Veterinary Biosciences - Research Publications

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    Overcoming challenges in extracting prescribing habits from veterinary clinics using big data and deep learning
    Hur, B ; Hardefeldt, LY ; Verspoor, K ; Baldwin, T ; Gilkerson, JR (WILEY, 2022-05)
    Understanding antimicrobial usage patterns and encouraging appropriate antimicrobial usage is a critical component of antimicrobial stewardship. Studies using VetCompass Australia and Natural Language Processing (NLP) have demonstrated antimicrobial usage patterns in companion animal practices across Australia. Doing so has highlighted the many obstacles and barriers to the task of converting raw clinical notes into a format that can be readily queried and analysed. We developed NLP systems using rules-based algorithms and machine learning to automate the extraction of data describing the key elements to assess appropriate antimicrobial use. These included the clinical indication, antimicrobial agent selection, dose and duration of therapy. Our methods were applied to over 4.4 million companion animal clinical records across Australia on all consultations with antimicrobial use to help us understand what antibiotics are being given and why on a population level. Of these, approximately only 40% recorded the reason why antimicrobials were prescribed, along with the dose and duration of treatment. NLP and deep learning might be able to overcome the difficulties of harvesting free text data from clinical records, but when the essential data are not recorded in the clinical records, then, this becomes an insurmountable obstacle.
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    Attitudes towards Use of High-Importance Antimicrobials-A Cross-Sectional Study of Australian Veterinarians
    Sri, A ; Bailey, KE ; Gilkerson, JR ; Browning, GF ; Hardefeldt, LY (MDPI, 2022-11)
    The timely implementation of antimicrobial stewardship interventions could delay or prevent the development of higher levels of antimicrobial resistance in the future. In food-producing animals in Australia, high-importance antimicrobials, as rated by the Australian Strategic and Technical Advisory Group (ASTAG), include virginiamycin and third-generation cephalosporins (in individual pigs or cattle). The use of high-importance antimicrobials in companion animals is more widespread and less regulated. There is no national antimicrobial use surveillance system for animals in Australia. Consequently, there is a gap in the knowledge about reasonable use across all sectors of veterinary practice. This study explored attitudes towards the use in veterinary medicine of antimicrobials with high importance to human health, and determined levels of agreement about the introduction of restrictions or other conditions on this use. An online survey was distributed via social media and email from June to December 2020 to veterinarians working in Australia. Of the 278 respondents working in clinical practice, 49% had heard of the ASTAG rating system, and 22% used a traffic light system for antimicrobial importance in their practice. Overall, 61% of participants disagreed that veterinarians should be able to prescribe high-importance antimicrobials without restrictions. If there were to be restrictions, there was most agreement amongst all respondents for only restricting high-importance antimicrobials (73%). There is a need for education, guidance, and practical support for veterinarians for prescribing high-importance antimicrobials alongside any restrictions.
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    Assessment of Humoral and Long-Term Cell-Mediated Immune Responses to Recombinant Canarypox-Vectored Equine Influenza Virus Vaccination in Horses Using Conventional and Accelerated Regimens Respectively
    El-Hage, C ; Hartley, C ; Savage, C ; Watson, J ; Gilkerson, J ; Paillot, R (MDPI, 2022-06)
    During Australia's first and only outbreak of equine influenza (EI), which was restricted to two northeastern states, horses were strategically vaccinated with a recombinant canarypox-vectored vaccine (rCP-EIV; ProteqFlu™, Merial P/L). The vaccine encoded for haemagglutinin (HA) belonging to two equine influenza viruses (EIVs), including an American and Eurasian lineage subtype that predated the EIV responsible for the outbreak (A/equine/Sydney/07). Racehorses in Victoria (a southern state that remained free of EI) were vaccinated prophylactically. Although the vaccine encoded for (HA) belonged to two EIVs of distinct strains of the field virus, clinical protection was reported in vaccinated horses. Our aim is to assess the extent of humoral immunity in one group of vaccinated horses and interferon-gamma ((EIV)-IFN-γ)) production in the peripheral blood mononuclear cells (PBMCs) of a second population of vaccinated horses. Twelve racehorses at work were monitored for haemagglutination inhibition antibodies to three antigenically distinct equine influenza viruses (EIVs) The EIV antigens included two H3N8 subtypes: A/equine/Sydney/07) A/equine/Newmarket/95 (a European lineage strain) and an H7N7 subtype (A/equine/Prague1956). Cell-mediated immune responses of: seven racehorses following an accelerated vaccination schedule, two horses vaccinated using a conventional regimen, and six unvaccinated horses were evaluated by determining (EIV)-IFN-γ levels. Antibody responses following vaccination with ProteqFlu™ were cross-reactive in nature, with responses to both H3N8 EIV strains. Although (EIV)IFN-γ was clearly detected following the in vitro re-stimulation of PBMC, there was no significant difference between the different groups of horses. Results of this study support reports of clinical protection of Australian horses following vaccination with Proteq-Flu™ with objective evidence of humoral cross-reactivity to the outbreak viral strain A/equine/Sydney/07.
