Risk Factors for Antibiotic Treatment of Pigs Between Birth and Slaughter – A Longitudinal Study

Abstract Background: Recently, we found an association between antibiotic treatment and antibiotic resistance in fecal Escherichia coli from rearing pigs during their life. In this study, our aim was to investigate potential risk factors for antibiotic treatment at different production stages of these pigs.Results: In a longitudinal study, antibiotic use was recorded in commercial pig production chains, starting in 29 breeding herds. Information on housing system and management, management of animals and feeding, animal health and performance was surveyed in the herds. In total 55, 57 and 66 variables were evaluated for the production stages suckling, weaning and fattening. In descriptive and univariable analyses seven to eight variables per production stage were associated with antibiotic use. In multivariable analyses, rodent control carried out by a company was associated with an increased risk of antibiotic treatment (odds ratio (OR), 6.86, confidence limits, CL, 1.12 – 41.83, p = 0.023) at suckling. At weaning, production type (farrow-to-finish vs. movement of pigs to another farm after suckling or weaning; OR 0.15, CL 0.02 – 0.89, p = 0.023) was associated with the risk of antibiotic treatment. During the fattening stage, animals were treated more often when the number of weaned piglets per sow and year increased (additional piglet: OR 2.5, CL 0.6 – 29.6, p = 0.0172).Conclusions: Different risk factors were associated with an increased risk of antibiotic treatment in the individual production stages. Therefore, focus on specific measures, especially at suckling and weaning, when most antibiotics are used, is needed. Further research on key factors driving antibiotic use and the causative pathogens that require treatment is necessary in pig production.

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Understanding Antibiotic Use for Pig Farming in Thailand: A Qualitative Study

10.21203/rs.3.rs-71593/v1 ◽

2020 ◽

Author(s):

Angkana Lekagul ◽

Viroj Tangcharoensathien ◽

Marco Liverani ◽

Anne Mills ◽

Jonathan Rushton ◽

...

Keyword(s):

Health Professionals ◽

Professional Training ◽

Central Government ◽

Animal Health ◽

Antibiotic Use ◽

Economic Incentives ◽

Antibiotic Prescribing ◽

Pig Production ◽

Factors Influencing ◽

Pig Farming

Abstract Background: Antimicrobial resistance (AMR), recognised as a serious and growing threat to global health, is driven by antibiotic use. Understanding factors influencing antibiotic use is essential to design and implement effective interventions to reduce unnecessary antibiotic use and AMR. This study aims to explore the practices and views of the key actors associated with the use of antibiotics for pig farming in Thailand, from local farmers to officers in central government institutions. Methods: A total of 31 in-depth interviews were conducted with pig farmers (n=13), drug retailers (n=5), veterinarians (n=7), and government officers (n=3) and representatives of health professional councils (n=2). Direct observations were conducted in pig farms. Thematic analysis based on practices, views and interests of actors regarding antibiotic use in pig production in Thailand. Results: There are various factors influencing the use of antibiotics. The factors may trigger greater antibiotic use including lack of knowledge and awareness about antibiotics and AMR, economic incentives, and loose regulatory frameworks. Farmers considered that antibiotics are necessary to maintain animal health, prevent and control diseases, and ensure economic gains, so using antibiotics was considered a worthwhile investment in pigs. There was limited information about antibiotic use in the curriculum and lack of clinical practice guidelines for health professionals. Veterinarians faced challenges in diagnosis and lacked antibiotic prescribing guidelines. Pharmaceutical companies applied market promotion strategies to increase sales; and used professionals as mediators with farmers. There was no control of antibiotic sale and prescription via the regulatory environment. The national policy on AMR could be facilitating factor to optimise use of antibiotics but its influence was weak relative to other influences which favoured antibiotic use. Conclusions: Our study highlights the need to improve antibiotic use in pig production in Thailand. Access to veterinary services and reliable information about animal health needs to be improved among farmers. Innovative low-cost investment in biosecurity could improve farm management and decrease reliance on antibiotics. Developing professional training and clinical guidelines, and establishing a code of conduct, are needed to improve practices in antibiotic prescription and sale amongst health professionals and industry.

