B.J. Rauch

Effects of clinical mastitis caused by gram-positive and gram-negative bacteria and other organisms on the probability of conception in New York State Holstein dairy cows

The objective of this study was to estimate the effects of different types of clinical mastitis (CM) on the probability of conception in New York State Holstein cows. Data were available on 55,372 artificial inseminations (AI) in 23,695 lactations from 14,148 cows in 7 herds. We used generalized linear mixed models to model whether or not a cow conceived after a particular AI. Independent variables included AI number (first, second, third, fourth), parity, season when AI occurred, farm, type of CM (due to gram-positive bacteria, gram-negative bacteria, or other organisms) in the 6 wk before and after an AI, and occurrence of other diseases. Older cows were less likely to conceive. Inseminations occurring in the summer were least likely to be successful. Retained placenta decreased the probability of conception. Conception was also less likely with each successive AI. The probability of conception associated with the first AI was 0.29. The probability of conception decreased to 0.26, 0.25, and 0.24 for the second, third, and fourth AI, respectively. Clinical mastitis occurring any time between 14 d before until 35 d after an AI was associated with a lower probability of conception; the greatest effect was an 80% reduction associated with gram-negative CM occurring in the week after AI. In general, CM due to gram-negative bacteria had a more detrimental effect on probability of conception than did CM caused by gram-positive bacteria or other organisms. Furthermore, CM had more effect on probability of conception immediately around the time of AI. Additional information about CM (i.e., its timing with respect to AI, and whether the causative agent is gram-positive or gram-negative bacteria, or other organisms) is valuable to dairy personnel in determining why some cows are unable to conceive in a timely manner. These findings are also beneficial for the management of mastitic cows (especially those with gram-negative CM) when mastitis occurs close to AI.

Randomized clinical trial to evaluate the efficacy of a 5-day ceftiofur hydrochloride intramammary treatment on nonsevere gram-negative clinical mastitis

The objective of this study was to evaluate the efficacy of intramammary treatment with ceftiofur hydrochloride of nonsevere, clinical coliform mastitis. One hundred four cases on 5 farms met the enrollment criteria for the study. Escherichia coli was the most common coliform species identified in milk samples from cows with mild to moderate clinical mastitis, followed by Klebsiella spp. and Enterobacter spp. At enrollment, a milk sample from the affected quarter was taken and used for on-farm culture or submitted to the laboratory. For cows in the treatment group, treatment was initiated with ceftiofur hydrochloride via intramammary infusion at 24-h intervals for 5 d according to label standards. Cows in the control group did not receive treatment. Culture results were available on the day after enrollment and only cows with coliform mastitis continued in the treatment and untreated control groups. Bacteriological cure was defined based on 2 posttreatment milk samples. Molecular typing was used for final definition of bacteriological cure. Treatment of nonsevere clinical gram-negative mastitis with ceftiofur hydrochloride resulted in a significant increase in bacteriological cure compared with nontreated controls in animals infected with E. coli or Klebsiella spp. Treated animals clinically improved significantly more compared with control cows. No significant differences were observed between treated and control animals in milk production or linear score before or after clinical mastitis. Treated animals left the study less frequently compared with control animals.

Noninferiority trial comparing a first-generation cephalosporin with a third-generation cephalosporin in the treatment of nonsevere clinical mastitis in dairy cows

The objective of this study was to evaluate the noninferiority of 2 intramammary treatments for nonsevere clinical mastitis. The 2 treatments were a first-generation cephalosporin (cephapirin sodium, 2 treatments 12h apart) and a third-generation cephalosporin (ceftiofur hydrochloride, treatments once a day for 5d). A total of 296 cases on 7 farms met the enrollment criteria for the study. Streptococcus dysgalactiae was the most common bacterial species identified in milk samples from cows with mild to moderate clinical mastitis, followed by Escherichia coli, other esculin-positive cocci, Streptococcus uberis, and Klebsiella spp. Treatment was randomly allocated as either cephapirin sodium or ceftiofur hydrochloride via intramammary infusion according to label standards. Bacteriological cure was defined based on 2 posttreatment milk samples taken at 10 and 17d after enrollment. Noninferiority of cephapirin relative to ceftiofur was shown for bacteriological cure of gram-positive cases and for clinical cure of all cases. Ceftiofur showed a significantly higher bacteriological cure in gram-negative cases. Treatments showed no significant difference in bacteriological cure of all cases and in time to exit from the study, where the absence of a difference does not imply noninferiority. Based on the findings from this study, farm-specific treatment protocols that differ for gram-positive and gram-negative cased may be developed.

Defining standardized protocols for determining the efficacy of a postmilking teat disinfectant following experimental exposure of teats to mastitis pathogens.

The objective of this paper was to define standardized protocols for determining the efficacy of a postmilking teat disinfectant following experimental exposure of teats to both Staphylococcus aureus and Streptococcus agalactiae. The standardized protocols describe the selection of cows and herds and define the critical points in performing experimental exposure, performing bacterial culture, evaluating the culture results, and finally performing statistical analyses and reporting of the results. The protocols define both negative control and positive control trials. For negative control trials, the protocol states that an efficacy of reducing new intramammary infections (IMI) of at least 40% is required for a teat disinfectant to be considered effective. For positive control trials, noninferiority to a control disinfectant with a published efficacy of reducing new IMI of at least 70% is required. Sample sizes for both negative and positive control trials are calculated. Positive control trials are expected to require a large trial size. Statistical analysis methods are defined and, in the proposed methods, the rate of IMI may be analyzed using generalized linear mixed models. The efficacy of the test product can be evaluated while controlling for important covariates and confounders in the trial. Finally, standards for reporting are defined and reporting considerations are discussed. The use of the defined protocol is shown through presentation of the results of a recent trial of a test product against a negative control.

