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Hoet © 2017
IICA-OSU-Antimicrobial Drug
Resistance Group for the Caribbean
Armando E. Hoet, DVM, PhD, DACVPM
Director, Veterinary Public Health Program
Hoet © 2017
1. Antimicrobial Use and Antimicrobial
Resistance in Agriculture Training
2. Technical Missions and Sensitization Talks
3. CISARA Project
 SOPs
 Webinar Training
 Field Team Training
4. CISARA Preliminary Results
Hoet © 2017
Hoet © 2017
Hoet © 2017
December
2015
TRAINING ON ANTIMICROBIAL USE AND ANTIMICROBIAL
RESISTANCE IN AGRICULTURE: THE OHIO STATE UNIVERSITY
July
2015
Pilots were created
during 2-week
training program
Hoet © 2017
Phase 1: Multi-country Pilot Studies in Primary
Production Caribbean countries
Antigua
3
1
1
1
3
1
2
3
1
4 1
St. Kitts & Nevis
1
4
1
St. Vincent and the Grenadines
1
1
33 Participants
14 Caribbean Countries**
1
Hoet © 2017
Hoet © 2017
Hoet © 2017
Hoet © 2017
Phase 1: Multi-country Pilot Studies in Primary
Production Caribbean countries
 Selection of Target Study Population
 Targeted Microorganism
 Sampling Design
o Type and source of Sample
o Representativeness
o Sample Size
o Sampling Scheme
o Sample Collection (Methods)
 Laboratory Testing Methodology
o Bacterial Culture, Isolate Identification and
Storage of isolates
o Antimicrobial Susceptibility Testing
 Reporting / Confidentiality
Hoet © 2017
• One of the most consumed sources of
protein of animal origin in the Caribbean
• Locally produced
With per capita consumption of 46 kg per annum, the
poultry sector accounts for 80% of meat consumption in
the Caribbean Agritrade 2011
 Selection of Target Study Population
=> Main commodity: Poultry
Phase 1: Multi-country Pilot Studies in Primary
Production Caribbean countries
Hoet © 2017
Phase 1: Multi-country Pilot Studies in Primary
Production Caribbean countries
Hoet © 2017
PoultryProduction
Breeders /
Hatcheries
Poultry
Farms
Processing
Plants
Distribution
Chain
Retailers
Consumer
 Critical Point “1” or preslaugther
Poultry Production Systems Baseline
Study or Pilot 1
 Critical Point “2” or retail
Retail Poultry Baseline Study or
Pilot 2
Phase 1: Multi-country Pilot Studies in Primary
Production Caribbean countries
 Selection of Target Study Population
Hoet © 2017
 Targeted Microorganism
=> The targeted pathogen:
Salmonella spp
PILOT STUDIES ON PRE-HARVEST AND RETAIL POULTRY
SIMPLE BUT SCALABLE
- One of the most common microorganisms
associated with foodborne illnesses in the region
- Excellent marker to monitor antimicrobial
resistance
Hoet © 2017
PILOT 1
Pre-Harvest
PILOT 2
Retail
Type of
Sample
Locally produced
(non-imported)
raw chicken parts
Standard
ceca sample
Sample
Source
Retail points
(supermarkets, butcher
shops, wet markets, etc.)
Licensed /commercial
slaughter plants
 Sampling
Design
PILOT STUDIES ON PRE-HARVEST AND RETAIL POULTRY
=> The Country Logistical Teams selected such locations
trying to maintain the representativeness
Hoet © 2017
PILOT 1
Pre-Harvest
PILOT 2
Retail
100 chicken parts
per country
100 cecal
per country
Sampling
Scheme
One bird/Farm
10 farms/week
1 - 4 packages/store
10 - 12 samples/week
PILOT STUDIES ON PRE-HARVEST AND RETAIL POULTRY
 Sampling
Design
Sample
Size
700 samples
across the region
700 samples
across the region
Hoet © 2017
Hoet © 2017
Technical Missions and Sensitization Talks
 Laboratory Capacity
Hoet © 2017
Technical Missions and Sensitization Talks
 AMR Talks
>100 Participants
7 Caribbean Countries
Hoet © 2017
Hoet © 2017
PILOT STUDIES ON PRE-HARVEST AND RETAIL POULTRY
 Standard Operating Procedures
Hoet © 2017
PILOT STUDIES ON PRE-HARVEST AND RETAIL POULTRY
 Webinar Training on Field and Lab SOPs
>87 Participants
7 Caribbean Countries
7 Participants
2 Countries
Hoet © 2017
PILOT STUDIES ON PRE-HARVEST AND RETAIL POULTRY
 Field Team Training
6 Direct Trainees
>24 Indirect Trainees*
6 Countries
Hoet © 2017
Hoet © 2017
Phase 1: Current Status
 Pilot 1: 100%
 Pilot 2: 100%
 Phenotyping: 100%
 MIC Confirmation: IP
 Pilot 1: 100%
 Pilot 2: 100%
 Phenotyping: 100%
 MIC Confirmation: IP
 Pilot 1: 100%
 Pilot 2: 100%
 Phenotyping: 100%
 MIC Confirmation: IP
 Pilot 1: 100%
 Pilot 2: 100%
 Phenotyping: 100%
 MIC Confirmation: IP
 Pilot 1: 100%
 Pilot 2: 100%
