IS-03 Practical Aspects of Antibiotic Stewardship in Animal Production

Antimicrobial resistance (AMR) is emerging and is a threat for human and animal health. This increasing resistance results into treatment failures and increased mortality in humans and animals. If there is no action to reduce antimicrobial use (AMU), it is forecasted that the number of people dying due to AMR will increase considerably in the near future. AMU in animals poses a potential risk for public health as it contributes to the selection and spread of AMR which can disseminate to humans. Therefore, at global level WHO, FAO and OIE combined efforts in a such called One Health approach to minimize the public health impact of AMR associated with AMU in farm animals. The Global Action Plan on antimicrobial resistance (GAP) has been adopted by the World Health Assembly in 2015. This plan contains five strategic objectives. WHO urged all member states to develop a National Action Plan in line with the five objectives of the GAP, and with a One Health approach. Indonesia has submitted the National Action Plan on Antimicrobial Resistance 2017-2019 in the Library of National Action Plans of WHO.Although it is not clear to what level AMU in animal production contributes to the AMR problem humans, there is a worldwide urge to reduce AMU in animal production to a minimum to protect human health. The basis of this so-called ‘antimicrobial stewardship’ is focusing on (preventive) measures which enable animals to remain healthy and thus take away the need for antimicrobial treatment. Another pillar of stewardship is limiting and strictly regulating the use of so-called ‘’critically important antimicrobials for human medicine’’, like fluoroquinolones. It can be difficult to change AMU practices which have become habits for farmers and veterinarians; therefore specific triggers are required. In the Netherlands the total therapeutic AMU (in mass sold) in farm animals doubled between 1990 and 2007; parallel to the EU-ban of antimicrobial growth promotors which were completely phased out by 2006. From 2005 onwards, several events triggered a series of measures and initiatives to reduce AMU in livestock with almost 70%. This reduction was followed by reduced AMR levels in livestock. Some key success factors were: clear reduction targets defined by the government, having full transparency on antimicrobial prescription and usage, the existence of a surveillance system for AMR, and a close collaboration of all stakeholders and a shared goal. Although specific contexts differ between countries and production systems, tailored approaches taking into account specific contexts and stakeholders can be effective in responsible use of antimicrobials

Living in Cold Blood: Arcobacter, Campylobacter, and Helicobacter in Reptiles

Species of the Epsilonproteobacteria genera Arcobacter, Campylobacter, and Helicobacter are commonly associated with vertebrate hosts and some are considered significant pathogens. Vertebrate-associated Epsilonproteobacteria are often considered to be largely confined to endothermic mammals and birds. Recent studies have shown that ectothermic reptiles display a distinct and largely unique Epsilonproteobacteria community, including taxa which can cause disease in humans. Several Arcobacter taxa are widespread amongst reptiles and often show a broad host range. Reptiles carry a large diversity of unique and novel Helicobacter taxa, which apparently evolved in an ectothermic host. Some species, such as Campylobacter fetus, display a distinct intraspecies host dichotomy, with genetically divergent lineages occurring either in mammals or reptiles. These taxa can provide valuable insights in host adaptation and co-evolution between symbiont and host. Here, we present an overview of the biodiversity, ecology, epidemiology, and evolution of reptile-associated Epsilonproteobacteria from a broader vertebrate host perspective

