Veterinary Vertex
Veterinary Vertex is a weekly podcast that takes you behind the scenes of the clinical and research discoveries published in the Journal of the American Veterinary Medical Association (JAVMA) and the American Journal of Veterinary Research (AJVR). Tune in to learn about cutting-edge veterinary research and gain in-depth insights you won’t find anywhere else. Come away with knowledge you can put to use in your own practice – along with a healthy dose of inspiration to remind you what you love about veterinary medicine.
Veterinary Vertex
Tracking Antimicrobial Use in US Animal Agriculture: Challenges and Solutions
Ever wondered how we can better track and manage antimicrobial use in US animal agriculture? Join Drs. Katherine Huebner and Susan Bright-Ponte as they unravel the complexities of data collection in livestock, sharing insights from FDA-funded projects that started in 2016. Discover the historical challenges of establishing a national database and how understanding antimicrobial use in varied contexts like disease outbreaks or natural disasters can inform better stewardship practices. This episode promises to enhance your understanding of how critical data informs policies to combat antimicrobial resistance.
Katherine and Susan emphasize the importance of building trust with producers and the challenges of data collection across livestock segments. They also spotlight the role of public-private partnerships and the FDA’s ongoing support. All this wrapped up with a One Health approach to stewardship and some lighthearted moments that bring a personal touch to the professional dialogue. Don't miss out on this illuminating conversation!
JAVMA article: https://doi.org/10.2460/javma.24.03.0180
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Speaker 2:Learn more at nextcardcombocliniccom. Today You're listening to Veterinary Vertex, a podcast of the AVMA Journals. In this episode we chat about mapping the future of antimicrobial use data collection in US animal agriculture with our our guests Kate Huebner and Susan Bright.
Speaker 3:Welcome to Veterinary Vertex. I'm Editor-in-Chief Lisa Fortier, and I'm joined by Associate Editor Sarah Wright. Today we have Kate and Susan joining us. Thank you again, kate and Susan, so much for being here with us today.
Speaker 4:We're very excited to be here. Thank you for inviting us. Yes, thank you.
Speaker 2:All right, let's explore the fascinating world of antimicrobials. So your current Someone Health Jafna article discusses mapping the future of antimicrobial use data collection in US animal agriculture. Please share with our listeners the background on this article and US animal agriculture.
Speaker 4:Please share with our listeners the background on this article. So antimicrobial use data collection is an issue that the Center for Veterinary Medicine, or CVM, has been discussing for a long time for many years as there's not really currently a coordinated national database repository in the US to collect this type of information in animals. So, basically, to better understand how antimicrobial drugs are used in livestock production and to gauge the impact of ongoing antimicrobial stewardship efforts, the FDA had funded two cooperative agreements for antimicrobial use data collection in food producing animals that had began in 2016. And the primary goals for those projects was basically to kind of provide baseline information on antimicrobial use practices in the four major food-producing animals so those are cattle, swine, chickens and turkeys and basically to gather information on data collection methodologies. And this was all aimed at just helping to optimize long-term strategies for collecting and reporting antimicrobial use data.
Speaker 2:Yeah, thank you for submitting this to JAFMA. Definitely it's going to be a very informative article for our readers. So what were some of the important take-home messages from this article?
Speaker 5:I'll be happy to go over that one, I guess.
Speaker 5:First, to frame this for listeners who may not have read the article or just skimmed it, in this article we focused on summarizing the methods or methodologies used by the FDA-funded cooperative agreement projects and, instead of summarizing the trends that were studied in those projects and so the studies, extracted antimicrobial use data collected between 2016 to 2021 across beef, feedlot animals, dairy cattle, swine and poultry, and in the article we focused on really looking into the diverse data sources that were used to source that information, and one of the big takeaways was just how different those data sources were across the different animal sectors, which we found very interesting.
Speaker 5:Also, in general, I think an important take-home point is kind of the why do we care about this and why is antimicrobial use data important, and what is the purpose for going through these great lengths to extract that information and to answer that at a high level? I think I would state that antimicrobial use data is a really valuable information for monitoring trends, but also for informing different policies or stewardship interventions at various levels, whether that's national, regional or even the individual practice level, and it can be used to inform also the different drivers of antimicrobial resistance in veterinary settings or agricultural settings.
