Negatively controlled,randomized clinical trial to evaluate intramammary treatment of nonsevere,gram-negative clinical mastitis

The objective of this negatively controlled, randomized clinical trial was to examine clinical outcomes of 2-d or 8-d treatment using an approved intramammary (IMM) product containing ceftiofur hydrochloride compared with no antimicrobial treatment of nonsevere, gram-negative cases of clinical mastitis (CM). Additionally, we contrasted clinical outcomes of cases caused by Escherichia coli (n = 56) or Klebsiella pneumoniae (n = 54). Cases (n = 168) of nonsevere (abnormal milk or abnormal milk and udder) CM were randomly assigned to receive 2 d (n = 56) or 8 d (n = 56) of IMM ceftiofur or assigned to a negative control group (n = 56). At enrollment, quarter milk samples were collected and used for on-farm culture, somatic cell count (SCC), and confirmatory microbiological analysis. Quarter milk samples were collected weekly from 7 to 28 d after enrollment for microbiological and SCC analysis. Clinical outcomes were followed for 90 d or until the end of lactation (follow-up period, FUP). Overall, no significant differences in quarter-level recurrence of CM (32% for negative control, 34% for the 2-d treatment, and 32% for the 8-d treatment), culling (18% for negative control, 12% for 2-d treatment, and 11% for 8-d treatment), voluntary dry-off of affected quarters (20% for negative control, 30% for 2-d treatment, and 27% for 8-d treatment), days until return to normal milk (4.2 days for negative control, 4.8 days for 2-d treatment, 4.5 days for 8-d treatment), weekly quarter-SCC during the FUP (6.1, 6.3, and 6.0 log₁₀SCC for the negative control, 2-d, and 8-d treatments, respectively), or daily milk yield during the FUP (37.1, 36.3, and 37.6 kg/cow per day for the negative control, 2-d, and 8-d treatments, respectively) were observed among experimental groups. Days of discarded milk were greater for cows assigned to 8-d IMM ceftiofur (11.1 d) than for cows assigned to 2-d (6.9 d) or cows assigned to negative control (5.6 d). Bacteriological cure (BC) at 14 and 21 d after enrollment was greater in cows assigned to 8-d (89%) and 2-d (84%) treatment than in cows assigned to negative control (67%), but this outcome was confounded by pathogen. For CM caused by Kleb. pneumoniae, BC was greater for quarters assigned to receive treatment (combined 2-d and 8-d groups; 74% BC) than for quarters assigned to negative control (18%). In contrast, no differences in BC were observed for CM caused by E. coli (97–98%). Culling and voluntary dry-off of affected quarters were significantly greater for cows with quarters affected by Kleb. pneumoniae (22% culled, 39% voluntary dry-off of quarters) than for cows with quarters affected with E. coli (7% culled, 11% voluntary dry-off of quarters). Overall, use of IMM ceftiofur did not result in improvement of most clinical outcomes, but differences between E. coli and Kleb. pneumoniae were evident. In contrast to E. coli, Kleb. pneumoniae caused chronic intramammary infection and induced worse clinical outcomes. Intramammary antibiotic treatment of most mild and moderate cases of CM caused by E. coli is not necessary, but more research is needed to identify which quarters affected by Kleb. pneumoniae may benefit from antimicrobial therapy.     

Negatively controlled,randomized clinical trial to evaluate use of intramammary ceftiofur for treatment of nonsevere culture-negative clinical mastitis

