Western Poultry Conference, Feb 29, 2016,

Sheraton, Red Deer, AB

Antibiotics in Canadian Poultry - what

this all means and how it affects us at the

farm level?

Tom Inglis BSc. Ag, DVM, Dipl. ACPV

What will we be talking about today

Predictions?

The Canadian antibiotic landscape is

changing rapidly due to increased demand

for antibiotic-free production and to the push

for reduced antibiotic use. Tom will provide

us with some clarity for what this all means

and how it affects us at the farm level.

“Those who have knowledge, don’t predict

and those who predict don’t have

knowledge.” Lao Tzu

What will we be talking about today

What is changing

Society

Regulations

Industry response

Tell our own story

Report Card

AMR and AMU

Roll up our sleeves, at the farm level

RWA – balancing act

Back to basics – real alternatives to antibiotics

Deep Thought

If teachers struggle to educate students who pay to

take classes from them what are the chances of

educating consumers?

Price, Taste, other

Price:Competitive

Taste+Other:Creative“Health by stealth”

Understanding Consumer Concerns

Source: The Responsible Use of Health Management Products for Poultry

Production: A Home Study Course for Alberta Producers.

Does AMU equal AMR?

Image Source: http://amrls.cvm.msu.edu/veterinary-public-

health-module/ii.-the-human-health-impact-of-antimicrobial-

resistance-in-animal-populations

Regulatory Changes

CFIA under Health Canada not

Agriculture – One Medicine

Most programs are under review and

moving to outcomes based auditing

and regulation

Overseeing HACCP based

requirements – setting standards

USDA – move to publishing results

rather than focusing on corrective

actions and fines

Regulatory Changes

Human health side – education and

changes in common practices (not all

bugs need drugs campaign)

Category 1

AM

Prophylactic

Use of AM

New Measures Health Canada proposes new measures

to address antimicrobial resistance -April 17, 2015

“Health Canada … to phase out all growth promotion claims of medically-important antimicrobial drugs by December 2016….

strengthen the control over the importation of veterinary active pharmaceutical ingredients (APIs); and

… increase … veterinary oversight with respect to access to all medically-important antimicrobial drugs that are used in livestock drinking water and feeds.”

Types of treatment:

Growth promotion is no longer considered an

acceptable claim for treatment

Preventative - “administration without having

observed clinical signs/disease”

Metaphylaxis – timely mass medication to

eliminate or minimize an expected outbreak of

disease

Therapeutic – treatment of a diagnosed disease

or disorder

On label/Off label

Types of treatment:

Therapeutic: following diagnosis of disease

Lower Classes of Antimicrobials 4,3,2,1

Treatment of subclinical disease will require

early observation of problems

Treat diseases not symptoms

Treat first ask later, Ask first treat later

Judicious = Wise (Dx), Responsible (Rx), Well

advised (Veterinarians with valid VCR)

Antimicrobial Classification System Public Health Agency of Canada

13

Category Importance to Humans Criteria

I Very High Importance Essential for serious human

infections; few or no alternatives;

may be last resort

II High Importance Variety of infections, including

serious ones. Few alternatives.

III Medium Importance Alternatives generally available

IV Low Importance Not used for humans

Classification of Poultry Antibiotics

14

Category Examples of Agriculture AMU*

I • Ceftiofur (ExcenelTM) – extra-label

• BaytrilTM – extra-label

II • Viginiamycin (e.g. StafacTM)

• LincomixTM, LincomycinTM

• TylanTM

• UniprimTM – extra-label

• RometTM – extra-label

• Penicillins (e.g. Pot-PenTM, Super BoosterTM, Pen-PTM)

III • BMDTM

• Sulphonamides (e.g. SulfaTM)

• Tetracyclines

• Neomycin

• ApralanTM – extra-label

IV • Ionophores (e.g. RumensinTM, MontebanTM, MaxibanTM,

SacoxTM, etc.)

Based on the 2002 Uses of Antimicrobials in Food Animals in Canada: Impact on Resistance and

Human Health report of the Advisory Committee on Animal Uses of Antimicrobials and Impact on

Resistance and Human Health, Veterinary Drugs Directorate

Category 1

AM

Prophylactic

Use of AM

Industry Response

Voluntary withdrawal of the

preventative use of Class 1

Antimicrobials (Ceftiofur – Excenel,

Enrofloxacin - Baytril)

Chicken, Hatching Egg, Turkey

What does this mean?

