Contents Animal‐friendly, economical, resource‐saving milk production provides the basis for sustained consumer acceptance. Bovine mastitis plays a decisive role in the dairy industry—disturbing animal health and welfare and causing considerable economic losses on the other hand. Currently, antimicrobial treatment is indispensable to keep bovine udder health, animal welfare and economic aspects in balance. On the contrary, emergence and spread of antimicrobial resistance (AMR) is an urgent matter of particular public interest, and as a consequence, antimicrobial usage (AMU) in production livestock is a critically discussed subject. In urgent need of future reduction in AMU in the dairy industry, this review article describes and discusses possible approaches promising prompt implementation, including therapeutical alternatives as well as pro‐ and metaphylactic concepts such as the implementation of evidence‐based mastitis therapy concepts and selective dry cow treatment (sDCT), in search of the most effective and contemporary methods for decreasing AMU and AMR in dairy production.
Clinical mastitis of dairy cows is a visible inflammation of the udder, which is usually caused by bacteria and treated with antibiotics. Although pressure is increasing to reduce antibiotic usage in livestock in the European Union, feedback from the field suggests that clinical mastitis treatment is frequently repeated after the initial per-label treatment, thereby extending treatment duration. The aim of this study was to explore the social factors influencing farmers' decision-making on the duration of antibiotic treatment of clinical mastitis. In total, 38 dairy farmers in the Netherlands (n=17) and Germany (n=21) were interviewed in a qualitative semi-structured way. Extended treatment was defined as any treatment longer than that given in label directions. Of the 38 farmers, 30 reported routine and 7 occasional extended antibiotic treatment. The interviewed farmers were sensitive toward social norms of other farmers and recognition for good stockmanship. Extended treatment is perceived as part of the social norm of "being a good farmer." The participants' perception was that mastitis is not treated "thoroughly" if clinical symptoms were still visible at the time of cessation of treatment, because it may persist or recur. As a result, treatment was frequently extended by repeating the initial label treatment. Farmers, specifically the more "cow-oriented" farmers, expressed insecurity on how to treat mastitis effectively. This insecurity made them more sensitive to comply with other farmers' injunctive ("what ought to be") and descriptive ("what is done") norms and the perceived veterinarians' informational norm that extended treatment is better, resulting in an approved social norm. Social approval reduces the insecurity of being perceived as a poor farmer; thus, extended treatment is emotionally rewarded. This social reward apparently outweighs the higher costs of more waste milk and more antibiotic usage. Perceived positive reference groups with whom the farmer identifies and regularly communicates face to face, such as other farmers, the herd veterinarian, and other farm advisors, confirm the farmer's judgment on extending treatment and influences him or her toward socially accepted behavior. Society was the most negative reference group, barely influencing farmers' decision-making on treatment. The emotional gap between farmers and society is large and probably difficult to overcome. Legislation may reduce antibiotic usage, if doable and controllable. Evidence-based information on treatment efficacy or practical on-farm decision support indicating when to end treatment may be able to change social norms of "thorough" treatment, especially when communicated by a positive reference group such as veterinarians. Because prudent antibiotic use is hindered by perceived subjective norms on optimal duration of antibiotic treatment, more research is needed, particularly on the optimal duration of antibiotic treatment of specific pathogens as related to cure and recurrence of clinical mastitis.
It was the objective of the study to estimate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in bulk tank milk from German dairy herds and to characterize isolates from bulk tank milk with respect to their Staph. aureus protein A (spa) and staphylococcal cassette chromosome mec (SCCmec) type, their phenotypic antimicrobial resistance and resistance-resp. virulence-associated genes using broth microdilution and a microarray for Staph. aureus. Bulk tank milk samples (25 mL) were tested for MRSA using a 2-step selective enrichment protocol. Presumptive MRSA were confirmed by PCR. Thirty-six isolates collected from bulk tank milk of dairy herds in 2009 and 2010 were included in the characterization. All isolates displayed spa-types assigned to the clonal complex CC398. Based on the epidemiological cutoff values for the interpretation of minimum inhibitory concentrations isolates were resistant to tetracycline (100%), clindamycin (58%), erythromycin (52%), quinupristin/ dalfopristin (36%), and kanamycin (27%). Isolates did not carry genes associated with typical virulence factors for Staph. aureus such as the Panton-Valentine leukocidin. However, they did carry hemolysin genes. Livestock-associated MRSA of CC398 does occur in German dairy herds and the strains have similar properties as described for strains from pigs.
Intramammary infections (IMI) with Staphylococcus aureus are a common cause of bovine mastitis and can result in both clinical (CM) or subclinical mastitis (SCM). Although bacterial isolates of S. aureus differ in their virulence potential it is largely unclear which bacterial virulence factors are responsible for increased clinical severity. We performed a genome wide association study and used a generalized linear mixed model to investigate the correlation between gene carriage, lineage and clinical outcome of IMI in a collection of S. aureus isolates from cattle with CM (n = 125) and SCM (n = 151) from 11 European countries. An additional aim was to describe the genetic variation of bovine S. aureus in Europa. The dominant lineages in our collection were clonal complex (CC) 151 (81/276, 29.3%), CC97 (54/276, 19.6%), CC479 (32/276, 11.6%) and CC398 (19/276, 6.9%). Virulence and antimicrobial resistance (AMR) gene carriage was highly associated with CC. Among a selection of nine virulence and AMR genes, CC151, CC479 and CC133 carried more virulence genes than other CCs, and CC398 was associated with AMR gene carriage. Whereas CC151, CC97 were widespread in Europe, CC479, CC398 and CC8 were only found in specific countries. Compared to CC151, CC479 was associated with CM rather than SCM (OR 3.62; 95% CI 1.38–9.50) and the other CCs were not. Multiple genes were associated with CM, but due to the clustering within CC of carriage of these genes, it was not possible to differentiate between the effect of gene carriage and CC on clinical outcome of IMI. Nevertheless, this study demonstrates that characterization of S. aureus CC and virulence genes helps to predict the likelihood of the occurrence of CM following S. aureus IMI and highlights the potential benefit of diagnostics tools to identify S. aureus CC during bovine mastitis.
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