The objective of this negatively controlled randomized clinical trial was to compare clinical outcomes of 5-d intramammary treatment using ceftiofur hydrochloride and no antimicrobial treatment of nonsevere culture-negative cases of clinical mastitis (CM). A total of 121 cases of nonsevere (abnormal milk or abnormal milk and udder) culture-negative CM were randomly assigned to either treatment (n = 62) or negative control (n = 59) groups. Quarters assigned to treatment received 1 daily intramammary infusion with an approved commercially available product containing ceftiofur hydrochloride for 5 d. Quarters assigned to the negative control group did not receive any interventions. Enrolled cows were followed for 90 d or until the end of lactation. At enrollment, milk samples from the affected quarter were used for on-farm culture, somatic cell count (SCC) analysis, and further microbiological analysis. During the follow-up period, milk samples were collected for microbiological analysis and SCC analysis. No significant differences between treatment and negative control groups were identified for treatment failure (5% for treatment vs. 10% for negative control, n = 121), quarter-level CM recurrence (8 vs. 5%, n = 91), intramammary infection at 14 or 28 d after enrollment (13 vs. 26%, n = 86), days until clinical cure (4.2 vs. 4.0 d), days to culling (48.3 vs. 36.8 d), daily milk production (43.3 vs. 43.6 kg/cow per day), or weekly quarter SCC (5.5 vs. 5.4 log₁₀ SCC). Days of milk discard were greater for cows assigned to the treatment group (8.5 d) compared with cows assigned to the negative control group (5.6 d). During the follow-up period, cases in the treatment group had a 50% risk reduction in IMI compared with cases in the negative control group. Irrespective of group, negative outcomes such as quarter-level CM recurrence (12%), treatment failure (12%), and culling (5%) occurred infrequently in nonsevere culture-negative cases of CM. Use of intramammary ceftiofur for treatment of nonsevere culture-negative cases of CM did not improve any economically relevant clinical outcome such as culling, milk production, or SCC.     

Invited review: Selective treatment of clinical mastitis in dairy cattle

Treatment of clinical mastitis (CM) and use of antimicrobials for dry cow therapy are responsible for the majority of animal-defined daily doses of antimicrobial use (AMU) on dairy farms. However, advancements made in the last decade have enabled excluding nonsevere CM cases from antimicrobial treatment that have a high probability of cure without antimicrobials (no bacterial causes or gram-negative, excluding Klebsiella spp.) and cases with a low bacteriological cure rate (chronic cases). These advancements include availability of rapid diagnostic tests and improved udder health management practices, which reduced the incidence and infection pressure of contagious CM pathogens. This review informed an evidence-based protocol for selective CM treatment decisions based on a combination of rapid diagnostic test results, review of somatic cell count and CM records, and elucidated consequences in terms of udder health, AMU, and farm economics. Relatively fast identification of the causative agent is the most important factor in selective CM treatment protocols. Many reported studies did not indicate detrimental udder health consequences (e.g., reduced clinical or bacteriological cures, increased somatic cell count, increased culling rate, or increased recurrence of CM later in lactation) after initiating selective CM treatment protocols using on-farm testing. The magnitude of AMU reduction following a selective CM treatment protocol implementation depended on the causal pathogen distribution and protocol characteristics. Uptake of selective treatment of nonsevere CM cases differs across regions and is dependent on management systems and adoption of udder health programs. No economic losses or animal welfare issues are expected when adopting a selective versus blanket CM treatment protocol. Therefore, selective CM treatment of nonsevere cases can be a practical tool to aid AMU reduction on dairy farms.     

Efficacy of 5-day parenteral versus intramammary benzylpenicillin for treatment of clinical mastitis caused by gram-positive bacteria susceptible to penicillin in vitro

The efficacy of parenteral (intramuscular) or intramammary (IMM) benzylpenicillin treatment for clinical mastitis caused by gram-positive bacteria susceptible to penicillin in vitro was investigated. Cows with clinical mastitis in 1 udder quarter were randomly placed into 2 treatment groups. The preliminary bacteriological diagnosis of intramammary infection (IMI) was based on on-farm culturing, and the bacteriological diagnoses were later confirmed by a quantitative PCR assay. Clinical mastitis caused by gram-positive bacteria susceptible to benzylpenicillin was treated with penicillin via either the parenteral route (20 mg/kg) or IMM route (600 mg) once per day for 5 d. The outcome of the treatment was evaluated 3 to 4 wk after the onset of the treatment. The affected quarter was examined to assess the clinical cure, and milk samples were collected from the affected quarter to determine the bacteriological cure and milk N-acetyl-β-d-glucosaminidase activity. The survival and the composite milk somatic cell counts of the treated cows were followed up for 6 and 3 mo after treatment, respectively. A total of 140 cows with clinical mastitis were included in the study, 61 being treated with benzylpenicillin parenterally and 79 via the IMM route. From all quarters treated, 108 of 140 (77.1%) were cured clinically and 77 of 140 (55.0%) were cured bacteriologically. The route of treatment did not significantly affect the outcome of the treatment; 80.3% of the quarters with parenteral treatment and 74.7% of the quarters with IMM treatment showed a clinical cure, and 54.1 and 55.7% a bacteriological cure, respectively. The milk N-acetyl-β-d-glucosaminidase activity was significantly lower in the quarters with a clinical or bacteriological cure than in the quarters with no cure. The 6-mo survival and the proportion of cows with composite milk somatic cell counts <200,000/mL among the treated cows during the 3-mo follow-up period did not significantly differ between the treatment groups. In conclusion, the outcome of either parenteral or IMM benzylpenicillin treatment of clinical mastitis caused by penicillin-susceptible bacteria was similar.     