Types of Use

Categories of Antimicrobials

Regulatory Changes

CIPARS measuring resistance profiles

of pathogens found in retail meat

products

Did you know you had a report card?

Canadian Integrated Program for

Antimicrobial Resistance Surveillance

(CIPARS)

CIPARS is run by Public Health Agency of

Canada

Report card on AMR and AMU in the

Canadian poultry industry

What is the story?

Antimicrobial use and resistance

patterns in broiler and breeders in

Alberta 2010-2015(Jan-Oct)

Data collected from the clinical cases submitted to the Poultry Health Centre of Excellence in Alberta

Report generated by the staff at Poultry Health Services

Data Sources All data is sourced from Poultry Health Centre

of Excellence submissions to the lab in Airdrie

Alberta local data is compared to CIPARS

data

Alberta Broiler Chickens

Alberta broiler chicken diagnostic cases; number

of cases provided a prescription (only 9%-39% of

cases treated)

**

* Jan-Oct 2015

Alberta broiler chicken diagnostic cases;

distribution of antibiotics prescribed (71-91% of

use is Category 3)

Numbers of Alberta broiler chicken diagnostic cases with no

prescription or by antibiotic prescribed (enrofloxacin used 0-7

times/year our of 226-338 cases)

*

* Jan-Oct 2015

Broiler Take Home Messages

86-94% category 3 antimicrobial used (sulfaquinoxaline)

Low rate of use of antibiotics in clinical cases (91% to 71% of cases not treated)

Enrofloxacin used in 0-6% of broiler cases and CIPARS reports 0% Campylobacter resistance!

High correlation with CIPARS data with higher numbers 128 Alberta isolates versus 98 National isolates

Why is industry not reporting this type of use and sensitivity data?

Proportion of resistant E. coli isolates from PHCE

diagnostic cases (2013, 2014, 2015)

*E.Coli is naturally resistant to Penicillin

Broiler Resistance Take Home Message

In E. coli decreasing resistance noted

in 8/11 antimicrobials in Alberta in the

last few years

Alberta Breeder Chickens

Alberta broiler breeder diagnostic cases;

number of cases provided a prescription

n = 226,281,252,307,332,165(to date 2015)

*

* Jan-Oct 2015

Alberta broiler breeder diagnostic cases;

distribution of antibiotics prescribed

Numbers of Alberta broiler breeder diagnostic

cases with no prescription or by antibiotic

prescribed

*

* Jan-Oct 2015

Breeder Take Home Messages

AMU is different in Breeders (more flocks treated more with higher category antimicrobials (15-68% of cases treated, of those up to 60% of treated flocks received enrofloxacin)

Apramycin (category 3) is a viable alternative to enrofloxacin (category 1) for early breeder infections

Enrofloxacin is still deemed clinically necessary for severe E. coli and Pasturella sp. infections

Comparing resistant E. coli isolates in Alberta

broiler breeders and chicken broilers (2013)

Breeder versus Broiler Take Home

Messages

More resistance seen in long lived

birds (expected)

Different patterns (lower resistance)

seen in broiler offspring (less likely that

vertical transmission is a key element

for resistance in broilers – E. coli)

Antibiotic Class AntibioticCIPARS data

n = 91

PHCE data

n = 158

Aminoglycosides

Gentamicin 19.7 55.1

Kanamycin 18.7 ─

Streptomycin 45.1 ─

Neomycin ─ 20.3

Aminocylcitol Apramycin ─ 8.9

B-lactams

Ampicillin 72.5 ─

Amoxillin-clavulanic acid 54.9 ─

Ceftriaxone 53.8 ─

Cefoxitin 53.8 ─

Ceftiofur 50.5 51.9

Amoxicillin ─ 74.7

Penicillin ─ 99.4

Folate pathway inhibitors

Sulfisoxasole 31.9 ─

TMS 6.6 18.4

Triple sulfa ─ 73.4

MacrolidesAzithromycin 0 ─

Erythromycin 84.8

PhenicolsChloramphenicol 6.6 ─

Florfenicol ─ 16.5

Quinolones

Ciprofloxacin 0 ─

Nalidixic Acid 7.7 ─

Enrofloxacin ─ 1.9

Tetracyclines Tetracycline 56 79.1

CIPARS Data Take Home

Messages

High correlation with CIPARS data

although different drugs measured using

different methods

If use is not reported it is assumed to be

the cause of the resistance

If all use is prescribed, all use could be

reported* Regulator

We must measure resistance outcomes

not only efforts to reduce resistance

RWA -Consumer Perceptions -

demands

Responsible:

