scholarly journals Informing Stewardship Measures in Canadian Food Animal Species through Integrated Reporting of Antimicrobial Use and Antimicrobial Resistance Surveillance Data—Part II, Application

Pathogens ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1491
Author(s):  
Agnes Agunos ◽  
Sheryl P. Gow ◽  
Anne E. Deckert ◽  
David F. Léger
Keyword(s):  
Antimicrobial Resistance ◽  
Animal Health ◽  
Surveillance Data ◽  
Integrated Analysis ◽  
Antimicrobial Use ◽  
Integrated Reporting ◽  
Farm Level ◽  
Antimicrobial Resistance Surveillance ◽  
Defined Daily Doses ◽  
The Impact

Using the methodology developed for integrated analysis and reporting of antimicrobial use (AMU) and antimicrobial resistance (AMR) data, farm-level surveillance data were synthesized and integrated to assess trends and explore potential AMU and AMR associations. Data from broiler chicken flocks (n = 656), grower–finisher pig herds (n = 462) and turkey flocks (n = 339) surveyed by the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) at the farm-level (2015–2019) were used. The analyses showed a reduction in mean flock/herd level number of defined daily doses using Canadian standards (nDDDvetCA) adjusted for kg animal biomass that coincided with the decline in % resistance in the three species. This was noted in most AMU-AMR pairs studied except for ciprofloxacin resistant Campylobacter where resistance continued to be detected (moderate to high levels) despite limited fluoroquinolone use. Noteworthy was the significantly negative association between the nDDDvetCA/kg animal biomass and susceptible Escherichia coli (multispecies data), an early indication that AMU stewardship actions are having an impact. However, an increase in the reporting of diseases in recent years was observed. This study highlighted the value of collecting high-resolution AMU surveillance data with animal health context at the farm-level to understand AMR trends, enable data integration and measure the impact of AMU stewardship actions.

scholarly journals Informing Stewardship Measures in Canadian Food Animal Species through Integrated Reporting of Antimicrobial Use and Antimicrobial Resistance Surveillance Data—Part I, Methodology Development

Pathogens ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1492
Author(s):  
Agnes Agunos ◽  
Sheryl P. Gow ◽  
Anne E. Deckert ◽  
Grace Kuiper ◽  
David F. Léger
Keyword(s):  
Antimicrobial Resistance ◽  
Data Integration ◽  
Animal Species ◽  
Antimicrobial Use ◽  
Integrated Reporting ◽  
Farm Level ◽  
Antimicrobial Resistance Surveillance ◽  
Food Animal ◽  
Level Data ◽  
Selection Of

This study explores methodologies for the data integration of antimicrobial use (AMU) and antimicrobial resistance (AMR) results within and across three food animal species, surveyed at the farm-level by the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). The approach builds upon existing CIPARS methodology and principles from other AMU and AMR surveillance systems. Species level data integration involved: (1) standard CIPARS descriptive and temporal analysis of AMU/AMR, (2) synthesis of results, (3) selection of AMU and AMR outcomes for integration, (4) selection of candidate AMU indicators to enable comparisons of AMU levels between species and simultaneous assessment of AMU and AMR trends, (5) exploration of analytic options for studying associations between AMU and AMR, and (6) interpretation and visualization. The multi-species integration was also completed using the above approach. In addition, summarized reporting of internationally-recognized indicators of AMR (i.e., AMR adjusted for animal biomass) and AMU (mg/population correction unit, mg/kg animal biomass) is explored. It is envisaged that this approach for species and multi-species AMU–AMR data integration will be applied to the annual CIPARS farm-level data and progressively developed over time to inform AMU–AMR integrated surveillance best practices for further enhancement of AMU stewardship actions.

scholarly journals The Impacts of Animal Health Service Providers on Antimicrobial Use Attitudes and Practices: An Examination of Poultry Layer Farmers in Ghana and Kenya

Antibiotics ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 554 ◽  
Author(s):  
Kofi Afakye ◽  
Stella Kiambi ◽  
Eric Koka ◽  
Emmanuel Kabali ◽  
Alejandro Dorado-Garcia ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Health Service ◽  
Service Providers ◽  
Animal Health ◽  
Vital Role ◽  
Antimicrobial Use ◽  
Health Seeking ◽  
Attitudes And Practices ◽  
Health Service Providers ◽  
The Impact

