# data[].attributes.body
1. Was there a risk to farm staff?

Yes, because the pigs were resistant to so many different AMs, specifically the critically highest priority AMs, it may pose a threat to public health – for example if any human got infected, then there wouldn’t be a treatment to cure it and they would potentially die.

2. What can be learned from this case?

Don’t use so many AMs as a ‘back up’, instead, try another treatment that is not an AM and see if that works. Also, first consult a vet when using AMs, especially so many, as clearly the wide variety of AMs used from a young age throughout the entire farm has caused the multi-drug resistance.

# data[].attributes.body
Was there a risk to the farm staff? Yes. The large range of antimicrobials the farmer has included in the diet of piglets along with injectables has driven the selection of E. coli that are resistant to highest priority critically important antimicrobials. These then grow and multiply, and could transfer the plasmids carrying the resistant genes to bacteria living in the enclosure of the piglets, especially pathogenic ones. Staff could get exposed to the pathogenic bacteria and get infected. Also, it could be more difficult to treat due the bacteria being resistant.

What can be learned from this case?

Use of antibiotics should be prevented as much as possible. Also, they should have consulted vets about techniques in prevention of diseases and contamination control for piglets before making their own decisions and giving the piglets antibiotics.

# data[].attributes.body
Q1: yes there is a risk to staff since there is resistance to the high priority critical importance antimicrobials. the resistance could be spread to bacteria that infect humans. or the bacteria infecting pigs could make the jump to humans. in that case that would make treatment extremely difficult. there is the fact that bacteria have developed resistance to older antibiotics and other antibiotics that are not used due to co-selection. so the staff if infected may not expect the multidrug resistance, which would make treatment less effective.

Q2: do not use antibiotics unless it is actually needed. there are other ways to support treatment of diarrhea as well as prevent it by providing plenty of fluids, good nutrition and keeping the furrows clean. and isolating animals with symptoms so that they dont contaminate other places, they dont have to go straight to using antibiotics. As for respiratory disease and strep infections, a clean environment would reduce the number of sick animals. and the farmers could have considered using vaccines to prevent them from getting sick in the first place. there are many alternatives and supporting treatments for antibiotics, so dont rely solely on them, explore alternative treatments first. and dont mass dispense them to use on all animals, only use on those who actually need it.

# data[].attributes.body
yes the was a potential risk to staff as using the idea of one health where all organisms to a certain points health is linked leading to epidemics the increase in AMR and the detecion of ESBL-producing E. coli suggests a serious crossover risk if not handled propally

this case shows the important link between the health of animals and humans giving an example warning of how serious antimicrobial resistance is in a onehealth outlook

# data[].attributes.body
1. Was there a risk to farm staff?

Yes, there was a potential risk to farm staff. The detection of ESBL-producing E. coli and multidrug-resistant strains in piglets raises concern because these bacteria can be transmitted to humans through direct contact with animals, contaminated environments, or indirectly via food chains. Although the isolates were present in relatively low numbers (<1% of samples), their resistance to critically important antimicrobials such as fluoroquinolones, 3rd/4th generation cephalosporins, and amoxicillin-clavulanate poses a public health hazard. Farm staff working closely with pigs, handling manure, or administering treatments could have been exposed to resistant bacteria, potentially leading to colonization or infection. While the absolute risk may have been limited by hygiene practices, the presence of such resistance profiles in commensal E. coli means zoonotic transmission was a realistic concern.

2. What can be learned from this case?

This case demonstrates the strong link between antimicrobial use (AMU) and antimicrobial resistance (AMR) in livestock systems. The routine use of multiple antimicrobials in feed and injectables created selective pressure that not only increased resistance to the drugs used but also drove co-selection for resistance to unrelated classes (e.g., trimethoprim-sulphonamide and chloramphenicol, which were not administered on the farm). The persistence of fluoroquinolone resistance after enrofloxacin use further illustrates how even short-term interventions can leave a lasting resistance footprint. The key lessons are:

Antimicrobial stewardship is essential: prophylactic and routine use of critically important antimicrobials should be avoided.

Preventive herd health measures (biosecurity, vaccination, nutrition, housing) must replace reliance on medicated feed.

Monitoring and surveillance of commensal bacteria can provide early warning of resistance trends before they become entrenched.

