An Epidemiologic Study of Antimicrobial Resistance

The emergence of antimicrobial resistant bacteria has become a concern in veterinary medicine. In addition to this problem, appropriate usage of antimicrobials is a concern in the U.S. as well as in developing countries such as South Africa. The objectives of this study were 1) to investigate the burden and patterns of antimicrobial resistance (AMR) among equine Staphylococcus samples submitted to the University of Kentucky Veterinary Diagnostic Laboratory (UKVDL); 2) to investigate the opinions, knowledge and perceptions of veterinarians in Kentucky regarding AMR and antimicrobial prescription practices; and 3) to identify predictors of their knowledge and opinions; 4) to investigates the knowledge, prescription practices and attitudes towards AMR among veterinarians in the City of Tshwane, Metropolitan Municipality; and 5) to identify predictors of their knowledge and attitudes. In study 1, the proportion of resistant isolates by animal breed, species of organism, sample source, and time period were computed. Chi-square and Cochran-Armitage trend tests were used to identify significant associations and temporal trends, respectively. Logistic regression models were used to investigate predictors of AMR and multidrug resistance (MDR). In studies 2 and 3, a 30-question survey was administered to members of the Kentucky Veterinary Medical Association (KVMA) and among veterinarians in the City of Tshwane, Metropolitan Municipality. The proportion of responses to survey questions and 95% confidence intervals were computed. Predictors knowledge of antimicrobial resistance and antimicrobial prescription practices of respondents as well as their colleagues were investigated using Ordinary logistic models and multinomial logistic regression models.Study 1 found significant (p<0.05) associations between odds of AMR and horse breed, species of organism and year. Similarly, significant (p<0.05) associations were identified between odds of MDR and breed and age. Study 2 observed no significant associations among any of the predictors. However, in study 3 veterinarians in mixed animal practice had significantly lower odds (OR=0.20; p=0.0103) of associating "improper use of antimicrobials" to "selection for AMR" compared to those in small animal practice. Compared to females, males were significantly more likely (Relative Risk Ratio [RRR]=10.5; p=0.002) to indicate that their colleagues overprescribed antimicrobials rather than to "neither agree nor disagree" or "disagree."

Portions of this document were previously published in the BMC Veterinary Research Journal in 2018.