Tetanus vaccination in pregnant women: a systematic review and meta-analysis of the global literature.

OBJECTIVES: This study aimed to determine the effect of several factors on the uptake of tetanus vaccination in pregnant women. STUDY DESIGN: This is a systematic review and meta-analysis of the global literature. METHODS: The search strategy was carried out in the EMBASE and MEDLINE (Pubmed) databases, without language restrictions. The databases were searched from the beginning until May 2020. Fixed and random effect models were applied according to the methodological heterogeneity between the included studies. The I2 test was performed to assess the magnitude of the heterogeneity. The results were presented as a grouped odds ratio (OR) with a 95% confidence interval (CI) and a significance level of 0.05. RESULTS: The initial search strategy generated 14,349 original articles. In total, 31 studies met all inclusion criteria and 20 articles were included in the meta-analysis. The grouped and subgroup analyses showed a significant association between tetanus vaccination and the following factors: higher number of prenatal visits (OR: 2.00; 95% CI: 1.17-3.42), higher maternal age (OR: 1.24, 95% CI: 1.02-1.50), being single (OR: 1.41; 95% CI: 1.20-1.65), professional vaccine guidance (OR: 9.00; 95% CI: 1.81-44.75) and uptake of influenza vaccine (OR: 5.87; 95% CI: 1.39-24.73). CONCLUSIONS: The uptake of tetanus vaccine in pregnant women is associated with various factors. The identification of these factors is an important step towards the implementation of public health strategies aimed at improving immunisation against tetanus in pregnant women.

Change in the ileal bacterial population of turkeys fed different diets and after infection with Salmonella as determined with denaturing gradient gel electrophoresis of amplified 16s ribosomal DNA.

Changes in ileal bacterial populations of Salmonella-infected turkeys fed different diets were analyzed by using 16S-V3 PCR denaturing gradient gel electrophoresis. Turkeys raised on litter flooring were fed wheat- and corn-based diets with and without enzyme preparations (XY1 and XY2, respectively) from 0 to 126 d. Preparation XY1 contained exclusively endoxylanase, whereas preparation XY2 contained endoxylanase, protease, and alpha-amylase (Danisco, , Wiltshire, UK). The dietary activity levels of XY1 and XY2 were 2,500 and 650 endo-1,4-beta-xylanase units/kg of feed, respectively. Microbial DNA was extracted from the ileal content of 16-wk-old turkeys, and the 16S rDNA gene was amplified by PCR and analyzed by denaturing gradient gel electrophoresis. Diversity indexes, including richness (number of species, S), evenness (relative distribution of species, EH), diversity (using Shannon's index, H'), and Sorenson's pairwise similarities coefficient (measures the species in common between different habitats, Cs) were calculated. Additionally, diversity indexes were associated with Salmonella prevalence determined from fresh fecal droppings collected from each pen. On the basis of contrast analysis, the wheat-based diets resulted in higher microbial diversity indexes than the corn-based diets (S = 10 vs. 12; EH = 0.9 vs. 0.8; H' = 2.2 vs. 1.9, P < 0.05). Likewise, enzyme supplementation stimulated growth of the microbiota and increased the diversity indexes in comparison with unsupplemented treatments (S = 13 vs. 10; EH = 0.9 vs. 0.8; H' = 2.2 vs. 1.9, P < 0.05). Salmonella prevalence was higher (P < 0.05) at 15 wk in turkeys fed the corn-based diet (Salmonella prevalence = 50%) than in turkeys fed the corn-enzyme (Salmonella prevalence = 13%) and wheat-based (Salmonella prevalence = 0%) dietary treatments. Therefore, contrast analysis showed that birds fed the corn control diet had lower microbiota diversity but higher Salmonella prevalence than birds fed the enzyme-supplemented and wheat-based diets. In contrast, birds fed the wheat-based diets had higher diversity but lower Salmonella prevalence than birds fed the corn-based diets. High dietary nonstarch polysaccharides from wheat and dietary exogenous enzyme supplementation promoted microbial community diversity and apparently discouraged Salmonella colonization through competitive exclusion. Nonstarch polysaccharides and dietary exogenous enzyme supplementation may be practical tools to control enteric pathogens and benefit the intestinal health and food safety of the birds.

Effects of a direct-fed microbial (primalac) on turkey poult performance and susceptibility to oral Salmonella challenge.

A study was conducted to determine 1) the effect of a dietary direct-fed microbial (DFM) on turkey poult performance, 2) the effect of a DFM on a Salmonella challenge, and 3) the effect of feed processing on the efficacy of the dietary DFM. Day-of-hatch Large White female poults were placed in 2 rooms in 2 Petersime batteries per room. Twelve pens of 7 birds each were used in each battery (24 pens per room, 336 birds total). One of 4 dietary feed treatments was assigned to each pen (6 pens per room for each diet). One room housed non-Salmonella-challenged poults, and the other room housed poults challenged with a 1-mL oral gavage of Salmonella (10(10) cfu/mL). A single batch of starter ration was split into 4 parts and used to provide 4 dietary treatments: 1) mash feed with no DFM (M), 2) mash feed with DFM (Primalac; 0.9 kg/tonne of feed, MD), 3) pelleted (20-s steam conditioning at 80 degrees C) and crumbled feed with no DFM (C), and 4) pelleted and crumbled feed with DFM (CD). Feed and deionized, distilled water were provided ad libitum. Data were collected and analyzed separately for each room. Mortality was recorded for each pen on a daily basis and totaled by week and for the 3-wk period. Individual BW and feed consumption, by pen, were measured weekly. Weekly and cumulative BW gains and feed to gain ratios (F:G) were calculated. Liver, spleen, total and lower intestinal tract weights, intestinal length, and most-probable-number Salmonella populations were determined for one randomly selected bird per pen. Feeding processed feed resulted in improved BW and F:G. Feeding the DFM improved 3-wk cumulative F:G in birds not gavaged and reduced relative intestinal weight in birds gavaged. Salmonella populations were reduced 1 log by feeding DFM. Dietary DFM improved bird performance, reduced Salmonella populations, and was not affected by feed processing.