Yield losses associated with clinical mastitis occurring in different weeks of lactation

The effects of the first lactational incidence of clinical mastitis (CM) on milk, fat, and protein production were studied in the Swedish Red and Swedish Holstein breeds. The data consisted of 38,535 weekly production records from 1,192 lactations (506 cows), sampled from 1987 to 2004 in one of the university's research herds. Daily yields were analyzed using a repeated-measures mixed model with an interaction between mastitis index and lactational stage, breed, parity, reproductive status, year-season of calving, and various indices for other disorders as independent variables. The indices were used to distinguish between cows with and without the studied diagnoses, as well as to indicate time (test day) in relation to day of diagnosis. Inclusion of the interaction made it possible to study the effects of CM occurring in different weeks of lactation. Primiparous and multiparous cows were analyzed separately, and the yields of nonmastitic cows were used as a reference for the production level in healthy cows. Lactational (305-d) yield losses were extrapolated from the daily estimates. High milk yield was predisposing to CM. Daily milk yield started to decline 2 to 4 wk before diagnosis. On the day of clinical onset, the milk yield of mastitic cows was reduced by 1 to 8 kg. After a case of CM, milk yield was suppressed throughout lactation. The magnitude of the yield losses was determined by the week of lactation at clinical onset. The greatest losses occurred when primiparous cows developed CM in wk 6, whereas multiparous cows experienced the greatest losses when diseased in wk 3. The 305-d milk, fat, and protein production in mastitic primiparous cows were reduced by 0 to 9, 0 to 8, and 0 to 7%, respectively. The corresponding reductions in mastitic multiparous cows were 0 to 11, 0 to 12, and 0 to 11%, respectively.     

Intramammary antimicrobial treatment of subclinical mastitis and cow performance later in lactation

The aim of this study was to evaluate long-term therapeutic effects of antimicrobial treatment of recently acquired subclinical mastitis (RASCM) during lactation. Quarter-level clinical mastitis (CM) follow-up, composite somatic cell counts (SCC), and cow-level milk yield later in lactation were evaluated using follow-up data from 2 previously published linked randomized field trials. The first trial randomly assigned antimicrobial treatment with any intramammary product or negative control to culture-positive quarters of cows having a first elevated composite SCC after 2 consecutive low composite SCC measurements. Untreated cows that had a second elevated composite SCC at the next measurement and were staphylococci-positive (i.e., Staphylococcus aureus or non-aureus staphylococci) were randomly assigned to treatment or control. Quarter-level CM cases were reported by the participating herd personnel, and milk yield and composite SCC data were obtained from the regular test-day recording. Frailty survival models were used to evaluate the long-term therapeutic effects of antimicrobial treatment of RASCM on quarter-level CM follow-up. Mixed linear regression models were applied to quantify the effect on milk yield and composite SCC. Data of 638 quarters from 486 cows in 38 herds were available for statistical analyses, of which 229 quarters of 175 cows received antimicrobial treatment for RASCM. Antimicrobial treatment culminated in reduced composite SCC levels later in lactation but did not result in different milk yield levels or CM follow-up compared with control cows. Antimicrobial treatment of cows with RASCM should therefore only be considered in exceptional situations given the current focus on antimicrobial usage reduction in animal husbandry.     

The influence of cow factors on the incidence of clinical mastitis in dairy cows

Many cow-specific risk factors for clinical mastitis (CM) are known. Other studies have analyzed these risk factors separately or only analyzed a limited number of risk factors simultaneously. The goal of this study was to determine the influence of cow factors on the incidence rate of CM (IRCM) with all cow factors in one multivariate model. Also, using a similar approach, the probability of whether a CM case is caused by gram-positive or gram-negative pathogens was calculated. Data were used from 274 Dutch dairy herds that recorded CM over an 18-mo period. The final dataset contained information on 28,137 lactations of 22,860 cows of different parities. In total 5,363 CM cases were recorded, but only 2,525 CM cases could be classified as gram-positive or gram-negative. The cow factors parity, lactation stage, season of the year, information on SCC from monthly test-day records, and CM history were included in the logistic regression analysis. Separate analyses were performed for heifers and multiparous cows in both the first month of lactation and from the second month of lactation onward. For investigating whether CM was caused by gram-positive or gram-negative pathogens, quarter position was included in the logistic regression analysis as well. The IRCM differed considerably among cows, ranging between 0.0002 and 0.0074 per cow-day at risk for specific cows depending on cow factors. In particular, previous CM cases, SCC in the previous month, and mean SCC in the previous lactation increased the IRCM in the current month of lactation. Results indicate that it is difficult to distinguish between gram-positive and gram-negative CM cases based on cow factors alone.     