Speaker 4:I think another key take-home for us is that context is key. So antimicrobial use metrics you know how they're measured, what measurements we collect they need to be interpreted in the context of the system from which they are collected. So, for example, a lot of things add to the context, including even things like disease, outbreaks, natural disasters, drug shortages you know anything that could affect antimicrobial drug use basically. So it's kind of really important to just understand and interpret the data within you know the setting or within the circumstances. So one I was going to say recent, but it's been a while now example is the COVID-19 pandemic, which definitely impacted drug availability and drug use patterns in some cases.
Speaker 4:Drug availability and drug use patterns in some cases, for example, there was a penicillin shortage which occurred during the pandemic and seemed to especially affect turkeys. And I guess the other thing to take note of is that there's no standardized kind of one size fits all metric that will fit for every species or every population of animals. So kind of that choice of antimicrobial use metric really can depend on the scale of data collection and what you're collecting the data for. So, for example, if it's to inform, you know individual farm stewardship programs, or if it's being collected to help inform more. You know national trend analyses, so yeah.
Speaker 3:I really like, susan, how you said it's important to know the context, because I think a lot of at least the general public think of antimicrobial use in any food or farm animal as nefarious. It's all to make the animal grow faster, grow bigger. They shouldn't be doing that. Our kids are going to get those residuals. So I really like how you put that into context. That's really important, I think.
Speaker 4:Good yeah, I think that's important too. Thank you.
Speaker 3:What sparked your research interest in antimicrobial use data?
Speaker 4:For me. I guess I was kind of intrigued more by the epidemiologic aspects of AMU, or antimicrobial use, data collection and analysis, and how we can kind of consider that in light of really the diversity and the diverse nature of agricultural settings agricultural settings I've always had just kind of an interest in epidemiology and especially epidemiology of AMR, antimicrobial resistance and when I had been working on my MPH program the focus of my program was epidemiology. I had done a project for my MPH capstone at the time related to adverse drug event analysis and for particular animal drugs, and I found just the data analysis and data mining aspect of that to be really interesting and applicable to many other types of data analysis projects that we have going on in CVM. So of course my clinical practice experience also contributed to it and these cooperative agreements that we had going just really kind of increased my own awareness also about antimicrobial use practices in clinics. So, Kate, what about you?
Speaker 5:Yeah. So I guess after I graduated from veterinary school at the University of Pennsylvania, pennwe, I went on to do a livestock medicine and surgery internship at Colorado State University and then I stayed there City and then I stayed there. Oh yeah, I actually looked at Cam the Ram. That's another story. So during my internship year I had a crash course about the role of the veterinarian and what goes on when it comes to working with farmers on antimicrobial stewardship and how to appropriately use antimicrobials, for example, treatment protocols on dairy farms, and also just the appropriate steps to diagnose and treat sick animals at individual levels. And then during my master's program in the Department of Clinical Sciences at Colorado State, I did a project looking at a clinical trial in feedlot cattle, kind of comparing antimicrobial treatments to antimicrobial alternatives and looking at disease outcomes, specifically liver abscesses, but also antimicrobial resistance and microbiomes from those clinical trials. So I definitely became really interested in everything related to antimicrobial use patterns and resistance through those different experiences.
Speaker 3:And I like what one of you said. I think it was you, susan, who said it's not just what's happening now. This is to inform the three five-year plan of how we can improve stewardship.
Speaker 4:Exactly.
Speaker 3:Kate. Well, I have you. Both of you spoke a little bit of what were some of the important take-home messages, but always when you do studies, there's things that you're like wow, I didn't expect that. Each of you let me know what is something that surprised you about the results of this study.
Speaker 5:Yeah, one of the findings from kind of methodically going through the different studies and summarizing them and comparing across the different sectors, one thing that we found really interesting was sort of what are the success factors of collecting antimicrobial use data, and one of the factors that we identified was that early interactions and trust building between producers or data holders and the researchers was really key and that this was a critical factor to successfully collect representative data. And I think it highlights just how important having those collaborative relationships are when it comes to these goals of long-term data collection and reporting, rather than only focusing on the technical or logistical aspects. So I guess it's not really surprising per se, but maybe what was surprising was just how essential it was to find those champions committed to building those relationships early on and spearheading the effort. How about you, Susan? Yeah?
Speaker 4:that's really important, kate.
Speaker 4:I think another surprising factor for me well I'm not sure if it's surprising, but interesting finding is just kind of how we were able to identify some of the kind of significant challenges in data collection and this type of data collection, such as some of the limitations and the kind of significant challenges in data collection and this type of data collection, such as some of the limitations and the type of sampling we use convenience or the project coordinators use convenience sampling.
