Minimizing the use of antibiotics in poultry production

Tyson Food Inc. - USA

REDUCING ANTIBIOTIC USE WITH SOUND POULTRY HUSBANDRY

Bill Hewat, DVM, MAM, DACPV

Tyson Foods

Objectives of Presentation

• To describe broiler production conditions in the US (and other

Countries where you may operate !?)

• To illustrate antibiotic-resistance issues in your production and

market context

• To explain the evolution of broiler meat market, regulations and

consumers’ trends toward limited antibiotic if not antibiotic-free

production

• To illustrate prevention strategies as alternative to antibiotics or to

minimize their use.

• To possibly present data supporting your (company) strategy.

National Placement/Volume

Approximately 9,250,000,000 head placed annually

Players (Head slaughter/wk)

Tyson – 33,480,0000 Operations in US, China and India

Pilgrim’s Pride – 28,850,000 Perdue – 12,990,000 Koch – 12,000,000 Sanderson – 9,150,000 Wayne – 6,590,000 Mountaire – 6,480,000 Foster’s – 5,750,000 George’s – 5,300,000 Watt Poultry

US Production

Markets (Traditional & Niche)

Cornish (2.10 lbs)

Small Broiler – Fast Food and portioning (3.6 to 4.10 lbs)

Large Broiler – Portioning, IQF Sales Clubs, Retail/Tray Pack (4.8 to 7.0 lbs)

XL Broiler and XXL Broiler – Debone, portioning, FP (7.0 to 9+ lbs)

Organic, Veg Fed, RWA/Never-Ever

When Are Antibiotics Used in Poultry?

Primarily used to combat RESPIRATORY AND ENTERIC Diseases Treatment The use of a specific procedure to treat or cure a disease

Acute or secondary bacterial disease Control Ongoing procedures aimed at reducing disease that are imminent

Coccidiosis Prevention Hindering the occurrence of disease in a susceptible population

Mycoplasma Growth Enhancement The use of products that increase weight gain and improve feed efficiency

Antibiotic Transparency

Customers want transparency around the use of antibiotics in animal agriculture: Antibiotic residues in food Antibiotic resistance in the environment

Are these concerns valid? Clinical evidence to suggest antibiotic resistance may occur in a production

unit Some suggest resistance transfers to humans

Questions remain regarding animal welfare and sustainable food production

What is “Antibiotic Free”?

Defined based on Retail Label or Customer Specification No Antibiotics Ever (NAE): no antibiotics are used in any

phase of production. No Shared Class Use: Use of antibiotics that share classes

with antibiotics used in human medicine are prohibited. (ionophores)

Certified Use: Use of antibiotics labeled for poultry may be used in a defined and responsible manner as prescribed by a veterinarian.

No antibiotics used for growth promotion

What is “Antibiotic Free”?

Our Job

Convert grains into animal proteins (meat) using the chicken’s gastrointestinal tract in an efficient and humane manner

Always maintain “Steady State” Excessive variability creates stress

Attempt to emulate “Mother Nature” Albeit may not “look” natural

These factors, when properly applied to animal management, will lead to a healthy, happy and efficient flock with little need for antibiotics.

Components of Antibiotic Reduction

Health Maintenance & Disease Prevention Housing and Infrastructure Biosecurity High quality DOC Management Practices (FLAWLB) Vaccination Disease Surveillance

Antibiotic Stewardship Proper use of the correct antibiotic (judicious use, drug selection, dose, etc.) Sensitivity, absorption, withdrawal Antibiotic Alternatives

Elements of Industry Disease eradication programs Marketing System (integration)

Health Maintenance

Health Maintenance - Infrastructure

Facilities must be able to support Management and Biosecurity programs Animal Husbandry, mortality management, litter management, environmental

control, utility preservation, etc. Properly designed and constructed Must include farms, hatcheries, feed mills, transportation and plant receiving Housing must be designed to provide a low stress environment

