaccine uptake among employees within the non-health related critical infrastructure sectors: A review.

This review aimed to identify barriers to employee vaccination, motivators for vaccination, and vaccine uptake strategies within the critical infrastructure sectors. We focused on non-healthcare-related sectors, including food and agriculture, manufacturing, and education where employee vaccination is rarely mandated. We conducted a search for literature published from 2012 to 2022 from MEDLINE-PubMed, PsycINFO, and Web of Science Core Collection, which resulted in 22 studies that met the inclusion criteria. We found that 1) barriers to vaccination differ by infectious disease and population; 2) common motivators for vaccination were about protecting self, family, and community; and 3) common uptake strategies for influenza (which accounted for 83% of uptake strategies in reviewed studies) addressed convenience and confidence barriers such as vaccination cost and education. Our review highlights the need for employers, policymakers, and researchers to identify infectious disease and population-specific barriers to vaccination and implement strategies aimed at addressing the identified barriers.

Responsible antibiotic use labeling and consumers' willingness to buy and pay for fluid milk.

Concerns about antibiotic resistant infections in the United States have called for reduction of antibiotic use in livestock, including dairy cattle. Although effective in curbing antibiotic use, universal organic dairy farming would be impractical and unattainable due to its high land and premium demands. The US Department of Agriculture's organic certification, which completely eliminates antibiotic use in milk production, also raises animal welfare concerns, as it could discourage the use of antibiotics even to treat indicated diseases. Therefore, a proposed alternative for US consumers is a label indicating the responsible antibiotic use (RAU) - not complete elimination - that would minimize antibiotics more than conventional (unlabeled) milk and maximize animal welfare more than organic milk. Our goal was to determine consumers' (1) self-reported preference and (2) willingness to pay for this hypothetical RAU label of milk relative to existing substitutes in organic and unlabeled fluid milk. We conducted (1) a nationally representative survey of US adults and (2) a randomized non-hypothetical experimental Becker-Degroot-Marschak auction with real money and real milk. Although almost half of the survey participants (48.5%) responded that they would buy a RAU-labeled milk, consumers in the experimental auction refused to pay a significant premium for the milk compared with unlabeled milk (mean willingness to pay (95% confidence interval) per half-gallon: $1.92 ($1.65-$2.19) for RAU-labeled milk versus $1.86 ($1.58-$2.13) for unlabeled milk). These results suggest that consumers' survey-identified preferences for RAU-labeled milk could reflect either social desirability bias or a genuine preference for which, however, consumers simply will not pay a significant premium. The study provides preliminary data for future exploration of marketability of the proposed RAU label in the United States and demonstrates the benefits of using complementary survey and experimental auction approaches to understand the potential market for a new dairy product.

Understanding Antibiotic Resistance as a Perceived Threat towards Dairy Cattle through Beliefs and Practices: A Survey-Based Study of Dairy Farmers.

Antibiotic use is an important component in dairy herd management both to treat bacterial diseases and to maximize animal welfare. However, there is concern among scientists that antibiotic misuse and/or overuse by farmers might promote the emergence of resistant pathogens. We conducted a cross-sectional web-based questionnaire study with dairy farmers/managers in New York, USA to evaluate their (i) level of concern about antibiotic resistance and (ii) interest in adopting new judicious antibiotic use practices regarding mastitis treatment. A total of 118 responses were subjected to statistical analysis. The findings revealed that nearly half (45%) of study participants were undecided or disagreed that antibiotic resistance due to antibiotic use in dairy farming may negatively impact the health of dairy cattle. In contrast, the majority (78%) of participants self-reported that they do not treat with antibiotics at the first sign of mastitis, and the majority (66%) have either fully or partially implemented culture-based mastitis treatment on their farm. The self-reported adoption of culture-based mastitis treatment practices was statistically significantly associated with higher numbers of injectable and intramammary doses of antibiotics used on the participants' farms. These findings will aid future research investigations on how to promote sustainable antibiotic use practices in dairy cattle.

