Open access peer-reviewed chapter
Tank milk quality according to somatic cell count (BTSCC) and Colony forming units (CFU).
Abstract
The excessive and irrational use of antimicrobials for the control of bovine mastitis has been the subject of study throughout the world for many decades. Currently, the use of antimicrobials in livestock is of great interest from the “One Health” approach. Scientific research has revealed that the reasons for the inappropriate use of antimicrobials in production are related to human behavior, political, commercial, and economic factors. The objective of this study was to understand the attitudes toward the use of the laboratory and the social influences for decision-making in the choice of antimicrobials in the treatment of bovine mastitis in the North of Antioquia, Colombia. The study was developed through mixed methods (cross-sectional and grounded theory) with a convergent triangulation design. Two hundred and sixteen dairy farmers and 9 veterinarians participated. The results allow us to conclude that the problem of antimicrobial resistance related to mastitis and udder health planning depends on both technical aspects and access to knowledge and to laboratory services and, perhaps, even more importantly, on the culture and social relations that are established between the dairy farmer and the other actors of the dairy chain in the north of Antioquia.
Keywords
- social influences
- decision-making
- antimicrobials use
- laboratory use
- bovine mastitis
- antimicrobials resistance
1. Introduction
Bovine mastitis is the most important bacterial disease in primary milk production [1]. In the dairy sector, antimicrobials are widely used as a strategy to control this disease, once an inflammatory process has been detected in the mammary gland [2, 3]. In several countries, such as Ireland, Canada, and the Netherlands, approximately one-fifth of the antimicrobials used in dairy farming are used for the treatment of clinical mastitis and about half is used in the treatment of dry cows [4, 5, 6].
It is estimated that more antimicrobials are used in animals than in humans. In addition, many of the classes of antimicrobials used in humans are also marketed for use in animals, including broad-spectrum beta-lactams and quinolones. In addition, other antimicrobials such as tetracycline, triazoles, and streptomycin are used both in humans and in animals, and even therapeutically in plants. This has raised concerns in terms of public health due to its impact on human, animal, and environmental health [7].
Antimicrobial resistance has been shown to be easily transferred between different ecosystems and bacterial populations; even resistant zoonotic bacteria can be found in soil, which can infect plants, animals, and humans. For example, Methicillin-resistant
The use of antimicrobials in the dairy sector is influenced by social factors, where dairy farmers are sensitive to social norms set by other producers and rely on the expertise of other actors, such as veterinarians. In addition, public policies, education, communication, time, finances, and adequate language are considered alternatives to transform inappropriate practices in the use of antimicrobials among dairy farmers and to promote appropriate decision-making [10, 11].
In Colombia, there are no specific policies on the restricted use of antimicrobials in the dairy sector, and no studies have been carried out on the use of the laboratory and social influences to promote an appropriate use of antimicrobials in the prevention and control of bovine mastitis. Therefore, the objective of this study was to understand attitudes toward laboratory use and social influences on decision-making on the choice of antimicrobials in the treatment of bovine mastitis in the north of Antioquia, Colombia.
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2. Materials and methods
Dairy farmers and veterinarians who attend the farms of the participating farmers took part in the qualitative phase. The number of participants was defined through a theoretical sampling by category saturation [12], the saturation of pre-established and emerging categories was achieved with 17 dairy farmers. The selection of participants was carried out through a sampling of maximum variation, with the aim of capturing the maximum plurality of discourses that characterize human reality in relation to the objective of the study: gender, age, farm size, municipality, educational level, and functions on the farm. Likewise, these participants were considered as key actors according to the results of the survey. For the population of veterinarians, the saturation of pre-established and emerging categories was reached with 9 veterinarians. Sampling by maximum variation included: gender, age, work experience as a dairy farm veterinarian, municipality, and employment relationship.
A semi-structured interview was developed from the categories identified in two systematic reviews on udder health [13, 14]. The instrument underwent an initial appearance validation and a content validation of the selected themes. The interview inquired the meanings, representations, and attitudes about the self-consumption of milk, the use of milk with antimicrobial residues, and the formal and informal milk trade that dairy farmers and veterinarians experience in their daily lives. The interview starts from the following scheme: (a) Contextualization of the study and informed consent, (b) self-consumption of milk, (c) use of antimicrobials, and (d) formal and informal milk trade, without it following a pre-established order. Two to three face-to-face interviews were conducted with each participant according to the open format, axial coding, and selective grounded theory [15].
The data on the udder health indicators (BTSCC and CFU) were supplied by the dairy company to which the farmer sells his milk, with his prior endorsement. The laboratories are accredited under the NTC-ISO/IEC 17025 standard: 2005. The averages for these variables were calculated by taking biweekly data during the period between September 2019 and August 2020. The CFU and BTSCC variables are presented according to ranges based on Colombian regulations and adapted by Múnera-Bedoya et al. (2017) [17].