Influence of housing system, grain type, and particle size on Salmonella colonization and shedding of broilers fed triticale or corn-soybean meal diets.

Salmonella colonization in poultry may be influenced by grain type and particle size. Broilers reared either in nonlitter cage-based housing or in a conventionally floored litter house from 0 to 42 d were assigned to 1 of 4 dietary treatments: 1) ground corn-soybean meal (C, 560 microm), 2) coarsely ground corn-soybean meal (CC, >1,700 microm), 3) ground triticale-soybean meal (T, 560 microm), or 4) whole triticale-soybean meal (WT). A 4-strain cocktail of Salmonella enterica was orally gavaged into each chick at placement. Growth performance, cecal and fecal Salmonella populations, gizzard and proventriculus pH, intestinal size, jejunum histomorphometry, and carcass yields were measured. Broilers responded differently to the dietary treatments according to the housing system used. At 42 d, birds reared on litter and fed ground grain had greater BW than those fed coarse grain (2.87 vs. 2.71 kg), whereas cage-reared broilers fed ground triticale were heavier than those fed corn (2.75 vs. 2.64 kg). Broilers raised on litter had a better feed conversion ratio than those raised in cages (1.71 vs. 1.81 g/g). Independent of the housing system, relative eviscerated carcass weights of birds fed T and C were heavier than those of CC- and WT-fed broilers (762 vs. 752 g/kg). Generally, the jejunum villus area and mucosal depth were larger, whereas the small intestine was lighter and shorter in broilers raised on litter. Relative gizzard weights of broilers raised on litter and fed the coarser diets were heavier than those of broilers reared in cages and fed finely ground diets. Feeding whole or coarsely ground grains decreased cecal Salmonella populations in 42-d-old broilers (3.8, 3.9, 4.4, and 4.4 log most probable number/g for CC, WT, C, and T, respectively). Additionally, 42-d-old broilers reared on litter had lower cecal Salmonella populations than those in cages (3.8 vs. 4.4 log most probable number/g). In conclusion, as a feed ingredient, triticale is a good alternative to corn, resulting in improved BW and reduced Salmonella colonization. Broilers raised on litter may have achieved lower cecal Salmonella populations than caged birds because access to litter may have modulated the intestinal microflora by increasing competitive exclusion microorganisms, which discouraged Salmonella colonization.

Genotypes, serotypes, and antibiotic resistance profiles of Salmonella isolated from commercial North Carolina turkey farms.

This study was designed to determine the serotypes, genotypes, and antibiotic resistance (AbR) patterns of 42 Salmonella isolates recovered from either fecal or litter samples of 12 commercial turkey farms across two seasons (summer and winter) and two ages (3 and 19 weeks). Isolates were serotyped on the basis of the Kauffmann-White scheme. Genotyping was done by restriction digestion of cDNA (XbaI) and subsequent pulsed-field gel electrophoresis (PFGE). The AbR was determined with Sensititre susceptibility plates. Serovar Kentucky was the most prevalent serotype (26%), followed by Senftenberg (19%), Muenster (17%), Mbandaka (10%), Javiana (7%), Hadar (5%), Heidelberg (5%), 8,(20):nonmotile (5%), Agona (2%), Infantis (2%), and 4,12:r:-(2%). Serovars Kentucky, Heidelberg, Hadar, and 8,(20):nonmotile were isolated only from the 19-week-old bird samples, whereas Senftenberg and Muenster were isolated only from the young birds (3 weeks old). Isolates within any one serotype showed minor PFGE banding pattern differences, but dendogram analysis indicated that sequence variability between serotypes was more significant than within serotypes. Isolates were resistant to tetracycline (86%), sulfisoxazole (71%), streptomycin (64%), gentamicin (41%), ampicillin (36%), kanamycin (26%), sulfamethoxazole-trimethoprim (7%), nalidixic acid (5%), cefoxitin (2%), and ceftiofur (2%). One isolate (Muenster) was resistant to nine antibiotics (2%), and the others were resistant to six (7%), five (12%), four (10%), three (21%), two (24%), and one (10%) antibiotic. Only two isolates (5%) were susceptible to all antibiotics tested. The AbR patterns were affected by age; on average, strains recovered from young birds were resistant to more than four drugs compared with fewer than three in older birds (P < 0.05). This study showed that Salmonella enterica subsp. enterica serotypes, genotypes and AbR patterns were affected by bird age but not by season or farm.