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Risk factors for depression during the COVID-19 pandemic: a longitudinal study in middle-aged and older adults

BJPsych Open ◽

10.1192/bjo.2021.997 ◽

2021 ◽

Vol 7 (5) ◽

Author(s):

Jamie Rutland-Lawes ◽

Anna-Stiina Wallinheimo ◽

Simon L. Evans

Keyword(s):

Risk Factors ◽

Older Adults ◽

Longitudinal Study ◽

Regression Models ◽

Protective Factor ◽

Significant Risk ◽

Living Alone ◽

Depression Symptoms ◽

Middle Aged ◽

Increased Risk

Background The COVID-19 pandemic and resultant social restrictions have had widespread psychological ramifications, including a rise in depression prevalence. However, longitudinal studies on sociodemographic risk factors are lacking. Aims To quantify longitudinal changes in depression symptoms during the pandemic compared with a pre-pandemic baseline, in middle-aged and older adults, and identify the risk factors contributing to this. Method A total of 5331 participants aged ≥50 years were drawn from the English Longitudinal Study of Ageing. Self-reported depression symptoms in June/July 2020 were compared with baseline data from 2–3 years prior. Regression models investigated sociodemographic and lifestyle variables that could explain variance in change in depression. Results Within-participant depression scores increased significantly from pre-pandemic levels: 14% met the criteria for clinical depression at baseline, compared with 26% during the pandemic. Younger age, female gender, higher depression scores at baseline, living alone and having a long-standing illness were significant risk factors. Gender-stratified regression models indicated that older age was protective for women only, whereas urban living increased risk among women only. Being an alcohol consumer was a protective factor among men only. Conclusions Depression in UK adults aged ≥50 years increased significantly during the pandemic. Being female, living alone and having a long-standing illness were prominent risk factors. Younger women living in urban areas were at particularly high risk, suggesting such individuals should be prioritised for support. Findings are also informative for future risk stratification and intervention strategies, particularly if social restrictions are reimposed as the COVID-19 crisis continues to unfold.

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Faktor Risiko Penyebaran Escherichia coli Penghasil ESBL pada Ternak Ayam Komersial

Jurnal Ilmu Peternakan dan Veteriner Tropis (Journal of Tropical Animal and Veterinary Science) ◽

10.46549/jipvet.v11i2.136 ◽

2021 ◽

Vol 11 (2) ◽

pp. 146

Author(s):

Freshinta Jellia Wibisono

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Animal Health ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Primary Data ◽

Antibiotic Administration ◽

Cross Sectional ◽

Commercial Chicken ◽

And Control

Escherichia coli producing ESBL in humans, animals and the environment trigger the emergence of antimicrobial resistance. This study analyzes the potential risk factors in commercial chickens as an infectious factor for the ESBL-producing Escherichia coli as an effort to prevent and control the wider spread of Escherichia coli-producing ESBL events. This study was a descriptive analytic epidemiological study with a cross-sectional study design. Sampling using stratified random sampling by taking as many as 5 samples per commercial chicken farm in Blitar District. Data collection is done by direct interviews with farmers based on a questionnaire and field observations and inspection of livestock, supplemented with supporting documentation. Primary data were obtained through a questionnaire and direct observation of the research object to determine risk factors that could affect the Escherichia coli producing ESBL that were resistant to antibiotics in commercial chicken in Blitar District. Escherichia coli is a commensal bacterium that is naturally present in the chicken digestive tract. The existence of the highest ESBL producing Escherichia coli was 45.56% in the type of partnership farming. Risk factors with the highest association strength on risk factors for partnership type (OR = 11.02, CI 95% = 5.84-20.77), the presence of antibiotic administration programs (OR = 6.76, 95% CI = 2.05-22.22), broiler chicken species ( OR = 5.34, 95% CI = 2.76-10.32), and the purpose of using antibiotics as prevention (OR = 3.55, 95% CI = 1.86-6.74). Efforts to prevent and control the ESBL-producing Escherichia coli in commercial poultry can be done by increasing surveillance of antibiotic use, in this regard it is necessary to supervise animal health personnel in the management of livestock raising for the correct use of antibiotics in commercial chicken farms.