All interviews were recorded. The recordings were transcribed with the Transcribe version 4.13.0 software, reviewed, and corrected manually, guaranteeing their total accuracy. Later, they were imported into the Atlas.ti version 22 software. The interviews were analyzed following the open, axial, and selective coding stages. Open coding allowed the conceptualization from the abstract representation of the phenomena described by the participants. In this sense, a code was assigned to each fragment of the text. These codes were compared according to their common characteristics and meanings. This coding is born from theoretical categories pre-established by the authors and from the words of the participants. Axial coding arises from the codes created in open coding. Here, the categories and subcategories were established, and their relationship according to their properties and dimensions. The central category (Use of milk with antimicrobial residues) was determined by selective coding, and all categories were integrated to propose a theoretical construct. The central category was defined based on the following criteria proposed by Strauss and Corbin: I. That all the main categories are related to the central category, II. Where each one of them, or the majority, contributes indicators to the concept, III. That the relationship between the categories allows a solid explanation, IV. That it explains the contradictory cases, or alternatives, to the central idea of the category, V. That the concept is refined when it is integrated with other concepts. The theoretical scheme made it possible to eliminate excess data and complete the underdeveloped categories, through additional theoretical sampling. The constructed theory was validated by comparing it with the raw data and by the recognition of the theoretical proposal by the participants as an approximate conceptualization of their realities [15].
Based on the methodological proposal for mixed methods with a convergent triangulation design, an analysis of the integration of results was carried out through the comparison of qualitative and quantitative results in a matrix and theoretical discussion [12].
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3. Results
The analysis by age groups shows that the majority of dairy farmers participating in the study are located in the adult category (77.8%), followed by older adults (17.1%) and by young people (5.1%). Only 6% of the participants were women. 80.6% of the surveyed farmers only studied up to secondary school, while only 7.9% reached technical-technological training (7.4%), and 11.5% achieved professional training with or without specialization. The highest proportion of farmers was classified in socioeconomic stratum 2 (49.5%), followed by socioeconomic stratum 3 (27.8%). Half of the surveyed people perform all functions in the production system and are associated with a cooperative. 40.2% represent small farmers (less than 1529 liters/week), 32.9% medium-sized farmers (between 1530 and 3822 liters of milk/week), and 26.9% large farmers (more than 3822 liters/week).
The sanitary quality of the milk (BTSCC) was deficient in 67.6% of the farms, while 31% of them had an acceptable or good sanitary quality, and only 1.4% had an excellent sanitary quality. Regarding the hygienic quality of milk (CFU), 54% of the farms obtained an excellent rating, 24% obtained an acceptable or good rating, and 22% presented deficiencies in this aspect (see Table 1).
| BTSCC | CFU | ||||
|---|---|---|---|---|---|
| Classification (range: cells/mL) | n | % | Classification (range: Units/mL) | n | % |
| Excellent (< 150,000) | 3 | 1.4 | Excellent (< 75,000) | 117 | 54 |
| Good (150,001 - 250,000) | 19 | 8.8 | Good (75,001 - 150,000) | 39 | 18 |
| Acceptable (250,001 - 400,000) | 48 | 22.2 | Acceptable (150,001 - 250,000) | 12 | 6 |
| Poor (> 400,000) | 146 | 67.6 | Poor (> 250,000) | 48 | 22 |
Table 1.
A relation was found between those who intend to sell their milk in the town, when the dairy industry does not buy it because it has a high BTSCC, and the BTSCC variable. Which is more prevalent in those who plan to sell their milk in the informal trade. Likewise, a relation was identified between those who intend to sell their milk in the town when the dairy industry does not buy it due to a high BTSCC and the intention to choose antimicrobial treatment, based on laboratory results. 91.1% of those who plan to sell their milk in the informal trade disagree with making use of the laboratory to select an adequate treatment (p < 0.001). CFUs are higher for those who perform less than one antimicrobial treatment per month; those who do not agree to perform cultures and antibiograms in milk samples from cows with mastitis, to select a suitable antimicrobial according to the susceptibility of the isolated bacteria; those who do not train their workers in mastitis prevention; or those who do not have workers. The BTSCC and the CFU are higher for those who do not receive an offer of laboratory services for their cows from the collecting company (see Table 2).