 Phenotyping: 100%
 MIC Confirmation: IP
 Pilot 1: 100%
 Pilot 2: 100%
 Phenotyping: 100%
 MIC Confirmation: IP
Pilot 1: 100%
Pilot 2: 100%
Phenotyping: 100%
MIC Confirmation: IP
Hoet © 2017
Phase 1: Current Status
PILOT 1
Pre-Harvest
PILOT 2
Retail
Prevalence
2% – 25.6%**
(preliminary)
1% - 37.6%**
(preliminary)
 Prevalence
Samples
Collected to
date
700 samples
across the region
700 samples
across the region
IP
(all countries have positives)
IP
(all countries have positives)
Salmonella
Positive
Hoet © 2017
Phase 1: Current Status
• All countries can now
perform antimicrobial
resistance test
No previous capacity before
initiating this pilots
Hoet © 2017
PILOT 1
Pre-Harvest
PILOT 2
Retail
Prevalence
of MDR
In Progress In Progress
 Antimicrobial
Resistance
Profiles
Susceptible In ProgressIn Progress
Phase 1: Current Status
No Multidrug
Resistant Strain Yet
No Multidrug
Resistant Strain Yet
Multidrug
Resistant
Hoet © 2017
Phase 1: Next Steps
Short Term
1st Confirm results by MIC
* Whole Genome Sequencing – ODA-ADDL
2nd Analysis of Epidemiological Data from Surveys
3rd Report results
- Country Level
- Regional Level
- WHOnet
Hoet © 2017
Phase 1: Next Steps
Long Term
Targeted Studies based on Countries’ needs
 Next Target Commodity
• Imported Poultry Products
Hoet © 2017
The Most Valuable Asset
Educated and trained
over 230 Public and Animal Health
Professionals on antimicrobial
resistance in agriculture, while
generating preliminary data and
consolidating their in-country diagnostic
and coordination capacity
Thisproject“madeusfeelbetter
professionalsasweare havingan
impactnotonlyonpublichealth,
butalsoinprotectingourfamilies”
Hoet © 2017
Hoet © 2017
Transboundary
Infectious Diseases
• Networking
• Team Work
• Interdisciplinary
Work
• Cultural
Differences
• Language
Barriers
• Environmental
Impact
International
Regulations /
USA Regulations
International
Commerce – Global
Food Systems
Zoonotic and
Foodborne Diseases
and Human Health
Food Production
Systems
FARM TO TABLE STUDY PROGRAM
Hoet © 2017
Hoet © 2017
Armando E Hoet, DVM, PhD, DACVPM
hoet.1@osu.edu
Veterinary Preventive
Medicine
The Ohio State University

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Dr. Armando E. Hoet - Caribbean Integrated Surveillance System on Antimicrobial Resistance in Agriculture

  • 1. Hoet © 2017 IICA-OSU-Antimicrobial Drug Resistance Group for the Caribbean Armando E. Hoet, DVM, PhD, DACVPM Director, Veterinary Public Health Program
  • 2. Hoet © 2017 1. Antimicrobial Use and Antimicrobial Resistance in Agriculture Training 2. Technical Missions and Sensitization Talks 3. CISARA Project  SOPs  Webinar Training  Field Team Training 4. CISARA Preliminary Results
  • 5. Hoet © 2017 December 2015 TRAINING ON ANTIMICROBIAL USE AND ANTIMICROBIAL RESISTANCE IN AGRICULTURE: THE OHIO STATE UNIVERSITY July 2015 Pilots were created during 2-week training program
  • 6. Hoet © 2017 Phase 1: Multi-country Pilot Studies in Primary Production Caribbean countries Antigua 3 1 1 1 3 1 2 3 1 4 1 St. Kitts & Nevis 1 4 1 St. Vincent and the Grenadines 1 1 33 Participants 14 Caribbean Countries** 1
  • 10. Hoet © 2017 Phase 1: Multi-country Pilot Studies in Primary Production Caribbean countries  Selection of Target Study Population  Targeted Microorganism  Sampling Design o Type and source of Sample o Representativeness o Sample Size o Sampling Scheme o Sample Collection (Methods)  Laboratory Testing Methodology o Bacterial Culture, Isolate Identification and Storage of isolates o Antimicrobial Susceptibility Testing  Reporting / Confidentiality
  • 11. Hoet © 2017 • One of the most consumed sources of protein of animal origin in the Caribbean • Locally produced With per capita consumption of 46 kg per annum, the poultry sector accounts for 80% of meat consumption in the Caribbean Agritrade 2011  Selection of Target Study Population => Main commodity: Poultry Phase 1: Multi-country Pilot Studies in Primary Production Caribbean countries
  • 12. Hoet © 2017 Phase 1: Multi-country Pilot Studies in Primary Production Caribbean countries