Biosecurity Infrastructure Monitoring Modern Housing

Health Maintenance - Biosecurity

First Stage • Bio-Exclusion • Prevent initial introduction

Third Stage • Bio-Containment • Prevent spread

Second Stage • Bio-Reduction • Reduce dose or times

Disease Triad

DOSE = BIOSECURITY Properly designed infrastructure can facilitate management of dose

Health Maintenance - Biosecurity

Mind-set or Way of Life – Easy to talk about, hard to do. Written procedures requires training, teaching, and

communication Biosecurity procedures should be “second nature” and never questioned or

compromised for convenience Accepted principles practiced by all persons involved in the operation Regardless of the specifics of, all aspects should be practiced at all times Theoretical and physical barriers should never be compromised

Control and Buffer Zones Lines of Demarcation Farm vs. House Biosecurity

Requires proper infrastructure Deliberate actions and behaviors

Health Maintenance - DOC Quality

Breeder Program Clean egg pack Proper handling

Hatchery Proper incubation and sanitation

High quality DOC Consistent DOC supply with similar:

Maternal antibodies Parent management programs Maternal disease condition Parent age

Importance of Mycoplasma freedom or control A good DOC sets the foundation for thrifty broilers

Health Maintenance - Husbandry

TOTAL CONTROL OF ENVRONMENT AND BIRDS Feed

Properly formulated and freshly mixed High quality digestible ingredients No “anti-nutritional” factors Preserves normal gut flora Maintains normal gut integrity Proper form to enhance feed intake

Air Proper ventilation

Elimination of noxious materials (Ammonia, CO2, CO, moisture, dust) Provides fresh air (O2)

Temperature and Moisture Control

Keep the gut

HEALTHY

Health Maintenance - Husbandry

Water Good quality Adequate volume (drinking & cooling) Readily available at all times Clean & Fresh

Litter Absorbent Good quality (residue & pathogen free) Adequate amount Dry, but not dusty

Lights Maintain proper feed intake Proper intensity and duration

Brooding Early access to feed, water, lights & correct temperature

Health Maintenance - Vaccination

Vaccine management Matching the vaccine to the specific disease (ex. IBV) Proper cold chain, storage, and handling Accurate administration (mass application) Understand the balance of over and under vaccinating

Use what’s available but Prevent overuse Avoid vaccines that are overly virulent Consider disease and management status of flocks

Don’t create more problems than you solve

Health Maintenance - Surveillance

Disease status must be monitored Serology Posting Sessions Sentinel Birds Observation (Gemba) A gemba walk is the term used to describe personal observation of work –

where the work is happening. The original Japanese term comes from gembutsu, which means “real thing.” 1. It also sometimes refers to the “real place.” The place where value is created.

Health Maintenance - Surveillance

Health Maintenance - Response

Alternative products & programs may not be as efficacious as antibiotics, especially after onset of clinical signs, morbidity, etc.

Anticipate changes in health and be Proactive Modify existing programs or alternatives during times of

“stress” Disease cycling Feed changes Vaccination Temperature/Seasonal changes Turn-out Thinning Feed outs/ management mistakes

If alternative approaches are ineffective, revert to traditional treatment

Antibiotic Stewardship

Antibiotic Stewardship – Judicious Use

5 “D’s” Right Diagnosis Right Drug Right Dose Right Duration De-escalation (narrowest spectrum antibiotic possible)

Antibiotic Stewardship – Proper Use

Mass Application Feed Water

Withdrawal periods Courage to eliminate dependence on “Chemical

Control” Decision tree or Cost vs Benefit analysis Attitude that can change

Antibiotic Stewardship - Alternatives

While alternative compounds may not be as efficacious as traditional antibiotics, benefits do exist Use “alternatives” as first choice Never “Don’t treat”

Alternatives include Essential Oils/Botanicals (oregano, cinnamon, clove) Yeast/Fermentation products, ß-glucans, immunostimulants Enzymes Minerals (Copper sulfate, zinc, others) Pre/Probiotics Organic Acids

Feed & Water application Alternatives should not be relied upon as complete solution

Elements of Industry

Elements of Industry - Disease Eradication Programs

Programs supported by Government Targeted Diseases

Primary pathogens Primarily vertically transmitted

Mycoplasma & Salmonella species National Poultry Improvement Plan Reduce/eliminate the need for treatment