| BTSCC average | CFU average | |||
|---|---|---|---|---|
| % | Mean (IQR) | Mean (IQR) | ||
| Antimicrobial treatments for mastitis per year per farm (treatments per month) | 0 to 6 in a year (less than 1 treatment per month) | 31.5 | 514,533 (380945–670,480) | 113,609 (32656–303,134)* |
| 12 to 24 in a year (from 1 to 2 treatments per month) | 43.1 | 543,467 (369875–690,933) | 42,950 (22222–131,453)* | |
| 26 to 416 in a year (more than 3 treatments per month) | 25.5 | 439,650 (363973–654,786) | 53,099 (20556–139,133)* | |
| The antimicrobials that I use are solving the mastitis problem on my farm | In disagreement | 11.6 | 644,000 (398444–670,480) | 68,022 (34422–303,134) |
| In agreement | 88.4 | 495,089 (357127–670,480) | 55,600 (22166–169,444) | |
| I choose antimicrobial treatment based on culture results and antibiogram | In disagreement | 73.6 | 522,911 (378933–670,480) | 79,000 (26267–274,750)* |
| In agreement | 26.4 | 439,888 (327550–670,480) | 37,333 (15044–112,468)* | |
| Perception of cost of inputs and animal health vs. price of milk | Fair | 0.5 | 188,400 (188400–188,400) | 13,555 (13555–13,555) |
| Unfair | 99.5 | 495,156 (368067–670,480) | 63,622 (22682–206,622) | |
| The company to which you sell your milk offers laboratory services for your cows | Yes | 52.3 | 465,822 (332600–670,480)* | 48,220 (25267–110,267)* |
| No | 47.7 | 634,350 (398235–687,727)* | 110,000 (18640–303,134)* | |
| Mastitis prevention training | Yes | 63.9 | 487,557 (345356–670,480) | 51,827 (18822–154,456) |
| No | 36.1 | 511,828 (398444–670,480) | 85,245 (31867–220,467) | |
| Training of workers in mastitis prevention | Yes | 25 | 439,769 (365800–670,480) | 40,820 (15555–124,529)* |
| No | 43.5 | 480,622 (350042–670,480) | 53,429 (20866–206,622)* | |
| Has no workers | 31.5 | 590,605 (408814–671,174) | 93,356 (30267–303,134)* | |
Table 2.
Use of antimicrobials, use of laboratory, and training.
indicates the association between each of the independent variables and the dependent variables BTSCC or CFU when the p value is less than 0.05 (p < 0.05).
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4. Categories and subcategories built on the analysis of actions, related to decision-making regarding the choice of antimicrobials, and the risk of promoting bacterial resistance to antimicrobials
The qualitative analysis of the interviews with dairy farmers (DF) and veterinarians (V) allowed us to recognize 4 categories: use of the laboratory (culture and antibiogram), social influences on the use of antimicrobials, resistance to antimicrobials, education, and technical assistance.
4.1 Use of the laboratory (culture and antibiogram)
Dairy farmers are reluctant to perform cultures and antibiograms, which leads to indiscriminate use of antimicrobials, and this hinders medical work to treat mastitis.
Due to the culture of intervention in cases of mastitis, in which a negative attitude toward the use of the laboratory and self-medication is encouraged, veterinarians experience pressures that lead them to recommend the use of antimicrobials without performing antimicrobial susceptibility tests. In some cases, this results in an unsatisfactory cure for mastitis.
The use of culture and antibiogram is the last option and is performed when the cow has already received several antimicrobials and mastitis continues, suspecting bacterial resistance to antimicrobials.
For those who sell their milk to the only collection company that provides a laboratory service to evaluate mastitis in their cows, it is easier to reach an appropriate diagnosis and the description of susceptibility to antimicrobials.
The most committed farmers, working together with the veterinarian, send milk samples for culture and antibiogram; however, they report resistance to all antimicrobials at times.
The long distances between the farms and the veterinary diagnostic laboratories generate a lack of interest in the use of the culture and antibiogram for the diagnosis of mastitis. In turn, the time in the delivery of test results affects adherence to this service, which has direct effects on decision-making in the appropriate use of antimicrobials and bacterial resistance.
4.2 Social influences on the use of antimicrobials
The veterinarian plays a crucial role in the appropriate choice of antimicrobials and in the implementation of udder health interventions. However, farmers are often more influenced by the recommendations of other farmers, rather than following the professional’s instructions. This social behavior, together with the lack of interest in using the laboratory, forces veterinarians to design strategies to analyze each case of mastitis and make decisions based on the disposition of the farmer. Often, the irrational use of antimicrobials is resorted to, before sending a milk sample for culture and antibiogram.
Farmers are often receptive to recommendations from agricultural store staff. These untrained personnel promote irrational use and resistance to antimicrobials during mastitis treatment.
