Fighting superbugs with better antibiotic monitoring
By Krishna Ramanujan, Cornell Chronicle
Researchers hope that by closing a critical gap in monitoring antimicrobial use in dairy cows, poultry and companion animals, animal caretakers may make more informed decisions when treating pets and livestock and help reduce antibiotic-resistant bacteria that can proliferate when the medicines are used.
The project is made possible thanks to a five-year, $7.5 million grant from the Food and Drug Administration (FDA).
Resistant bacteria could jeopardize food security for over 2 billion people and increase annual healthcare costs by $159 billion annually by 2050, according to the Institute for Health Metrics and Evaluation.
The researchers say it is challenging to monitor antibiotic use in animals because farmers and veterinarians are reluctant to share that data, and because of inconsistent standards of measurement. The team hopes to make it easier to collect existing data by addressing reasons why farmers and veterinarians don’t trust sharing information.
The project aims to develop a secure data repository that aggregates antimicrobial use statistics while keeping individual information private and secure. A dashboard that provides average national and local antimicrobial use may help farmers and veterinarians make smarter decisions about how to treat their animals.
“We cannot manage how antimicrobials are used in animals unless we can measure, and we cannot measure because data are fragmented, siloed and unstandardized and there are no incentives for data sharing, and so there are these big hurdles about trust,” said Dr. Renata Ivanek, professor of population medicine and diagnostic sciences in the College of Veterinary Medicine (CVM) and the grant’s principal investigator.
“The big goal for us is to actually make this possible by addressing that lack of reliable standardization and shareable information and integrating both advanced privacy-protected technologies for data sharing and stakeholder-centered governance,” Ivanek said.
Bacteria can become resistant to antibiotics through random mutations in their genes and when bacteria transfer genes to each other. Though antimicrobials are an essential weapon against bacterial illness, resistance can be worsened when antibiotics are used and kill susceptible bacteria while leaving resistant ones to survive and multiply.
Resistant bacteria, dubbed superbugs, not only affect humans, livestock and companion animals, but can transfer to people through food and contact with animals and the environment, in addition to resistance in humans driven by antibiotic use in humans. Among other things, the new grant will help researchers distinguish the extent that antibiotic use in animals might influence the development of superbugs in both animals and humans.
One of the grant’s goals will be to address low trust levels from farmers and veterinarians in sharing data that stem in part from their concerns that they might be criticized or judged by their peers, government regulators, consumers and clients regarding perceived overuse or underuse of antimicrobials, which can be mis-interpreted when outside parties don’t know the full context behind why animals were or weren’t treated.
“Government officials would like to know how much antimicrobials are used to get a handle on stewardship to curb resistance,” Ivanek said. “And consumers are very invested in how food is produced. Some consumers do not want any antibiotics used on animals. At the same time, pet owners naturally expect the best care for their pets and may advocate using antibiotics.”
Project leaders plan to keep individual data private by providing participants with a computer model that aggregates information at the data source and then returns the aggregated information back to a data repository. Also, the project aims to collect multiple data streams from dairy and poultry farmers and companion animal veterinarians, and ultimately also beef and swine producers, to break up information silos and compile a more complete picture.
Because farmers and veterinarians have been reluctant to share details, the main source of antimicrobial use data comes from pharmaceutical companies that share sales figures by the tonnage sold, a very imprecise metric for understanding the extent and purpose of antibiotic use.
The hope is that in return for sharing data, approved users could get actionable information, such as seeing how their antimicrobial use compares to a national average, which could potentially provide guidance for appropriate treatment decisions. The information may point to areas where more research is needed, Ivanek said.
The grant will also address developing a system for standardizing metrics. Currently, antibiotic use is measured in milligrams, or in doses, or even as a number of visits to a veterinarian for treatments, each of which captures an incomplete picture of use. The project team will explore implementing a novel and unifying standard metric that can be applied to the whole system across different sectors.
Co-principal investigators include faculty members Dr. Daryl Nydam and Dr. Casey Cazer (CVM); Steven Wolf, Kurt Waldman, and danah boyd (College of Agriculture and Life Sciences); Daniel Susser, Hakim Weatherspoon, Christopher De Sa, Immanuel Trummer and Jennifer Sun (Cornell Bowers Computing and Information Science); Dr. Randall Singer (Mindwalk Consulting Group, LLC) and Dr. Jennifer Granick (University of Minnesota).
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