“To ensure that Plan diseases are not spread, flocks must be qualified for their intended Plan classifications before being moved into (breeder) production facilities” - NPIP

Elements of Industry - Marketing Systems

Integrated System -single entity that controls entire Live Bird Supply Chain Each segment has the same customer with the same specification

Open Market System -multiple entities with variable control of Live Bird Supply Chain The needs of the end customer and individual entities may not be the same

China

Real Life Experience

Real Life Experience – China

Real Life Experience – China

Final Thoughts

Consumers/customers are focusing on antibiotic residues that may become a Point of Differentiation for producers

Must strike the important balance between protecting Animal Welfare/Health and the Production of High Quality and Safe Food

Proper Disease Prevention practices result in less antibiotic use Use of antibiotics should be:

Judicious use with as Narrow Spectrum as possible Used in accordance with local Regulatory Requirements Under the Supervision of an animal health professional

Mass Application makes treatment more difficult in animals (poultry) that are difficult to handle individually

Antibiotic Reduction/Elimination requires a Multifactorial approach that varies system to system

Thank You

Minimizing the use of antibiotics in poultry production

AHS-GD - Holland

Antimicrobials: a rational (Dutch) approach

M.J. Kense DVM, MAHM

GD Animal Health Service Deventer, the Netherlands

Merial Avian Forum, Barcelona, 28th April 2016

GD/ Animal Health Service

• Develops and implements animal health programmes

• Monitoring • Field trials • Training & consultancy • Diagnostics &

Proficiency testing schemes • Follows trends & developments

Veterinary expertise, advice and R&D

Laboratory Data analysis

Antibiotic use under pressure

Development antimicrobials and resistance

Source: Högberg et al. (2010) Trends in Pharmacological Sciences, Vol.31 No.11

Consumption of antimicrobials for systemic use in EU/EEA countries 2012

Source: Surveillance of antimicrobial consumption in Europe 2012 www.ecdc.europe.eu

(Veterinary) Antibiotic use leads to ??? • Increase in

– MRSA – ESBL – VRE

2008 study:

• Every year > 25 000 patients in the European Union alone die from

an infection caused by multidrug-resistant bacteria

• Estimated additional health-care costs and productivity losses are

Staphylococcus aureus. % invasive MRSA isolates 2014

Source: Antimicrobial resistance surveillance in Europe 2014 http://ecdc.europa.eu/en/activities/surveillance/EARS-Net/Pages/index.aspx

Prevalence MRSA Humans & broilers (NL) Humans • All humans: 5% positive • Prevalence in Dutch hospitals low: Broilers • Flocks on slaughterhouse positive 35% • Employees slaughterhouse: 5,6% • Poultry meat >90%

Broiler farmers: 33 % positive

Source: Wagenaar JA en van de Giessen AW. Veegerelateerde MRSA: epidemiologie in dierlijke productieketens, transmissie naar de mens en karakterisatie van de kloon RIVM rapport 330224001 2009 Geenen P L et al 2013

ESBL (Extended Spectrum Beta Lactamase) • 10% humans carry ESBL

• All broiler farms positive

• 94% meat positive for ESBL

• 33% of farmers/employees positive

• 20% ESBL forming E. coli in humans genetically

Source: Dierikx et al 2013, Extended-spectrum-β-lactamase- and AmpC-β-lactamase-producing Escherichia coli in Dutch broilers and broiler farmers

European surveillance

• 2008: – The European Council called upon the Member States to:

• strengthen surveillance systems • improve the quality

– of data on antimicrobial resistance – consumption of antimicrobial agents within both

humans and veterinary sectors

European surveillance • 2009:

– The European Surveillance of Veterinary Antimicrobial Consumption (ESVAC) project was launched.

• 2010: – Started collection and reporting of data on the use of

antimicrobial agents in animals from EU Member States.

