The effects of ceftiofur and chlortetracycline treatment on antibiotic resistant Salmonella populations in feedlot cattle

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The effects of ceftiofur and chlortetracycline treatment on antibiotic resistant Salmonella populations in feedlot cattle Naomi Ohta Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences

Salmonellosis (Salmonella enterica) - Background - Salmonella enterica: Family of Enterobacteriaceae, Gram negative bacillus, with over 2,500 serotypes 2 nd most common foodborne pathogen 1.2 million people get infected with foodborne Salmonella in the United States 19,000 hospitalization - 450 deaths Drug-resistant non-typhoidal Salmonella were classified as a SERIOUS THREAT by the CDC in 2013

- Background - Cephalosporin resistant Salmonella Salmonellosis treatments for humans cephalosporins, fluoroquinolones Ceftriaxone is used for children and high risk adults (Critically important antibiotic, WHO) Ceftiofur crystalline-free acid (CCFA: Excede ) is in the same class as ceftriaxone Used for bovine respiratory disease complex (BRD) treatment and control in cattle C Human Ceftriaxone Cattle Ceftiofur NARMS 2014 Resistant Salmonella bla CMY-2 Cross-resistance

- Background - Chlortetracycline (CTC: Aureomycin ) Top-dressed or feed-mixed supplement For the control and treatment of bacterial infections, such as Pasteurella spp. Bovine respiratory disease (BRD) Salmonellosis in cattle Subclinical infection or carriers: intermittent shedding Control by vaccination Antibiotic resistant Salmonella may be selected by antibiotics for BRD treatments? http://www.thecis.co.uk/thecis/default.aspx

- Background - Effects of ceftiofur and chlortetracycline on E. coli populations Chlortetracycline treatment in feedlot cattle reduced ceftiofur resistance (Platt et al., 2008) Phenotype Tetracycline resistance Ceftiofur resistance Ceftiofur followed by chlortetracycline treatment in feedlot cattle (Kanwar et al., 2013, 2014, Cottell et al., 2012) Tetracycline resistance Co-resistance to ceftiofur tet (A), (B) bla CMY-2 Ceftiofur induced more resistant isolates

Objectives of the study Pen level intervention that might reduce pathogens and antibiotic resistance 1. To explore the effects of ceftiofur and chlortetracycline on the dynamics of the Salmonella population in the feces of feedlot cattle 2. To compare whole-genome sequencing to other approaches to classifying isolate resistance a. Also, comparison of serotyping results

- Methods - Treatment regimens - Two way factorial design - 16 pens (11 steers/pen) 2 replicates (total 176 steers, 88 steers/replicate) Treatments All (8 pens) Ceftiofur (mixing) 1 out of 11 (8 pens) CTC Yes (8 pens) No (8 pens) All CCFA & CTC (4 pens) All CCFA (4 pens) 1 CCFA & CTC (4 pens) 1 CCFA (Control) (4 pens) Cattle treatments (@Canyon, TX)

Treatment doses and days - Methods - CCFA CTC 1 CTC 2 CTC 3 End Day 0 4 8 10 14 16 20 26 13: CCFA withdrawal time CCFA: 6.6mg/kg subcutaneously base of ear CTC: 22mg/kg feed dressing 5 days, 1-day interval, 3 times (consistent with Platt study) Samples tested: days 0, 4, 8, 14, 20, and 26

- Methods - Salmonella isolation from feces c c c c 500mg of Glycerol Feces @ -80 C 1040 samples TSB broth Tetrathionate broth + iodine Rappaport Vassiliadis broth Brilliant Green agar Blood agar O-antigen test

- Methods - Antibiotics Susceptibility Test Antibiotic Range Breakpoint Ampicillin (AMP) 1-32 32 Amoxicillin/Clavulanic Acid (AUG2) 1/0.5-32/16 32/16 Azithromycin (AZI) 0.12-16 32 Cefoxitin (FOX) 0.5-32 32 Ceftiofur (TIO) 0.12-8 8 Ceftriaxone (AXO) 0.25-64 4 Chloramphenicol (CHL) 2-32 32 Ciprofloxacin (CIP) 0.015-4 1 Gentamicin (GEN) 0.25-16 16 Nalidixic Acid (NAL) 0.5-32 32 CLSI or NARMS breakpoints If resistant to 3 classes of antibiotics, classified as multidrug-resistant (MDR) Streptomycin (STR) 2-64 64 Sulfisoxazole (SOX) 16-256 512 Tetracycline (TET) 4-32 16 Trimethoprim/Sulphamethoxazole (SXT) 0.12/2.4-4/76 4/76