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Abstract P252: Duration and Life-stage of Antibiotic Use and Risk of Cardiovascular Disease in Women

Circulation ◽

10.1161/circ.135.suppl_1.p252 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Yoriko Heianza ◽

Yan Zheng ◽

Wenjie Ma ◽

Tiange Wang ◽

Dianjianyi Sun ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Life Stage ◽

Antibiotic Use ◽

Healthy Eating Index ◽

Increased Risk ◽

Antibiotics Use ◽

History Of ◽

Traditional Risk Factors ◽

Tract Infections

Background and Aims: Growing data suggest that antibiotic use, which may alter the gut microbiome, is related to risk of cardiovascular disease (CVD) and mortality. However, evidence from prospective cohort studies is still scarce; and no large prospective study has investigated associations between cumulative antibiotic use during adulthood and risk of CVD. We aimed to examine duration of antibiotic use and risk of CVD among apparently healthy women from the Nurses’ Health Study (NHS). Methods: This study included 36,922 women without history of myocardial infarction (MI), angina pectoris, stroke, or cancer in the NHS and with available data on total days of antibiotics use per year (0 to <15 days, 15 days to <2 months, or 2 months or more) during ages 20-39, 40-59 and after age 60, as reported on the 2004 questionnaire. Incidence of CVD (MI or stroke) over 8 years was assessed. Hazard ratios (HRs) were estimated as categories of duration of use compared with the none to <15 days per year group, using multivariate-adjusted Cox proportional hazards model including traditional risk factors (such as demographic variables, hypertension, diabetes, hypercholesterolemia, smoking, physical activity, Alternative Healthy Eating Index score, body mass index, aspirin, and anti-inflammatory medication), and reasons for antibiotics use (respiratory infection, urinary tract infections, acne or rosacea, chronic bronchitis, or dental), as well as other medications (such as H2 blockers, proton pump inhibitors), and other diseases (such as lung or kidney disease). Results: As compared to women with “none to <15 days per year of use” during age 40-59 y, those with a history of antibiotics use “15 days to < 2 months” or “2 months or more” had a significantly increased risk of CVD with an adjusted hazard ratio (HR [95%CI])_ of 1.19 (1.03, 1.38) and 1.34 (1.08, 1.66), respectively. Reported use of antibiotics for 2 months or more per year after age 60 was also associated with a HR of 1.24 (1.02, 1.51) for CVD. A longer exposure of antibiotics use was more strongly associated with increased risk of stroke than MI Antibiotic use during young adulthood (age 20-39) was not significantly associated with elevated risk of CVD. Conclusions: Our results suggest greater duration of exposure to antibiotics in middle- and older adulthood may be related to an increased risk of future CVD, independent of traditional risk factors.

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Investigating the association of room features with healthcare-facility–onset Clostridioides difficile: An exploratory study

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1307 ◽

2020 ◽

pp. 1-6

Author(s):

Elisabeth Dowling Root ◽

Megan Lindstrom ◽

Amy Xie ◽

Julie E. Mangino ◽

Susan Moffatt-Bruce ◽

...

Keyword(s):

Risk Factors ◽

Exploratory Study ◽

Healthcare Facility ◽

Antibiotic Use ◽

Surveillance Data ◽

Hospital Room ◽

Factors Associated ◽

Patient Level ◽

Clostridioides Difficile ◽

Increased Risk

Abstract Objective: To investigate hospital room and patient-level risk factors associated with increased risk of healthcare-facility–onset Clostridioides difficile infection (HO-CDI). Design: The study used a retrospective cohort design that included patient data from the institution’s electronic health record, existing surveillance data on HO-CDI, and a walk-through survey of hospital rooms to identify potential room-level risk factors. The primary outcome was HO-CDI diagnosis. Setting: A large academic medical center. Patients and participants: All adult patients admitted between January 1, 2015, and December 31, 2016 were eligible for inclusion. Prisoners were excluded. Patients who only stayed in rooms that were not surveyed were excluded. Results: The hospital room survey collected room-level data on 806 rooms. Included in the study were 17,034 patients without HO-CDI and 251 with HO-CDI nested within 535 unique rooms. In this exploratory study, room-level risk factors associated with the outcome in the multivariate model included wear on furniture and flooring and antibiotic use by the prior room occupant. Hand hygiene devices and fixed in-room computers were associated with reduced odds of a HO-CDI. Differences between hospital buildings were also detected. The only individual patient factors that were associated with increased odds of HO-CDI were antibiotic use and comorbidity score. Conclusion: Combining a hospital-room walk-through data collection survey, EHR data, and CDI surveillance data, we were able to develop a model to investigate room and patient-level risks for HO-CDI.