– The first report: Trends in the sales of veterinary

European Policy

• Directive on the monitoring of zoonoses and zoonotic agents (2003/99/EC)

• Guidelines for the prudent use of antimicrobials in veterinary medicine (2015/C 299/04)

The European Surveillance of Veterinary Antimicrobial Consumption (ESVAC)

Source: Sales of veterinary antimicrobial agents in 26 EU/EEA countries in 2013. Fifth ESVAC Report. http://www.ecdc.europa.eu

Sales antimicrobials for veterinary use (2013)

PCU: Population correction unit Source: Sales of veterinary antimicrobial agents in 26 EU/EEA countries in 2013. Fifth ESVAC Report. htt // d

Sales in tonnes of veterinary antimicrobials for food producing animals (2010-2013)

PCU: Population correction unit Source: Sales of veterinary antimicrobial agents in 26 EU/EEA countries in 2013. Fifth ESVAC Report.

//

The Dutch Model • Agreement 2008: Taskforce reduction antimicrobial resistance

• the Netherlands Veterinary Medicines Authority SDa (2010)

• Better relation between vets and their farmers • Registration antimicrobial use farms and vets • Benchmarking

• Advise of the health council (2011)

• 2012: Volentary stop of production of medicated feed

Source: Report Usage of Antibiotics in Agricultural Livestock in the Netherlands in 2014; Trends and benchmarking of livestock farms and veterinarians h // i i di idd l l/ li h

Sales veterinary antimicrobial agents in NL:1999-2012

Source: MARAN 2008

Total sales antimicrobials and antimicrobial growth promoters NL

Dutch indicators broiler farms 2015 • Action zone: >30 DD/AY

– Immediate action needed

• Signaling zone: 15-30 DD/AY – Antibiotic use needs special attention

• Target zone: <15 DD/AY – No immediate action needed

Advice Health council • No use in animals of all new antibiotics:

– Carbapenems, tigecycline, daptomycin, oxazolidones, mupirocin etc.

• No more use of Fluoroquinolones and 3rd/4th generation Cephalosporins: – unless there is no alternative

• Colistin, beta-lactams, aminoglycosides:

Trends in antimicrobial use per species 2004-2014

Source: Report Usage of Antibiotics in Agricultural Livestock in the Netherlands in 2014; Trends and benchmarking of livestock farms and veterinarians htt // t it itdi idd l l/ li h

Bleu: Veal Orange: Broilers Dark green: Sows/piglets Light green: Fattening pigs

Dutch reduction goals and achievements in broilers

Antimicrobial use in broilers Year DD/AY Achieved

(%) Goal (%)

2009 34.5 - 2010 28,7 17 2011 24,9 28 20 2012 21,8 37 2013 17,6 49 50 2014 15,1 56 2015 12,0 65

Reduction 1st, 2nd and 3rd choice antimicrobials

Year 1st choice (DD/AY)

2nd choice (DD/AY)

3rd

choice (DD/AY)

2011 7,0 15,4 2,5 2012 7,4 12,6 1,7 2013 8,2 8,7 0,6 2014 7,6 7,1 0,4 2015 5,9 6,1 0,15

Shifts in proportion Dutch farms in benchmark zones 2012-2104

Source: SDA report Usage of antibiotics in agricultural livestock in the Netherlands in 2014. Trends and benchmarking of livestock farms and veterinarians

Target zone % Signaling zone % Action zone % 2012 2013 2014 2012 2013 2014 2012 2013 2014

Broilers 52 68 66 31 25 21 17 6 13 Turkeys - 50 51 - 25 22 - 25 27

What Next!! • Health council evaluation

• SDa/ KPMG report: – investigation of antimicrobial registration by

veterinarians and the databases

• SDa report: – relations between antimicrobial use and prevalence of

resistant microorganisms

Health council evaluation 2015 • Total use

– Stagnation in 2014 • ↓ 3e/4e generation cephalosporin • ↓ Polymyxin (but not in Poultry)

Advice

– Focus on farms and vets in action zone – Adjust benchmark targets

SDa report Relation between antimicrobial use and presence of resistant microorganisms • Decline in presence of resistance in E. coli

– In Veal, pigs and broilers (faeces samples)

• Benchmark method not adjusted – Not enough data

• Monitoring resistance slaughterhouses: indication – Samples on farm level would be better

Report Council for animal maters

• Completely antibimicrobial free industry with good animal welfare is impossible

• Monitoring of animal welfare indicators • Selective and responsible use of antimicrobials. • Focus on farms and vets that use and prescribe

high levels of antimicrobials. • Industry innovations: research into practices,

stimulation with incentives

Dutch National Poultry antibiogram • Assessing the clinical breakpoints for poultry

pathogens isolated out of lesions.