Public health implications must be considered, as resistant commensals in food animals can act as reservoirs for resistance genes transferable to human pathogens.

# data[].attributes.body
1. Yes there is a high risk of contamination

2. This much antibiotics should not be used as prevention but it should be only be given tot the pigs for who its absolutely necessary

# data[].attributes.body
1. I believe so as e coli can spread to humans

2. Antibiotics should not be used as preventative measures

# data[].attributes.body
1. Yes there was definitely a risk to farm staff, as infections or mutations could have been passed on.

2. Antibiotics should have been used to treat infections if they occurred, not prevent them. They should’ve cleaned pens regularly to prevent infections occurring to begin with.

# data[].attributes.body
1)Yes. it definitely was a risk to farm staff, as the bacterium is still being pass from animal to animal(humans).

2)What should be learnt from this is the fact owners and animal handlers like the farm staff should always aim to maintain the cleanliness of the farm area for the safety of their animals as well as them.

# data[].attributes.body
Yes there was a risk to farm staff. The bacterium could pose a risk to human health.

Antibiotics should be reserved for treatment rather than prevention whenever possible. Overcrowding and poor biosecurity measures are possible factors which increased the rate of the spread of disease.

# data[].attributes.body
1) Yes, there was a risk to farm staff. This risk was due to several factors Presence of resistant strains of E. coli ESBL+ bacteria in piglets – these are strains producing extended-spectrum β-lactamases that can cause infections that are difficult to treat in humans. High resistance to fluoroquinolones, third/fourth generation cephalosporins and amoxicillin with clavulanic acid – these groups of drugs are considered clinically important in human medicine. Possibility of transferring zoonotic bacteria (e.g. through direct contact, the environment or contaminated surfaces), which can result in infections in people working with animals. Long-term use of antibiotics in feed and by injection – can increase selection pressure and promote the development of multidrug-resistant strains.

2) AMU on the farm was associated with AMR in commensal bacteria, i.e. bacteria that naturally occur in animals. High resistance to older classes of antibiotics (e.g. tetracyclines, trimethoprim/sulfamethoxazole, chloramphenicol) indicates long-term selection of resistant strains. Resistance to drugs considered a priority in human treatment, such as fluoroquinolones and third- and fourth-generation cephalosporins, poses a threat to public health.

# data[].attributes.body
1) Yes, as there could have been a spread of bacteria from direct contact with the infected animal or contact with an infected surface, spread could have especially arisen from contact with the animal faeces.

2) antimicrobials should be limited to minimise the amount of resistance that occurs, other means of prevention would be improving the hygiene of the enviroment.

# data[].attributes.body
yes. the farm staff could have brought it in from being somewhere else.

i would avoid using to much antibiotics and have a better biosecurity that will help prevent these problems but enough were the pigs body can fight it off as well.

# data[].attributes.body
1) Yes, these bacterium are able to spread through direct contact, contaminated surfaces and poor hygiene practices and staff could have been within close contact to the faeces of an infected pig.

2) There are three main lessons that can be learned from this case. Firstly, AMU should be limited and carefully managed to prevent resistance from occurring - often times it is better for the animal to be naturally exposed and respond to the pathogen to help build a stronger immune system. Secondly, there should be better AMR monitoring and biosecurity measures and lastly prevention (such as vaccines and hygiene) should be a priority over antibiotic use.

# data[].attributes.body
1) Most likely as staff could of been exposed to infected faeces of a pig and the AMR germs could of been spread to them

2) Antibiotics should not be used with appropiate reason and should not be used inexcess. Some animals must come into contact with pathogens to build up their own immunity system responces. The anitboitics should only of been used if a pig was immunocomprimised or as a last resort

# data[].attributes.body
1) Yes - faeces contamination may have posed a public health risk as staff have direct contact with it

2) Antibiotics should not be mixed with food and should be given to animals directly and they should only be used where absolutely necessary

# data[].attributes.body
yes- bacteria could be spread through direct contact, faeces etc

using antibiotics can cause further antibiotic resistance and shouldn't be a regularly issued item . I think that the hygiene of these animals could possibly be improved like their feed, water source and bedding in order to prevent the spread of disease from direct contact with each other or the infected surfaces

# data[].attributes.body
1) yes, the contamination of faeces posed a public heath threat due to the direct contact staff must have.