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Childhood dietary patterns and cardiovascular risk factors in adolescence: results from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort

Public Health Nutrition ◽

10.1017/s1368980016001592 ◽

2016 ◽

Vol 19 (18) ◽

pp. 3369-3377 ◽

Cited By ~ 5

Author(s):

Caroline J Bull ◽

Kate Northstone

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Longitudinal Study ◽

Cardiovascular Risk Factors ◽

Dietary Patterns ◽

Dietary Pattern ◽

Cvd Risk ◽

Parents And Children ◽

Increased Risk ◽

Avon Longitudinal Study

AbstractObjectiveTo investigate the prospective associations between dietary patterns in childhood and CVD risk in adolescence.DesignProspective cohort study. Exposures were dietary patterns at age 7, 10 and 13 years derived by cluster analysis. Outcomes were physiological and biochemical cardiovascular risk markers.SettingAvon Longitudinal Study of Parents and Children (ALSPAC), UK.SubjectsChildren (n2311, 44.1 % male) with complete data available.ResultsAfter adjustment for known confounders, we observed an association between being in the ‘Processed’ and ‘Packed lunch’ dietary pattern clusters at age 7 and BMI at age 17. Compared with the ‘healthy’ cluster, the OR (95 % CI) for being in the top 10 % for BMI was 1·60 (1·01, 2·55;P=0·05) for the ‘Processed’ cluster and 1·96 (1·22, 3·13;P=0·005) for the ‘Packed lunch’ cluster. However, no association was observed between BMI and dietary patterns at age 10 and 13. Longitudinal analyses showed that being in either the ‘Processed’ or ‘Packed lunch’ cluster at age 7 was associated with increased risk of being in the top 10 % for BMI regardless of subsequent cluster membership. No associations between other cardiovascular risk measures and dietary patterns were robust to adjustment for confounders.ConclusionsWe did not find any consistent evidence to support an association between dietary patterns in childhood and cardiovascular risk factors in adolescence, with the exception of BMI and dietary pattern at age 7 only. However, the importance of dietary intake in childhood upon health later in life requires further investigation and we would encourage the adoption of a healthy diet as early in life as possible.

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Treatment for Positive Urine Cultures in Hospitalized Adults: A Survey of Prevalence and Risk Factors in 3 Medical Centers

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2015.281 ◽

2015 ◽

Vol 37 (3) ◽

pp. 319-326 ◽

Cited By ~ 17

Author(s):

Jonathan D. Grein ◽

Katherine L. Kahn ◽

Samantha J. Eells ◽

Seong K. Choi ◽

Marianne Go-Wheeler ◽

...

Keyword(s):

