Veterinary Biosciences - Research Publications

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    Cross-sectional evaluation of a large-scale antimicrobial stewardship trial in Australian companion animal practices
    Richards, S ; Bailey, KE ; Scarborough, R ; Gilkerson, JR ; Browning, GF ; Hur, B ; Ierardo, J ; Awad, M ; Chay, R ; Hardefeldt, LY (WILEY, 2024-02-17)
    BACKGROUND: Antimicrobial stewardship programmes (ASPs) are critically important for improving the appropriate use of antimicrobial agents in veterinary practice. METHODS: One of three ASPs was implemented in 135 Australian general veterinary practices in 2018-2020. The ASP interventions and the perceived impact they had on antimicrobial prescribing were assessed by the veterinarians working in these veterinary practices. An online survey was distributed to all 520 veterinarians working in the trial practices and 267 responses were analysed. RESULTS: Most veterinarians (174/267, 65%) thought they had an ASP at their clinic and most respondents who said that they were aware that they had an ASP at their clinic indicated that they had changed the way they prescribed antimicrobials because of the trial (125/170, 74%). Antimicrobial prescribing guidelines, the traffic light system for indicating antimicrobial importance, delayed prescribing and antimicrobial stewardship champions were reported to have had the biggest impact. LIMITATIONS: All practices in the trial belong to a single corporate group, which may impact the external validity of these results when applied to general small animal practice. CONCLUSION: Antimicrobial stewardship has a positive impact on antimicrobial prescribing in veterinary medicine and future interventions should focus on the implementation of the effective interventions identified in this study.
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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 crosssectional study of Australian veterinarians
    Sri, A ; Bailey, K ; Gilkerson, J ; Browning, G ; Hardefeldt, L (E.U. European Publishing, 2023-01-01)
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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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    Descriptive analysis of horses and ponies attending horse auctions in Victoria from July 2019 to March 2020
    Chapman, GR ; Wells, B ; Gilkerson, JR ; Flash, ML (WILEY, 2023-01)
    INTRODUCTION: In recent years there has been public speculation about the breed, destination and number of horses being sold by public auction at livestock saleyards in Australia. Currently, there is little objective information available about the breed and condition of horses sold through this medium. With little publicly available objective data on these horses, the horse industry has been left vulnerable to misinformation. Accurate information regarding the composition and condition of horses attending saleyards is important to identify and address any welfare issues and to inform public debate. METHOD: Data were collected on 312 horses and ponies presented for sale through the Pakenham Horse Sales between July 2019 and March 2020. All horses and ponies were inspected at the saleyards and information on breed, age, body condition score (BCS), purchaser and sale price were recorded as the animals were auctioned. RESULTS: Crossbred horses and ponies were the largest groups presented for sale. Ponies were more likely to be sold to private buyers. Quarter horses and riding ponies were as likely to be sent to slaughter as thoroughbreds and standardbreds. Entire males and females sold for lower prices than geldings. Most horses and ponies (64%) were sold to private buyers. More than three-quarters (77%) of horses and ponies presented for sale had a BCS greater than or equal to three out of five. CONCLUSION: This pilot study challenges perceptions that thoroughbreds are the primary breed to attend public sales or that animals attending the sales are in poor condition.
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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.