2) limiting the use of antibiotics as a preventive measure to further limit resistance in future offspring, only using as treatment.

# data[].attributes.body
1) Yes - faeces contamination poses risk to humans as it could contain the resistant bacteria. Resistance to high priority CIAs pose an issue to public health

What can be learned from this case

2) Using antibiotics as a preventative measure, and using them over long periods of times is ineffective. It may seem to solve the imminent problems of current infections but has an impact of the resistance of bacteria. We need to learn that over reliance on antibiotics can be harmful and that measures and guidance should be put in place to support farmers with other solutions and preventative measures, as well as responsible use of antibiotics.

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1. coming into contact with resistant bacteria is faeces which is highly contagious

2. antibiotics should be used only when strictly necessary as animals immune system will be lower for genuine infections

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1. yes there's a risk for them, due the direct contact.

2. do not mixed the antibiotics with the food and give directly, increase the biosecurity.

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Yes, there are risks for the health of the farm staff as the come in contact with faeces that are contaminated with resistant bacteria that may also affect not only the animals, but themselves.

I don't believe that antibiotics should be added to food unless strictly necessary to the animal's wellbeing as they can lead to the growth of more resistant bacteria.

# data[].attributes.body
1. Yes, they are at risk because they have contact with resistant bacteria on that farm. Hygiene and sanitation among animal handlers should be improved.

2. Prudent antibiotic use should be consider to reduce AMR in that farm

# data[].attributes.body
1. Yes they will be coming into contact with multi resistant bacteria daily

2. Avoid overuse of antibiotics - consider improved bio security measures to reduce AM use

# data[].attributes.body
1. Yes, farm staff are at risk because they come into contact with faeces contaminated with multi- resistant bacteria which would be difficult to treat if they were to become infected themselves.

2. Adding antibiotics to food increases the risk of multi resistant bacteria. Better husbandry methods should have been adopted as an alternative to antibiotics and fade and infected animals should be isolated from the herd.

# data[].attributes.headline
The piglets had respiratory diseases, which had heavy antibiotics in the body may be contractible in the air.                      The bacteria were in 3rd and 4th generations, which may also cause a threat as they have mutated more than once which, could be susceptible by the staff.               From this case, the overuse of antimicrobials can lead to even more problems and risks on a larger scale.                

# data[].attributes.subject
The piglets had respiratory diseases, which had heavy antibiotics in the body may be contractible in the air.                      The bacteria were in 3rd and 4th generations, which may also cause a threat as they have mutated more than once which, could be susceptible by the staff.               From this case, the overuse of antimicrobials can lead to even more problems and risks on a larger scale.                

# data[].attributes.body
1. Yes, there is a direct risk to farm staff. They come into contact with these bacteria every day, and likely brought them home on their clothing. While they may not be pathogenic strains of E.coli they could still affect the lives of the farm staff by passing their plasmids on.
2. There should not be such a need for antimicrobials on this farm. The farmer needs to change their practices in order to promote the welfare of the animals.

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1. Maybe not any direct risk, but indirectly yes. With the antibiotics being in the feed they would be inhaling low levels of antibiotics on a daily basis, levels far below the MIC but enough to affect their microbiota. Should they become infected with any of the resistant bacteria their own treatment my be compromised.

2. I have a personal issue with animal management systems that need to be propped up using growth promotants and antibiotics.

Without getting too political, we need to be prepared to pay a fair price for our meat and dairy products so that producers can farm more extensively

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1. The staffs at the farm were at great risk because of the use of the antimicrobials at the place. The resistant genes may be transferred due to contact of feed, water, faeces of the pig.

2. Steps to be taken are:
a. Appropriate use of antimicrobials should be done.
b. Avoid misuse, overuse of antimicrobials.
c. Educate the stakeholders/ farm people about the adverse effect of improper use of antimicrobials.

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Yes, the farm staff were at risk because of the use of antimicrobials on the farm. The use of antimicrobials will cause resistance in the future meaning the pigs will harvest that AMR bacteria resistance and because the staff were in contact with the pigs they could be infected meaning if they required antibiotics they may be resistant to it.

2. Antimicrobials should be used appropriately and correct education should be provided to help minimise antimicrobial resistance.