Campylobacter: Animal Reservoirs, Human Infections, and Options for Control

Campylobacteriosis is a frequently diagnosed disease in humans. Most infections are considered foodborne and are caused by Campylobacter jejuni and C. coli. The animal reservoirs of these Campylobacter species, and the sources and routes of transmission, are described and discussed in this chapter. Most warm-blooded animals can be colonized by Campylobacter, but avian species, and in particular poultry, are preferred hosts. Much of the world’s poultry production is colonized by Campylobacter. Source attribution studies estimate that 20–40% of cases are attributed to the handling and consumption of chicken meat, while up to 80% of cases are due to Campylobacter found in the chicken reservoir. The difference suggests that routes other than through the food chain, i.e., environmental contamination, are important. The epidemiology of infections in humans differs between industrialized and low- and middle-income countries. Thus, the most effective interventions would be targeted to primary production. To date, only improved biosecurity is available. If effectively implemented, strict biosecurity can reduce the number of Campylobacter-positive flocks, but implementation to this level has proved difficult for the poultry industry. Available interventions in chicken processing plants can substantially reduce Campylobacter numbers on carcasses and consequently reduce the risk to humans. Public health strategies therefore utilize control programs, which aim at reducing the level of Campylobacter by measures along the food chain. It is now recognized that commercially acceptable complementary interventions for primary production, such as vaccines and feed additives, are urgently needed. Once Campylobacter in poultry is controlled then other minor sources of Campylobacter including contaminated drinking water, direct contact with (pet) animals, and other food items (e.g., red meat and milk) can be addressed

Whole genome sequence analysis indicates recent diversification of mammal-associated Campylobacter fetus and implicates a genetic factor associated with H2S production

cknowledgements We like to thank Emma Yee (U.S. Department of Agriculture) for the generation of sequence data, we thank James Bono (U.S. Department of Agriculture) for the generation of PacBio RS reads and thank Dr. Brian Brooks and Dr. John Devenish (Canadian Food Inspection Agency) for providing C. fetus strains and for critical review of this manuscript. Funding Publication charges for this article have been funded by Utrecht University, the Netherlands.Peer reviewedPublisher PD

IS-03 Practical Aspects of Antibiotic Stewardship in Animal Production

Antimicrobial resistance (AMR) is emerging and is a threat for human and animal health. This increasing resistance results into treatment failures and increased mortality in humans and animals. If there is no action to reduce antimicrobial use (AMU), it is forecasted that the number of people dying due to AMR will increase considerably in the near future. AMU in animals poses a potential risk for public health as it contributes to the selection and spread of AMR which can disseminate to humans. Therefore, at global level WHO, FAO and OIE combined efforts in a such called One Health approach to minimize the public health impact of AMR associated with AMU in farm animals. The Global Action Plan on antimicrobial resistance (GAP) has been adopted by the World Health Assembly in 2015. This plan contains five strategic objectives. WHO urged all member states to develop a National Action Plan in line with the five objectives of the GAP, and with a One Health approach. Indonesia has submitted the National Action Plan on Antimicrobial Resistance 2017-2019 in the Library of National Action Plans of WHO.Although it is not clear to what level AMU in animal production contributes to the AMR problem humans, there is a worldwide urge to reduce AMU in animal production to a minimum to protect human health. The basis of this so-called ‘antimicrobial stewardship’ is focusing on (preventive) measures which enable animals to remain healthy and thus take away the need for antimicrobial treatment. Another pillar of stewardship is limiting and strictly regulating the use of so-called ‘’critically important antimicrobials for human medicine’’, like fluoroquinolones. It can be difficult to change AMU practices which have become habits for farmers and veterinarians; therefore specific triggers are required. In the Netherlands the total therapeutic AMU (in mass sold) in farm animals doubled between 1990 and 2007; parallel to the EU-ban of antimicrobial growth promotors which were completely phased out by 2006. From 2005 onwards, several events triggered a series of measures and initiatives to reduce AMU in livestock with almost 70%. This reduction was followed by reduced AMR levels in livestock. Some key success factors were: clear reduction targets defined by the government, having full transparency on antimicrobial prescription and usage, the existence of a surveillance system for AMR, and a close collaboration of all stakeholders and a shared goal. Although specific contexts differ between countries and production systems, tailored approaches taking into account specific contexts and stakeholders can be effective in responsible use of antimicrobials

