Antimicrobial consumption: Comparison of three different data collection methods.

The increasing incidence of antimicrobial resistance represents a global threat. As a result, surveillance programmes monitoring antimicrobial consumption and resistance in animals have been implemented in several countries throughout the world. However, such programmes depend on the accurate and detailed collection of data on antimicrobial consumption. For this reason, the aim of this longitudinal study was to compare the consistency of data on antimicrobial consumption between three different data collection methods. Antimicrobial consumption data associated to udder health were collected from 20 veterinary practices and 92 dairy farms for 18 months. The compared data sources were: 1) data extracted from veterinary practice software 2) farm treatment journals and 3) on-farm discarded drug packages (garbage). Two different procedures were chosen to analyse the data issued from treatment journals: 1) only complete entries were analysed 2) entries with missing dosage were supplemented with the information provided by the Swiss Compendium of Veterinary Medicinal Products. The antimicrobial data were divided into intramammary preparations used during lactation (IMM), intramammary preparations used for dry off (DRY) and systemic treatments (SYS). We compared the quantities of injectors (IMM and DRY), the quantities of active substances (SYS) and the treatment incidences (TI) for the defined daily dose (DDD) per 1000 cow-days (IMM and SYS) and the defined course dose (DCD) per 1000 cow-days (DRY). Additionally, the variety of antimicrobial products among the different data sources was compared. The highest quantity of antimicrobials for IMM, DRY and SYS could be collected with the software data. The lowest quantity was collected by using the data of the treatment journal with only complete entries. For IMM and DRY, software and garbage performed similar, with agreement on the number of injectors used in 56.1% of the analysed cases. The widest variety of intramammary antimicrobial preparations was found in the garbage whilst most systemic preparations were collected using software data. The results of the study show a lack of data consistency between the three different data sources. None of the methods was able to collect the integral antimicrobial consumption in the participating farms. Finally, the results emphasise the need to implement a standardised system to quantify and assess the antimicrobial consumption at veterinary practice and farm level.

Veterinary peer study groups as a method of continuous education-A new approach to identify and address factors associated with antimicrobial prescribing.

Within the dairy industry, most antimicrobials are used for dry-cow therapy or mastitis treatment. To reduce antimicrobial usage in dairy cows, increasing awareness and behaviour change is necessary. As veterinarians are known to be influenced by their peers, peer study groups as a continuous education might contribute to this. Therefore, the objective of this study was to analyse written records of veterinary peer study group meetings to identify factors associated with antimicrobial prescribing decisions, and to analyse veterinarians' attitude towards the benefits of this continuous education method. Twenty-three participating Swiss cattle practitioners were divided into three groups. Each group met every two to five months, together with a facilitator and an expert on the topic to be discussed. Written records from every meeting were taken and analysed qualitatively to identify factors influencing veterinarians' decisions on antimicrobial prescribing and mastitis therapy. In addition, focus group discussions were conducted after the last meeting, to assess the veterinarians' learning achievements gained during the peer study group meetings. Extrinsic factors such as external pressure, competition, farmer, individual animal, farm and diagnostics as well as intrinsic factors such as own experience/attitude, knowledge and change of mindset during career could be shown to influence veterinarians' decisions on antimicrobial prescribing. In the focus group discussions, the veterinarians stated that they gained new knowledge, received new stimuli, exchanged with their peers and felt supported in their relationship to their farmers. Since the identified factors are partly interrelated, it is not sufficient to change a single factor to achieve a change in the antimicrobial prescription behaviour of veterinarians. Veterinary peer study groups could contribute to the intention to change, because veterinarians experienced multiple benefits from this method of continuous education. In order to quantify this, the prescription data of the veterinarians are analysed in a next step.

Evaluating diagnostic tests for bovine tuberculosis in the southern part of Germany: A latent class analysis.

Germany has been officially free of bovine tuberculosis since 1996. However, in the last years there has been an increase of bovine tuberculosis cases, particularly in the southern part of Germany, in the Allgäu region. As a consequence a one-time tuberculosis surveillance program was revisited with different premortal and postmortal tests. The aim of this paper was to estimate diagnostic sensitivities and specificities of the different tests used within this surveillance program. In the absence of a perfect test with 100% sensitivity and 100% specificity, thus in the absence of a gold standard, a Bayesian latent class approach with two different datasets was performed. The first dataset included 389 animals, tested with single intra-dermal comparative cervical tuberculin (SICCT) test, PCR and pathology; the second dataset contained 175 animals, tested with single intra-dermal cervical tuberculin (SICT) test, Bovigam® assay, pathology and culture. Two-way conditional dependencies were considered within the models. Additionally, inter-laboratory agreement (five officially approved laboratories) of the Bovigam® assay was assessed with Cohen's kappa test (21 blood samples). The results are given in posterior means and 95% credibility intervals. The specificities of the SICT test, SICCT test, PCR and pathology ranged between 75.8% [68.8-82.2%] and 99.0% [96.8-100%]. The Bovigam® assay stood out with a very low specificity (6.9% [3.6-11.1%]), though it had the highest sensitivity (95.7% [91.3-99.2%]). The sensitivities of the SICCT test, PCR, SICT test, pathology and culture varied from 57.8% [48.0-67.6%] to 88.9% [65.5-99.7%]. The prevalences were 19.8% [14.6-26.5%] (three-test dataset) and 7.7% [4.2-12.3%] (four-test dataset). Among all pairwise comparisons the highest agreement was 0.62 [0.15-1]). In conclusion, the specificity of the Bovigam® assay and the inter-laboratory agreement were lower than expected.