International organizations and governments have argued that animal health service providers can play a vital role in limiting antimicrobial resistance by promoting the prudent use of antimicrobials. However, there is little research on the impact of these service providers on prudent use at the farm level, especially in low- and middle-income countries where enforcement of prudent-use regulations is limited. Here, we use a mixed-methods approach to assess how animal health-seeking practices on layer farms in Ghana (n = 110) and Kenya (n = 76) impact self-reported antimicrobial usage, engagement in prudent administration and withdrawal practices and perceptions of antimicrobial resistance. In general, our results show that the frequency of health-seeking across a range of service providers (veterinarians, agrovets, and feed distributors) does not significantly correlate with prudent or non-prudent use practices or the levels of antimicrobials used. Instead, we find that patterns of antimicrobial use are linked to how much farmers invest in biosecurity (e.g., footbaths) and the following vaccination protocols. Our results emphasize that more research is required to understand the interactions between animal health service providers and farmers regarding antimicrobial use and antimicrobial resistance. Addressing these gaps will be crucial to inform antimicrobial stewardship training, curriculums and, guidelines whose ultimate purpose is to limit the selection and transmission of antimicrobial resistance.

scholarly journals Quality Assessment of an Antimicrobial Resistance Surveillance System in a Province of Nepal

2021 ◽  
Vol 6 (2) ◽  
pp. 60
Author(s):  
Jyoti Acharya ◽  
Maria Zolfo ◽  
Wendemagegn Enbiale ◽  
Khine Wut Yee Kyaw ◽  
Meika Bhattachan ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Surveillance System ◽  
Surveillance Data ◽  
World Health ◽  
Cross Sectional ◽  
Antimicrobial Resistance Surveillance ◽  
Data Collection Process ◽  
Data Compilation ◽  
Site Variation ◽  
Health Organization

Antimicrobial resistance (AMR) is a global problem, and Nepal is no exception. Countries are expected to report annually to the World Health Organization on their AMR surveillance progress through a Global Antimicrobial Resistance Surveillance System, in which Nepal enrolled in 2017. We assessed the quality of AMR surveillance data during 2019–2020 at nine surveillance sites in Province 3 of Nepal for completeness, consistency, and timeliness and examined barriers for non-reporting sites. Here, we present the results of this cross-sectional descriptive study of secondary AMR data from five reporting sites and barriers identified through a structured questionnaire completed by representatives at the five reporting and four non-reporting sites. Among the 1584 records from the reporting sites assessed for consistency and completeness, 77–92% were consistent and 88–100% were complete, with inter-site variation. Data from two sites were received by the 15th day of the following month, whereas receipt was delayed by a mean of 175 days at three other sites. All four non-reporting sites lacked dedicated data personnel, and two lacked computers. The AMR surveillance data collection process needs improvement in completeness, consistency, and timeliness. Non-reporting sites need support to meet the specific requirements for data compilation and sharing.

scholarly journals Data handling as a basis for local antimicrobial resistance surveillance

2020 ◽  
Vol 22 (2) ◽  
pp. 137-141
Author(s):  
Alina G. Vinogradova ◽  
Alexey Yu. Kuzmenkov
Keyword(s):  
Antimicrobial Resistance ◽  
Surveillance Data ◽  
Surveillance Systems ◽  
Data Handling ◽  
Basic Principles ◽  
Antimicrobial Resistance Surveillance ◽  
Local Levels

Continuing trends of antimicrobial resistance growth require a set of countermeasures, of which antimicrobial resistance surveillance at the global, national, and local levels plays one of the most important roles. Local surveillance systems are the most significant in controlling the changes in susceptibility of microorganisms in specific settings and contribute to the necessary activities, including prevention of epidemics. This paper presents basic principles and recommendations for handling antimicrobial resistance surveillance data, provides examples of table completion and metadata quick guide. A focus is made on specific issues and problems associated with surveillance data handling and the ways to resolve those problems are proposed.

scholarly journals Physicians' Perspective on Prescribing Patterns and Knowledge on Antimicrobial Use and Resistance in Penang, Malaysia: A Qualitative Study

2020 ◽  
Vol 8 ◽  
Author(s):  
Ali Akhtar ◽  
Amer Hayat Khan ◽  
Hadzliana Zainal ◽  
Mohamed Azmi Ahmad Hassali ◽  
Irfhan Ali ◽  
...  
Keyword(s):  
Health Care ◽  
Antimicrobial Resistance ◽  
Qualitative Study ◽  
Health Care System ◽  
Tertiary Care ◽  
Prescribing Patterns ◽  
Antimicrobial Use ◽  
Prescribing Practices ◽  
The Impact ◽  
Care System