Modelling the effects of antibiotic usage in livestock on human salmonellosis

Antibiotic usage in livestock has been suggested as a driver of antimicrobial resistance in human and livestock populations. This has contributed to the implementation of stewardship programs to curtail usage of antibiotics in livestock. However, the consequences of antibiotic curtailment in livestock on human health are poorly understood. There is the potential for increases in the carriage of pathogens such as Salmonella spp. in livestock, and subsequent increases in human foodborne disease. We use a mathematical model fitted to four case studies, ampicillin and tetracycline usage in fattening pig and broiler poultry populations, to explore the impact of curtailing antibiotic usage in livestock on salmonellosis in humans. Increases in the daily incidence of salmonellosis and a decrease in the proportion of resistant salmonellosis were identified following curtailment of antibiotic usage in livestock. The extent of these increases in human foodborne disease ranged from negligible, to controllable through interventions to target the farm-to-fork pathway. This study provides a motivating example of one plausible scenario following curtailment of antibiotic usage in livestock and suggests that a focus on ensuring good farm-to-fork hygiene and livestock biosecurity is sufficient to mitigate the negative human health consequences of antibiotic stewardship in livestock populations.ISSN:2352-771

Importance of Campylobacter jejuni FliS and FliW in Flagella Biogenesis and Flagellin Secretion

Flagella-driven motility enables bacteria to reach their favorable niche within the host. The human foodborne pathogen Campylobacter jejuni produces two heavily glycosylated structural flagellins (FlaA and FlaB) that form the flagellar filament. It also encodes the non-structural FlaC flagellin which is secreted through the flagellum and has been implicated in host cell invasion. The mechanisms that regulate C. jejuni flagellin biogenesis and guide the proteins to the export apparatus are different from those in most other enteropathogens and are not fully understood. This work demonstrates the importance of the putative flagellar protein FliS in C. jejuni flagella assembly. A constructed fliS knockout strain was non-motile, displayed reduced levels of FlaA/B and FlaC flagellin, and carried severely truncated flagella. Pull-down and Far Western blot assays showed direct interaction of FliS with all three C. jejuni flagellins (FlaA, FlaB, and FlaC). This is in contrast to, the sensor and regulator of intracellular flagellin levels, FliW, which bound to FlaA and FlaB but not to FlaC. The FliS protein but not FliW preferred binding to glycosylated C. jejuni flagellins rather than to their non-glycosylated recombinant counterparts. Mapping of the binding region of FliS and FliW using a set of flagellin fragments showed that the C-terminal subdomain of the flagellin was required for FliS binding, whereas the N-terminal subdomain was essential for FliW binding. The separate binding subdomains required for FliS and FliW, the different substrate specificity, and the differential preference for binding of glycosylated flagellins ensure optimal processing and assembly of the C. jejuni flagellins

Campylobacter fetus Subspecies Contain Conserved Type IV Secretion Systems on Multiple Genomic Islands and Plasmids

Acknowledgments We like to thank Dr. John Devenish and Dr. Brian Brooks (Canadian Food Inspection Agency) for providing strains. We thank Nathaniel Simon and Mary Chapman for the generation of Illumina MiSeq reads and we thank James Bono for the generation of PacBio RS reads. Funding: The authors have no support or funding to report.Peer reviewedPublisher PD

School functioning in 8- to 18-year-old children born after in vitro fertilization

The aim of this study was to examine the school functioning of 8- to 18-year-old children born after in vitro fertilization (IVF). We compared 233 children born after IVF to 233 matched control children born spontaneously from parents with fertility problems on measures of education level, general cognitive ability, school performance (need for extra help, repeating a grade, special education), and rates of learning and developmental disorders. No differences were found between IVF and control children on these measures of school functioning. More than 60% of adolescents at secondary school attended high academic levels (with access to high school or university). We conclude that children and adolescents born after IVF show good academic achievement and general cognitive ability. They do not experience any more educational limitations than the naturally conceived children and adolescents of the control group. The tendency of reassuring school functioning already found in younger IVF children has been shown to continue at secondary school age