Katharina Stärk - Academia.edu (original) (raw)

Papers by Katharina Stärk

Frontiers in Veterinary Science, 2021

Integrated surveillance systems for antimicrobial use (AMU) and antimicrobial resistance (AMR) re... more Integrated surveillance systems for antimicrobial use (AMU) and antimicrobial resistance (AMR) require regular evaluation to ensure the effectiveness and efficiency of the system. An important step in the evaluation is to choose an appropriate tool for the purpose of the evaluation. The “Integrated Surveillance System Evaluation” (ISSE) framework is a conceptual framework that was developed to evaluate One Health (OH) integration in surveillance system for AMU/AMR. This study aimed to evaluate the performance and value of integrated surveillance system for AMU/AMR in England by applying the ISSE framework, which was used to develop data collection protocols and define the study design. A qualitative study using semi-structured interviews was conducted to collect the data and analyse it thematically. Eighteen stakeholders from human, animal, food and environment sectors that are involved in AMU/AMR surveillance were interviewed. Four main themes emerged from the analysis: (1) Cross-s...

Veterinary Record, 2021

Background: Surveillance of antimicrobial resistance (AMR) is an essential component of any strat... more Background: Surveillance of antimicrobial resistance (AMR) is an essential component of any strategy to mitigate AMR and needs regular evaluation to ensure its effectiveness. A first step for any evaluation is to describe the system and context. In this study, we aimed to characterise and map the surveillance system for AMR and antimicrobial use (AMU) in the United Kingdom (UK) using a One Health (OH) approach and to identify integration points in the system.Methods: To describe the surveillance system for AMR/AMU, international guidelines for establishing surveillance systems for AMR and AMU were used. A review of the literature was conducted to collect information on the different parameters identified.Results: Multiple data collection systems exist for AMU and AMR in humans, animals and food. Each sector is responsible for the planning, implementation, analysis and reporting of its own surveillance for AMR and AMU. Some cross‐sectoral collaborative activities exist such as the UK...

Frontiers in Veterinary Science, 2020

International Conference on the Epidemiology and Control of Biological, Chemical and Physical Hazards in Pigs and Pork, 2005

An optimized national resistance monitoring program should deliver a precise estimate of the resi... more An optimized national resistance monitoring program should deliver a precise estimate of the resistance situation for a given combination of bacteria and antimicrobial at a low cost. In order to achieve this, decisions need to be made on the number of samples to be collected at each of different possible sampling points along the food production line. Sampling decisions do not only depend on the prevalence of resistance and sensitivity and specificity of resistance testing, but also on the prevalence of the bacteria, and test characteristics of isolation of these bacteria. Our aim was to develop a stochastic simulation model that optimized a national resistance monitoring program in pig production, taking multi-stage sampling, imperfect sensitivity and specificity of diagnostic tests, and cost-effectiveness considerations into account.

Frontiers in Public Health, 2020

One Health surveillance of antimicrobial resistance (AMR) depends on a harmonized method for dete... more One Health surveillance of antimicrobial resistance (AMR) depends on a harmonized method for detection of AMR. Metagenomics-based surveillance offers the possibility to compare resistomes within and between different target populations. Its potential to be embedded into policy in the future calls for a timely and integrated knowledge dissemination strategy. We developed a blended training (e-learning and a workshop) on the use of metagenomics in surveillance of pathogens and AMR. The objectives were to highlight the potential of metagenomics in the context of integrated surveillance, to demonstrate its applicability through hands-on training and to raise awareness to bias factors 1. The target participants included staff of competent authorities responsible for AMR monitoring and academic staff. The training was organized in modules covering the workflow, requirements, benefits and challenges of surveillance by metagenomics. The training had 41 participants. The face-to-face workshop was essential to understand the expectations of the participants about the transition to metagenomics-based surveillance. After revision of the e-learning, we released it as a Massive Open Online Course (MOOC), now available at https://www.coursera.org/learn/metagenomics. This course has run in more than 20 sessions, with more than 3,000 learners enrolled, from more than 120 countries. Blended learning and MOOCs are useful tools to deliver knowledge globally and across disciplines. The released MOOC can be a reference knowledge source for international players in the application of metagenomics in surveillance.