  • 13. Hoet © 2017 PoultryProduction Breeders / Hatcheries Poultry Farms Processing Plants Distribution Chain Retailers Consumer  Critical Point “1” or preslaugther Poultry Production Systems Baseline Study or Pilot 1  Critical Point “2” or retail Retail Poultry Baseline Study or Pilot 2 Phase 1: Multi-country Pilot Studies in Primary Production Caribbean countries  Selection of Target Study Population
  • 14. Hoet © 2017  Targeted Microorganism => The targeted pathogen: Salmonella spp PILOT STUDIES ON PRE-HARVEST AND RETAIL POULTRY SIMPLE BUT SCALABLE - One of the most common microorganisms associated with foodborne illnesses in the region - Excellent marker to monitor antimicrobial resistance
  • 15. Hoet © 2017 PILOT 1 Pre-Harvest PILOT 2 Retail Type of Sample Locally produced (non-imported) raw chicken parts Standard ceca sample Sample Source Retail points (supermarkets, butcher shops, wet markets, etc.) Licensed /commercial slaughter plants  Sampling Design PILOT STUDIES ON PRE-HARVEST AND RETAIL POULTRY => The Country Logistical Teams selected such locations trying to maintain the representativeness
  • 16. Hoet © 2017 PILOT 1 Pre-Harvest PILOT 2 Retail 100 chicken parts per country 100 cecal per country Sampling Scheme One bird/Farm 10 farms/week 1 - 4 packages/store 10 - 12 samples/week PILOT STUDIES ON PRE-HARVEST AND RETAIL POULTRY  Sampling Design Sample Size 700 samples across the region 700 samples across the region
  • 18. Hoet © 2017 Technical Missions and Sensitization Talks  Laboratory Capacity
  • 19. Hoet © 2017 Technical Missions and Sensitization Talks  AMR Talks >100 Participants 7 Caribbean Countries
  • 21. Hoet © 2017 PILOT STUDIES ON PRE-HARVEST AND RETAIL POULTRY  Standard Operating Procedures
  • 22. Hoet © 2017 PILOT STUDIES ON PRE-HARVEST AND RETAIL POULTRY  Webinar Training on Field and Lab SOPs >87 Participants 7 Caribbean Countries 7 Participants 2 Countries
  • 23. Hoet © 2017 PILOT STUDIES ON PRE-HARVEST AND RETAIL POULTRY  Field Team Training 6 Direct Trainees >24 Indirect Trainees* 6 Countries
  • 25. Hoet © 2017 Phase 1: Current Status  Pilot 1: 100%  Pilot 2: 100%  Phenotyping: 100%  MIC Confirmation: IP  Pilot 1: 100%  Pilot 2: 100%  Phenotyping: 100%  MIC Confirmation: IP  Pilot 1: 100%  Pilot 2: 100%  Phenotyping: 100%  MIC Confirmation: IP  Pilot 1: 100%  Pilot 2: 100%  Phenotyping: 100%  MIC Confirmation: IP  Pilot 1: 100%  Pilot 2: 100%  Phenotyping: 100%  MIC Confirmation: IP  Pilot 1: 100%  Pilot 2: 100%  Phenotyping: 100%  MIC Confirmation: IP Pilot 1: 100% Pilot 2: 100% Phenotyping: 100% MIC Confirmation: IP
  • 26. Hoet © 2017 Phase 1: Current Status PILOT 1 Pre-Harvest PILOT 2 Retail Prevalence 2% – 25.6%** (preliminary) 1% - 37.6%** (preliminary)  Prevalence Samples Collected to date 700 samples across the region 700 samples across the region IP (all countries have positives) IP (all countries have positives) Salmonella Positive
  • 27. Hoet © 2017 Phase 1: Current Status • All countries can now perform antimicrobial resistance test No previous capacity before initiating this pilots
  • 28. Hoet © 2017 PILOT 1 Pre-Harvest PILOT 2 Retail Prevalence of MDR In Progress In Progress  Antimicrobial Resistance Profiles Susceptible In ProgressIn Progress Phase 1: Current Status No Multidrug Resistant Strain Yet No Multidrug Resistant Strain Yet Multidrug Resistant
  • 29. Hoet © 2017 Phase 1: Next Steps Short Term 1st Confirm results by MIC * Whole Genome Sequencing – ODA-ADDL 2nd Analysis of Epidemiological Data from Surveys 3rd Report results - Country Level - Regional Level - WHOnet
  • 30. Hoet © 2017 Phase 1: Next Steps Long Term Targeted Studies based on Countries’ needs  Next Target Commodity • Imported Poultry Products
  • 31. Hoet © 2017 The Most Valuable Asset Educated and trained over 230 Public and Animal Health Professionals on antimicrobial resistance in agriculture, while generating preliminary data and consolidating their in-country diagnostic and coordination capacity Thisproject“madeusfeelbetter professionalsasweare havingan impactnotonlyonpublichealth, butalsoinprotectingourfamilies”
  • 33. Hoet © 2017 Transboundary Infectious Diseases • Networking • Team Work • Interdisciplinary Work • Cultural Differences • Language Barriers • Environmental Impact International Regulations / USA Regulations International Commerce – Global Food Systems Zoonotic and Foodborne Diseases and Human Health Food Production Systems FARM TO TABLE STUDY PROGRAM
