Antimicrobial Resistance: We don’t have all the answers yet!

Antimicrobial Resistance: We don’t have all the answers yet!

odlandLate in the day as you are watching the evening news you learn about an individual who was confirmed with an antibiotic resistant bacterial infection. The story continues describing how there has been an increase in antibiotic-resistant infections around the world and the news anchor quotes CDC by stating that antibiotic use in livestock is a large contributor to antimicrobial resistance in humans. The route of transmission for the resistance between livestock and humans is suspected to be through food or the environment…

The sound of the TV becomes a blur in the background and you start thinking about a recent group of pigs that went through a health problem in one of your barns. The pigs became sick fast – they were thumping, feverish and not eating or drinking. When your veterinarian came out to the farm, diagnostics were collected and a PRRS virus introduction was confirmed along with secondary bacterial infections. You followed the veterinarians’ recommendations of medication through the water as well as individually treating sick pigs with an antibiotic and anti-inflammatory medication…. …

How many of you can relate to this experience of sickness showing up suddenly in your barn and needing to run antibiotics in the water or giving individual pigs antibiotic treatments to save their lives? Is there any harm in doing this? Is that what the news anchor was talking about?

As a veterinarian who is involved in disease challenges and medication recommendations every day, these are the types of questions that I wanted to investigate further! As a result, I enrolled with the University of Minnesota Master’s Degree Program to study and help provide answers to some of these critical questions:

When we treat our pigs with an antibiotic does the antimicrobial resistance patterns change (resistance to an increased number of drugs)?

If so, how long does the resistance remain in the pig or environment?

Are we able to eliminate the transmission of resistance from one group to the next group within the environment?

In the past year, I started conducting my Master’s research project to start understanding the questions above.

As an industry, we care. We care about making sure that our pigs are healthy and that antibiotics work to treat disease if/when needed. And we care about our family, our friends and others – we care about doing our part to make sure antibiotics continue to work for human health. Because we care, it is critical for us to continue to deepen our understanding of antimicrobial resistance.

… … You are probably thinking “Great questions, Dr O! Can you just get to the part where you tell us the answers?!”
But the truth is we don’t have all the answers yet! So I wanted to invite you on this journey as I finish my Master’s project and navigate through some of these questions.

Benefits to Animal Health and Bottom Line with Pipestone Antibiotic Resistance Tracker

Benefits to Animal Health and Bottom Line with Pipestone Antibiotic Resistance Tracker

curt johnson and joseph

With 23,000 deaths in the U.S. each year attributed to infections that are antibiotic resistant, and increasing interest from consumers, food companies and restaurants in the use of antibiotics in livestock production, today’s livestock producers are facing pressures to reduce antibiotic use on their farms. However, antibiotics remain a key element of treatment protocols for producers.

Curt and Diane Johnson are one of many producers who are using a tool from Pipestone Veterinary Services, called Pipestone Antibiotic Resistance Tracker (PART) to record and monitor antibiotic resistance and antibiotic usage, then make changes that benefit animal health and their operation’s bottom line.

The Johnsons have been farming south of Pipestone, Minnesota, since 1994. They are owners in the Fox Run sow farm and finish about 20,000 pigs each year. They also raise corn, soybeans and stock cows. They began using the Pipestone Antibiotic Resistance Tracker (PART) tool when it was introduced in 2017.

PART is a web-based system that allows producers the ability to record antibiotic purchases and usage, then benchmark their operation against others. Participants receive regular updates and consult with their Pipestone veterinarian on a regular basis to review usage and performance.

“We are able to use the tracker to monitor our antibiotic use month-by-month on a site level, then consult with our veterinarian on what changes or improvements we can make,” said Curt. “We are now more targeted in how we use antibiotics, so our total usage is way down and we are seeing cost savings and health benefits across the barns.”

The system tracks usage by purchase and amount across a total farm and to the site level. It records both the amount and type of antimicrobial used, including injectables, water soluble and feed grade products, said Joseph Yaros, DVM, staff veterinarian at Pipestone. Another important element of the program is tracking usage of antibiotics deemed important to human health.

“Because of issues with antibiotic resistance, the FDA has assigned three categories: critically important to human health, highly important and not medically important,” said Dr. Joseph Yaros. “We are now able to review antibiotics used across a farm and see if there are alternatives that are less medically important for human health that can be just as effective or better for animal health.”