Porcine Health Management, 2020

Background The reduction of antimicrobial usage (AMU) is in the focus in modern pig production. T... more Background The reduction of antimicrobial usage (AMU) is in the focus in modern pig production. The objective of this study was to assess the effectiveness of alternatives to reduce AMU at herd level. In a prospective study, 68 farrow-to-finish pig herds located in Belgium, France, Germany and Sweden were recruited on a voluntary basis to implement tailor-made intervention plans to reduce their AMU. Alternative measures included improvement of biosecurity (n = 29 herds), vaccination (n = 30), changes of feeding schemes or drinking water quality (n = 45), improved pig health and welfare care (n = 21) as well as changes in stable climate and zootechnical measures (n = 14). Herds were followed for 1 year after implementation of measures. Annual antimicrobial expenditures or treatment records, as well as disease incidence scores were collected and compared to those of the year before intervention. AMU was measured as the treatment incidence and calculated by age category, antimicrobial ...

Epidemiology and Infection, 2018

Antimicrobial use in pig farming is influenced by a range of risk factors, including herd charact... more Antimicrobial use in pig farming is influenced by a range of risk factors, including herd characteristics, biosecurity level, farm performance, occurrence of clinical signs and vaccination scheme, as well as farmers’ attitudes and habits towards antimicrobial use. So far, the effect of these risk factors has been explored separately. Using an innovative method called multiblock partial least-squares regression, this study aimed to investigate, in a sample of 207 farrow-to-finish farms from Belgium, France, Germany and Sweden, the relative importance of the six above mentioned categories or ‘blocks’ of risk factors for antimicrobial use in pig production. Four country separate models were developed; they showed that all six blocks provided useful contribution to explaining antimicrobial use in at least one country. The occurrence of clinical signs, especially of respiratory and nervous diseases in fatteners, was one of the largest contributing blocks in all four countries, whereas th...

Bulletin of the World Health Organization, 2019

Nature microbiology, Jan 23, 2018

Antimicrobial resistance (AMR) in bacteria and associated human morbidity and mortality is increa... more Antimicrobial resistance (AMR) in bacteria and associated human morbidity and mortality is increasing. The use of antimicrobials in livestock selects for AMR that can subsequently be transferred to humans. This flow of AMR between reservoirs demands surveillance in livestock and in humans. We quantified and characterized the acquired resistance gene pools (resistomes) of 181 pig and 178 poultry farms from nine European countries, sequencing more than 5,000 Gb of DNA using shotgun metagenomics. We quantified acquired AMR using the ResFinder database and a second database constructed for this study, consisting of AMR genes identified through screening environmental DNA. The pig and poultry resistomes were very different in abundance and composition. There was a significant country effect on the resistomes, more so in pigs than in poultry. We found higher AMR loads in pigs, whereas poultry resistomes were more diverse. We detected several recently described, critical AMR genes, includi...

Revue Scientifique et Technique de l'OIE, 2007

Before the start of systematic disease control, respiratory diseases in swine in Switzerland caus... more Before the start of systematic disease control, respiratory diseases in swine in Switzerland caused estimated losses of several million euros per year. In 1993, a national programme to control enzootic respiratory diseases in pigs was proposed, with the aim of reducing the incidence of clinical cases to less than 1%. Enzootic pneumonia (EP) caused by Mycoplasma hyopneumoniae and clinical cases of pleuropneumonia caused by any serotype of Actinobacillus pleuropneumoniae (APP) would be targeted, in addition to any cases with serological evidence of APP serotype 2. This control programme was initiated in 1996, region by region, and fully implemented by 2004. Clinical, epidemiological and laboratory test results were used to identify the appropriate disease control measures. Partial depopulation was used to control EP on breeding and breeding-finishing farms. Total depopulation was implemented on all farms affected with APP and finishing farms affected with EP. Animal trade was strictly regulated during the programme and all suspected cases of respiratory disease in pigs were made notifiable. Continued monitoring is based on clinical suspicion of infection and/or the detection of gross pathological lesions at slaughter, followed by laboratory confirmation. In 2005, the incidence of clinical cases was less than 1%. Regulations have been introduced to control the international trade in live pigs and prevent the re-introduction of respiratory diseases into Switzerland.

Frontiers in Veterinary Science, 2017

Epidemiology and infection, Mar 12, 2016

Animal health surveillance enables the detection and control of animal diseases including zoonose... more Animal health surveillance enables the detection and control of animal diseases including zoonoses. Under the EU-FP7 project RISKSUR, a survey was conducted in 11 EU Member States and Switzerland to describe active surveillance components in 2011 managed by the public or private sector and identify gaps and opportunities. Information was collected about hazard, target population, geographical focus, legal obligation, management, surveillance design, risk-based sampling, and multi-hazard surveillance. Two countries were excluded due to incompleteness of data. Most of the 664 components targeted cattle (26·7%), pigs (17·5%) or poultry (16·0%). The most common surveillance objectives were demonstrating freedom from disease (43·8%) and case detection (26·8%). Over half of components applied risk-based sampling (57·1%), but mainly focused on a single population stratum (targeted risk-based) rather than differentiating between risk levels of different strata (stratified risk-based). About...