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Preventative antimicrobials should not be given as this only leads to resistance leading to further problems down the line.

# data[].attributes.body
1. There was a risk to farm staff because the pigs were harvesting AMR bacteria resitiant to human-use antibiotics- if the workers were infected antibiotics would not be a treatment option.

# data[].attributes.body
1. yes the farm staff are at risk due to exposure to these resistant bacteria and may pick up the infection.
2. antimicrobials should only be used appropriately and should not be used in high volumes over a long period of time. Other practices should be used, such as improving biosecurity, to limit cases requiring antibiotics.

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1. Farm staff are at risk because they come into contact with faeces contaminated with multi-resistant bacteria, which would be difficult to treat if they were to become infected.
2. Adding antibiotics to food increases the risk of multi-resistant bacteria. Better husbandry methods should be adopted as an alternative to antibiotics in feed and infected animals should be isolated from the herd.

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1) yes staff was dealing with feaces and was at risk if protocol was not followed.(P.P.E)
2) Antimicrobials at growing stage of life developed resistance, so avoid unnecessary use. Only use in suspect is there.

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Q1 - Yes the farm staff is in risk

Q2 - They can avoid the use of antibiotic therapy to prevent diseases

# data[].attributes.body
1. Yes farm staff would be at risk as they dealt with piglet faeces.
2. Instead of the use on antibiotics, the farmer should have looked to how he kept the piglets living conditions, health and hygiene. As now due to using antibiotics to try and prevent diseases, the piglets and now resistant to many of the diseases listed.

# data[].attributes.body
Question 1: Yes, as they are in close contact with the animals and their feaces and other body fluids, resistant bacteria or resistance genes could be transferred from the pigs to the staff or vice-versa.
Question 2: Antibiotics should not be used as a prophylactic measure. Correct husbandry, hygiene and introduction of healthy animals to the farms should be the preventive measures to avoid disease and therefore avoid the use of antimicrobials.

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Farm stuff would have been at risk due to close contact and also that amr is at risk of increase due to the drug usage

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1 Yes, but they don't know that, do they? 2 That antibiotics are too accessible for mass usage and it has mass effect on AMR

# data[].attributes.subject
1 Yes, but they don't know that, do they? 2 That antibiotics are too accessible for mass usage and it has mass effect on AMR

# data[].attributes.body
There will always be a risk to farm staff, as the resistant strains have the ability to develop in a way that they can too infect humans (as seen in bird flu, which is rare but certainly possible) and if we cannot treat the infections with antibiotics then this poses even more of a problem. Quite simply, what this case demonstrates is the importance of only using antibiotics on animals when absolutely necessary, and in very controlled amounts under a controlled time period.

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1. Yes it is highly likely that it could transfer to the farmers, which poses a rather large threat to them and also consumer safety.

# data[].attributes.body
1. There was a very large risk of zoonosis to the staff as well as whomever may have eaten the pigs, as the resistant E. coli bacterium can be passed from animals to humans. Also, staff should be wearing correct PPE 2. Antibiotic therapy in use as a preventative practice, rather than in assisting the animals in recovering from a pathogen, contributes to AMR. Antibiotics and antimicrobials are being overused in this situation and more priority should be in reducing the amount of antibitoic used as it leads to the generation of resistant strains.

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Farm staff are in a high risk of contamination with antimicrobial residues excreted by pigs.

# data[].attributes.subject
Farm staff are in a high risk of contamination with antimicrobial residues excreted by pigs.

# data[].attributes.body
What should be done is to avoid unnecessary use of antimicrobial
Because the farmer have already use antimicrobial they must abide with antimicrobial withdraw time

# data[].attributes.body
1. Yes there is a huge risk of the transfer of resistant bacteria from the pigs to both farm staff and consumers.
2. In this case the farmer hasn't thought about limiting their use of antibiotic. They are being used long-term to prevent diarrhoea when instead they should be focusing on biosecurity.

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1. Yes, this poses a risk to the farm staff and also , pig being a food animal, if proper hygiene is not maintained during slaughter and packing of the meat it can cause a threat to the public health.

2. In this particular farm, antibiotics therapy is being used as a preventive measure, which is not advisable as it can contribute to amr. Instead, inorder to prevent diseases, they should give more focus to the overall hygiene and proper management of farm.