Randomized noninferiority trial comparing 2 commercial intramammary antibiotics for the treatment of nonsevere clinical mastitis in dairy cows

The purpose was to evaluate 2 intramammary treatments for mild-to-moderate cases of clinical mastitis in a noninferiority comparison. Noninferiority trials are intended to show whether a given treatment, hetacillin potassium, has at least comparable efficacy as the reference treatment, ceftiofur hydrochloride. Treatments can be deemed inferior to the reference treatment by an amount less than the margin of noninferiority, or inconclusive if the confidence interval crosses the margin of noninferiority. Cows with clinical mastitis from 6 farms were considered for enrollment. Using a randomized design, cows with mild or moderate mastitis in 1 quarter were assigned to on-label treatment with either ceftiofur or hetacillin. A total of 596 cows met the criteria needed for continued enrollment. Treatment distribution resulted in 309 cows in the ceftiofur group and 287 cows in the hetacillin group. Mixed regression analysis was performed for the following outcomes: bacteriological cure, pathogen cure, clinical cure, postevent milk production and linear score, and survival to d 30 and 60. Cox proportional hazards analysis was used to describe treatment effect on survival and mastitis risks. Bacteriological cure, defined as absence of causative organism in samples retrieved at d 14 and 21 postmastitis, was similar between groups. No significant statistical differences were found in cure risk, and noninferiority of hetacillin relative to ceftiofur for bacteriological cure was conclusive (hetacillin=67%, ceftiofur=72%). Absence of a pathogen on both follow-up samples designated a cow as a pathogen cure. Pathogen cure was similar between treatment groups and noninferiority of hetacillin relative to ceftiofur was shown (hetacillin=35%, ceftiofur=32%). Clinical cure (hetacillin=68%, ceftiofur=64%), postevent milk production (hetacillin=37.0kg, ceftiofur=38.2kg), and linear scores (hetacillin=3.4, ceftiofur=3.1) were also not statistically different between treatment groups. Noninferiority of hetacillin relative to ceftiofur was shown for survival to d 30 and survival to d 60, whereas hetacillin was more likely to have a clinical cure than ceftiofur by d 4. No differences were seen between groups when Cox proportional hazards were performed, neither for exit from the herd in the 60 d following the event nor in the risk for a subsequent mastitis event. These findings can be used to develop farm-specific protocols for clinical mastitis treatment.

Noninferiority trial on the efficacy of premilking teat disinfectant against naturally occurring new intramammary infections using a novel 2-step diagnostic process

The objective of the study was to evaluate premilking teat disinfectant efficacy with the use of a novel diagnostic protocol against a positive control. The evaluation of efficacy was based on establishing noninferiority of a new premilking teat disinfectant compared with an existing premilking teat disinfectant. Approximately 200 cows were randomly allocated to 1 of 2 groups. Study personnel were blinded as to cow allocation and identification of the premilking disinfectants. Quarters were disinfected using a dip cup before milking with either the control or experimental product. The disinfectant was left on the teat for approximately 30s before being wiped off in preparation for milking. Quarter-level bacteriological infection status was established at the beginning of the study and quarter milk samples were collected biweekly thereafter. Bacteriological analyses were performed only when somatic cell counts in milk samples crossed a parity-specific threshold. Poisson regression models were used to analyze data. The difference in the rate of new intramammary infections was small and the upper bound of the 95% confidence interval of the rate difference was smaller than a predefined noninferiority limit. Based on the observed difference in new intramammary infections rate between the experimental and control product, it was concluded that the experimental disinfectant was not inferior compared with the positive control. The protocol used in this study proposes a valid and economically attractive methodology to evaluate the efficacy of teat disinfectants relative to a positive control.

The efficacy of two iodine teat dips based on naturally occurring new intramammary infections

Based on proving non-inferiority of one product compared to another, this study was designed to compare the efficacy of an experimental pre-milking teat dip against a positive control in reducing naturally occurring intramammary infections (IMI). To test this methodology in the field, 199 cows were randomly allocated to two groups (Control, CG; n=100 and Experimental, EG; n=99) in Spring/Summer 2010. Personnel were blinded as to the origin of the product. Cows were milked two times per day following standard pre-milking procedures. Quarters of CG and EG cows were pre dipped for 30 sec with the control product and experimental products, respectively. Both different products were 0.5% iodine and 5% emollient. After milking, both groups were dipped with the control product. Quarter milk samples were collected for SCC analysis, at the beginning of the trial and afterwards every two weeks until 70 d. Quarter-level bacteriological status was established in all quarters at the beginning of the study. Milk samples collected thereafter were cultured only if SCC was >100,000 cells/ml in heifers and >200,000 cells/ml in cows. Logistic and linear regressions were used for data analysis. Overall, 148 CG (7.1%) and 130 EG (6.3%) milk samples were bacteriologically positive. Staphylococcus spp. (3.6% of tested samples tested), and Staphylococcus aureus (1.2% of tested samples) were commonly isolated in both groups. Streptococcus uberis was frequently isolated in CG (0.9% vs. 0.2% in EG). SCC geometric means were 32,000 (CG) and 25,000 (EG) cells/ml. No differences between groups in the log odds of having either an IMI or a new IMI (NIMI) were observed. The critical difference in the NIMI rate between both products was set at 0.03. The observed difference in NIMI rate was negligible, showing a non-inferiority of the experimental product vs. control. This study provided evidence of a valid and field-tested methodology to evaluate the efficacy of teat disinfectants under the assumption of non-inferiority.