Journal of Antimicrobial Chemotherapy, 2014

Objectives: To establish a consensus defined daily dose animal (DDDA) for each active substance (... more Objectives: To establish a consensus defined daily dose animal (DDDA) for each active substance (AS) and administration route for porcine veterinary antimicrobial products authorized in four European countries, thus allowing crosscountry quantification and comparison of antimicrobial usage data. Methods: All veterinary antimicrobial products authorized for porcine use in Belgium, France, Germany and Sweden were listed for each administration route. First, separate DDDAs for each product were defined based on the recommended dosing for the main indication. Second, a consensus DDDA was established by taking the mean of the DDDAs for each product within a certain category of AS plus administration route. Results: One-hundred-and-fifty-nine, 240, 281 and 50 antimicrobial products were licensed in Belgium, France, Germany and Sweden, respectively, in February 2013. Large variations were observed for dosage and treatment duration recommendations between products and between countries for the same ASs. Only 6.8% of feed/water and 29.4% of parenteral AS groups had the same recommended dosage in the four countries. Conclusions: This study presents a consensus DDDA list for use in the quantification and comparison of antimicrobial consumption. Four major recommendations have been formulated: (i) urgent need for harmonization of authorization and recommended summary of product characteristics (SPC) dosages; (ii) expand the developed preliminary DDDA list to include all authorized veterinary medicinal products in all EU member states and for all (food-producing) animal species; (iii) improved accessibility of country-specific SPC data would be preferable; and (iv) statement of the 'long-acting' duration of a product in the SPC.

Preventive Veterinary Medicine, 2015

The identity of the cells that form the periosteum during development is controversial with curre... more The identity of the cells that form the periosteum during development is controversial with current dogma suggesting these are derived from a Sox9-positive progenitor. Herein, we characterize a newly created Prrx1eGFP reporter transgenic mouse line during limb formation and postnatally. Interestingly, in the embryo Prrx1eGFP-labeled cells become restricted around the Sox9-positive cartilage anlage without themselves becoming Sox9-positive. In the adult, the Prrx1eGFP transgene live labels a subpopulation of cells within the periosteum that are enriched at specific sites, and this population is diminished in aged mice. The green fluorescent protein (GFP)-labeled subpopulation can be isolated using fluorescence-activated cell sorting (FACS) and represents approximately 8% of all isolated periosteal cells. The GFP-labeled subpopulation is significantly more osteogenic than unlabeled, GFP-negative periosteal cells. In addition, the osteogenic and chondrogenic capacity of periosteal cells in vitro can be extended with the addition of fibroblast growth factor (FGF) to the expansion media. We provide evidence to suggest that osteoblasts contributing to cortical bone formation in the embryo originate from Prrx1eGFP-positive cells within the perichondrium, which possibly piggyback on invading vascular cells and secrete new bone matrix. In summary, the Prrx1eGFP mouse is a powerful tool to visualize and isolate periosteal cells and to quantify their properties in the embryo and adult.

Veterinary Record, 2013

Animal health surveillance in Great Britain (GB) is conducted through public and private initiati... more Animal health surveillance in Great Britain (GB) is conducted through public and private initiatives, yet there is no consolidated information on these activities and their outcomes. We developed an inventory of livestock health surveillance programmes in GB to identify gaps in resource use and potential synergies that could be exploited. The inventory contained details of 36 livestock surveillance activities active in 2011. Data were collected by questionnaire and interviews. Livestock health surveillance funding was found to be unevenly distributed between species: the vast majority (approximately 94 per cent) was spent on cattle diseases (tuberculosis surveillance accounted for most of this expenditure), with 2 per cent on pigs, 2 per cent on sheep/goats, 1 per cent on poultry, and 1 per cent on antimicrobial resistance surveillance across all species. Consequently, surveillance efforts in GB appears heavily skewed towards regions with high cattle densities, particularly high‐pre...