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    Antimicrobial stewardship in companion animal practice: an implementation trial in 135 general practice veterinary clinics
    Hardefeldt, LY ; Hur, B ; Richards, S ; Scarborough, R ; Browning, GF ; Billman-Jacobe, H ; Gilkerson, JR ; Ierardo, J ; Awad, M ; Chay, R ; Bailey, KE (OXFORD UNIV PRESS, 2021-12-22)
    BACKGROUND: Antimicrobial stewardship programmes (ASPs) have been widely implemented in medical practice to improve antimicrobial prescribing and reduce selection for multidrug-resistant pathogens. OBJECTIVES: To implement different antimicrobial stewardship intervention packages in 135 veterinary practices and assess their impact on antimicrobial prescribing. METHODS: In October 2018, general veterinary clinics were assigned to one of three levels of ASP, education only (CON), intermediate (AMS1) or intensive (AMS2). De-identified prescribing data (1 October 2016 to 31 October 2020), sourced from VetCompass Australia, were analysed and a Poisson regression model fitted to identify the effect of the interventions on the incidence rates of antimicrobial prescribing. RESULTS: The overall incidence rate (IR) of antimicrobial prescribing for dogs and cats prior to the intervention was 3.7/100 consultations, which declined by 36% (2.4/100) in the implementation period, and by 50% (1.9/100) during the post-implementation period. Compared with CON, in AMS2 there was a 4% and 6% reduction in the overall IR of antimicrobial prescribing, and a 24% and 24% reduction in IR of high importance antimicrobial prescribing, attributable to the intervention in the implementation and post-implementation periods, respectively. A greater mean difference in the IR of antimicrobial prescribing was seen in high-prescribing clinics. CONCLUSIONS: These AMS interventions had a positive impact in a large group of general veterinary practices, resulting in a decline in overall antimicrobial use and a shift towards use of antimicrobials rated as low importance, with the greatest impact in high-prescribing clinics.
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    Association of Equine Herpesvirus 5 with Mild Respiratory Disease in a Survey of EHV1,-2,-4 and-5 in 407 Australian Horses
    El-Hage, C ; Mekuria, Z ; Dynon, K ; Hartley, C ; McBride, K ; Gilkerson, J (MDPI, 2021-12)
    Equine herpesviruses (EHVs) are common respiratory pathogens in horses; whilst the alphaherpesviruses are better understood, the clinical importance of the gammaherpesviruses remains undetermined. This study aimed to determine the prevalence of, and any association between, equine respiratory herpesviruses EHV1, -2, -4 and -5 infection in horses with and without clinical signs of respiratory disease. Nasal swabs were collected from 407 horses in Victoria and included clinically normal horses that had been screened for regulatory purposes. Samples were collected from horses during Australia's equine influenza outbreak in 2007; however, horses in Victoria required testing for proof of freedom from EIV. All horses tested in Victoria were negative for EIV, hence archived swabs were available to screen for other pathogens such as EHVs. Quantitative PCR techniques were used to detect EHVs. Of the 407 horses sampled, 249 (61%) were clinically normal, 120 (29%) presented with clinical signs consistent with mild respiratory disease and 38 (9%) horses had an unknown clinical history. Of the three horses detected shedding EHV1, and the five shedding EHV4, only one was noted to have clinical signs referable to respiratory disease. The proportion of EHV5-infected horses in the diseased group (85/120, 70.8%) was significantly greater than those not showing signs of disease (137/249, 55%). The odds of EHV5-positive horses demonstrating clinical signs of respiratory disease were twice that of EHV5-negative horses (OR 1.98, 95% CI 1.25 to 3.16). No quantitative difference between mean loads of EHV shedding between diseased and non-diseased horses was detected. The clinical significance of respiratory gammaherpesvirus infections in horses remains to be determined; however, this survey adds to the mounting body of evidence associating EHV5 with equine respiratory disease.