4.3 Antimicrobial resistance
Farmers and veterinarians are immersed in a culture of inappropriate use of antimicrobials, where the decisions to choose these are based on availability, previous experience, or empirical recommendations. Veterinarians are aware that many farmers are reluctant to send milk samples to the laboratory for culture and antibiogram but feel it is their duty to ask about this as a measure to promote udder health and public health.
Self-medication, indiscriminate mixing of antimicrobials, underdosing, and errors in the application route are behaviors that decrease the probability of success in the treatment of mastitis and promote resistance to antimicrobials, which represents a significant risk to public health. This situation is further aggravated when antimicrobials for human use are used in animals.
Farmers, in their desire to avoid culling cows that produce large amounts of milk but have mastitis caused by multiresistant bacteria such as
According to veterinarians, another behavior that may be contributing to antimicrobial resistance in the udder is the administration of antimicrobials without the concomitant use of anti-inflammatories and analgesics, because this can limit the penetration of the drug into the tissue, in the concentrations necessary to fight the infection.
The indiscriminate use of antimicrobials in drying therapy has been a common practice in the dairy industry. However, its nonselective use and without antimicrobial susceptibility testing may favor the development of mastitis in early lactation and increase antimicrobial resistance in cows.
Choosing antimicrobials based on milk pH is another nonassertive veterinary practice that represents unnecessary use of antimicrobials and promotes bacterial resistance.
Bacterial resistance to antimicrobials is promoted in calves, with the widespread use of milk from cows undergoing antimicrobial treatment for mastitis.
Farmers before consulting with a veterinarian have tested all the antimicrobials they have. Sometimes, the veterinarian sees the drug options exhausted and opts for alternative medicine.
Lack of commitment and lack of training of workers in the antimicrobial application can promote antimicrobial resistance in mastitis-causing bacteria.
4.4 Education and technical assistance
Knowledge transfer to dairy farmers has been deficient. Farmers often find it exhausting to attend multiple trainings where the same basic mastitis topics are repeated. This has led to a lack of motivation on the part of farmers to attend educational events, which could be different if they were better planned.
It is common to find training offered to dairy farmers by suppliers of inputs and medicines, but often these talks have a commercial focus and promote their own products. This situation creates a conflict of interest and may result in inappropriate decisions in the management of mastitis. It is necessary to look for more objective training alternatives free of commercial interests to improve the knowledge and decision-making of farmers.
Training on the proper use of medicines to treat mastitis and other diseases can be more successful if they are carried out in areas close to the production systems, and scientific issues are explained in a language appropriate to the needs of dairy farmers. Local dairy continuous education programs are successful. These initiatives are based on a collective interest and therefore can involve different actors, such as collecting companies, input suppliers, and educational institutions. Veterinarians and farmers have highlighted positive experiences, where the location of the event was close to farmers, continuity was maintained in the meetings, current issues were addressed, and field practices were included to apply what was learned.
The availability of continuous education for dairy farmers is crucial for public health. There is a lack of knowledge on the part of some farmers about the use of antimicrobials and their impact on public health. However, other farmers are aware of the implications of their actions. Therefore, educational programs must not only address technical knowledge but also work on the transformation of inappropriate attitudes and behaviors, taking into account the cultural dimension.
When the importance of mastitis is brought to economic terms in personal advice or training, there is greater receptivity from dairy farmers.
The low knowledge that dairy farmers have about the importance of udder health for the production of quality and quantity milk, added to the culture of milk production in large volumes, has generated a negative attitude and lack of interest toward their participation in educational events on mastitis and udder health. On many occasions, the lack of time and the distance of the meeting are argued as excuses for not attending. However, there is a greater interest and attendance in training related to reproduction.
Training constitutes a collective action event and is essential for effective udder health interventions that also do not put public health at risk. Veterinarian-led interventions can only be successful if the dairy farmer understands the process and the importance of their role in mastitis control.
The socio-cultural and economic differences between farmers have an impact on the ability to achieve the objectives established in the training. Illiteracy is an obstacle to learning and the adoption of a critical attitude to identify problems in management and milking practices that affect udder health and the use of antimicrobials.
The extension is essential to improve udder health. This type of accompaniment promotes a critical attitude for decision-making in dairy farmers.
