Gastrointestinal disease is the most common cause of mortality in dairy calves. Septicemia is an important sequela of diarrhea, and the possibility of bacteremia is the primary justification for empirical antimicrobial therapy. Prior reports estimate that approximately one-third of diarrheic calves are bacteremic; however, those estimates may not be representative of routine cases in heifer calves on commercial dairy operations early in the course of disease. We hypothesized that the prevalence of bacteremia in calves with diarrhea and systemic signs of illness is less than prior estimates (∼31%), and that clinical signs or hematological values would be associated with the presence or absence of bacteremia. Female calves less than 21 d of age with and without diarrhea were enrolled from 2 commercial dairy farms over a 10-wk period. Diarrheic calves were enrolled if they were newly diagnosed, had loose to watery stool, had either dehydration (assessed by skin tent and eye position) or depression (assessed by suckle reflex and standing ability), and had no prior antimicrobial treatments. Complete health assessments were conducted at 0, 7, and 14 d following enrollment. An aseptic jugular venous sample was collected and cultured using aerobic and anaerobic methods, and bacterial species were identified using mass spectrometry. Poisson regression models were used to identify associations with bacteremia and compute adjusted prevalence ratios. The prevalence of bacteremia in diarrheic and healthy calves was 9.26% (10/108, 95% confidence interval: 4.5-16%) and 14.8% (4/27, 95% confidence interval: 1.4-28.2%), respectively. Among calves with diarrhea, those with a fever (>39.7°C) or depression were 4.8 and 6.5 times more likely, respectively, to have bacteremia. Only 1 of 47 calves (2%) without signs of depression was bacteremic. The prevalence of bacteremia in diarrheic calves with signs of systemic illness (depression or dehydration) was significantly lower than previous estimates, and bacteremia was rare among calves without observed depression. Antimicrobial therapy targeting bacteremia is not currently justified in routine cases of diarrhea in preweaning calves without signs of depression. These results suggest a substantial opportunity for more targeted antimicrobial therapy to improve antimicrobial stewardship.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in humans in late 2019 and spread rapidly, becoming a global pandemic. A zoonotic spillover event from animal to human was identified as the presumed origin. Subsequently, reports began emerging regarding spillback events resulting in SARS-CoV-2 infections in multiple animal species. These events highlighted critical links between animal and human health while also raising concerns about the development of new reservoir hosts and potential viral mutations that could alter the virulence and transmission or evade immune responses. Characterizing susceptibility, prevalence, and transmission between animal species became a priority to help protect animal and human health. In this study, we coalesced a large team of investigators and community partners to surveil for SARS-CoV-2 in domestic and free-ranging animals around Ohio between May 2020 and August 2021. We focused on species with known or predicted susceptibility to SARS-CoV-2 infection, highly congregated or medically compromised animals (e.g., shelters, barns, veterinary hospitals), and animals that had frequent contact with humans (e.g., pets, agricultural animals, zoo animals, or animals in wildlife hospitals). This included free-ranging deer (n = 76 individuals), free-ranging mink (n = 57), multiple species of bats (n = 59), and other wildlife in addition to domestic cats (n = 275) and pigs (n = 184). In total, we tested 792 individual animals (34 species) via rRT-PCR for SARS-CoV-2 RNA. SARS-CoV-2 viral RNA was not detected in any of the tested animals despite a major peak in human SARS-CoV-2 cases that occurred in Ohio subsequent to the peak of animal samplings. Importantly, we did not test for SARS-CoV-2 antibodies in this study, which limited our ability to assess exposure. While the results of this study were negative, the surveillance effort was critical and remains key to understanding, predicting, and preventing the re-emergence of SARS-CoV-2 in humans or animals.

OBJECTIVE: To understand antimicrobial stewardship (AS) and infection prevention and control (IPC) activities in veterinary schools. METHODS: An online survey was completed by representatives from American Association of Veterinary Medical Colleges–accredited veterinary schools in the US and Caribbean prior to attending the Inaugural Small Animal Antimicrobial Stewardship Workshop for US Veterinary Schools. Responses were examined to identify patterns among AS and IPC activities and adherence to the AVMA core principles. RESULTS: Half (12 of 24) of the surveyed schools had an AS committee and most (79% [19 of 24]) had an IPC committee. Lack of dedicated staff time was a common barrier to AS (88% [21 of 24]) and IPC (75% [18 of 24]) reported by schools both with and without AS and IPC committees. Eleven of 24 schools (46%) reported performing at least 1 activity focused on each of the AVMA’s 5 core principles of AS. Although 79% (19 of 24) of schools incorporate AS into preclinical curricula, training of clinical faculty (17% [4 of 24]), veterinary technicians and support staff (21% [5 of 24]), and house officers (42% [10 of 24]) is less common, despite these individuals engaging in teaching clinical-year veterinary students. CONCLUSIONS: Veterinary schools varied in established AS education and AS and IPC practices, though financial and human resources were a common barrier. CLINICAL RELEVANCE: A collaborative and cohesive approach to AS and IPC among schools to create sustainable frameworks for practice improvement will help combat the global threat of antimicrobial resistance. This is a critical action for settings where future veterinarians are trained.