Preventive Veterinary Medicine, 2005

The worldwide increase of antimicrobial resistance in microorganisms complicates medical treatmen... more The worldwide increase of antimicrobial resistance in microorganisms complicates medical treatment of infected humans. We did a risk-factor analysis for the prevalence of antimicrobial resistant Campylobacter coli on 64 Swiss pig finishing farms. Between May and November 2001, 20 faecal samples per farm were collected from the floor of pens holding finishing pigs shortly before slaughter. Samples were pooled and cultured for Campylobacter species. Isolated Campylobacter strains were tested for resistance against selected antimicrobials. Additionally, information on herd health and management aspects was available from another study. Because data quality on the history of antimicrobial use on the farms was poor, only non-antimicrobial risk factors could be analysed. Statistical analyses were performed for resistance against ciprofloxacin, erythromycin, streptomycin, tetracycline, and for multiple resistance, which was defined as resistance to three or more antimicrobials. Risk factors for these outcomes-corrected for dependency of samples at herd level-were analysed in five generalised estimation-equation models. Prevalence of antimicrobial resistance among Campylobacter isolates was ciprofloxacin 26.1%, erythromycin 19.2%, streptomycin 78.0%, tetracycline 9.4%, and multiple resistance 6.5%. Important risk factors contributing to the prevalence of resistant strains were shortened tails, lameness, skin lesions, feed without whey, and ad libitum feeding. Multiple resistance was more likely in farms which only partially used an all-in-www.elsevier.com/locate/prevetmed

The Lancet Infectious Diseases, 2011

In the past two decades there has been a growing realisation that the livestock sector was in a p... more In the past two decades there has been a growing realisation that the livestock sector was in a process of change, resulting from an expansion of intensive animal production systems and trade to meet a globalised world's increasing demand for livestock products. One unintended consequence has been the emergence and spread of transboundary animal diseases and, more specifi cally, the resurgence and emergence of zoonotic diseases. Concurrent with changes in the livestock sector, contact with wildlife has increased. This development has increased the risk of transmission of infections from wildlife to human beings and livestock. Two overarching questions arise with respect to the real and perceived threat from emerging infectious diseases: why are these problems arising with increasing frequency, and how should we manage and control them? A clear conceptual research framework can provide a guide to ensure a research strategy that coherently links to the overarching goals of policy makers. We propose such a new framework in support of a research and policy-generation strategy to help to address the challenges posed by emerging zoonoses.

European Journal of Wildlife Research, 2007

Epidemiology and Infection, 2010

SUMMARYKnowledge on the relative importance of alternative sources of human campylobacteriosis is... more SUMMARYKnowledge on the relative importance of alternative sources of human campylobacteriosis is important in order to implement effective disease prevention measures. The objective of this study was to assess the relative importance of three key exposure pathways (travelling abroad, poultry meat, pet contact) for different patient age groups in Switzerland. With a stochastic exposure model data onCampylobacterincidence for the years 2002–2007 were linked with data for the three exposure pathways and the results of a case-control study. Mean values for the population attributable fractions (PAF) over all age groups and years were 27% (95% CI 17–39) for poultry consumption, 27% (95% CI 22–32) for travelling abroad, 8% (95% CI 6–9) for pet contact and 39% (95% CI 25–50) for other risk factors. This model provided robust results when using data available for Switzerland, but the uncertainties remained high. The output of the model could be improved if more accurate input data are avai...

Food Control, 2014

The UK Food Standards Agency is currently funding research to build the evidence base for the mod... more The UK Food Standards Agency is currently funding research to build the evidence base for the modernisation of meat inspection. This includes an assessment of the risks to public health and animal health/welfare of moving to a visual-only post-mortem meat inspection (PMMI), where routine mandatory palpation and incision procedures are omitted. In this paper we present the results of a risk assessment for a change from current to visual-only PMMI for cattle, sheep/goats and farmed/wild deer. A large list of hazard/species pairings were assessed and prioritised by a process of hazard identification. Twelve hazard/species pairings were selected for full consideration within the final risk assessment. The results of the public health risk assessment indicated that all hazard/species pairings were Negligible with the exception of Cysticercus bovis in cattle, which was judged to be of low-medium increased risk for systems not conforming to criteria as laid down by EC Regulation 1244/2007, compared to systems that do conform to Regulations for visual-only PMMI. Most hazard/species pairings were concluded to pose a potential increased risk to animal health/ welfare, including Mycobacterium bovis (very low e low increase in risk, but with considerable uncertainty), Fasciola hepatica (negligible e very low) and Cysticercus bovis (very low e low). Due to low feedback rates to farmers, the real risk to animal health/welfare for F. hepatica and C. bovis, including animals in non-conforming systems under visual-only PMMI, is probably negligible. That then leaves M. bovis as the only confirmed non-negligible animal health and welfare risk.