Consumer

Society

Environment

Birds

Stewardship:

balance

Sustainable

Conceptual (debated), Outcomes

(measured)

RWA- Providing Choices

Consumer role is to vote with their

purchases

Welfare

Public Health

Food SafetyCost

Environment

Tasty

Convenient

Healthy Local

Quality

Consumer role is to vote with their

purchases

Welfare

Public Health

Food SafetyCost

Environment

Tasty

Convenient

Healthy Local

Quality

Challenge/Protection/Response Model

Primary Risk Factor

Requirement

Infectious Pressure/Stress

Biological Response

Challenge/Protection/Response Model

Biological Response:

“The birds never lie” “Even a broken clock

is right twice a day”

Pulling off the band-aids: Some people go

to Harvard….others learn the hard way

RWA is not currently a sustainable alternative for the

whole industry – it doesn’t meet all consumer needs

Traditional to RWA Production:

Managing Disease

Brooding

Temperature

Infectious Pressure/Stress

Biological Response

Vaccination

Maternal

Antibodies

C & D

Water

sanitation

Nutrition

Air Quality

Class 4 AM’s

Class 3 AM’s

Class 2 AM’s

Class 1 AM’s

Raised Without Antibiotics Production

Brooding

Temperature

Infectious Pressure/Stress

Biological Response

Vaccination

Maternal

Antibodies

C & D

Water

sanitation

Nutrition

Air Quality

Class 4 AM’s

Class 3 AM’s

Class 2 AM’s

Brooding

Temperature

Infectious Pressure/Stress

Biological Response

Vaccination

Maternal

Antibodies

C & D

Water

sanitation

Nutrition

Air Quality

Class 4 AM’s

Class 3 AM’s

Raised Without Antibiotics Production

Brooding

Temperature

Infectious Pressure/Stress

Biological Response

Vaccination

Maternal

Antibodies

C & D

Water

sanitation

Nutrition

Air Quality

Class 4 AM’s

Raised Without Antibiotics Production

Brooding

Temperature

Infectious Pressure/Stress

Biological Response

Vaccination

Maternal

Antibodies

C & D

Water

sanitation

Nutrition

Air Quality

Raised Without Antibiotics Production

Brooding

Temperature

Infectious Pressure/Stress

Biological Response

Vaccination

Maternal

Antibodies

C & D

Water

sanitation

Nutrition

Air Quality

Litter

Management

Raised Without Antibiotics Production

Identify Weaknesses and Challenges

Flock Health Check

Brooding

Temperature

Infectious Pressure/Stress

Biological Response

Vaccination

Maternal

Antibodies

C & D

Water

sanitation

Nutrition

Air Quality

Identify Weaknesses and Challenges

Flock Health Check

Brooding

Temperature

Infectious Pressure/Stress

Biological Response

Vaccination

Maternal

Antibodies

C & D

Water

sanitation

Nutrition

Air Quality

Identify Weaknesses and Challenges

Flock Health Check

Brooding

Temperature

Infectious Pressure/Stress

Biological Response

Vaccination

Maternal

Antibodies

C & D

Water

sanitation

Nutrition

Air Quality

“Nothing fails like success”

”There is no better teacher than failure”

What has RWA taught us:

• Antibiotics can fix/hide problems we don’t

understand

• How critical placement temperature and

humidity are…table stakes in the hatchery

12 hours later?

• Water sanitation, cleaning and

disinfection – bird health

• Biofilms are a reservoir for disease and

AMR!