Background: Unnecessary antimicrobial use is an emerging problem throughout the world. To design future interventions to ensure rational antimicrobial use and decrease the risk of antimicrobial resistance, physician's knowledge and prescribing practices of antimicrobials should be assessed. Therefore, the main objective of this study is to investigate the physician's knowledge along with their prescribing patterns of antimicrobials in their health care system.Methods: The present qualitative study was conducted in a tertiary care public hospital located at Penang island, situated in Northwest of Malaysia. A total of 12 semi-structured, face to face interviews were conducted with purposive sampling technique. Physicians recruited had different specialties. All interviews were audio recorded, then transcribed into English language and analyze by thematic content analysis.Results: Four major themes were identified: (1) prescribing patterns of physicians regarding antimicrobials; (2) physician's knowledge about antimicrobials; (3) antimicrobial resistance; (4) satisfaction with management of infections. Physicians believed in regular educational activities and updates about the latest antimicrobial guidelines may change the prescribing behavior of physicians to optimize the use of antimicrobials. This may lead to decrease in burden of antimicrobial resistance in their health care system. Physicians emphasized that stricter rules and regular monitoring of antimicrobial use should be implemented to overcome the main challenges of antimicrobial resistance.Conclusion: Different factors were identified to assist optimized use of antimicrobials and decrease the risk of antimicrobial resistance. The present study helps to design targeted future interventions to ensure rational antimicrobial use and decrease the impact of antimicrobial resistance in Malaysia.

scholarly journals Effect of Antimicrobial Dosage Regimen on Salmonella and Escherichia coli Isolates from Feeder Swine

2008 ◽  
Vol 74 (6) ◽  
pp. 1731-1739 ◽  
Author(s):  
Bruce A. Wagner ◽  
Barbara E. Straw ◽  
Paula J. Fedorka-Cray ◽  
David A. Dargatz
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Commensal Bacteria ◽  
Antimicrobial Use ◽  
Control Analysis ◽  
Fecal Samples ◽  
E Coli ◽  
The Impact ◽  
Susceptibility And Resistance ◽  
Continuous Pulse

ABSTRACT A body of evidence exists that suggests that antimicrobial use in food animals leads to resistance in both pathogenic and commensal bacteria. This study focused on the impact of three different antimicrobial regimes (low-level continuous, pulse, and no antimicrobial) for two antimicrobials (chlortetracycline and tylosin) on the presence of Salmonella spp. and on the prevalence of antimicrobial resistance of both Salmonella spp. and nonspecific Escherichia coli in fecal samples from feeder swine. The prevalence of fecal samples positive for Salmonella spp. significantly decreased between the samples taken at feeder placement compared to samples taken when the animals were close to market weight. Differences in resistance of Salmonella spp. did not appear to be influenced by dosing treatment including the control. Analysis of antimicrobial resistance examining both susceptibility and resistance, as well as MIC outcomes, demonstrated that only resistance to cephalothin increased in E. coli under the pulse chlortetracycline treatment. These results suggest that the dosing regimes examined in this study did not lead to an increase in either the prevalence of Salmonella spp. or the prevalence of antimicrobial resistance in isolates of Salmonella spp. or E. coli.

scholarly journals Building the European Antimicrobial Resistance Surveillance network in veterinary medicine (EARS-Vet)

2021 ◽  
Vol 26 (4) ◽  
Author(s):  
Rodolphe Mader ◽  
Peter Damborg ◽  
Jean-Philippe Amat ◽  
Björn Bengtsson ◽  
Clémence Bourély ◽  
...  
Keyword(s):  
Veterinary Medicine ◽  
Antimicrobial Resistance ◽  
Antimicrobial Stewardship ◽  
One Health ◽  
Action Plan ◽  
Animal Health ◽  
World Health ◽  
European Economic Area ◽  
Surveillance Network ◽  
Antimicrobial Resistance Surveillance

Antimicrobial resistance (AMR) should be tackled through a One Health approach, as stated in the World Health Organization Global Action Plan on AMR. We describe the landscape of AMR surveillance in the European Union/European Economic Area (EU/EEA) and underline a gap regarding veterinary medicine. Current AMR surveillance efforts are of limited help to veterinary practitioners and policymakers seeking to improve antimicrobial stewardship in animal health. We propose to establish the European Antimicrobial Resistance Surveillance network in Veterinary medicine (EARS-Vet) to report on the AMR situation, follow AMR trends and detect emerging AMR in selected bacterial pathogens of animals. This information could be useful to advise policymakers, explore efficacy of interventions, support antimicrobial stewardship initiatives, (re-)evaluate marketing authorisations of antimicrobials, generate epidemiological cut-off values, assess risk of zoonotic AMR transmission and evaluate the burden of AMR in animal health. EARS-Vet could be integrated with other AMR monitoring systems in the animal and medical sectors to ensure a One Health approach. Herein, we present a strategy to establish EARS-Vet as a network of national surveillance systems and highlight challenges of data harmonisation and bias. Strong political commitment at national and EU/EEA levels is required for the success of EARS-Vet.