Growth and survival of aerobic and Gram-negative bacteria on fresh spinach in a Chinese supply chain from harvest through distribution and refrigerated storage.

Spinach is a highly perishable product that degrades over time, including due to bacteria contaminating the product prior to packaging, yet the dynamics of bacterial spoilage and factors that affect it are not well understood. Notably, while China is the top producer of spinach globally, there is limited available microbiological data in the literature for spinach supply chains in China. The overall goal of this foundational study was to establish a baseline understanding of bacterial population dynamics on spinach from harvest to 10 days postprocessing for a Chinese supply chain that includes distribution via traditional grocery (a local physical store) and eCommerce (an online store). To this end, organic spinach samples were collected at different stages in a Chinese supply chain by following the same 3 lots, starting at point-of-harvest through processing and distribution via a local grocery store and eCommerce. After distribution, the same 3 lots were stored at 4 °C with microbiological testing performed on multiple days up to day 10 postprocessing, simulating storage at the point-of-consumer. Results showed aerobic plate counts and total Gram-negative counts did not significantly differ across stages in the supply chain from harvest through processing. However, packaged spinach from the same processing facility and lots, exhibited different patterns in bacterial levels across 0 to 10 days postprocessing, depending on whether it was distributed via the local grocery store or eCommerce. Evaluation of bacterial populations performed on a subset of the packaged spinach samples indicated Gram-negative bacteria, in particular Pseudomonas, were predominant across all days of testing (days 0, 3, and 10 postprocessing), with populations differing at the genus level by day. Overall, this study improves our understanding of the dynamics of bacterial populations on spinach and provides baseline data needed for future studies.

Comparison of different biomass methodologies to adjust sales data on veterinary antimicrobials in the USA.

OBJECTIVES: The United States (US) FDA, European Surveillance of Veterinary Antimicrobial Consumption (ESVAC), Public Health Agency of Canada (PHAC) and World Organisation for Animal Health (OIE) established methodologies that characterize antimicrobial sales for use in food animals by adjusting the sales by animal biomass. Our aim was to review and compare these methodologies on US-specific data. METHODS: Annual antimicrobial sales for cattle, swine, chickens and turkeys in the USA between 2016 and 2018 were adjusted by the FDA, ESVAC, PHAC and OIE methodologies. To better understand the advantages and disadvantages of the four methodologies, their biomass denominators were compared regarding the level of detail accounted for in the estimated US livestock biomass, their ability to observe temporal trends in animal biomass within a country and practicality in biomass estimation for comparing antimicrobial sales across countries. RESULTS: The four methodologies resulted in substantially different estimates of biomass-adjusted antimicrobial sales for use in US food animals. The 2018 estimates were the highest with the ESVAC methodology (314.7 mg of active antimicrobial ingredient/kg of animal biomass), followed by PHAC (191.5 mg/kg), FDA (127.6 mg/kg) and OIE (111.5 mg/kg). The animal weight parameters used in each methodology had the most impact on the biomass-adjusted sales estimates. CONCLUSIONS: In regard to the estimation of the animal biomass, no methodology was found to be perfect; however, the FDA methodology had the best resolution in characterizing the US livestock biomass while the OIE methodology was best for biomass estimation for global monitoring of antimicrobial sales for use in food animals.

How does public perception of antibiotic use on dairy farms contribute to self-reported purchasing of organic?