• Subclinical disease control is critical (HE,

IBD, REO)

• Autogenous Vaccine - copy the culprit

What we used to do:

a b c d e f g h I j k l m n o p q

0

0.5

1

1.5

2

2.5

3

Ave

rag

e m

icro

sc

op

ic le

sio

n s

co

re

Farm

Maxiban/Monteban/BMD 2010

Duod Micro Score(0-4)

Jejun Micro Score(0-4)

Cecal Micro Score(0-4)

Program 1

Program 2

Data loggers

HOBO data loggers

Temperature

Humidity

Dew point

Placed in barn, at bird level

Temperature recommendations

Temperature recommendations vary with range in RH

Total range = 18 – 36 degrees Celsius

Broiler Temperature and humidity (Ross 308)

Recommended temperature at a given % RH

Age (days) 40% RH 50% RH 60% RH 70% RH 80% RH

0 36 33.2 30.8 29.2 27

3 33.7 31.2 28.9 27.3 26

6 32.5 29.9 27.7 26 24

9 31.3 28.6 26.7 25 23

12 30.2 27.8 25.7 24 23

15 29 26.8 24.8 23 22

18 27.7 25.5 23.6 21.9 21

21 26.9 24.7 22.7 21.3 20

24 25.7 23.5 21.7 20.2 19

27 24.8 22.7 20.7 19.3 18

30 22.7 21.7 20.7 19.3 18

33 21.7 20.7 20.7 19.3 18

36 20.7 20.7 20.7 19.3 18

39 20.7 20.7 20.7 19.3 18

42 20.7 20.7 20.7 19.3 18

Barn A Dew Point (°c)

0

5

10

15

20

25

0 1 2 3 6 9 12 15 18 21 24 27 30 33

DP

(°C

)

Age (days)

Recommended Dew Point vs Actual Loggers 26, 32 & 70

40% RH

Right Front 32

Mid 70

Back Left 26

80% RH

* Early chilling * Early chilling

AVG: 0.32

Program 1

Barn A – Water ResultsAnalysis Units Result Det. Limit Guideline

Microbiological Analysis

Total Coliforms MPN/100 mL 14 1.8 10

Pseudomonas aeruginosa CFU/100 mL >1,500,000 1

Escherichia coli MPN/100 mL 14 1.8

Chemical Analysis

pH 8.31 6.5 - 8.5

Electrical Conductivity µS/cm 1,720 1

Calcium mg/L 8.8 0.2

Magnesium mg/L 2.7 0.2

Sodium mg/L 388 0.4 200

Potassium mg/L 2.1 0.4

Iron mg/L 0.06 0.01 0.3

Manganese mg/L 0.008 0.005 0.05

Chloride mg/L 3 0.4 250

Nitrate-N mg/L 0.82 0.01 10

Nitrite-N mg/L <0.005 0.005 1

Sulfate mg/L 291 0.9 500

Hydroxide mg/L <5 5

Carbonate mg/L <6 6

Bicarbonate mg/L 737 5

Total Dissolved Solids mg/L 1,060 1

Life Cycle of Biofilms E.coli, Pseudomonas, Salmonella sp.

bioFILM PA Kit - ComponentsBiofilm growth & inoculation system

(Modified MBEC Assay)

Growth of biofilm from organism(s) recovered

from sputum sample and inoculation of

bacteria into wells

MBEC Assay with 96-peg lid and ridged trough

A

www.innovotech.ca

Detection and monitoring -

Biofilm

Detection and monitoring - Biofilm

0%

20%

40%

60%

80%

100%

Ecoli

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ss

0%

20%

40%

60%

80%

100%

Be

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Bio

sentr

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Ble

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Pseudomonas

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Antimicrobial Resistance is

Complex

Image Source: http://www.ift.org/knowledge-center/read-ift-publications/science-reports/expert-reports/antimicrobial-

resistance/backgrounder-summary.aspx

AMR is complex- multidrug resistance

plasmids

Autogenous Vaccines – Copy the

Culprit

Cholera

Erysipelas

Inclusion Body Hepatitis

Salmonella

Staph. aureus

REO virus

E.coli

Clostridium (Gangrenous dermatitis)

REO Virus – preventing arthritis

Virus sequencing of Reo isolates collected in 2013

REO viruses in

Western Canadian

Flocks

Are those viruses common?!

Antibiotic Use and Resistance

Take Home Messages

If we don’t tell our story someone else will

We should make changes in use in a systematic, controlled way to ensure bird welfare, sustainable production outcomes and resource use and above all do no harm

Changes in AMU that result in increasing: bird suffering, mortality, morbidity, cost of production and potentially pathogen counts on product without reducing AMR would be irresponsible and unsustainable

PHS team

Thank you……..Questions

The only way to predict the future is to have power to shape

the future.

Eric Hoffer