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5. Discussion
The results of the quantitative component indicate some attributes that in their integration and comparison with the theory built through the grounded theory allow a greater understanding of the phenomena around decision-making, in the choice of antimicrobials for the treatment of bovine mastitis, and the risks of bacterial resistance (see Table 3).
| Variable | Characteristic | Theory (based on qualitative analysis) |
|---|---|---|
| Antimicrobial treatments for mastitis per month per farm. | 31.5% less than 1 treatment/month Higher CFU for those who do less than 1 treatment per month. Bab BTSCC, regardless of the number of treatments. | Social influences on the use of antimicrobials The veterinarian is the main social influencer of dairy farmers for making assertive decisions in the choice of antimicrobials. Farmers are receptive to antimicrobial recommendations by untrained agricultural store staff or other dairy farmers. Antimicrobial resistance Farmers choose antimicrobials based on availability. Self-medication, mixing antimicrobials without knowledge, underdosing of antimicrobials, and errors in the application route have decreased the probability of success. Conservation of cows with mastitis caused by multi-resistant bacteria without measuring risk to the herd. Supplying antimicrobials without applying anti-inflammatory, limits the entry into tissue. The use of antimicrobials in non-selective drying therapy and without susceptibility testing promotes bacterial resistance. Choosing antimicrobials based on milk pH is another non-assertive practice. Feeding calves with milk from cows with mastitis, and under treatment, promotes resistance in their bacteria. Lack of commitment and lack of training of workers in the application of antimicrobials can promote resistance. |
| Choose antimicrobial treatment based on culture results and antibiogram. | 73.6% disagree, that is, they do not do it. Higher CFU and BTSCC for those who do not perform culture and antibiogram to choose the antimicrobial. | Use of the laboratory (culture and antibiogram) Dairy farmers do not want to do cultures. Veterinarians are pressured to recommend antimicrobials without susceptibility testing. The culture and antibiogram are done when several treatments have been done without success. The remoteness of the laboratories and the delivery times of results affect adherence to the use of culture and antibiogram. |
| The company to which you sell your milk offers laboratory services for your cows | 47.7% do not receive a laboratory service offer for the diagnosis of mastitis in their cows. Higher CFU and BTSCC for those who do not receive an offer of laboratory services for the diagnosis of mastitis in their cows. | Use of the laboratory (culture and antibiogram) Only one collection company offers a service for collecting milk samples, diagnosis for mastitis, and antibiogram. Farmers who do not sell to this collector hardly have access to diagnostic services for mastitis. |
| Training of workers in mastitis prevention | 25% do it. Lower CFU and BTSCC for those who train their workers. | Education and technical assistance The transfer of knowledge to the dairy farmer has failed. Most of the training are offered by suppliers of inputs and medicines and are for commercial purposes. The training are successful when they take place close to the farms, in a language according to their knowledge, with continuity of meetings, current issues, and practices. The offer of continuous education for dairy farmers is a fundamental action for public health. There is greater receptivity in advice or training when the health problem together with the economic impact is explained to the farmer. There is disinterest in participating in mastitis talks. Culturally, the interests of farmers are focused on reproduction. Illiteracy has made it difficult to learn and build a critical attitude. |
Table 3.
Similarity comparison matrix and integration of qualitative and quantitative results.
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6. Use of the laboratory (culture and antibiogram)
The reasons why farmers in other countries are reluctant to carry out culture and antibiogram tests are similar to the case of the north of Antioquia. A third of Swiss and Scandinavian farmers consider that results take longer than they can expect to treat mastitis; however, more than 60% state that they decide which antimicrobial to treat with, based on culture and antibiogram results [18, 19]. In the Netherlands, most farmers do not treat all clinical mastitis cases with antimicrobials; they prefer to select cows for treatment based on the severity of the mastitis case, that is, with low SCCs, or treat them with antimicrobials only after a non-antimicrobial treatment has failed. Most farmers perform a bacteriological culture only occasionally, mainly to better understand the mastitis problem on the farm or to choose the appropriate antimicrobial [4]. In the case of farmers in the north of Antioquia, the use of the laboratory is occasional and generally when the producers have already used several antimicrobials indiscriminately without success. This behavior depends on many factors, among them are the offer of services and the delivery times of results. Concerns of this same nature prompted New Zealand researchers to evaluate new technologies for the identification and antimicrobial susceptibility testing of the main mastitis-causing bacteria in the country, with results within 24 hours that were similar to those obtained by conventional tests [6]. If in Colombia and in other countries policies that favor the use of the laboratory are not designed, in order to choose appropriate antimicrobials to control bovine mastitis, and additionally, if technological developments are not implemented, which allow obtaining results of susceptibility to antimicrobials in a shorter time, it will be difficult to transform the culture of dairy farmers, and a series of events in the use of antimicrobials will continue, which will favor the development of resistance to antimicrobials.
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7. Social influences on the use of antimicrobials
Dairy farmers recognize other producers, veterinarians, and staff in pharmacies and agricultural stores as influential players in the choice of antimicrobials to treat mastitis. Dairy farmers’ decision-making has been found to be a complex process influenced by many factors, including external controls such as financial rewards or sanctions [20], internal controls such as motivations [21], individual values and beliefs [22], and analysis of recommendations in the context of experience and characteristics of the production system [21]. The social referents for decision-making are related to internal controls, since behaviors, attitudes, and beliefs are built in relationships with the actors whom the dairy farmer trusts [23].