The United States regulates the use of antibiotics in agricultural settings to address the global antibiotic resistance problem. Conventional dairy cows treated with antibiotics are kept in the herd and after the withholding period milk is harvested. On organic farms, the US organic standard on antibiotic use requires sick dairy cows to be treated, but treated cows must be removed from the herd and their milk can never again be sold as certified organic. This study investigated the US public's perceptions of the organic dairy farming, antibiotic use on dairy farms, and whether these perceptions affect consumer's self-reported purchasing behavior for organic. We used a nationally representative phone-based survey of 1000 US adults and characterized participants' self-reported (i) knowledge of the legality of antibiotic use on dairy farms (conventional and organic) and (ii) frequency of purchasing organic instead of conventional dairy products, as well as several demographic and other variables. The results indicated that participants' knowledge about antibiotic use practices in dairy farming have no effect on their self-reported purchasing behavior for organic or conventional dairy products. However, respondents who were familiar with the regulations of antibiotic use on dairy farms were more likely to oppose the US organic standard on antibiotic use in dairy farming and thought that past antibiotic use should not permanently remove a cow's organic status. These findings contribute to understanding of public perceptions that shape the US dairy organic market. PRACTICAL APPLICATION: Income, employment, health and political values, but not consumers' knowledge about antibiotic use in dairy farming, affect self-reported purchasing behavior for organic dairy products. However, consumers who are familiar with the regulations of antibiotic use on US dairy farms disagree with the US organic standard on antibiotic use mandating loss of organic status for any cattle treated with antibiotics. These findings may be useful to organic markets.

Survey of perceptions and attitudes of an international group of veterinarians regarding antibiotic use and resistance on dairy cattle farms.

Veterinarians are the main source of information for farmers regarding the responsible use of antibiotics in farm animals and how to reduce the risk of antibiotic resistance. Consequently, understanding how veterinarians perceive their clients' and colleagues' antibiotic use and their own beliefs about the development of antibiotic resistance is essential to determining areas in which antibiotic use practices can be improved to minimize the emergence of antibiotic resistance. An international cross-sectional study was carried out using a questionnaire designed to elucidate perceptions, attitudes, and concerns of dairy veterinarians regarding antibiotic use and the emergence of antibiotic resistance in dairy farming. The questionnaire was initially administered to veterinarians attending the International Bovine Mastitis Conference in Milano, Italy, 2018, followed by veterinarian members of the National Mastitis Council, and all conference registrants. A total of 71 participants from 21 countries participated in the survey, the majority were from the United States and member countries of the European Union. Logistic regression analysis was conducted to identify predictors of veterinarians' level of concern about the development of antibiotic resistance on their clients' farms. Associations were described with odds ratios (ORs) and the associated 95 % confidence intervals (95 % CIs). Free text responses where participants shared their views on the reason for overprescribing antibiotics by veterinarians were analyzed using thematic analysis. Participants perceived that nearly half of their clients overuse or inappropriately use antibiotics, and nearly half of their colleagues overprescribe or inappropriately prescribe antibiotics. After controlling for other factors, the odds of veterinarians being concerned about antibiotic resistance on dairy farms they served decreased by a factor of 0.91 for each additional year of participants' experience working with dairy cattle (OR = 0.91, 95 % CI = 0.84-0.99). Participants concerned about antibiotic resistance on clients' dairy farms were also more likely to consider better adherence to drug labelling as important for reducing farmers' antibiotic use (OR = 6.86, 95 % CI = 1.21-38.93). Thematic analysis revealed four themes surrounding the perceived reasons for veterinarians' overprescribing of antibiotics: (i) knowledge, (ii) attitudes, (iii) barriers, and (iv) rules and regulations. The study findings will aid in the development of strategies to improve antibiotic use in dairy farming and educational initiatives looking to enhance the communication between veterinarians and farmers about judicious use of antibiotics.

Genome analysis of antimicrobial resistance, virulence, and plasmid presence in Turkish Salmonella serovar Infantis isolates.