The ability to benchmark their operation with others in the PART system has also been valuable for the Johnsons.

“We can see how we compare – on an anonymous basis – with everyone else in the PART system. It gives us an idea of where we stand and where we can make improvements,” said Curt.

“The Johnsons are one of many producers who have seen value in the ability to review and make changes to their antibiotic usage,” Dr. Yaros said. “Overall, they’ve seen an 80 percent reduction of antibiotic use and are seeing better performance with less medication usage. In addition, they’ve been able to reduce use of medications that the FDA considers critically important to human health from 25 percent of usage to less than 10 percent.”

The data for producers who participate in the program is kept confidential and will not be shared.

“Our goal is not to get to zero antibiotic usage. We are working to attach data to the responsible use of antibiotics and ensure pigs are getting proper care,” he said. “When we start to measure something, it is the first step to making improvements.”

The ability to Record, Review and Respond for the responsible use of antibiotics is now an important element of the Johnson’s approach to animal care.

“We’ll use the PART tool to maintain the progress we’ve made and keep making improvements. If a new medication is available, we can work with Dr. Yaros to incorporate it into our programs and track how it works,” said Curt. “We can also see in the benchmarking reports if other producers are finding ways to reduce usage even further, then decide if that would work for us.”

They also see it as key to sharing information about raising pigs and livestock with consumers.

“From a consumer perspective, this is a great way to show our commitment to animal health and that we are using antibiotics in a responsible way, not over-using them,” said Diane. “We have a protocol that we can share and be able to explain what we are doing and why with a focus on taking care of our animals.”

Keeping Antibiotics in the Arsenal: Pigs Can Still Get Sick

Keeping Antibiotics in the Arsenal: Pigs Can Still Get Sick

By Ann Hess, editor at National Hog Farmer

When the new FDA antibiotic guidance rules went into effect Jan. 1, 2017, it was a good reminder to all pig farmers that antibiotic stewardship is very important and to strive for reduction in use when possible.

Brad Greenway says his farm’s use of antibiotics has decreased, but it’s not something he plans to take out of the toolbox anytime soon.

“The thing we have found on our farm is we need to have antibiotics as a tool,” the Mitchell, S.D. pork producer says. “I think every producer does their very best to use all the preventative measures to keep pigs healthy but sometimes they still get sick.”

The 2016 America’s Pig Farmer of the Year is just one of the 150 Pipestone independent producers that signed up to take part in the Pipestone Antibiotic Resistance Tracker program.

Participating in PART
In addition to the comprehensive antibiotic monitoring system, the Greenways have built a solid working relationship with their veterinarian through their participation in PART. The veterinarian not only oversees the pig health program at their farm, but also at the 13 other Davison County farms that cooperatively own Bluestem Family Farms. Managed by Pipestone Veterinary Services, the sow farm supplies pigs for the owners’ respective pig farms in the area.

“We know exactly what the health status is at the sow barn, our source of the baby pigs, and what to look for,” Greenway says. “I think that has really been a plus the last couple years, really paying attention to that and being prepared, knowing the health status of the pigs coming on to our farm and then having that relationship with our veterinarian to continue that protocol.”

When a new batch of pigs arrive at either of their two 2,400 wean-to-finish barns, they are accompanied with a current health status report and veterinarian treatment and care recommendations. Each week the Greenways also report back any mortalities and challenges they are seeing. That way the whole group that gets pigs from the sow barn can be prepared.

“It’s that communication amongst the whole group that I think has really been a strong point and helped us learn from each other,” Greenway says.

Biosecurity and nutrition

Besides the increased communication with their veterinarian and the other farms, Greenway also credits their heightened biosecurity efforts for their decreased antibiotic use. Also, having their own feed mill on site reduces outside traffic coming to the farm.

The Greenways also ensure the barns are comfortable when pigs come in to keep stress down and work closely with their swine nutritionist, making sure the diets are balanced and adjusted as the pigs grow.

“From biosecurity, to having the barns prepared, ready and comfortable, to having the right feed, that goes a long way in preventing disease,” Greenway says.