Consistent with the findings of this study, dairy farmers in the UK are commonly an influential source of information to their peers on antimicrobial use [24]. Veterinarians continue to be considered as reliable and influential reference actors in decision-making on the use of antimicrobials and biosafety issues [21]. In contrast to our study population, the study by Swinkels et al. (2015) found that nutritionists are also reference actors in decision-making on the use of antimicrobials [10], and dairy cooperatives are determining factors in mastitis problems [25].
In any of the cases, trust in the recommendations on the choice of antimicrobials and their use by actors with or without training in health is a problem, unless the recommendation is to resort to the clinical laboratory to perform culture and antibiogram tests on milk samples from cows with mastitis. This is recommended by veterinarians when, at the time of consultation, it is discovered that the farmer has applied various antimicrobials without success. However, the adoption of the veterinarian’s recommendations depends on the length of the relationship with the dairy farmer, given that long relationships are considered trustworthy and valuable in decision-making [26]. This has been a problem in the north of Antioquia, where the working and salary conditions of veterinarians do not promote their permanence in the region and, on the contrary, promote their rapid migration.
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8. Antimicrobial resistance
Self-medication, antimicrobial choice based on farm availability, underdosing, errors in the application route, lack of commitment and education of dairy farmers and workers, nonselective antimicrobial drying therapies, lack of antimicrobial susceptibility testing, keeping cows with mastitis caused by multiresistant bacteria, and feeding calves with milk with antimicrobials are actions related to the use of antimicrobials and the control of bovine mastitis that have been identified in research and that can promote antimicrobial resistance in bacteria from humans and animals. These actions are common among farmers from different countries, which is why professionals in microbiology and organizations focused on public health, such as the World Health Organization (WHO), recommend, above all, using antimicrobials only based on the results of culture and antibiogram with guidance from a veterinarian [27] and only when this accompaniment is not possible to follow the indications on the label [28]. Other recommendations are: The restricted use of parenteral antimicrobials only for severe cases of mastitis [29], avoidance of priority antimicrobials for use in humans [27], and when an antibiogram is not possible, use narrow-spectrum antimicrobials and always performing selective dry cow therapy [30].
In order to transform practices related to the use of antimicrobials in dairy farmers and workers, educational programs, training, and specific campaigns are a priority. In addition, the support to the farmer should focus on the implementation of effective measures to prevent mastitis [31]. In short, there are many errors made by dairy farmers included in the study in relation to the use of antimicrobials. Based on the experiences of other studies and of our study population, the best way to reduce the use of antimicrobials and the likelihood of promoting antimicrobial resistance is to implement measures that reduce the occurrence of mastitis in cattle, through strategic udder health planning, according to the characteristics of each farm.
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9. Education and technical assistance
Regarding education on the use of antimicrobials in the treatment of mastitis in dairy farmers, failed processes have been described by some farmers and veterinarians due to commercial interests and the lack of consideration of the producers’ needs. That is why, in order to guarantee an efficient and decentralized education, it is necessary to focus on the priority problems of particular groups of dairy farmers [21].
The prudent use of antimicrobials in the treatment of mastitis is complex and requires support in decision-making, for both farmers and veterinarians. To achieve assertive decision-making in the use of antimicrobials, it is essential to transform practices through continuing education and the application of skills [32]. In this sense, theory must be put into practice to achieve successful results, as has been demonstrated in experiences reported in the north of Antioquia, where theoretical-practical interventions have been developed [33].
Veterinary monitoring is essential in choosing the appropriate molecules to treat mastitis because it is one of the main sources of information for farmers. However, to change ingrained practices in the dairy farmer, it is important to have a reliable and stable advisor in the area since building trust depends on time and permanence [34]. Otherwise, the technical assistance could be a failure in terms of reaching the objectives, which depend to a large extent on adherence to the professional’s recommendations.
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10. Conclusion
This chapter refers to the excessive and irrational use of antimicrobials for the control of mastitis in the dairy sector of Northern Antioquia, as an example of a region with a great agricultural vocation but that presents typical dairy problems like those of many countries in the world. This problem is influenced by various cultural and social factors, such as the lack of state control and support, limited attention to mastitis, self-medication, and lack of commitment and education. In addition, bacterial resistance to antimicrobials may be related to the inappropriate choice of antimicrobial based on availability, the non-use of cultures and antibiograms, underdosing, errors in the application route, and the conservation of cows with multi-resistant mastitis.