- Methods - Serotypes, resistant genes, plasmids determination by whole-genome sequencing Becoming cost-effective and fast Illumina MiSeq Serotyping, genotyping, and finding plasmids, virulence genes detection DNA extraction with QIAcube HT Library preparation with Nextera XT kit

- Methods - Serotyping, Resistant genes, plasmids De novo assembly => Velvet on BaseSpace Salmonella Serotyping => web based tool SeqSero (Deng et al., 2015) Resistant genes, plasmids, MLST => SRST2 (Inouye et al., 2014) Sent 10 isolates to NVSL for traditional serotyping to confirm WGS serotyping results

Statistical analysis - Methods - STATA ver. 12.1 Bivariable analysis: Fisher s exact test Mixed logistic regression analysis: Prevalence of MDR Salmonella by treatment and day (full factorial) Day and treatments (CCFA and CTC) as main effects with pen as random effect

Descriptive statistics - Results - # of fecal samples tested: 1,040 # of Salmonella positive fecal samples: 566 => all sequenced # of phenotypically multidrug resistant (MDR) Salmonella: 88

- Results - Marginal model prevalence estimates of Salmonella by treatment and day Mixed logistic regression model

- Results - Marginal model prevalence estimate of MDR Salmonella by day and treatment Mixed logistic regression model

Distribution of phenotypically antibiotic resistant isolates Day 0 Day 4 Day 8 Day 14 Day 20 Day 26 Control CTC CCFA CTC & CCFA

- Results - Number of Salmonella isolates & proportion of MDR Salmonella

- Results - Most MDR isolates were Salmonella ser. Reading Serotypes Multidrug resistant Anatum Give Kentucky Mbandaka Montevideo Reading Total No 4 108 76 215 76 0 479 Yes 0 1 1 0 0 86 88 Total 4 108 77 215 76 86 566 All NVSL traditional serotyping (White-Kaufmann-Le Minor scheme) results matched with SeqSero results *subset of isolates

- Results - Phenotype and Genotype resistance Serotype Genotype Phenotype Total isolates Reading aada7 85 STR stra/strb bla CMY-2 like sul1/sul2 tet(a) flor AMP,AUG2,AXO,FOX,TI O SOX or -* TET CHL *3 were (MIC: =256) Reading aada7 aph(3 )-Iia stra/strb bla CMY-2 like sul1/sul2 tet(a) flor STR AMP,AUG2,AXO,FOX,TI O SOX TET CHL Kentucky aada7-truncated STR 1 One isolate (Give) was sul1 phenotypically resistant SUL to 7 antibiotics, but no genes were detected tet(a) TET 1

- Results - Plasmids detected in Salmonella isolates Plasmids Multidrug I2_Delta A/C2_1 A/C2_1 I1_Alpha I1_Alpha resistant I1_Alpha P1_Alpha Total No 9 1 0 20 1 31 Yes 0 82 4 1 0 87 Total 9 83 4 20 1 117 Fisher's exact = 0.000 Presence of IncA/C2 plasmid significantly associated with MDR Salmonella

Discussion Treatments with ceftiofur or chlortetracycline (or both) are significantly associated with overall decrease in Salmonella prevalence during treatment periods Prevalence of Salmonella recovered after 2 weeks in ceftiofur treatment group Addition of chlortetracycline treatment to ceftiofur significantly increased the proportion of MDR Salmonella starting on day 8, relative to control or single treatment groups

Discussion Six serotypes were found Serotypes determined by WGS and traditional serotyping matched Salmonella serovar Reading was the dominant MDR strain MDR pattern was almost identical among the isolates 96.5% match of genotype and phenotype results Resistant genes were likely located on IncA/C2 plasmid (sole plasmid in these isolates)

Conclusions The use of ceftiofur and chlortetracycline are strongly associated with a decrease in overall Salmonella prevalence and an increase prevalence of MDR Salmonella

Future studies Phylogenetic analysis Finish quantitative analysis Analysis of next generation sequencing data SNP, evolution of strains Virulence genes

Acknowledgments Researchers Dr. H. Morgan Scott (Texas A&M University) Dr. Keri Norman (Texas A&M University) Dr. Bo Norby (Michigan State University) Dr. Guy Loneragan (Texas Tech University) Dr. Sara Lawhon (Texas A&M University) Dr. Henk den Bakker (Texas Tech University) Grant Support USDA-NIFA-AFRI This work was supported by the USDA National Institute of Food and Agriculture, National Integrated Food Safety Initiative grant number 2010-51110-21083. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the USDA or NIFA. Beef Checkoff This work has been supported in part by a contract from the Beef Checkoff. Lab members Dr. Javier Vinasco Ms. Roberta Pugh All Scott lab (ME 2 ) members for technical, moral, and mental support.

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