Brad and Peggy Greenway at their pig farm on Thursday, Oct. 6, 2016, in Mitchell, S.D. Greenway is the National Pork Board's Pig Farmer of the Year. (Jay Pickthorn/AP Images for National Pork Board)
Brad and Peggy Greenway at their pig farm on Thursday, Oct. 6, 2016, in Mitchell, S.D. Greenway is the National Pork Board’s Pig Farmer of the Year. (Jay Pickthorn/AP Images for National Pork Board)

Pigs can still get sick
There’s a lot of different ways to raise pigs – whether that be outdoor, niche or conventional, and there is room for everybody. With the increased consumer demand for antibiotic-free production, Greenway says some farmers are able to provide that.

“I think the message to consumers is if we do use antibiotics, it’s done responsibly, under the advisement of our veterinarians, we document use, make sure we always follow the labels, and we follow antibiotic withdrawal times before delivering the pigs to market,” Greenway says. “We need to make sure the health and welfare of the animal is our top concern.”

It’s a commitment the Greenways have never faltered from, even with all the extra efforts they have made over the last two years to try to lower their antibiotic use on farm.

“As a trend over the last two years, we have seen a decrease, but as producers we need to recognize each group is different, each stress challenge is different, and things can happen,” Greenway says. “Be prepared for that and make sure that we continue to have antibiotics as a tool when needed because walking into a barn and seeing pigs challenged is disheartening to any pig farmer.”

Dr. Dee’s Research Provides Undisputable Evidence for Resposible Use of Antibiotics

Dr. Dee’s Research Provides Undisputable Evidence for Resposible Use of Antibiotics

On December 6, 2018, the first large-scale scientifically validated trial to better understand the importance of responsible antibiotic use in clinically sick pigs was published in PLOS ONE, the Public Library of Science. This journal is #1-2 in the world as it pertains to publication of medical science.

The trial sought to compare pigs raised according to one of three antibiotic protocols:

1. TI: Population treatment. All pigs received treatment on days 4 and 21 and therapeutically thereafter as group medication in water and feed or by individual injection.
2. T2: Modified population treatment. Identical to group T1 but with mass treatment only on day 4 and without subsequent therapeutic feed medication. There was a total of 675 pigs in this group.
3. T3: Antibiotic-free (ABF) regimen. There was 702 pigs in this group.

All pigs were vaccinated with a modified-live porcine reproductive and respiratory syndrome virus (PRRSV) vaccine 3 days after weaning. Using a seeder pig model to mimic real world infection scenarios, pigs were contact-challenged with a very potent PRRS virus.

Less pigs died in the groups that received antibiotic treatment when sick (T1 and T2 groups 20.94% and 24.89%, respectively versus the Antibiotic Free group 57.98%.) At finishing, average daily gain (ADG) and mean feed conversion ratio (FCR) were significantly better (p < 0.05) for TI and T2 groups compared to the “Antibiotic-Free” group, meaning more pigs gained properly with the feed they were fed because they felt better. Take out the piece about profit if going on PART website— we care about pigs, not profits here.

Under the conditions of this study, these results indicate that when infected with PRRS virus and exposed to other bacterial co-infections, an pigs NOT given antibiotics are at a considerable higher mortality risk and that judicious use can significantly improve animal health and well-being.

As veterinarians, Pipestone is proud to deliver science-based justification for the responsible use of antibiotics when treating sick livestock populations, to help our team make the best recommendations to help sick animals as possible. Please discuss with your veterinarian and/or contact me directly. Thanks for your support of PART.

Scott Dee, DVM MS PhD Dipl;ACVM

To view the entire publication, click here.

For the Love of Science…. and a Delicious Burger!

For the Love of Science…. and a Delicious Burger!

header-9778Fact: Using antibiotics responsibly is an important part of the welfare of our animals, food safety, and sustainability.

Science is an amazing tool that helps us to understand how AND WHY things work throughout the universe.  Science uses standardized methodologies, a strict level of testing, and enforces repeatability.  But science can be a difficult topic to communicate.

Unfortunately, some try to make something look scientific to have the illusion of credibility.  Take for example the new report by the NRDC on “How Top Restaurants Rate on Reducing Antibiotic Use in Their Meat Supply Chains”.

When you first read the media coverage on this report, you get the impression that they either found antibiotics in the meat at 22 of the 25 burger restaurants they evaluated or they have intimate knowledge about how much antibiotics are being used at the farms sourcing these restaurants.