In this sense, the veterinarian is an important social reference for dairy farmers, but more technical and educational support is required from these professionals to improve the choice and proper use of antimicrobials. The training offered by suppliers of inputs and medicines can be useful, but it is important that they are offered close to the farms, in an appropriate language and with continuity of meetings, always maintaining the health of the udder as the common objective, so that a transparent commercial relationship with farmers prevails.
In conclusion, the fight against antimicrobial resistance and udder health planning in the dairy sector depends on technical, cultural, and social aspects. It is important to promote adequate access to knowledge and laboratory services, as well as to improve social relations between dairy farmers and other actors in the dairy chain in northern Antioquia.
Acknowledgments
We are grateful to the dairy farmers, veterinarians, and dairy companies for participating in the study. Thanks to Minciencias for making the execution of the project feasible.
Conflicts of interest
The authors declare that they have no conflicts of interest.
Funding statement
RZS received funding from Minciencias https://minciencias.gov.co/-ColombianDoctoral funding program, Announcement 757 of 2016. The funders had no role in study design, data collection, analysis, decision to publish, or manuscript preparation.
References
- 1.
Down PM, Bradley AJ, Breen JE, Green MJ. Factors affecting the cost-effectiveness of on-farm culture prior to the treatment of clinical mastitis in dairy cows. Preventive Veterinary Medicine. 2017; 145 :91-99 - 2.
Deng Z, Lam TJGM, Hogeveen H, Spaninks M, Heij N, Postema M, et al. Antimicrobial use and farmers’ attitude toward mastitis treatment on dairy farms with automatic or conventional milking systems. Journal of Dairy Science. 2020; 103 (8):7302-7314 - 3.
Bates A, Laven R, Bork O, Hay M, McDowell J, Saldias B. Selective and deferred treatment of clinical mastitis in seven New Zealand dairy herds. Preventive Veterinary Medicine. 2020; 176 :104915 - 4.
More SJ, Clegg TA, McCoy F. The use of national-level data to describe trends in intramammary antimicrobial usage on Irish dairy farms from 2003 to 2015. Journal of Dairy Science. 2017; 100 (8):6400-6413 - 5.
Nobrega DB, De Buck J, Barkema HW. Antimicrobial resistance in non-aureus staphylococci isolated from milk is associated with systemic but not intramammary administration of antimicrobials in dairy cattle. Journal of Dairy Science. 2018; 101 (8):7425-7436 - 6.
Kuipers A, Koops WJ, Wemmenhove H. Antibiotic use in dairy herds in the Netherlands from 2005 to 2012. Journal of Dairy Science. 2016; 99 (2):1632-1648 - 7.
Velazquez-Meza ME, Galarde-López M, Carrillo-Quiróz B, Alpuche-Aranda CM. Antimicrobial resistance: One health approach. Veterinary World. 2022; 15 (3):743 - 8.
Oreiby A, Khalifa H, Eid A, Ahmed A, Shimamoto T, Shimamoto T. Clinical and molecular characterization of both methicillin-resistant and sensitive Staphylococcus aureus mastitis. The Journal of the Hellenic Veterinary Medical Society. 2019; 70 (3):1743-1748 - 9.
Kinross P, Petersen A, Skov R, van Hauwermeiren E, Pantosti A, Laurent F, et al. Livestock-associated methicillin-resistant Staphylococcus aureus (MRSA) among human MRSA isolates, European Union/European economic area countries, 2013. Euro Surveillance. 2017; 22 (44):1-13 - 10.
Swinkels JM, Hilkens A, Zoche-Golob V, Krömker V, Buddiger M, Jansen J, et al. Social influences on the duration of antibiotic treatment of clinical mastitis in dairy cows. Journal of Dairy Science. 2015; 98 (4):2369-2380 - 11.
Friedman DB, Kanwat CP, Headrick ML, Patterson NJ, Neely JC, Smith LU. Importance of prudent antibiotic use on dairy farms in South Carolina: A pilot project on farmers’ knowledge. Attitudes and Practices. Zoonoses Public Health. 2007; 54 :366-375 - 12.
Creswell JW, Plano Clark VL. Designing and Conducting Mixed Methods Research. 2th ed. Los Angeles: Sage Publications; 2011 - 13.
Zapata-Salas R, Guarín JF, Rios LA. Conceptual characterization of udder health in dairy systems: a systematic review 1962 – 2019. Tropical and Subtropical Agroecosystems. 2022; 25 (103):1-16 - 14.
Zapata-Salas R, Guarín JF, Ríos-Osorio LA. Udder health, conceptual construct, and uses of the term: A systematic review from 1962 to 2019. Veterinary World. 2022; 15 (4):855-869 - 15.