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    Evaluating the dose, indication and agreement with guidelines of antimicrobial use in companion animal practice with natural language processing
    Hur, B ; Hardefeldt, LY ; Verspoor, KM ; Baldwin, T ; Gilkerson, JR (Oxford University Press, 2021)
    As antimicrobial prescribers, veterinarians contribute to the emergence of MDR pathogens. Antimicrobial stewardship programmes are an effective means of reducing the rate of development of antimicrobial resistance. A key component of antimicrobial stewardship programmes is selecting an appropriate antimicrobial agent for the presenting complaint and using an appropriate dose rate for an appropriate duration.
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    Antimicrobial stewardship in Australia: the role of qualitative research in programme development
    Thursky, KA ; Hardefeldt, LY ; Rajkhowa, A ; Ierano, C ; Bishop, J ; Hawes, L ; Biezen, R ; Saha, SK ; Dowson, L ; Bailey, KE ; Scarborough, R ; Little, SB ; Gotterson, F ; Hur, B ; Khanina, A ; Urbancic, K ; Crabb, HK ; Richards, S ; Sri, A ; James, R ; Kong, DCM ; Marshall, C ; Mazza, D ; Peel, T ; Stuart, RL ; Manski-Nankervis, J-A ; Friedman, ND ; Bennett, N ; Schulz, T ; Billman-Jacobe, H ; Buono, E ; Worth, L ; Bull, A ; Richards, M ; Ayton, D ; Gilkerson, JR ; Browning, GF ; Buising, KL (OXFORD UNIV PRESS, 2021-09-30)
    Antimicrobial stewardship (AMS) in Australia is supported by a number of factors, including enabling national policies, sectoral clinical governance frameworks and surveillance programmes, clinician-led educational initiatives and health services research. A One Health research programme undertaken by the National Centre for Antimicrobial Stewardship (NCAS) in Australia has combined antimicrobial prescribing surveillance with qualitative research focused on developing antimicrobial use-related situational analyses and scoping AMS implementation options across healthcare settings, including metropolitan hospitals, regional and rural hospitals, aged care homes, general practice clinics and companion animal and agricultural veterinary practices. Qualitative research involving clinicians across these diverse settings in Australia has contributed to improved understanding of contextual factors that influence antimicrobial prescribing, and barriers and facilitators of AMS implementation. This body of research has been underpinned by a commitment to supplementing 'big data' on antimicrobial prescribing practices, where available, with knowledge of the sociocultural, technical, environmental and other factors that shape prescribing behaviours. NCAS provided a unique opportunity for exchange and cross-pollination across the human and animal health programme domains. It has facilitated synergistic approaches to AMS research and education, and implementation of resources and stewardship activities. The NCAS programme aimed to synergistically combine quantitative and qualitative approaches to AMS research. In this article, we describe the qualitative findings of the first 5 years.
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    Drivers of exit and outcomes for Thoroughbred racehorses participating in the 2017-2018 Australian racing season
    Shrestha, K ; Gilkerson, JR ; Stevenson, MA ; Flash, ML ; Smith, RL (PUBLIC LIBRARY SCIENCE, 2021-09-21)
    The destinations of Thoroughbred (TB) racehorses exiting the racing industry is a high-profile issue with ethical and welfare implications of interest to both animal welfare groups and racing regulators. This cross-sectional study investigated the reasons that TBs temporarily or permanently exited racing and training in Australia in the 2017-2018 racing season and the outcomes for these horses post-racing. An online questionnaire was sent to the last registered trainers of a representative sample of 2,509 'inactive' TBs. Inactive horses were defined as those horses that were recorded as 'active' but had not trialled or raced in the last 6 months of the racing season or had an inactive status recorded in the Racing Australia database. Of the 1,750 responses received, the largest group of inactive TBs had permanently exited the racing industry (45% retired, 5.3% deceased). A relatively large group exited racing temporarily (43%) but participated in the racing industry in the following season. The reasons for retirement were predominantly voluntary, such as poor performance or owner's request. Almost one third of retirements were due to injuries with tendon or ligament problems the most frequently conditions listed. The median age at retirement was five (Q1 4; Q3 7) years. Extrapolation of the survey results to the population of horses racing or training in Australia in 2017-2018 (n = 37,750) show that that 17% of the population retire each year and 2.1% die. These estimates provide benchmarks for industry and animal welfare organisations to resource and measure the effectiveness of interventions.