Risk Factors ◽

Antibiotic Treatment ◽

Broad Spectrum ◽

White Blood Cells ◽

Asymptomatic Bacteriuria ◽

Antibiotic Use ◽

Broad Spectrum Antibiotic ◽

National Healthcare ◽

National Healthcare Safety Network ◽

Diagnostic Concordance

BACKGROUNDAntibiotic treatment for asymptomatic bacteriuria (ASB) is prevalent but often contrary to published guidelines.OBJECTIVETo evaluate risk factors for treatment of ASB.DESIGNRetrospective observational study.SETTINGA tertiary academic hospital, county hospital, and community hospital.PATIENTSHospitalized adults with bacteriuria.METHODSPatients without documented symptoms of urinary tract infection per Infectious Diseases Society of America (IDSA) criteria were classified as ASB. We examined ASB treatment risk factors as well as broad-spectrum antibiotic usage and quantified diagnostic concordance between IDSA and National Healthcare Safety Network criteria.RESULTSAmong 300 patients with bacteriuria, ASB was present in 71% by IDSA criteria. By National Healthcare Safety Network criteria, 71% of patients had ASB; within-patient diagnostic concordance with IDSA was moderate (kappa, 0.52). After excluding those given antibiotics for nonurinary indications, antibiotics were given to 38% (62/164) with ASB. Factors significantly associated with ASB treatment were elevated urine white cell count (65 vs 24 white blood cells per high-powered field, P<.01), hospital identity (hospital C vs A, odds ratio, 0.34 [95% CI, 0.14–0.80], P =.01), presence of leukocyte esterase (5.48 [2.35–12.79], P<.01), presence of nitrites (2.45 [1.11–5.41], P=.03), and Escherichia coli on culture (2.4 [1.2–4.7], P=.01). Of patients treated for ASB, broad-spectrum antibiotics were used in 84%.CONCLUSIONSASB treatment was prevalent across settings and contributed to broad-spectrum antibiotic use. Associating abnormal urinalysis results with the need for antibiotic treatment regardless of symptoms may drive unnecessary antibiotic use.Infect. Control Hosp. Epidemiol. 2016;37(3):319–326

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Poor clinical outcomes associated with suboptimal antibiotic treatment among older long-term care facility residents with urinary tract infection: a retrospective cohort study

BMC Geriatrics ◽

10.1186/s12877-021-02378-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Haley J. Appaneal ◽

Theresa I. Shireman ◽

Vrishali V. Lopes ◽

Vincent Mor ◽

David M. Dosa ◽

...

Keyword(s):

Cohort Study ◽

Clinical Outcome ◽

Clinical Outcomes ◽

Antibiotic Treatment ◽

Antibiotic Use ◽

Poor Clinical Outcome ◽

Dose Frequency ◽

Term Care ◽

Increased Risk

Abstract Background Antibiotic use is associated with several antibiotic-related harms in vulnerable, older long-term care (LTC) residents. Suboptimal antibiotic use may also be associated with harms but has not yet been investigated. The aim of this work was to compare rates of poor clinical outcomes among LTC residents with UTI receiving suboptimal versus optimal antibiotic treatment. Methods We conducted a retrospective cohort study among residents with an incident urinary tract infection (UTI) treated in Veterans Affairs LTC units (2013–2018). Potentially suboptimal antibiotic treatment was defined as use of a suboptimal initial antibiotic drug choice, dose frequency, and/or excessive treatment duration. The primary outcome was time to a composite measure of poor clinical outcome, defined as UTI recurrence, acute care hospitalization/emergency department visit, adverse drug event, Clostridioides difficile infection (CDI), or death within 30 days of antibiotic discontinuation. Shared frailty Cox proportional hazard regression models were used to compare the time-to-event between suboptimal and optimal treatment. Results Among 19,701 LTC residents with an incident UTI, 64.6% received potentially suboptimal antibiotic treatment and 35.4% experienced a poor clinical outcome. In adjusted analyses, potentially suboptimal antibiotic treatment was associated with a small increased hazard of poor clinical outcome (aHR 1.06, 95% CI 1.01–1.11) as compared with optimal treatment, driven by an increased hazard of CDI (aHR 1.94, 95% CI 1.54–2.44). Conclusion In this national cohort study, suboptimal antibiotic treatment was associated with a 6% increased risk of the composite measure of poor clinical outcomes, in particular, a 94% increased risk of CDI. Beyond the decision to use antibiotics, clinicians should also consider the potential harms of suboptimal treatment choices with regards to drug type, dose frequency, and duration used.

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Revisiting travellers’ diarrhoea justifying antibiotic treatment: prospective study

Journal of Travel Medicine ◽

10.1093/jtm/taaa237 ◽

2020 ◽

Author(s):

A Turunen Katri ◽

A Kantele

Keyword(s):