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Yes, there is a great threat to the staff. Definitely the MDR organisms will be present in the environment and can be transferred to the staff.
The inadvertent use of antibiotic must be reduced. Using them as feed additives and prophylactic treatment may result in change of normal microflora and growth of resistant microbes. Constant stress or pressure from these antibiotics might help the microbes to evolve faster and attain resistance to most of them.

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there is always a risk that a disease can become zoonotic, meaning that the staff would have to wear ppe to stay safe. the pigs constantly being pumped full of antimicrobials is bad practice, especially in an animal so closely linked to humans.

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1. The staff were definitely at a rather high risk as E. coli is transferable from animals to humans.
2. Antimicrobials should not be used as a preventative measure as will increase the selection pressure for antimicrobial resistance. Instead better farming conditions should have been used as the preventative measure which would have been just as effective at reducing infections shilst reducing the selection pressure for resistance

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1. Yes there was a significant risk to the staff as they could have also been infected, even if hygiene practice is high. 2. Antibiotics/microbials were definitely overused here, and should not have been used as a preventative since this causes more long-term effects, posing a risk even to the staff. From this we can see the importance of not overusing antibiotics and antimicrobials and only using them when necessary and responsible.

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definitely risk to staff- AMR is transmissable and there is a large amount of piglets and weaners so bound to come into contact. 2. anitbiotics and antimicrobials should not be used as a whole scale preventative treatment. they were overused resulting in high resistance- should be contained to just the individual weaners needing them. very little responsibility shown

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1) There is risk of transmission of AMR or diseases which the pigs are more susceptible to. 2) AMS is important to the safety of the animal production industry. They should be used more restrictively to decrease the risk of developing AMR.

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2. Overuse of antibiotics as a preventative measure is not a suitable response to animal care, it also makes the antibiotics ineffective in the case of an actual infection as well as making the piglets immune responses weaker to infections. Instead of unnecessary antibiotic use the farm should have used sow vaccinations and better hygiene

# data[].attributes.body
1. Yes - many of the zoonotic/antimicrobial diseases in human medicine are passed from animals and in a farm environment where direct contact between the pigs and the farmers occurs often transmission is likely (transmission becomes less likely if appropriate disinfection and safety measures are used)

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2. Medicating antibiotics as a prevention method is totally ineffective. Since, when the disease does occur, the antibiotic will be totally useless

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1 of course since it is a highly contagious disease.

# data[].attributes.body
1) yes, absolutely. AMR is transmissible through direct contact and contact with any AMR contaminated surface/object/animal to humans. 2) it shows how important it is to be responsible and critically selective about using antibiotics - overusing them (literally feeding them to the pigs!) will inevitably lead to a high prevalence of AMR bacteria

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1- Yes, the farm staff could be at risk, cause the AMR can be transmitted from animal to people, so they could have been exposed to the bacteria, which can transmit the AMR by 3 methods: transformation, conjugation and transduction.
2- This case confirms that is very important the correct use of antibiotics, because an inapropiate use dose rate, course duration, treatment plan, etc, can develop an AMR or MDR. So, it's necessary to avoid the overuse of any drug and also to keep high standars of hygiene to care animals and the farm staff.

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Staff working with the pigs and in the pens can acquired bacteria from the pigs, AMR strains can either remain in the workers for a period of time or transfer AMR to the worker's own microflora. The most classic examples are not with E. coli but with methicillin-resistant Staphylococcus aureus and Vancomycin-resistant Enterococcus. Vancomycin resistant enterococci were associated with the use of the now banned growth promoter avoparcin. Avoparcin is in the same antibiotic class as vancomycin - co-selection. Prophylactic use of antibiotics should be avoided where possible. Mycoplasmosis the most common respiratory disease problem of pigs is not eliminated, only controlled by tilmicosin.  Alternatives include the use of respiratory disease-free bred pigs and a closed farming system, the use of vaccinations; all-in-all-out systems.

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Multiple resistance has a major impact on length of stay, morbidity, and mortality. Improve practice and reduce errors, within the area of infection management planning, doing, studying and acting in the prescription of antimicrobials. My God, what kind of meat do humans eat?

