Antimicrobials in small-scale urban pig farming in a lower middle-income country - arbitrary use and high resistance levels

• Published in: Antimicrobial resistance & infection control Vol. 7; no. 1; p. 35
• Main Authors: Ström, G, Boqvist, S, Albihn, A, Fernström, L-L, Andersson Djurfeldt, A, Sokerya, S, Sothyra, T, Magnusson, U
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 07.03.2018; BioMed Central; BMC
• Subjects: Adult; Aged; Agricultural industry; Agricultural Sciences; Agriculture; Aminoglycosides; Amoxicillin; Ampicillin; Analysis; Animals; Annan veterinärmedicin; Anti-Bacterial Agents - administration & dosage; Anti-Infective Agents - administration & dosage; Anti-Infective Agents - therapeutic use; Antimicrobial resistance; Antimicrobial use; Bacteria; Cambodia; Clinical Science; Drug resistance in microorganisms; Drug Resistance, Bacterial; Drug Utilization; Escherichia coli; Escherichia coli - drug effects; Escherichia coli Infections - microbiology; Escherichia coli Infections - veterinary; Farmers - psychology; Farms; Female; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi; Health Knowledge, Attitudes, Practice; Humans; Klinisk vetenskap; Lantbruksvetenskap och veterinärmedicin; Livestock; Male; Middle Aged; Other Veterinary Science; Pathobiology; Patobiologi; Pig production; Pork industry; Poverty; Public Health, Global Health, Social Medicine and Epidemiology; Surveys; Surveys and Questionnaires; Swine; Swine Diseases - prevention & control; Urban Population; Veterinary Science; Veterinärmedicin; Young Adult; Cambodia; Pig production; Antimicrobial resistance; Cambodia; Antimicrobial use
• ISSN: 2047-2994; 2047-2994
• DOI: 10.1186/s13756-018-0328-y

Administration of antimicrobials to food-producing animals is regarded as a major contributor to the overall emergence of resistance in bacteria worldwide. However, few data are available on global antimicrobial use and resistance (AMR) in livestock, especially from low- and middle-income countries. We conducted a structured survey of 91 small-scale pig farms in the urban and peri-urban areas of Phnom Penh, Cambodia, to assess the farmers' knowledge, attitudes and practices related to antimicrobial use in their pig production. Commensal was isolated from three healthy pigs from each farm (  = 261) and susceptibility testing was performed against 14 antimicrobials, using broth microdilution. Univariable logistic regression and generalized linear mixed models were used to investigate potential associations between farm characteristics, management factors and resistance to different types of antimicrobials. We found a widespread and arbitrary use of antimicrobials, often based on the farmer's own judgment. Around 66% of the farmers reported frequently self-adjusting treatment duration and dosage, and 45% had not heard about the term 'antimicrobial resistance'. The antimicrobials most commonly mentioned or kept by the farmers were amoxicillin, tylosin, gentamicin and colistin. Around 37% used a feed concentrate that contained antimicrobials, while antimicrobials for humans were used as a last-line treatment by 10% of the farmers. Commensal exhibited high prevalence of resistance to several antimicrobials considered to be of critical importance for human medicine, including ampicillin, ciprofloxacin and colistin, and multidrug-resistance was found in 79% of the samples. Higher prevalence of resistance was observed on farms that administered prophylactic antimicrobials and on farms that treated the entire group or herd in the event of disease. The widespread and arbitrary use of antimicrobials in pig farming in Cambodia is highly worrisome. Overall, farmers had a low awareness of the risks and consequences related to antimicrobial use and AMR. The results presented in this study confirm the hypothesis that non-rational use of antimicrobials results in higher prevalence of AMR and highlight the need for professional animal health systems that involve medically rational use of antimicrobials in emerging economies such as Cambodia.