Risk Factors ◽

Antibiotic Treatment ◽

Multivariable Analysis ◽

Antibiotic Use ◽

Multidrug Resistant ◽

Antimicrobial Treatment ◽

Campylobacter Coli ◽

Related Factors ◽

Heat Stable ◽

Before And After

Abstract Background As antimicrobials increase the risk of acquiring multidrug-resistant (MDR) bacteria, unnecessary antibiotics should be avoided for travellers’ diarrhoea (TD). Antibiotics are recommended in TD accompanied by fever or incapacitation (TD justifying use of antibiotics, TDjuAB). Seeking tools for reducing antibiotic use, we explored factors predisposing to TDjuAB and scrutinized antibiotic treatment among those with TDjuAB and those with diarrhoea not justifying antibiotics. Methods We conducted a study among 370 prospectively recruited visitors to the tropics. Stool samples and questionnaires were collected before and after travel. Enteric pathogens were analysed by qPCR for enteropathogenic (EPEC), enteroaggregative (EAEC), enterotoxigenic (ETEC), enterohaemorrhagic (EHEC), and enteroinvasive (EIEC) E. coli/Shigella, Campylobacter, Salmonella, Yersinia and Vibrio cholerae, and for ETEC’s toxins LT (heat-labile), STh (human heat-stable) and STp (porcine heat-stable). TD was defined by the WHO criteria and TDjuAB as diarrhoea accompanied by fever, and/or disrupting or preventing daily activities. Multivariable analysis was applied—separately for travel-related factors and pathogens—to identify risk factors for TDjuAB(+). Results Among the 370 travellers, TD was contracted by 253 (68%), categorized as TDjuAB(+) in 93/253 (37%) and TDjuAB(−) in 160/253 (63%) of the cases. Antibiotics were used for TD by 41% in TDjuAB(+) and by 7% in the TDjuAB(−) group. Relative risk ratios (RRR) s are presented for both the TDjuAB(+) and the TDjuAB(−) groups. TDjuAB(+) was associated with long travel duration and young age. Among the 298 subjects not having taken antibiotics, increased RRRs were found e.g. for findings of Campylobacter coli/jejuni and ETEC’s STh toxin. Conclusions The first to analyse risk factors for TDjuAB, our study presents RRRs for demographic and behavioural factors and for various pathogens. Only less than half of those in the TDjuAB(+) group took antibiotics, which demonstrates that most cases meeting the current criteria recover without antimicrobial treatment.

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Risk Factors for Postpartum Maternal Infection Following Spontaneous Vaginal Delivery Complicated by Chorioamnionitis

American Journal of Perinatology Reports ◽

10.1055/s-0040-1709983 ◽

2020 ◽

Vol 10 (02) ◽

pp. e159-e164

Author(s):

Helen A. Daifotis ◽

Megan M. Smith ◽

Anna E. Denoble ◽

Sarah K. Dotters-Katz

Keyword(s):

Risk Factors ◽

Vaginal Delivery ◽

Primary Outcome ◽

Perineal Wound ◽

Antibiotic Use ◽

Bivariate Statistics ◽

Spontaneous Vaginal Delivery ◽

High Risk Women ◽

Increased Risk ◽

Perineal Wound Infection

Abstract Objective Guidelines for the management of chorioamnionitis include intrapartum antibiotics, while postpartum antibiotics after spontaneous vaginal delivery (SVD) are reserved high-risk women. Our objective is to describe the incidence of and risk factors for postpartum infection after SVD complicated by chorioamnionitis. Study Design This is a retrospective study of SVDs with clinically diagnosed chorioamnionitis at a single center. The primary outcome was a composite of postpartum infection. Women who developed the primary outcome were compared with those who did not using bivariate statistics. Regression models were developed to estimate adjusted odds of outcomes. Results In this cohort, 346 women underwent SVD complicated by chorioamnionitis. Of these, 23 (6.6%) developed postpartum infections (endometritis n = 7, urinary tract infection/pyelonephritis n = 6, sepsis n = 4, and perineal wound infection n = 6). Receipt of antibiotics intra- or postpartum did not differ between groups, but women with postpartum infections were more likely to deliver prior to 32 weeks (17.4 vs. 4.9%, p = 0.04). When controlling for antibiotic use, delivery at < 32 weeks was associated with 3.8-fold increased (95% confidence interval: 1.07–13.7) odds of postpartum infection. Conclusion Postpartum infections occur in ∼1/15 women delivering vaginally with chorioamnionitis, with those who deliver at < 32 weeks' gestation being at increased risk.

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