Learnings from an exploratory implementation of an innovative training-program to reduce antibiotic use in the dairy sector

Regarding antibiotic resistance issue, antibiotic use has to be reduced. In the dairy sector, antibiotics are mostly used for the control and treatment of mastitis. We designed an exposed/non-exposed epidemiological study in Western France to evaluate effectiveness, strengths and weaknesses of an innovative training program: one classroom-training day, virtual classrooms, and an individual support with the farmer. Two groups of farmers addressed two different themes, depending on their herds’ udder health: (i) improvement of mastitis prevention during lactation for herds experiencing frequent clinical mastitis, and (ii) implementation of selective dry cow therapy for herds with good udder health, instead of implementing blanket dry cow therapy. We collected different sets of data to evaluate evolution of knowledge, practices of farmers, animal health and antibiotic use as well as their appreciation of the program. Some farmers appreciated the virtual classroom training method because it was flexible (frequency, timetable, etc.) and little time consuming. However, connection or computing logistic problems made the participation in the virtual classrooms difficult. For the “prevention” group, results also showed limited improvement of knowledge, perception and practices of farmers. Improvement of knowledge and perception was significant. Both exposed and non-exposed farmers did improve their practices of antibiotic use at dry-off, which could show a trend in the general population for the improvement of practices at dry-off, animal health and antibiotic use. The duration of the program (one and a half year) was relatively short to observe a change in practices, longer program could provide better results. Further insight should be provided with the results of “dry-cow” group

Increased risk of severe COVID-19 in hospitalized patients with SARS-CoV-2 Alpha variant infection: a multicentre matched cohort study

International audienceBackground: The impact of the variant of concern (VOC) Alpha on the severity of COVID-19 has been debated. We report our analysis in France.Methods: We conducted an exposed/unexposed cohort study with retrospective data collection, comparing patients infected by VOC Alpha to contemporaneous patients infected by historical lineages. Participants were matched on age (± 2.5 years), sex and region of hospitalization. The primary endpoint was the proportion of hospitalized participants with severe COVID-19, defined as a WHO-scale > 5 or by the need of a non-rebreather mask, occurring up to day 29 after admission. We used a logistic regression model stratified on each matched pair and accounting for factors known to be associated with the severity of the disease.Results: We included 650 pairs of patients hospitalized between Jan 1, 2021, and Feb 28, 2021, in 47 hospitals. Median age was 70 years and 61.3% of participants were male. The proportion of participants with comorbidities was high in both groups (85.0% vs 90%, p = 0.004). Infection by VOC Alpha was associated with a higher odds of severe COVID-19 (41.7% vs 38.5%-aOR = 1.33 95% CI [1.03-1.72]).Conclusion: Infection by the VOC Alpha was associated with a higher odds of severe COVID-19