• Goals: – Source for vet when choosing an antimicrobial – Early Warning System shifts in sensitivity – Monitoring specific resistance (like ESBL en MRSA) – Continues quality control of veterinary practices – Data for new drugs formulary

Results 2015 E. coli

54% from 1st week of live

E. coli (n=350) Antimicrobieel agens MIC waarden (µg/mL) MIC 50 MIC 90 S I R Conv Org Broilers Layers

0,25 0,5 1 2 4 8 16 32 64 128 256 512 1024 >1024 (µg/mL) (µg/mL) (%) (%) (%) R (%) R (%) R (%) R (%) Amoxicilline/Clavulaanzuur a 0,6 0,3 7,1 39,7 14,9 31,1 4,6 0,3 1,4 4 8 94 4 2 - - - - Ampicilline 0,0 0,0 2,0 32,6 20,0 1,7 0,0 0,3 43,4 4 >32 56 0 44 57 21 62 14 Apramycine 97,7 1,7 0,6 ?8 ?8 99 - 1 - - - - Colistine 93,1 3,1 2,0 0,3 0,3 0,6 0,6 ?0,5 ?0,5 98 0 2 - - 0 0 Cefotaxim 93,7 0,6 1,1 4,6 ?1 ?1 93 1 6 3 3 3 1 Enrofloxacine 83,7 3,4 4,3 0,9 7,7 ?0,25 1 87 4 9 - - - - Florfenicol 24,8 52,3 20,9 2,0 4 8 25 52 23 1 0 - - Fluméquine 60,3 12,9 12,3 2,0 12,5 ?2 >16 73 12 15 - - - - Gentamicine 96,6 1,4 0,6 1,4 ?2 ?2 98 1 1 7 1 6 1 Neomycine 95,1 1,1 0,9 2,9 ?4 ?4 96 1 3 - - - - Sulfamethoxazol 41,4 5,4 2,9 50,3 >256 >256 50 - 50 51 17 53 6 Spectinomycine 0,8 11,1 52,9 12,6 4,9 17,7 32 >128 65 12 23 - - - - Streptomycine 23,4 38,9 6,6 5,4 6,3 5,7 13,7 4 >64 69 5 26 58 25 - - Trimethoprim/Sulfamethoxazol b 62,6 1,4 0,9 0,9 1,1 33,1 ?0,25 >4 66 - 34 - - - - Tetracycline 2,6 12,0 38,9 12,0 0,3 0,8 4,0 29,4 1 >16 66 1 33 41 15 42 14 Tiamuline 0,3 0,0 0,6 99,1 >32 >32 0 - 100 - - - - Tilmicosine 0,0 0,0 0,3 0,0 0,0 99,7 >32 >32 0 0 100 - - - - Tylosine 0,0 0,0 0,0 0,0 0,3 99,7 >4 >4 R int R int R int - - - - Trimethoprim 62,3 0,8 0,3 0,0 0,0 0,3 36,3 ?0,5 >16 63 - 37 41 15 45 6

MARAN 2014 MARAN 2015

Future • Adjustments of formulary

– Based on effectivity and not only on chance of resistance • Pharmacokinetics • Sensitivity of pathogen

• Benchmarking of:

– Animal welfare parameters – Hatcheries – Feed companies

Antimicrobial stewardship

Practical guidelines

Pharmaco-kinetic/-dynamic

considerations

Clinical microbiology

data

Resistance and use

surveillance

Infection control

practices

National, international regulations

Education

Owner compliance

Questions