# data[].attributes.body
Yes a risk is likely.....alternatives should have been introduced earlier

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1) There is a risk to the staff working 2) Antibiotics shouldn't be used in every case

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1. Yes they were in danger of contracting AMR, with working closely with piglets.
2. I belive that it increased the AMR within the piglets. Vaccinations were used on healthy piglets to determine an experiment within the farm this meaning that the piglets would come immune to antibiotics, increasing the chance of infection through out and passing on to the farms other swine/litter.

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1. yes high risk of AMR zoonotic infections. 2. AMU should be on individual basis to clinically sick animals. Focus on hygiene and vaccination programs (sow) to reduce piglet exposure and increase passive immunity initially and later (piglet) to increase adaptive immunity. Oh and Hygiene. Depopulation and disinfection would be nice, or increased periods of "rest" and disinfection of installations between cycles. Convince owner of $ savings to reduced AMU.

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Undoubtedly there is a high risk to the working staff, several antibiotics have been used unnecessarily on the farm, the ideal is to use these drugs only when necessary and, of course, to maximise biosecurity measures so that the animals do not get sick.

# data[].attributes.body
!) yes, since they were in frequent contact with the pigs they might have developed AMR
2) the use of antibiotics should not be applied in every case, only when they are needed. In this particular case they should have avoided its use when it was not necessary, because it only increased the AMR in the environment.

# data[].attributes.body
1) yes farm staff are at risk as they may develop AMR from contact with the pigs 2) this case shows that antibiotics should only be used when they are needed not just as a safety net to prevent infection that may not even occur as this can lead to AMR

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2)This case shows us reliable proof that excessive use of antibiotics when symptoms are not shown can be extremely dangerous and result in AMR, not only in those who have taken the antimicrobial but for animals around them as susceptibility to the resistance is increased in uncontrolled environments

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1)yes, staff are at risk as there come in contact not only  with the pigs, but with their feed, water and surfaces on which the pigs have been in contact with- having previously learnt that all these can assist in the transmission from animal to animal.

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2. The excessive use of preventative antimicrobials should be discouraged and ways to reduce the use of these should be investigated by the vet and farmer to avoid future problems

# data[].attributes.body
1. Yes- staff in close contact with animals, feed, surfaces and water that could have been exposed to the bacteria, leading to an increased risk of animal to animal transmission

# data[].attributes.body
1) It is likely that the risk of occupational zoonotic infections of farm workers was increased owing to the resistance patterns identified. This cases highlights that the prophylactic use of antimicrobials in an intensive rearing facility results in massive selection pressure and the development of AMR. In doing so, the risk of infection of farm workers and consumers is increased. It is important to consider alternative means of disease control in intensive farming models which may focus on: good hygiene and sanitation protocols; stress reduction strategies e.g., reduced stocking densities; and infrastructural improvements inclusive of uniform ventilation, maintenance of temperature, quality controlled diet, reliable and regular access to clean drinking water, suitable bedding, means of environmental enrichment for the prevention of cannibalism and development of vices.

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1. the farm staff are at high risk  and tighter restriction and safety measures should be put in place to protect them. 2. there need to be a evaluation at that farm or any farm in a similar case on the welfare and the heath of the animal to whether there needs to be changes in the husbandry , enclosures or in the hygiene of the farm and work out the best way to reduce the need for so much medication to be used

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There is a high chance the farm staff are at risk due bacteria's ability to transmit AMR. Tighter hygiene measures are needed specifically around feeding, watering and nearby surfaces and evidently the use of antibiotics needs to be reduced and revaluated.

# data[].attributes.body
Yes farm staff can be at risk. The overuse and inappropriate  use of antibiotics should be discouraged.

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Yes the farm staff are at risk as Zoonotic. Over use of antibiotics so all involved need educated on correct use and risks associated with improper use.

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Yes.
Unneeded usage of antibiotics will always lead to increased AMR.

# data[].attributes.body
1. Yes, animal to animal transmission can occur if contact with surfaces, water, feed and people 2. unneeded antimicrobials can lead to increased AMR easily

# data[].attributes.body
yes the farm staff was at risk. more resistant strains were made when unnecessary use of antimicrobials was used.

# data[].attributes.body
yes there is a very high risk to the farm staff! Higher standards of hygiene is required and also the need to minimise the usage of antibiotics.