Speaker 4:There was maybe variable industry participation and just kind of a gap in a kind of comprehensive data across all segments of a commodity. So for example, in the projects they were not really able to get information from breeding animals or breeding operations and the youngest animals and you know those kind of challenges in getting that type of information. Just kind of highlighted that there are still some gaps in the data that are currently available which need to be addressed to enhance kind of the accuracy and reliability of the data that we're collecting in the future. So I guess I hadn't really it was a little surprising to me because I hadn't really been aware of the kind of extent of some of the data gaps and variability of the data sources and records when we first started the projects, so that was interesting.
Speaker 2:Yeah, thank you, susan. So you kind of already talked a little bit about the future. So, speaking of the future, what are the next steps for research in antimicrobial use?
Speaker 4:Well, both the methodologies and kind of like the baseline antimicrobial use information that was generated out of these cooperative agreements are very foundational to the development of future programs and I believe that FDA really hopes to continue to support the momentum of some of these efforts in addition to other ongoing efforts by the agency. And just also to note the poultry projects in particular are still ongoing and the poultry industry is continuing to support those efforts. So I think that really helps demonstrate the industry's growing commitment. Existing and growing commitment demonstrate the industry's growing commitment, existing and growing commitment to advance antimicrobial stewardship through judicious use practices and through participating in antimicrobial use data collection projects. Actually, kate, do you have anything to add to that?
Speaker 5:Sure. So while these projects that we talk about in this article are really foundational, the United States is still in the early stages of developing national infrastructure to source data on antimicrobial use across multiple sectors medicines perspective. The CVM does continue to support these efforts. In fact, over the last couple of years FDA has invested resources on collecting feedback from stakeholders on a potential framework to track these data through public-private partnerships. Fda collaborated with a group called Reagan Udall Foundation for FDA to collect this feedback and a summary is available on this potential framework and it was published in a series of reports. So this hypothetical public-private partnership framework that is described in those reports considered different feedback such as what could a potential organizational structure look like, how would this be funded, how could the data be standardized where appropriate, and different data reporting strategies. The hypothetical model kind of describes at a high level different components, so a database repository coordinator, a steering committee and external data partners in order to collect that information.
Speaker 5:I can share that in March 2024, fda announced a new cooperative agreement funding opportunity for long-term data collection of antimicrobial use in animals. It's really structured similarly to the data partners that's described in that Reagan Udall Foundation report. So funds from the program will be to support projects to collect antimicrobial use data from a diverse array of animal sectors, including domestic livestock, poultry, cats, dogs and horses, as well as minor species, and secondly, to contribute, going forward, to the development of data collection frameworks, including public-private partnerships. The development of data collection frameworks, including public-private partnerships. So at this stage, fda is still reviewing and awarding proposals through this new program so definitely stay tuned.
Speaker 3:Lots of exciting stuff coming, yes.
Speaker 5:That's fantastic. Kate, do you see a role for AI in this area of research? Yeah, I do see a role for AI tools in this field, certainly. I think it's really a matter of time before some of these tools are incorporated into long-term data collection frameworks as they are developed. That said, these tools hold a lot of promise, but I think the application of the tools to antimicrobial use data sets is still in the exploratory phase, as is getting access to certain data sets and, from FDA perspective, I know that FDA is seeking still to understand the full scope of the capabilities and limitations of AI tools, such as how to integrate them while also maintaining data integrity and, of utmost importance, data privacy and confidentiality, which is one of the biggest challenges that we face in this field.
Speaker 5:We did learn, though, that you know, as I mentioned, the data sources were highly varied across our cooperative agreements focused on food animals, ranging from electronic health systems to administration records, invoices, prescription records and also survey response data. So, given the diversity of the data sources, prescription records and also survey response data. So, given the diversity of the data sources and you know facts that veterinary electronic health records are often free text fields a lot of different tools like natural language processing could be used to kind of extract that varied lexicon and standardize it so that it's searchable and ready to be analyzed. In fact, some of our additional companion animal cooperative agreements that are ongoing, they're already exploring the use of natural language processing to extract that information from the unstructured data fields. So yeah, I do think there's a lot of potential for you know data integration, analysis, predictive modeling. You know also data reporting and visualization. So a lot of excitement, but definitely still in the early stages in this field, I think.
Speaker 2:Yeah, that's fascinating. Thank you so much for sharing and for those of you just joining us, we're discussing mapping the future of antimicrobial use, data collection and US animal agriculture with our guests Kate Huebner and Susan Bright. So, kate, you talked a little bit about your internship at Colorado State. How did your advanced training prepare you to write this manuscript?