Salmonella enterica subsp. enterica serovar Infantis (S. Infantis) isolates were found to have a multi-drug resistance profile (kanamycin, streptomycin, nalidixic acid, tetracycline, sulfonamide, and sometimes to ampicillin) and high prevalence (91%) in Turkish poultry in our previous studies. To investigate the mechanism behind multi-drug antimicrobial resistance (AMR) and high prevalence in Turkish poultry, 23 of the isolates were sequenced for comparative genomic analyses including: SNP-based comparison to S. Infantis from other countries, comparison of antimicrobial resistance genes (AMGs) with AMR phenotypes, and plasmid identification and annotation. Whole-genome SNP-based phylogenetic analysis found that all 23 Turkish S. Infantis isolates formed a distinct, well-supported clade, separate from 243 comparison S. Infantis genomes in GenomeTrakr identified as from the US and EU; the isolates most closely related to the cluster of these Turkish isolates were from Israel and Egypt. AMGs identified by bioinformatic analysis, without differentiating chromosomal or plasmid located genes, implied AMR phenotypes with 94% similarity overall to wet lab data, which was performed by phenotypic and conventional PCR methods. Most of the S. Infantis (21/23) isolates had identifiable plasmids, with 76% (16/21) larger than 100 kb and 48% (10/21) larger than 200 kb. A plasmid larger than 200 kb, with the incompatibility type of IncX1, similar to United States S. Infantis plasmid N55391 (99% query coverage and 99% identity overall), which itself is similar to Italian and Hungarian S. Infantis plasmids. Turkish S. Infantis plasmids had different beta-lactam resistance genes (blaTEM-70, blaTEM-148 and blaTEM-198) than the gene blaCTX-M-65 found in S. Infantis plasmids from other countries. This is the first observation of these three genes in S. Infantis isolates. The plasmids larger than 200 kb had two distinct regions of interest: Site 1 and Site 2. Site 1 (around 130 kb) had virulence- and bacteriocin- associated genes such as bacteriocin secretion system and type II toxin-antitoxin system genes (vagC, ccdA, ccdB, mchE, cvaB) and an aminoglycoside resistance gene (str). Site 2 (around 75-110 kb) had the antimicrobial resistance genes (aadA, sulI, tetA, tetR) and mercury (mer) resistance gene on tranposons Tn552 and Tn501. Presence of these AMR and virulence genes suggests they may have a role in the emergence of S. Infantis in poultry and support treating this serotype as a an important human health hazard.

Development of a multiplex real-time PCR assay using two thermocycling platforms for detection of major bacterial pathogens associated with bovine respiratory disease complex from clinical samples.

Bovine respiratory disease complex (BRDC) is one of the most significant diseases of cattle. Bacterial pathogens involved in BRDC include Mannheimia haemolytica, Mycoplasma bovis, Histophilus somni, and Pasteurella multocida. We developed and evaluated a multiplexed real-time hydrolysis probe (rtPCR) assay using block-based Peltier and rotary-based thermocycling on lung tissue, nasal swabs, and deep nasopharyngeal swabs. The rtPCR results were compared to culture or a gel-based M. bovis PCR using statistical analysis to determine optimum quantification cycle (Cq) cutoffs to maximize agreement. The limits of detection were 1.2-12 CFU/reaction for each pathogen. M. haemolytica was the most prevalent organism detected by rtPCR, and was most frequently found with P. multocida. The rtPCR assay enabled enhanced levels of detection over culture for all pathogens on both thermocycling platforms. The rotary-based thermocycler had significantly lower Cq cutoffs (35.2 vs. 39.7), which maximized agreement with gold standard culture or gel-based PCR results following receiver operating characteristic analysis to maximize sensitivity (Se) and specificity (Sp). However, overall assay Se and Sp were similar on both platforms (80.5% Se, 88.8% Sp vs. 80.1% Se, 88.3% Sp). Implementation of these tests could enhance the detection of these pathogens, and with high-throughput workflows could reduce assay time and provide more rapid results. The assays may be especially valuable in identifying coinfections, given that many more antemortem samples tested in our study were positive for 2 or more pathogens by rtPCR ( n = 125) than were detected using culture alone ( n = 25).

Phenotyping and genetic characterization of Salmonella enterica isolates from Turkey revealing arise of different features specific to geography.

