Antimicrobial Use and Antimicrobial Resistance Indicators-Integration of Farm-Level Surveillance Data From Broiler Chickens and Turkeys in British Columbia, Canada.

Agnes Agunos,David F Léger,Carolee A Carson,Richard J Reid-Smith,Anne E Deckert,Daleen Loest,Rebecca J Irwin,Sheryl P Gow,Angelina L Bosman

doi:10.3389/fvets.2019.00131

Abstract

Using data from the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS), we aimed to describe trends in antimicrobial use (AMU) in broiler chickens and turkeys, to compare AMU across species, to compare with trends in antimicrobial resistance (AMR), and to assess the effects of various AMU/AMR units of measurement (metrics and indicators) on data integration. Data on AMU and AMR in enteric bacteria, collected from 2013 to 2017 from broiler chickens (n = 143 flocks) and turkeys (n = 145) were used. In broiler chickens, the total AMU in milligrams/population correction unit (mg/PCUBr) decreased by 6%, the number (n) of defined daily doses for animals using Canadian standards (nDDDvetCA) per 1,000 broiler chicken-days decreased by 12%, and nDDDvetCA/PCU decreased by 6%. In turkeys, the mg/PCUTk decreased by 1%, whereas the nDDDvetCA/1,000 turkey-days and the nDDDvetCA/PCU increased by 1 and 5%, respectively. The types of antimicrobial classes used in both species were similar. Using the frequency of flocks reporting use (i.e., number of flocks reporting use/number of flocks participating) as a measurement, the use of certain antimicrobials changed over time (e.g., Broilers, decreased cephalosporin use, virginiamycin use, emerging use of lincomycin-spectinomycin, and avilamycin; Turkeys: increased trimethoprim-sulfonamides and macrolide use). The trends in resistance to specific antimicrobials paralleled the frequency and quantity of use (e.g., ceftriaxone use decreased—ceftriaxone resistance decreased, and gentamicin use increased—gentamicin resistance increased) in some situations, but not others (decreased fluoroquinolone use—increased ciprofloxacin resistance). AMR data were summarized using the AMR indicator index (AMR Ix). The most notable AMR Ix trend was the decrease in ceftriaxone AMR Ix among Escherichia coli (0.19 to 0.07); indicative of the success of the poultry industry action to eliminate the preventive use of third generation cephalosporins. Other trends observed were the increase in ciprofloxacin AMR Ix among Campylobacter from 0.23 to 0.41 and gentamicin AMR Ix among E. coli from 0.11 to 0.22, suggestive of the persistence/emergence of resistance related to previous and current AMU not captured in our surveillance timeframe. These data highlight the necessity of multiple AMU and AMR indicators for monitoring the impact of stewardship activities and interventions.

Highlights

Strengthening current surveillance capacities and expertise in antimicrobial use (AMU) and antimicrobial resistance (AMR) is one of the strategic objectives identified in “Tackling Antimicrobial Resistance and Antimicrobial Use: A PanCanadian Framework for Action” (1). This effort aligns with the global call to address AMR, such as the World Health Organization’s (WHO) Global Action Plan (GAP) on AMR (2), the Food and Agriculture Organization of the United Nation’s (FAO) action plan on AMR (3), and the World Organisation for Animal Health’s (OIE) strategy on AMR and the prudent use of antimicrobials (4)
The broiler chicken and turkey flocks were sampled by all the major veterinary practices in British Columbia (BC) and the poults/chicks sampled originated from all the major hatcheries located in the province
Our data showed that the direction and magnitude of either trends or discrepancies between populations could change based on the metric or indicator chosen, but when the indicators were applied simultaneously to the same dataset, FIGURE 5 | Milligrams/population correction unit and antimicrobial resistance indicator index (AMR Ix) for Escherichia coli in broiler chickens and turkeys. (A) Milligram/population correction unitpoultry and AMR lx. (B) Milligram/population correction unitpoultrv and AMR lx. (C) Milligram/population correction unitpoultrv and AMR

Summary

Introduction

Strengthening current surveillance capacities and expertise in antimicrobial use (AMU) and antimicrobial resistance (AMR) is one of the strategic objectives identified in “Tackling Antimicrobial Resistance and Antimicrobial Use: A PanCanadian Framework for Action” (1). This effort aligns with the global call to address AMR, such as the World Health Organization’s (WHO) Global Action Plan (GAP) on AMR (2), the Food and Agriculture Organization of the United Nation’s (FAO) action plan on AMR (3), and the World Organisation for Animal Health’s (OIE) strategy on AMR and the prudent use of antimicrobials (4). One project relevant to AMU surveillance in animals arising from JPI-AMR is the AACTING project (network on quantification, benchmarking, and reporting of veterinary AMU at farm level), which developed a guideline document on AMU data collection and measurements at the farm level (15)

Objectives

Methods

Results

Conclusion