Speaker 5:Yeah. So I guess when I started my veterinary career I really had no idea that I would end up working for the FDA Center for Veterinary Medicine or government. You know I wanted to be a mixed animal practitioner but my career path did lead me this way and I'm really happy it did. I think you know I mentioned my CSU training were really key experiences to prepare me for this role and bringing me to this manuscript. A lot of my mentors emphasized how important it was to write high quality medical records, not naming any names, and they also supported me to write a manuscript for publication through both my internship and during my master's as well. So that definitely helped my science writing improve over time. And then I've definitely, you know, improved my skills through my current position. But really I've learned a tremendous amount from the different researchers involved in these cooperative agreements and you know I really consider them to be the real sector specific experts on the antimicrobial use data.
Speaker 2:That's really cool. Thank you for sharing Now. This next set of questions is going to be very important for our listeners, Susan, what is one piece of information the veterinarian should know about antimicrobial use in US animal agriculture?
Speaker 4:Well, I would say, first and foremost, antimicrobials play a critical role in animal agriculture in terms of keeping animals healthy. So it's really important for veterinarians to be familiar with judicious antimicrobial use principles so that the effectiveness of those antimicrobials can be preserved. So, as AVMA refers to in your judicious use principles, part of the judicious use is really maintaining accurate records of therapy and what the outcomes of those were, so that you can kind of hone, you know what's going to be effective in your practice.
Speaker 2:And then, on the other side of the relationship, what's one thing the public should consider around antimicrobial use in animal agriculture?
Speaker 5:Our article which was published in the Currents of One Health section of JAVMA. You know, I think it's helpful to emphasize the importance of One Health and the One Health approach, in that we all play a role in antimicrobial stewardship, particularly given the interconnectedness between animals, humans and the environment, you know, at various levels and at different systems levels. So I think for the public being aware of the One Health perspective, this is a quintessential antimicrobial resistance is a quintessential One Health problem and you know, I think this is one example of how we can contribute to that is through enhanced data collection to fill some of those gaps.
Speaker 3:Thank you for bringing that up, kate. I was going to ask you about that or at least compliment both of you. Like we try really hard when we're speaking to authors such as you and Susan about please try and emphasize the environment, and I think people will be really surprised how much the environment contributes to antimicrobial resistance and to how important it is for stewardship. As we wind down a little bit, we like to ask a fun question of our guests, so we'll start with Susan. What is the oldest or the most interesting thing on your desk or in your desk drawer?
Speaker 4:Well, I don't know if it's the most interesting, but I tend to stick up cartoons around my laptop and I have some up here on the wall and over here on the wall, and currently I have one that says well, let me look at it. It says keep your hopes high, but also keep some emergency chocolate readily available. So hopefully some chocoholics can relate to that.
Speaker 3:Can relate to that. Who's your favorite cartoonist or cartoon character like Garfield or Emma Hobbs, emma, calvin and Hobbs I?
Speaker 4:love Calvin and Hobbs. Love Calvin and Hobbs yeah, I would have to say them. I like Garfield too, but I like the interaction between the boy and the cat.
Speaker 3:We all know Calvin and Hobbes in our life. Kate, how about you? What's the oldest or most interesting item on your desk?
Speaker 5:Usually I have a desk cat who has been banished for the purposes of this recording. Her name is Astro, but the most interesting item oh, I see a cat tail now. Stroh, but the most interesting item oh, I see a cat tail now. The most interesting item on my on the shelf above my desk is a dog skull that I acquired during vet school. We each got one to learn the anatomy of the skull bones during vet school anatomy class and I actually painted mine with glitter paint and different colors on the different bones and, yeah, I just find skulls to be really, really interesting in terms of how they've evolved to be the shape that they are and, yeah, also from an anatomical standpoint.
Speaker 2:That's very cool. As you can see, I also have a desk cat as well. It's actually talking to someone about this another meeting and some people actually use a dummy laptop for their desk cat, so the cat will hopefully rub on the laptop that's not in use getting in your meetings, but I feel like this one might, might know that she's being punked, so I don't know if that would work for me. But thank you both so much. We really appreciate you being here and also for contributing your manuscript to Javma.
Speaker 4:Thank you for having us. Yes, thank you.
Speaker 2:And to our listeners. You can read Kate and Susan's article and print Javma or by using your favorite search engine. I'm Sarah Wright with Lisa Fortier. We want to thank each of you for joining us on this episode of the Veterinary Vertex podcast. We love sharing cutting edge veterinary research with you and we want to hear from you. Be sure to leave us a rating and review on Apple Podcasts or whatever platform you listen to.