192 Food samples (commonly consumed 8 food types), 355 animal samples (animal feces of bovine, ovine, goat and chicken) and 50 samples from clinical human cases in Sanliurfa city, Turkey in a year were collected to determine the Salmonella enterica subsp. enterica mosaic in Turkey. 161 Salmonella isolates represented 17 serotypes, 20 sequence types (STs) and 44 PFGE patterns (PTs). 3 serotypes, S. Enteritidis, S. Typhimurium and S. Kentucky, were recovered from three different hosts. The highest discriminatory power was obtained by PFGE (SID=0.945), followed by MLST (SID=0.902) and serotyping (SID=0.885) for all isolates. The prevalence of antimicrobial resistance genes (aadA1, aadA2, strA, strB, aphA1-Iab, blaTEM-1, blaPSE-1, tetA) was highly correlated with phenotypic profiles of aminoglycoside, ß-lactam and tetracycline groups (kappa >0.85). From our knowledge, this is the first study reporting spatial and temporal distribution of Salmonella species through phenotypic and genetic approaches over farm to fork chain in Turkey. Thus, our data provided further information for evolution, ecology and transmission of Salmonella in Turkey.

Subtyping of Salmonella Food Isolates Suggests the Geographic Clustering of Serotype Telaviv.

Salmonella is commonly found in a variety of food products and is a major cause of bacterial foodborne illness throughout the world. In this study, we investigated the prevalence and diversity of Salmonella in eight different food types: sheep ground meat, cow ground meat, chicken meat, cow offal, traditional Sanliurfa cheese, unripened feta cheese, pistachios, and isot (a spice blend of dried red peppers specific to Sanliurfa), traditionally and commonly consumed in Turkey. Among 192 food samples, Salmonella was detected in 59 samples, with the highest prevalence in raw poultry parts (58%) and offal (58%) samples, while Salmonella was not detected in pistachios and dried red pepper. Resultant Salmonella isolates were characterized by serotyping, multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE). Ten different serotypes represented 10 MLST sequence types (STs) with 1 novel ST and 17 PFGE types. Antimicrobial resistance profiling revealed that 30.5% of the isolates were resistant to two or more antimicrobials. Salmonella enterica subsp. enterica serotype Telaviv, which is rare throughout the world, was the second most common serotype isolated from food samples in this study, suggesting that this serotype might be one of the subtypes that is endemic to Turkey.

Salmonella surveillance on fresh produce in retail in Turkey.

Although Turkey is one of the major producers of fruits and vegetables in the world, there has been no information available on the prevalence of pathogens in fresh produce. To fill this gap, we collected 503 fresh produce samples including tomato, parsley, iceberg lettuce, green-leaf lettuce and five different fresh pepper varieties (i.e., green, kapya, bell, mazamort and Charleston) from 3 major districts within 9 supermarkets and 3 bazaars in Ankara, Turkey to investigate the presence of Salmonella. Salmonella was detected in 0.8% (4/503) of samples by conventional culturing method with molecular confirmation conducted through polymerase chain reaction (PCR). For further characterization of isolates, serotyping, antimicrobial susceptibility testing, multi-locus sequence typing (MLST; aroC, thrA, purE, sucA, hisD, hemD and dnaN) and pulsed-field gel electrophoresis (PFGE) were performed. Salmonella enterica subsp. enterica serotypes Anatum, Charity, Enteritidis and Mikawasima were isolated from two parsley, one pepper and one lettuce samples, respectively. MLST resulted in 4 sequence types (STs) for each serotype, including one novel ST for serotype Mikawasima. Similarly, PFGE revealed four different XbaI PFGE patterns. The results of this survey, obtained by the most common subtyping methods (i.e. serotyping, MLST and PFGE) worldwide, contributes to the development of a national database in Turkey, which is essential for investigating the evolutionary pathways, geographical distribution and genetic diversity of Salmonella strains.