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Antimicrobial Resistance

Role of Attending Veterinarians at Animal Facilities

Photo credit: https://pixnio.com/science/microscopy-images/brucellosis-brucella/temperature-of-37c-petri-dish-and-its-contents-were-incubated-in-a-co2-incubator-b-abortus-bacteria
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Objectives

Define Antimicrobial Resistance (AMR)

Identify risk factors contributing to AMR

Determine what you can do about it

Learn about ongoing efforts and resources

Photo credit: https://flickr.com/photos/nathanreading/6855788039
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What is AMR? 

Microorganisms encode survival mechanisms in DNA

• Avoid inhibition and destruction by traditional antibiotics

Microbes trade and spread genes as they multiply

• The more bacteria and fungi are in the presence of antimicrobials, the more 

likely they will trade and spread resistance genes, becoming able 

to establish drug-resistant infections in humans and animals
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Video of AMR

Click Here to be directed to the video clip below.
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Trading Genes

• Some bacterial DNA are in small 

pieces called plasmids

• Easily traded between neighbors

• Fast multiplication rate means 

millions of copies produced and 

spread rapidly
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Impact of AMR in Humans

• Traditional drugs no longer work! 1 in 

8 MRSA, 1 in 3 E. coli are resistant to 

first-line treatments

• 2013: 2.6 million infections, 44,000 

deaths

• 2019: 2.8M infections, 35,000 deaths 

in US; 3.1M deaths worldwide

• 18 bacteria and fungi of concern
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Impact of AMR in Animals

• AMR infections cause serious threat to 

animal health

• AVMA reports >20 pathogens of 

concern with resistance patterns

• Increasing efforts to prevent infections 

and practice good antimicrobial 

stewardship
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AMR is a Global, One Health Concern

Increasing infections outside of hospitals (community-acquired)

• Greater exposures (not contained)

• Difficult to track spread

• Threaten immunocompromised 
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Antimicrobial Stewardship

• Standards and guidance on proper use of antibiotics

• Reduce likelihood of selection pressure leading to resistance

• Prevent unnecessary or inappropriate use

• Continuous monitoring and evaluation of antimicrobial use practices

• Require veterinary oversight

• Husbandry and prevention
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Objectives

Define AMR

Identify risk factors contributing to AMR

Determine what you can do about it

Learn about ongoing efforts and resources
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AMR Risk Factors

• Expired, contaminated, or blanket prescription antimicrobials

• Written plans: “routine” prevention or group treatments

• Poor infection control strategies

• Health or environmental stressors

This Photo by Unknown Author is licensed under CC BY-SA
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AMR Risk Factors

Risks Management Strategies

Immune-suppressed patients: pregnant, 

young, stressed, cancer, diabetes, 

Cushing’s, allergies, chronic steroid use

Ensure good welfare, closely oversee 

treatments, take additional infection 

control precautions

Poor hygiene allows infections to spread Biosecurity, quarantine, infection control

Poor antimicrobial stewardship Vaccinate against bacterial infections; 

conduct culture and susceptibility testing; 

avoid antibiotics as routine prophylaxis

Raw food diets (~25% contamination rate) Hygiene; sanitization of food prep areas, 

tools and storage areas
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Objectives

Define AMR

Identify risk factors contributing to AMR

Determine what you can do about it

Learn about ongoing efforts and resources
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Qualifications of Attending Veterinarians

• Graduate of an AVMA accredited veterinary school, OR

• Certificate issued by AVMA Education Commission for Foreign 

Veterinary Graduates, OR

• Equivalent formal education as determined by the APHIS 

administrator;

• Training and/or experience in the care and management of the 

species being attended to as the veterinarian, AND

• Authority granted by the regulated facility to provide veterinary care 

for the animals
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The Attending Veterinarian’s Authority

• Ensure adequate veterinary care

• Oversee the adequacy of other aspects of animal care and use

• Duties performed by the AV to ensure compliance with the 

regulations are ultimately the responsibility of the licensee, who 

must provide the AV adequate authority to carry out his/her 

functions

• Authority over all aspects of veterinary care
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Licensees’/Registrants’ Responsibilities 

• Hire an Attending Veterinarian under formal arrangements

• Give the Attending Veterinarian authority

• Establish and follow programs of adequate veterinary care

• Perform daily observation of all animals

• Communicate directly and frequently with the Attending 

Veterinarian

• Provide appropriate facilities and equipment for adequate 

veterinary care
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Requirements of a Program of Veterinary Care

Availability of appropriate 

personnel, facilities, and 

equipment

Methods to prevent and control 

disease, including emergency 

care

Daily observation of all animals 

to assess health and well-being

Guidance to personnel involved 

in the care and use of animals

Adequate pre-procedural and 

post-procedural care
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Actions to Take with Individual Facilities

Preventive medicine program

• Vaccinations, deworming

• Screening tests

Written treatment protocols

Nutrition choices, food handling, preparation, and storage

This Photo by Unknown author is licensed under CC BY-NC.
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Actions to Take with Individual Facilities

Minimize health stressors: 

• Underlying conditions

• Parasites

• Poor body condition

• Allergies

Manage immunocompromised patients carefully

• Infection control measures

• Emphasize communication 
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Actions to Take with Individual Facilities

Infection control strategies

• Animal and human hygiene

• Quarantine/isolation

• Personal Protective Equipment (PPE)

• Disinfection (contact time!)