scholarly journals Evaluation of the impact of antimicrobial use protocols in PRRS virus infected swine on phenotypic antimicrobial resistance patterns

2021 ◽  
Author(s):  
Carissa A. Odland ◽  
Roy Edler ◽  
Noelle R. Noyes ◽  
Scott A. Dee ◽  
Joel Nerem ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Longitudinal Studies ◽  
Bacterial Infections ◽  
Population Level ◽  
Control Group ◽  
Antimicrobial Use ◽  
Treatment Groups ◽  
Resistance Patterns ◽  
The Impact ◽  
Over Time

A longitudinal study was conducted to assess the impact of different antimicrobial exposures of nursery-phase pigs on patterns of phenotypic antimicrobial resistance in fecal indicator organisms throughout the growing phase. Based on practical approaches used to treat moderate to severe PRRSV-associated secondary bacterial infections, two antimicrobial protocols of differing intensity of exposure [44.1 and 181.5 animal-treatment days per 1000 animal days at risk (ATD)] were compared with a control group with minimal antimicrobial exposure (2.1 ATD). Litter-matched pigs (n = 108) with no prior antimicrobial exposure were assigned randomly to the treatment groups. Pen fecal samples were collected nine times during the wean-to-finish period and cultured for Escherichia coli and Enterococcus spp. Antimicrobial susceptibility testing was conducted using NARMS gram-negative and gram-positive antibiotic panels. Despite up to 65-fold difference in ATD, few and modest differences were observed between groups and over time. Resistant patterns at marketing overall remained similar to those observed at weaning, prior to any antimicrobial exposures. Those differences observed could not readily be reconciled with the patterns of antimicrobial exposure. Resistance of E. coli to streptomycin was higher in the group exposed to 44.1 ATD, but no aminoglycosides were used. In all instances where resistance differed between time points, the higher resistance occurred early in the trial prior to any antimicrobial exposures. These minimal impacts on AMR despite substantially different antimicrobial exposures point to the lack of understanding of the drivers of AMR at the population level and the likely importance of factors other than antimicrobial exposure. IMPORTANCE Despite a recognized need for more longitudinal studies to assess the effects of antimicrobial use on resistance in food animals, they remain sparse in the literature, and most longitudinal studies of pigs have been observational. The current experimental study had the advantages of greater control of potential confounding, precise measurement of antimicrobial exposures which varied markedly between groups and tracking of pigs until market age. Overall, resistance patterns were remarkably stable between the treatment groups over time, and the differences observed could not be readily reconciled with the antimicrobial exposures, indicating the likely importance of other determinants of AMR at the population level.

scholarly journals ACORN (A Clinically-Oriented Antimicrobial Resistance Surveillance Network): a pilot protocol for case based antimicrobial resistance surveillance

2020 ◽  
Vol 5 ◽  
pp. 13
Author(s):  
Paul Turner ◽  
Elizabeth A. Ashley ◽  
Olivier J. Celhay ◽  
Anousone Douangnouvong ◽  
Raph L. Hamers ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Treatment Guidelines ◽  
Clinical Care ◽  
Local Treatment ◽  
Laboratory Data ◽  
Added Value ◽  
Pilot Phase ◽  
Surveillance Network ◽  
Antimicrobial Resistance Surveillance ◽  
The Impact

Background: Antimicrobial resistance (AMR) / drug resistant infections (DRIs) are a major global health priority. Surveillance data is critical to inform infection treatment guidelines, monitor trends, and to assess interventions. However, most existing AMR / DRI surveillance systems are passive and pathogen-based with many potential biases. Addition of clinical and patient outcome data would provide considerable added value to pathogen-based surveillance. Methods: The aim of the ACORN project is to develop an efficient clinically-oriented AMR surveillance system, implemented alongside routine clinical care in hospitals in low- and middle-income country settings. In an initial pilot phase, clinical and microbiology data will be collected from patients presenting with clinically suspected meningitis, pneumonia, or sepsis. Community-acquired infections will be identified by daily review of new admissions, and hospital-acquired infections will be enrolled during weekly point prevalence surveys, on surveillance wards. Clinical variables will be collected at enrolment, hospital discharge, and at day 28 post-enrolment using an electronic questionnaire on a mobile device. These data will be merged with laboratory data onsite using a flexible automated computer script. Specific target pathogens will be Streptococcus pneumoniae, Staphylococcus aureus, Salmonella spp., Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumannii. A bespoke browser-based app will provide sites with fully interactive data visualisation, analysis, and reporting tools. Discussion: ACORN will generate data on the burden of DRI which can be used to inform local treatment guidelines / national policy and serve as indicators to measure the impact of interventions. Following development, testing and iteration of the surveillance tools during an initial six-month pilot phase, a wider rollout is planned.

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