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    Chlamydia Psittaci ST24: Clonal Strains of One Health Importance Dominate in Australian Horse, Bird and Human Infections
    Anstey, SI ; Kasimov, V ; Jenkins, C ; Legione, A ; Devlin, J ; Amery-Gale, J ; Gilkerson, J ; Hair, S ; Perkins, N ; Peel, AJ ; Borel, N ; Pannekoek, Y ; Chaber, A-L ; Woolford, L ; Timms, P ; Jelocnik, M (MDPI, 2021-08)
    Chlamydia psittaci is traditionally regarded as a globally distributed avian pathogen that can cause zoonotic spill-over. Molecular research has identified an extended global host range and significant genetic diversity. However, Australia has reported a reduced host range (avian, horse, and human) with a dominance of clonal strains, denoted ST24. To better understand the widespread of this strain type in Australia, multilocus sequence typing (MLST) and ompA genotyping were applied on samples from a range of hosts (avian, equine, marsupial, and bovine) from Australia. MLST confirms that clonal ST24 strains dominate infections of Australian psittacine and equine hosts (82/88; 93.18%). However, this study also found novel hosts (Australian white ibis, King parrots, racing pigeon, bovine, and a wallaby) and demonstrated that strain diversity does exist in Australia. The discovery of a C. psittaci novel strain (ST306) in a novel host, the Western brush wallaby, is the first detection in a marsupial. Analysis of the results of this study applied a multidisciplinary approach regarding Chlamydia infections, equine infectious disease, ecology, and One Health. Recommendations include an update for the descriptive framework of C. psittaci disease and cell biology work to inform pathogenicity and complement molecular epidemiology.
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    Globetrotting strangles: the unbridled national and international transmission of Streptococcus equi between horses
    Mitchell, C ; Steward, KF ; Charbonneau, ARL ; Walsh, S ; Wilson, H ; Timoney, JF ; Wernery, U ; Joseph, M ; Craig, D ; van Maanen, K ; Hoogkamer- van Gennep, A ; Leon, A ; Witkowski, L ; Rzewuska, M ; Stefanska, I ; Zychska, M ; van Loon, G ; Cursons, R ; Patty, O ; Acke, E ; Gilkerson, JR ; El-Hage, C ; Allen, J ; Bannai, H ; Kinoshita, Y ; Niwa, H ; Becu, T ; Pringle, J ; Guss, B ; Bose, R ; Abbott, Y ; Katz, L ; Leggett, B ; Buckley, TC ; Blum, SE ; Lopez, FC ; Ros, AF ; Campi, MCM ; Preziuso, S ; Robinson, C ; Newton, JR ; Schofield, E ; Brooke, B ; Boursnell, M ; de Brauwere, N ; Kirton, R ; Barton, CK ; Abudahab, K ; Taylor, B ; Yeats, CA ; Goater, R ; Aanensen, DM ; Harris, SR ; Parkhill, J ; Holden, MTG ; Waller, AS (MICROBIOLOGY SOC, 2021-03)
    The equine disease strangles, which is characterized by the formation of abscesses in the lymph nodes of the head and neck, is one of the most frequently diagnosed infectious diseases of horses around the world. The causal agent, Streptococcus equi subspecies equi, establishes a persistent infection in approximately 10 % of animals that recover from the acute disease. Such 'carrier' animals appear healthy and are rarely identified during routine veterinary examinations pre-purchase or transit, but can transmit S. equi to naïve animals initiating new episodes of disease. Here, we report the analysis and visualization of phylogenomic and epidemiological data for 670 isolates of S. equi recovered from 19 different countries using a new core-genome multilocus sequence typing (cgMLST) web bioresource. Genetic relationships among all 670 S. equi isolates were determined at high resolution, revealing national and international transmission events that drive this endemic disease in horse populations throughout the world. Our data argue for the recognition of the international importance of strangles by the Office International des Épizooties to highlight the health, welfare and economic cost of this disease. The Pathogenwatch cgMLST web bioresource described herein is available for tailored genomic analysis of populations of S. equi and its close relative S. equi subspecies zooepidemicus that are recovered from horses and other animals, including humans, throughout the world. This article contains data hosted by Microreact.