Strauss A, Corbin J, Bases de investigación cualitativa. Técnicas y Procedimientos Para Desarrollar la teoría Fundamentada (Basics of Qualitative Research. Techniques and Procedures for Developing Grounded Theory). 2th ed. Medellín: Universidad de Antioquia; 2012 - 16.
Castillo E, Vásquez ML. El rigor metodológico en la investigación cualitativa (Methodological rigor in qualitative research). Colombia Médica. 2003; 34 (3):164-167 - 17.
Múnera-Bedoya OD, Cassoli LD, Machado PF, Cerón-Muñoz MF. Influence of attitudes and behavior of milkers on the hygienic and sanitary quality of milk. PLoS One. 2017; 12 (9):e0184640 - 18.
Schwendner AA, Lam TJ, Bodmer M, Cousin ME, Schüpbach-Regula G, van den Borne BH. Knowledge, attitude and practices of Swiss dairy farmers towards intramammary antimicrobial use and antimicrobial resistance: A latent class analysis. Preventive Veterinary Medicine. 2020; 179 :105023 - 19.
Emanuelson U, Sjöström K, Fall N. Biosecurity and animal disease management in organic and conventional Swedish dairy herds: A questionnaire study. Acta Veterinaria Scandinavica. 2018; 60 (1):1-7 - 20.
de Lauwere C, van Asseldonk M, Bergevoet R, Bondt N. Understanding decision-making of dairy farmers with regard to participation in a dairy health programme. Livestock Science. 2020; 239 :104061 - 21.
Garforth C. Livestock keepers’ reasons for doing and not doing things which governments, vets and scientists would like them to do. Zoonoses and Public Health. 2015; 62 :29-38 - 22.
Ritter C, Jansen J, Roche S, Kelton DF, Adams CL, Orsel K, et al. Invited review: Determinants of farmers’ adoption of management-based strategies for infectious disease prevention and control. Journal of Dairy Science. 2017; 100 (5):3329-3347 - 23.
Wong SS. Judgments about knowledge importance: The roles of social referents and network structure. Human Relations; Studies Towards the Integration of the Social Sciences. 2008; 61 (11):1565-1591 - 24.
Skaalsveen K, Ingram J, Urquhart J. The role of farmers’ social networks in the implementation of no-till farming practices. Agricultural Systems. 2020; 181 :102824 - 25.
Kayitsinga J, Schewe RL, Contreras GA, Erskine RJ. Antimicrobial treatment of clinical mastitis in the eastern United States: The influence of dairy farmers’ mastitis management and treatment behavior and attitudes. Journal of Dairy Science. 2017; 100 (2):1388-1407 - 26.
Mills KE, Koralesky KE, von Keyserlingk MAG, Weary DM. Social referents for dairy farmers: Who dairy farmers consult when making management decisions. Animal. 2021; 15 (10):100361 - 27.
Aidara-Kane A. Containment of antimicrobial resistance due to use of antimicrobial agents in animals intended for food: WHO perspective. Revue Scientifique et Technique. 2012; 31 (1):277-287 - 28.
Ruegg PL. Making antibiotic treatment decisions for clinical mastitis. Veterinary Clinics Food and Animal. 2018; 34 (3):413-425 - 29.
Oliveira L, Ruegg PL. Treatments of clinical mastitis occurring in cows on 51 large dairy herds in Wisconsin. Journal of Dairy Science. 2014; 97 (9):5426-5436 - 30.
Rajala-Schultz P, Nødtvedt A, Halasa T, Persson WK. Prudent use of antibiotics in dairy cows: The Nordic approach to udder health. Frontiers in Veterinary Sciences. 2021; 8 :623998 - 31.
Scherpenzeel CGM, Tijs SHW, Den Uijl IEM, Santman-Berends IMGA, Velthuis AGJ, Lam TJGM. Farmers’ attitude toward the introduction of selective dry cow therapy. Journal of Dairy Science. 2016; 99 (10):8259-8266 - 32.
Vaarst M, Bennedsgaard TW, Klaas I, Nissen TB, Thamsborg SM, Østergaard S. Development and daily Management of an Explicit Strategy of nonuse of antimicrobial drugs in twelve Danish organic dairy herds. Journal of Dairy Science. 2006; 89 :1842-1853 - 33.
Russell RA, Bewley JM. Characterization of Kentucky dairy producer decision-making behavior. Journal of Dairy Science. 2013; 96 :4751-4758 - 34.
Poizat A, Bonnet-Beaugrand F, Rault A, Fourichon C, Bareille N. Antibiotic use by farmers to control mastitis as influenced by health advice and dairy farming systems. Preventive Veterinary Medicine. 2017; 146 :61-72