Transcript Animal production in Mekong Delta of Vietnam

Antimicrobial resistance (AMR) profiling in
Escherichia coli from farmed and wild animals
in the Mekong delta of Vietnam
Nguyen Thi Nhung
Oxford University Clinical Research Unit, HCMC, Vietnam
Biodiversity and Health Symposium
Phnom Penh, 17-18 Nov 2014
Agenda
•Introduction
− Animal production in Mekong Delta of Vietnam
•Methods
− Sampling
− Laboratory methods
• Results
− Prevalence of AMR E. coli from farmed and wild animals
− AMR patterns of E. coli from different species
− Risk factors for multidrug resistance
• Conclusion
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Animal production in Mekong Delta of Vietnam
• Large poultry and pig population
• Mixed farms
• Small scale production systems
including household backyard farms
• Low bio-security and bio-containment
• Duck production systems integrated with rice
production systems (free ranging ducks)
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Use of Escherichia coli as indicator
• Commensal bacteria of warm-blooded animals
• High prevalence, simple and efficient isolation
procedures
• Useful indicator for the presence of AMR in
monitoring and surveillance programs
No studies have investigated the prevalence of AMR E. coli isolated from the
farmed and wildlife species in the Mekong Delta of Vietnam
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Aims of study
• To investigate the prevalence of AMR on E. coli indicator bacteria in
various food animals and wildlife
• To characterize E. coli phenotypic resistant profiles
• To identify risk factors for fecal carriage of AMR E. coli in animal
production
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Farm survey design
• Cao Lanh district, Dong Thap province
• 90 pig, duck and chicken farms (30 of each) were stratified by size (small, medium and
large)
•Fecal material was collected using a pair of boot swabs
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Small wild mammals trapping and processing
• Small wild mammals were trapped from pig and poultry farms, rice fields, forests
• Humanely culled by overdose of isoflurane
• 0.2g caecal contents were collected from large intestines
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Laboratory methods
E. coli isolation
AMR E. coli testing
Antimicrobial agents
Amoxicilin/clavulanic acid (30µg)
Ampicillin (10µg)
Ceftazidime (30µg)
Chloramphenicol (30µg)
Ciprofloxacin (5µg)
Gentamicin (10µg)
Tetracycline (30µg)
Trimethoprim-sulphamethoxazol (25µg)
Acronym
AMC
AMP
CAZ
C
CIP
CN
TE
SXT
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Results
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E. coli isolates
Species
Farmed
animals
Small wild
mammals
Total
No.
samples
No.
isolates
Chicken
30
148
Duck
30
143
Pig
30
143
Rattus argentiventer
9
33
Rattus tanezumi
19
62
Rattus exulans
5
16
Rattus norvegicus
10
28
Bandicota indica
16
67
Suncus murinus
7
28
156
Total
isolates
434
R. argentiventer
234
668
R. tanezumi
R. exulans
R. norvegicus
B. indica
S. murinus
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Prevalence of AMR E. coli from farmed animals
Unadjusted data
Adjusted data
TE: tetracycline, SXT: trimethoprim-sulphamethoxazole, CN: gentamicin, CIP: ciprofloxacin, AMP: ampicillin, AMC: amoxicilinclavulanic acid, CAZ: ceftazidime , C: chloramphenicol, ESBL: extended spectrum β lactamase, MDR: multidrug resistance, was defined
as resistant to at least three different of antimicrobials
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Prevalence of AMR E. coli from small wild animals
Farms
Non-farms
TE: tetracycline, SXT: trimethoprim-sulphamethoxazole, CN: gentamicin, CIP: ciprofloxacin AMP: ampicillin, AMC: amoxicilinclavulanic acid, CAZ: ceftazidime , C: chloramphenicol, ESBL: extended spectrum β lactamase, MDR: multidrug resistance, was
defined as resistant to at least three different of antimicrobials
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Minimum spanning tree of AMR patterns from different species
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DAPC of AMR profiles by host type
DAPC= Discriminant Analysis of
Principal Components
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Multivariable logistic regression of MDR
for isolates from farms
OR
95% CI
p-value
1.0
-
-
Small medium pig farm
1.18
1.04-1.35
0.0104
Large pig farm
1.41
1.27-1.57
<0.001
Age farmer (per 10-year period)
0.86
0.82-0.90
<0.001
Well-water: Large pig farm
1.24
1.15-1.33
<0.001
1.55
1.37-1.75
<0.001
Type of farm (baseline=chicken or duck)
Small medium pig farm
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Conclusions
• High levels of resistance to common antimicrobials among farmed animals
− Extensive range of antimicrobial compounds used not according to the dosage,
length of
treatment of the manufacturers
− Antimicrobials used on farm and human medicine are largely similar
• Small wild mammals trapped on farms seem to have higher prevalence of AMR
− Wildlife contact directly with antimicrobial residuals or resistant bacteria through
food and effluent systems
− Useful indicators of the presence of antimicrobial resistant populations in the
environment and/or farms
• There are some factors such as farm size (pigs), age of farmers, and water
sources that may contribute to the problem of AMR on farms
− The longitudinal studies need to be conducted
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Acknowledgements:
• Dr. Juan Carrique-Mas
• Dr. Ngo Thi Hoa
• Mr. James Campbell
• Mr. Nguyen Van Cuong
• Ms. Vo Nhu Thanh Truc
• Dr. Serge Morand
• Sub-Department of Animal Health Dong Thap
• Hospital Tropical Diseases HCMC
Funding:
VIZIONS WT/093724
ZoNMW / WOTRO/205100012 (The Netherlands)
Li-Ka-Shing Foundation
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Thank you!