Mapping the antibiotic use and resistance in Vietnamese poultry

Vietnam has had a tremendous economic development the past decades, which has come with an increasing demand for animal-source foods. This has led to a great expansion of the livestock sector, especially in poultry, and a trend towards larger farms is currently seen.

Keeping more animals is often associated with a higher disease pressure, and with that higher antibiotic use, especially if biosecurity measures are insufficient. There is also a considerable risk for misuse of antibiotics since access to over-the-counter antibiotics is widespread, often in combination with low access to veterinary diagnostics.

Taken together, these circumstances have led to several areas in Vietnam becoming “hotspots” for antibiotic use and resistance, and as in several Southeast Asian countries, alarmingly high levels of resistance have been reported from the human and livestock sectors. The Vietnamese government has high ambitions when it comes to dealing with the antibiotic resistance issue, mainly through legislations regarding antibiotic use and sales. However, the implementation of these regulations is still insufficient.

Mapping the resistance situation

The purpose of the research project is to map the resistance situation in small-scale chicken farms in one province in Northern Vietnam (Thai Nguyen), and to understand what drives antibiotic use, in order to facilitate the development of targeted, and effective, interventions to reduce the development of resistance in Vietnamese livestock production.

The research project includes three studies:

1. A questionnaire-based study to understand small-scale poultry producers’ knowledge and practices related to antibiotics and resistance, and what farm(-er) variables that affect those.
2. A microbiology study to describe the resistance to different antibiotic substances in commensal E. coli from chickens/hens in the same farms as in Study 1.
3. A questionnaire-based study to understand the knowledge and routines regarding antibiotics among veterinary drug shop workers (the main source of antibiotics to small-scale farmers in Vietnam)

In the seminar at NIVR it was pointed out that:

• Several on-farm practices regarding disease prevention and antibiotic use can be improved from an antibiotic resistance perspective, e.g. restrictive use of antibiotics for disease prevention and proper handling of leftover antibiotics.
  
  
• The combination of low access to professional animal health services, including diagnostics, and high access to over-the-counter antibiotics increases the risk for misuse of antibiotic in farms.
  
  
• The knowledge among farmers about antibiotic resistance as a phenomenon was relatively high, but knowledge about antibiotics’ mode of action, and the risk for spread of antibiotic-resistant bacteria between animals and humans was lacking.
  
  
• High levels of resistance against several antibiotic substances were seen on both isolate and farm level, including resistance against antibiotics classified as critically important for human medicine by the World Health Organization (WHO).
  
  
• Better knowledge and practices (related to disease prevention and antibiotic use) among farmers were not associated with lower resistance levels in commensal E. coli.
  
  
• Despite high education and knowledge levels about antibiotics and resistance among veterinary drug shop workers, they often had limited possibilities to contribute to more medically rational antibiotic use in farms, because of e.g.: lack of diagnostics and farmer compliance, as well as conflicting economic interests.

Conclusion

The results show on the complexity in handling the antibiotic resistance issue in a middle-income system with widespread use of, and access to, antibiotics, in combination with low access to animal health services, and lacking policy implementation.

The researchers hope that their findings will enhance the understanding of antibiotic resistance and its drivers in Vietnamese livestock production, providing valuable insights for designing effective interventions to reduce the resistance development.