Small animal antimicrobial stewardship (AS) is emerging as a priority area in the global battle against antimicrobial resistance. Veterinary practices have limited support for implementation of AS programs, and even within veterinary schools, efforts are largely siloed and often limited in scope. Increased collaboration is needed to support and unify AS and infection prevention and control efforts, and to identify priorities for continued research. To address this, a 2-day in-person small animal AS workshop was held in August 2023. Delegates representing 23 US veterinary schools and 4 corporations/government agencies gathered for a series of lightning talks and focused group discussions in 3 domains: implementation of clinical AS programs, research opportunities and needs, and education. The workshop’s goal was to identify and propose solutions for AS challenges. Meeting discussion identified a lack of resources and training as the greatest barriers to hospital AS program advancement and suggested creating standards for AS programs and a road map to support program development. Assessing antimicrobial treatment effects and performing studies to establish necessary treatment durations were considered the highest research priorities. Integrated educational practices were recommended to support unified messaging of AS concepts between preclinical and clinical training. The development of strategies to implement these suggestions was delegated to working groups with a goal to continue meeting biennially as a large group. Sharing news of these efforts is considered integral to heightening awareness and promoting implementation of AS practices moving forward in academic, specialty, and primary care settings.

Clinical veterinary microbiology laboratories and microbiologists are critical in combatting emerging and endemic pathogens and reducing the impact of antimicrobial resistance. For veterinarians, the microbiology laboratory can be an enigmatic place as results from the lab are produced with little transparency and thus can feel disconnected from the submitted specimen. Submission of clinically representative and high-quality specimens to the microbiology laboratory, with a good clinical history, is critically important because it enables the laboratory to produce accurate, efficient, and clinically relevant results. In human medicine, the Infectious Disease Society of America and the American Society of Microbiology have developed a guide for the use of microbiology laboratories to diagnose infectious diseases. It summarized best practices for clinicians and laboratorians to work together to lead to better patient outcomes. The goal of this article was to bring together veterinary microbiologists to build a guide inspired by the Infectious Disease Society of America/American Society of Microbiology document for use in veterinary medicine and to consolidate other recommendations for use in the veterinary microbiology laboratory.

Objective: The increasing threat of antimicrobial-resistant (AMR) organisms highlights the need for effective antimicrobial stewardship in veterinary medicine. This study evaluated how veterinarians treating companion animals utilize antimicrobial susceptibility testing (AST) reports and antimicrobial use guidelines and their impact on antimicrobial selection. Methods: An online survey was distributed to veterinarians across the US, collecting data on demographics, clinical case management, AST report preferences, and perceptions of AMR, diagnostic stewardship, and antimicrobial stewardship. Results: A total of 216 veterinarians participated. Results indicated a preference (83% to 89%) for AST reports with interpretative comments on antimicrobial selection and dosing. Most respondents (55% to 62%) preferred selective reporting over cascade reporting (25% to 30%). Clinical cases revealed the frequent selection of systemic antimicrobial therapy, with many respondents indicating the need for therapeutic consultation. Two identical cases with different AST report styles (full vs cascade) showed a 26% increase in good antimicrobial stewardship with the cascade report. Gaps in knowledge regarding AST principles were identified, with many respondents misunderstanding the establishment of breakpoints, AST and topical therapy, and the interpretation of MICs. Conclusions: These findings suggest that while veterinarians prefer full or selective AST reports, their antimicrobial choices align more closely with guidelines when cascade reports are used. This indicates that the AST report style may influence the antimicrobial stewardship practices of veterinarians and warrants further investigation. Clinical Relevance: This study demonstrates the need for improved AST reporting and education on AST interpretation and antimicrobial selection to support antimicrobial stewardship in veterinary medicine.