Photo credit – Adobe Stock
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Actions to Take with Individual Facilities

Maximize animal welfare!

• Poor welfare  chronic stress  immune suppression  more infections

Eliminate stressors from: 

• Housing – sanitization, injuries, overcrowding, fighting, compatibility

• Environment – temperature, humidity, ventilation

• Nutrition – appropriate diets, animals in good body condition

• Psychological distress – enrichment, socialization
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Actions to Take in Your Practice

Commit to a plan of stewardship

Judicious use of antimicrobials

• Culture and sensitivity

• Right drug, dose, duration

• Consider alternative therapies
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Actions to Take in Your Practice

• Use published, accepted medical diagnostics and treatment guidelines

• Monitor and evaluate antimicrobial use practices

• Emphasize preventive strategies 

• Educate clients, ensure compliance with antibiotic instructions

• Professional development on current drug recommendations
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Objectives

Define AMR

Identify risk factors contributing to AMR

Determine what you can do about it

Learn about ongoing efforts and resources
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Antimicrobial 

Resistance is a 

One Health

challenge

Animal Health

Environmental 

Health

Human Health
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Animal Health 

and 

Antimicrobial 

Resistance

Antimicrobial Use and 

Stewardship Monitoring

Antimicrobial Resistance 

Monitoring

Education and Outreach

Collaboration with Industry 

and University Partners
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Environmental Health

Crops

Wildlife
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International Antimicrobial Resistance Activities
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Resources

• Animal Care Aids

• Centers for Disease Control & Prevention

• U.S. Antibiotic Awareness Week (USAAW)

• National Antimicrobial Resistance Monitoring System

• FDA Center for Veterinary Medicine

• World Organisation for Animal Health (WOAH) ANIMUSE

• AVMA and other VMAs: AAAP

AABP

AAEP

AAFP/AAHA

APV

AASRP

AASV
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Resources

• Presidential Advisory Council on Combating Antibiotic Resistant Bacteria

• National Action Plan for Combating Antibiotic-Resistant Bacteria 2020-2025

• National Animal Health Laboratory Network (NAHLN) Dashboard

• National Animal Health Monitoring and Surveillance (NAHMS)

• National Institute of Antimicrobial Resistance Research and Education

• Ontario Animal Health Network

• USDA APHIS Vet Services NVAP Modules

• USDA One Health

• University of Minnesota AMR Learning Site

• World Antimicrobial Resistance Awareness Week (WAAW)
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Website: Attending Veterinarians

Adobe Stock

www.aphis.usda.gov/

animalwelfare
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Objectives

Define Antimicrobial Resistance (AMR)

Identify risk factors contributing to AMR

Determine what you can do about it

Learn about ongoing efforts and resources
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Slide References

4. https://youtu.be/yybsSqcB7mE

5. https://www.cdc.gov/drugresistance/pdf/threats-report/How-AR-Moves508.pdf

6. https://www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threatsreport-508.pdf 

7. https://www.avma.org/sites/default/files/2020-

10/AntimicrobialResistanceFullReport.pdf

8. https://www.fda.gov/animal-veterinary/animal-health-literacy/get-facts-rawpet-food-diets-can-be-dangerous-you-and-your-pet
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Slide References

8. https://www.wormsandgermsblog.com/2019/06/articles/animals/dogs

/raw-diets-and-multidrug-resistant-bacteria/

8. https://www.cdc.gov/campylobacter/outbreaks/puppies-9-17/index.html#print

8. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2784113

8. https://www.cdc.gov/drugresistance/pdf/Assessing-Campylobacter-Burden-inDogs-508.pdf

9. https://www.avma.org/sites/default/files/resources/

AntimicrobStewardshipDef_CorePrinciplesFlyer_052318.pdf
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Thank you! 

Kathy Campitelli, DVM, MPH

Kennel & Small Pet Field Specialist

Center for Animal Welfare

USDA APHIS Animal Care

Kathryn.M.Campitelli@usda.gov

CenterforAnimalWelfare@usda.gov

Chelsey Shivley, DVM, PhD, DACAW

Veterinary Medical Officer 

(Epidemiologist)

Antimicrobial Resistance Coordinator

Office of Interagency Coordination

USDA APHIS Veterinary Services 

Strategy & Policy

Chelsey.B.Shivley@usda.gov