Antimicrobial resistance (AMR) is a global health challenge and antimicrobial use (AMU) in the livestock sector has been considered as one of the contributing factors towards the development of AMR in bacteria. This study summarizes the results of a point prevalence survey conducted to monitor farm-level AMU in commercial broiler chicken farms in Punjab and Khyber Pakhtunkhwa (KPK) provinces of Pakistan. A cross-sectional study was conducted to quantify AMU and to check seasonal variations of AMU in 12 commercial broiler chicken farms (six from each province) during the summer and winter seasons of the year 2020–2021. AMU was recorded using three AMU metrics: kg, mg per population correction unit (mg/PCU), and mg/kg of final flock weight. A total of 22 antimicrobial drugs (348.59 kg) were used for therapeutic or prophylactic purposes in surveyed broiler chicken farms. The total combined AMU for all the broiler chicken farms was 462.57 mg/PCU. The use of most of the antimicrobials increased during winter flocks compared to summer. The top three antimicrobial drugs used during the summer were neomycin (111.39 mg/PCU), doxycycline (91.91 mg/PCU), and tilmicosin (77.22 mg/PCU), whereas doxycycline (196.81 mg/PCU), neomycin (136.74 mg/PCU), and amoxicillin (115.04 mg/PCU) during the winter. Overall, 60% of the antibiotics used in broiler chicken were critically important antimicrobial classes (CIA) for human medicine as characterized by the World Health Organization. Our findings showed high AMU in broiler chicken production and a call for urgent actions to regulate CIA use in food animals in Pakistan. This baseline survey is critical for the design and implementation of a subsequent national level AMU surveys that can include additional farming types, animals’ species, and geographical locations over a longer period of time.

The agriculture and food (agrifood) sectors play key roles in the emergence, spread, and containment of antimicrobial resistance (AMR). Pakistan’s first National Action Plan (NAP) on AMR was developed to guide One Health interventions to combat AMR through 2017–2022. To improve subsequent iterations, we assessed the implementation of Pakistan’s NAP in the agrifood sectors (NAPag) in October 2022, using the Progressive Management Pathway on AMR tool developed by the Food and Agriculture Organization of the United Nations (FAO). The assessment tool addressed four crucial focus areas of the NAPag: governance, awareness, evidence, and practices. Each focus area contains multiple topics, which involve four sequential stages of activities to progressively achieve systematic management of AMR risk in the agrifood sectors. High-level representatives of the NAPag stakeholders provided information for the assessment through pre-event documentary review and workshop discussions. The assessment results showed that Pakistan’s NAPag had an overall moderate coverage (59%) of the anticipated activities. Gaps were particularly notable in strengthening governance, good practices, and interventions in non-livestock sectors. Furthermore, only 12% of the evaluated activities were fully executed and documented, consistently remaining at the planning and piloting stages in the livestock sector across all the examined topics. Insufficient attention to non-livestock sectors, inadequate regulation and enforcement capacity, and resource constraints have hindered scalable and sustainable interventions under the current plan. This assessment provides valuable insights to strengthen the inclusiveness and contribution of the agrifood sectors in the next NAP iteration. In the short-to-medium term, strategic prioritization is necessary to optimize the use of limited resources and target the most critical gaps, such as improving awareness among key stakeholders and fortifying regulations for prudent antimicrobial use. In the long term, integration of AMR into the country’s broader health, development, and agricultural transformation agendas will be needed to generate sustainable benefits.

Peste des petits ruminants (PPR) is a highly contagious viral disease of domestic and wild small ruminants and thus has serious socioeconomic implications. In Pakistan, during the year 2012-2013, estimated losses due to PPR were worth Rs. 31.51 billions. Close contact between infected and susceptible animals is an important route of transmission of PPR. Therefore, carrier animals play an important role in unnoticed transmission of PPR. The objective of the study was to investigate the detection of PPR virus in goats recovered from PPR. A suspected PPR outbreak was investigated and confirmed as PPR after analysing appropriate samples collected from infected animals using rRT-PCR. A longitudinal study was conducted over the period of 16 weeks to ascertain the detection of PPR virus (PPRV) in faecal samples of recovered goats. Ninety-six (96) faecal samples from each sampling were collected at 4, 8, 12, and 16 weeks after the outbreak. Faecal samples were analysed using rRT-PCR. Of 96 from each sampling a total of 46, 37, 29, and 25 samples were positive for PPR viral genome at 4, 8, 12, and 16 weeks, respectively, after recovery. Attempts were made for the isolation of PPR virus on Vero cells, but results were negative. These results indicated the detection of PPR viral RNA up to 16 weeks after infection. Therefore, these results may help in the future epidemiology of PPR virus shedding and possible role as source of silent infection for healthy animals especially when there is no history of any outbreak in nearby flock or area.