But upon further review, this is not the case. It becomes clear that they are actually evaluating the written antibiotic POLICIES of each fast-food burger joint included in the report – with two receiving an A, one receiving a D-, all others receiving an F.  When you dig into the 63 page report, you learn that the only two restaurants that received an A source beef raised without antibiotics. It quickly becomes apparent that a good grade is awarded to restaurants who support farms that do not use antibiotics.

Despite my frustration with the misleading messages and scare tactics used in this report, I share a concern about antibiotic resistance.  With this in mind, I want to clear up a few false rumors that seem to be spreading around:

Truth: The meat that you purchase at a burger joint or your local grocery store are safe.  All animals that receive any antibiotic treatment MUST go through a waiting period prior to being harvested for food to let the antibiotic leave their system.
Truth: Unhealthy animals can carry more bacteria. Through responsible antibiotic use and keeping our animals healthy, there is less risk of bacteria contaminating our food.
Truth: The farms that I have the privilege of working with taking antibiotic treatments seriously. Farmers and veterinarians are committed to using antibiotics responsibly.  Using antibiotics responsibly means using antibiotics to treat animals if they are ill and to stop illnesses from spreading.
Responsible antibiotic use is the right thing to do for the welfare of the animals in our care AND sustainability of a safe & wholesome food supply.

Antibiotic resistance is real and so are the many scientific factors that play into the big picture of a safe food supply.  As a mother and veterinarian, I love science – and I love sharing a good burger with my family!  I urge you to PLEASE read to learn, listen to understand and don’t take media reports at a glance or half-truth headlines.  Dig deep, seek to understand – American farmers are feeding you safely every day.

If you have any questions regarding responsible antibiotic use please speak with your Pipestone veterinarian.

Carissa Odland, DVM

Veterinary Community Focuses on Antibiotics

Veterinary Community Focuses on Antibiotics

By: Dr. Carissa Odland

In March, I made a trip to San Diego for the American Association of Swine Veterinarians Annual meeting.   This meeting was attended by 1200 leaders in the swine industry to talk about our passion – taking care of pigs.

One of the main topics that were discussed was antibiotics.   Several of the presentations around antibiotic use in pigs – everything from disease prevention practices to avoid the need for antibiotics to farmer experiences on a “Never Ever” Antibiotic Program to the welfare implications of raising pigs without antibiotics.

You know when the swine veterinary community is spending a significant portion of their annual meeting on a topic – it is an area that we are deeply committed to and passionate about.  There are three reasons why we use antibiotics in veterinary medicine – 1) to treat disease, 2) to control disease and 3) to prevent disease.  The third reason (“prevention”) is being scrutinized with some critics calling this unnecessary.  By definition, using an antibiotic for “prevention” is treating an animal or group of animals before clinical signs of disease has occurred – these are animals that are in a high-risk situation for getting a bacterial infection.

So, why would I as a veterinarian prescribe medication for “prevention”?  The veterinarian makes this decision based on knowledge of how bacteria move through a population and the dynamics within that specific group of pigs.  Just as when antibiotics are used for treatment, antibiotics used for prevention also require a prescription from a veterinarian.  It is also important to understand that using an antibiotic for prevention or control uses lower doses than a treatment dose.  Administering an antibiotic prior to the onset of clinical signs can prevent severe illness and reduce the need for higher dose treatment later.  This uses fewer antibiotics overall and improves the welfare of the animal.  I would argue that the welfare implications around antibiotic use are really at the heart of this debated topic.

As we have shared in other blog posts, antibiotics are not the first choice for preventing disease.  During our annual swine veterinarian meeting, new technology and new tools for prevention of disease to avoid the need for antibiotics was also discussed.  For example, biosecurity technology, vaccinations, nutritional additives, and facility design are all aspects to evaluate for each individual farm as part of the disease prevention discussion.

The veterinary community is working together to protect the efficacy of antibiotics for generations to come.  Antibiotics are a crucial tool for maintaining animal welfare, whether it is the needs is to treat, control or prevent disease.  Work with your veterinarian on a disease prevention plan – they can help decide what method (whether antibiotics, vaccines, or others) will provide the best animal welfare outcome for your herd.


Using Data to Drive Decisions

Using Data to Drive Decisions

As popular headlines focus on the potential link between antibiotic resistance and usage of antibiotics in food animal production, it is more critical than ever for swine veterinarians and producers to work together to use antibiotics in the most effective and judicious ways possible.