  • 35. Hoet © 2017 Armando E Hoet, DVM, PhD, DACVPM hoet.1@osu.edu Veterinary Preventive Medicine The Ohio State University

Editor's Notes

  1. Type of Sample For pilot 1 (pre-harvest), a standard ceca sample Salmonella detected in these samples are expected to be representative of those circulating at the farm level. For pilot 2 (retail) locally produced (non-imported) raw chicken parts (finished product) this type of cut/product is commonly available at points of sale the most consumed product type in the region. sensitivity of detection of Salmonella increases when sampling chicken parts relative to whole chicken samples.
  2. Type of Sample For pilot 1 (pre-harvest), a standard ceca sample Salmonella detected in these samples are expected to be representative of those circulating at the farm level. For pilot 2 (retail) locally produced (non-imported) raw chicken parts (finished product) this type of cut/product is commonly available at points of sale the most consumed product type in the region. sensitivity of detection of Salmonella increases when sampling chicken parts relative to whole chicken samples.
  3. Type of Sample For pilot 1 (pre-harvest), a standard ceca sample Salmonella detected in these samples are expected to be representative of those circulating at the farm level. For pilot 2 (retail) locally produced (non-imported) raw chicken parts (finished product) this type of cut/product is commonly available at points of sale the most consumed product type in the region. sensitivity of detection of Salmonella increases when sampling chicken parts relative to whole chicken samples.
  4. Type of Sample For pilot 1 (pre-harvest), a standard ceca sample Salmonella detected in these samples are expected to be representative of those circulating at the farm level. For pilot 2 (retail) locally produced (non-imported) raw chicken parts (finished product) this type of cut/product is commonly available at points of sale the most consumed product type in the region. sensitivity of detection of Salmonella increases when sampling chicken parts relative to whole chicken samples.
  5. Type of Sample For pilot 1 (pre-harvest), a standard ceca sample Salmonella detected in these samples are expected to be representative of those circulating at the farm level. For pilot 2 (retail) locally produced (non-imported) raw chicken parts (finished product) this type of cut/product is commonly available at points of sale the most consumed product type in the region. sensitivity of detection of Salmonella increases when sampling chicken parts relative to whole chicken samples.
  6. Type of Sample For pilot 1 (pre-harvest), a standard ceca sample Salmonella detected in these samples are expected to be representative of those circulating at the farm level. For pilot 2 (retail) locally produced (non-imported) raw chicken parts (finished product) this type of cut/product is commonly available at points of sale the most consumed product type in the region. sensitivity of detection of Salmonella increases when sampling chicken parts relative to whole chicken samples.
  7. Type of Sample For pilot 1 (pre-harvest), a standard ceca sample Salmonella detected in these samples are expected to be representative of those circulating at the farm level. For pilot 2 (retail) locally produced (non-imported) raw chicken parts (finished product) this type of cut/product is commonly available at points of sale the most consumed product type in the region. sensitivity of detection of Salmonella increases when sampling chicken parts relative to whole chicken samples.
  8. Type of Sample For pilot 1 (pre-harvest), a standard ceca sample Salmonella detected in these samples are expected to be representative of those circulating at the farm level. For pilot 2 (retail) locally produced (non-imported) raw chicken parts (finished product) this type of cut/product is commonly available at points of sale the most consumed product type in the region. sensitivity of detection of Salmonella increases when sampling chicken parts relative to whole chicken samples.