Antimicrobial resistance (AMR) is a global public health issue, causing an estimated 1.27 million deaths in 2019. This systematic review and meta-analysis aim to assess the burden of AMR in food animals in Pakistan, identify resistant microbes, and highlight emerging trends in multidrug resistance (MDR). The major databases were searched for articles published between 2016 and 2020 on the prevalence of AMR in food animals in Pakistan. A random-effects model was employed to pool the prevalence of antibiotic-resistant Enterobacteriaceae and non-Enterobacteriaceae pathogens. Among 1,145 studies, 35 met the inclusion criteria as evidence of AMR in food animals. Escherichia coli showed the highest resistance to ampicillin (59.5%), ciprofloxacin (49%), oxytetracycline (39%), and chloramphenicol (35%); Salmonella to ampicillin (78.4%), amoxicillin (53.9%), chloramphenicol (40%), tetracycline (39.3%), and ciprofloxacin (39%); Staphylococci to cefoxitin (53.8%) and penicillin (34.8%); and Campylobacter and Klebsiella to ciprofloxacin (50.4% and 83.3%, respectively). MDR was observed in E. coli (12/12 studies), Salmonella (7/10), Staphylococci (3/8), Campylobacter (3/3), and Klebsiella (1/3), with extensive drug resistance in E. coli (3/12), Salmonella (4/10), Campylobacter (1/3), and Klebsiella (2/2). Enterobacteriaceae showed significant resistance to tetracyclines (pooled prevalence/PPr = 0.75) and aminopenicillins (PPr = 0.74), whereas non-Enterobacteriaceae showed resistance to cephalosporins (PPr = 0.67) and aminopenicillins (PPr = 0.59), both with substantial heterogeneity. This review shows the existence of bacteria resistant to commonly used antimicrobials in food animals, potentially a threat to both human and animal health. The findings suggest the continuous monitoring of AMR and antimicrobial use (AMU) and the regulation of AMU in the food and agriculture sectors.

Peste des Petits Ruminants (PPR) is a highly contagious viral disease of domestic and wild small ruminants causing high morbidity and mortality (up to 100%) and thus, has serious socioeconomic implications. In Pakistan, estimated losses due to PPR during the year 2012-13 were worth Pakistan Rs. 31.51 billion. Close contact between infected and susceptible animal is an important route of transmission of PPR. Therefore, carrier animals play an important role in unnoticed transmission of the disease. Limited information is available about the persistence of PPR virus in goats. Hence, the objective of the study was to investigate the persistence of PPR virus (PPRV) in goats recovered from PPR. A suspected PPR outbreak in sub-urban area of Lahore district of the Punjab Province in Pakistan was investigated. The outbreak was confirmed as PPR after analyzing appropriate samples (nasal/ocular swabs, fecal and tissue samples) collected from the infected animals. A longitudinal study was conducted over a period of 16 weeks to ascertain the persistence of PPRV in the fecal samples of recovered goats (n=96) collected at 4, 8, 12 and 16 weeks after the outbreak. Samples were analyzed using RT-PCR. Of the 96 fecal samples, 46, 37, 29 and 7 goats remained positive for PPRV genome at 4, 8, 12 and 16 weeks after recovery, respectively. The results revealed the detection of PPRV genome in goats at 16 weeks after recovery. Therefore, it can be concluded that PPR disease has a carrier potential and goats recovered from PPR infection may act as source of carrier animals.

Irrational use of antimicrobials in humans, livestock and poultry are often cited as the key drivers of accelerated emergence of antimicrobial resistance (AMR) in humans and animals. In Pakistan, the use of antimicrobials in livestock and poultry is not well-regulated owing to limited and/or ineffective implementation of existing legislations and lack of coordination amongst the key stakeholders. To gather data and information pertinent to the supply chain mapping and the usage of antibiotics in the livestock and poultry sectors of Pakistan, a national workshop among selected influential stakeholders was held in Islamabad, Pakistan during March 2020 to map the supply chain and usage of antibiotics in country. Participants from all relevant organizations identified the supply chain and discussed the status, challenges, and way forward to enhance data collection and monitoring of antimicrobials usage (AMU) in livestock and poultry sectors to contain emergence of AMR. The pre-workshop questionnaire was designed to gather relevant information on AMU and its distribution among diverse markets and users from the workshop participants, utilizing open-ended questions. A chart depicting the relative magnitude of an antimicrobial use (AMU) supply chain was constructed to illustrate the flow of antimicrobials from import and production to end-use at the farm level. This chart was shared with participants to gather their professional opinions and potential corrections. It also presented a list of agencies and their roles in regulating AMU, along with the types of AMU data available at each level. Specific recommendations were made at the end of the workshop to review and update legislation to cover the entire AMU supply chain, enhance regulations to restrict the use of antimicrobial growth promoters, build an integrated national AMU database system, and raise awareness about the responsible use of antimicrobials in the livestock and poultry sectors. It was concluded that the AMU supply chain in veterinary sector of Pakistan is fragmented and is co-regulated by various federal and provincial stakeholders. There are some drugs such as antibiotic growth promoters which are not regulated at all. The approach and findings from this study can serve as a model to validate the use and management of antibiotics in other similar countries currently grappling with serious antimicrobial resistance (AMR) crises.