The use of antibiotic sensitivity information has become an increasingly valuable tool in developing treatment protocols for pigs.

“For a long time, veterinarians have used antibiotic sensitivity assessments to assist in judging with which antibiotic would be effective in treating animals,” said Dr. Cameron Schmitt, Pipestone veterinarian.

Dr. Cameron Schmitt
Dr. Cameron Schmitt

For example, he said, if a barn with 1,000 pigs is experiencing issues with respiratory disease, the veterinarian may order a sensitivity assessment on samples from a pig that has died or been euthanized. A diagnostic report takes three to five days to be completed and typically shows the sensitivity of the organism to appropriate antibiotics.

A sensitivity assessment is conducted in a laboratory where a sample of bacteria from an infected animal is allowed to grow in a petri dish or test tube “broth” that contains an antibiotic.

“If the organism grows, we know that it is resistant to the antibiotic. If it isn’t able to grow, the antibiotic is effective against that bacteria,” he said.

Knowing which antibiotics the bacteria are sensitive to is a critical step in determining potential treatments, but understanding the pharmacology of each antibiotic option is also important.

“A certain drug may kill the organism in question, but if it is given orally, the drug doesn’t get to the site of the infection to effectively kill the organism,” he said. “There are several antibiotics that may show to be effective in a sensitivity assessment, but those are poorly absorbed when given orally.”

The combination of test results, animal and barn observations and understanding of how available antibiotic options will work, can provide a veterinarian and farmer with options to make the best decision for the health of the animals.

Veterinarians at Pipestone see potential for antibiotic sensitivity assessment results to provide information that will help not just on individual farms, but in identifying trends in antibiotic resistance on a much larger scale.

“We are beginning to track what we know about antibiotic resistance on a broader level,” said Dr. Schmitt. “If we look at thousands of isolates over time, we may be able to see patterns and trends that will help us get to the science behind antibiotic resistance for both animal and human health.”

The PART (Pipestone Antibiotic Resistance Tracker) program launched in 2017 is a first step in gathering important data. More than 180 subscribers representing 3.2 million pigs are currently tracking both purchase and usage of all types of antibiotic products including water soluble, feed additives and injectables.

Gathering and analyzing data necessary to track usage and resistance trends is a significant undertaking. Dr. Schmitt said that Pipestone plans to compile and publish research findings with shareholders, as well as with academics and industry representatives.

“We’re focused on putting science in front of the rhetoric,” said Dr. Schmitt. “We don’t want producers to stop using antibiotics just because someone said they should. Instead we need to build a scientific basis for making decisions that benefit both human health and animal welfare.”




PART: Review Your Antibiotic Use

PART: Review Your Antibiotic Use

PART allows producers to Record, Review, and Respond for the responsible use of antibiotics. Last time, we covered how PART Records and calculated antibiotic use.
Dr. Joel Nerem and Dr. Joseph Yaros cover the top reasons for increased antibiotic use when you are reviewing your PART data.

Pipestone works with FBI on Feed Risk

Pipestone works with FBI on Feed Risk

In December 2017, I presented information on the risk of the transboundary spread of foreign animal diseases through contaminated feed at the University of California Davis College of Veterinary Medicine. The audience included the FBI Weapons of Mass Destruction Division, the California Department of Agriculture along with several faculty from UC Davis vet school. The FBI took particular interest in the role of feed ingredients as a means of potential agro-terroristic attacks on the US. The Bureau had discussed the idea for several years and the Pipestone data supported the hypothesis that an attack of this type could possibly occur.

The FBI offered the following highlights:

  1. The information presented from Pipestone was considered new intelligence to support the concept of “purposeful” agro-terrorism.
  2. The Bureau was very appreciative of Pipestone’s willingness to share their information for the purpose of serving the greater good.
  3. Pipestone’s current project on mitigating the risk through feed additives was of high interest and will continue to be explored.

Overall, the meeting was a success and laid the foundation for further collaboration between the FBI and Pipestone as an opportunity to further protect our US food supply and independent farmer clients we work for.

When I was a 5-year old boy dreaming of becoming a veterinarian, I never would have thought I would ever work with the FBI! As a gesture of their appreciation for the new intelligence, the Bureau presented me with a “Warrior Chip” (pictured below).FBI 1