Antimicrobial treatment of clinical mastitis in the eastern United States: The influence of dairy farmers' mastitis management and treatment behavior and attitudes

To assess both the behaviors and social variables related to antimicrobial therapy for clinical mastitis, we sent a survey to 1,700 dairy farms in Michigan, Pennsylvania, and Florida in January and February 2013. The survey included questions related to 7 major areas: sociodemographic and farm characteristics, milking proficiency, milking systems, cow environment, infected cow monitoring and treatment, farm labor, and attitudes toward mastitis and related antimicrobial use. The overall response rate was 41% (21% in Florida, 39% in Michigan, and 45% in Pennsylvania). Herd size ranged from 9 to 5,800 cows. Only a small proportion of herds frequently or always cultured milk samples for bacteriology from cows with a high somatic cell count (17%), cows with clinical mastitis (18%), or bulk tank milk (13%). Likewise, only 56% of herds frequently or always maintained records of all treated cows and 49% reviewed records before administering mastitis treatments. Multivariate analysis determined that use of treatment records was associated with increased likelihood of frequent use for both intramammary (IMA) and systemic (SYA) administration of antimicrobial drugs for therapy of clinical mastitis. As would be expected, use of natural (organic) therapies was associated with decreased use of IMA, as was the respondent being a member of an Amish community. Lower levels of education and the use of bacterins to control Staphylococcus aureus mastitis were also associated with decreased IMA, whereas increased use of IMA at dry off and the belief that “bad luck” plays a role in mastitis problems were associated with increased IMA. Use of an internal teat sealant, the respondent being the sole proprietor, being from Michigan, use of conductivity to measure subclinical mastitis, the respondent placing increasing importance on decreasing antibiotic residues in cull cows, and having financial incentives for employees linked to somatic cell count were associated with increased use of SYA for the treatment of clinical mastitis. Use of sand or mattresses for bedding were associated with decreased SYA. These findings highlight the need to improve the acceptance of practices that are consistent with prudent antimicrobial use for the treatment of clinical mastitis on dairy farms. Additionally, the willingness of dairy farmers to administer antimicrobial drugs for the treatment of clinical mastitis is associated with other mastitis-related practices and attitudes.     

Randomized,blinded, controlled clinical trial shows no benefit of homeopathic mastitis treatment in dairy cows

Mastitis is one of the most common diseases in dairy production, and homeopathic remedies have been used increasingly in recent years to treat it. Clinical trials evaluating homeopathy have often been criticized for their inadequate scientific approach. The objective of this triple-blind, randomized controlled trial was to assess the efficacy of homeopathic treatment in bovine clinical mastitis. The study was conducted on a conventionally managed dairy farm between June 2013 and May 2014. Dairy cows with acute mastitis were randomly allocated to homeopathy (n = 70) or placebo (n = 92), for a total of 162 animals. The homeopathic treatment was selected based on clinical symptoms but most commonly consisted of a combination of nosodes with Streptococcinum, Staphylococcinum, Pyrogenium, and Escherichia coli at a potency of 200c. Treatment was administered to cows in the homeopathy group at least once per day for an average of 5 d. The cows in the placebo group were treated similarly, using a placebo preparation instead (lactose globules without active ingredients). If necessary, we also used allopathic drugs (e.g., antibiotics, udder creams, and anti-inflammatory drugs) in both groups. We recorded data relating to the clinical signs of mastitis, treatment, time to recovery, milk yield, somatic cell count at first milk recording after mastitis, and culling. We observed cows for up to 200 d after clinical recovery. Base-level data did not differ between the homeopathy and placebo groups. Mastitis lasted for an average of 6 d in both groups. We observed no significant differences in time to recovery, somatic cell count, risk of clinical cure within 14 d after disease occurrence, mastitis recurrence risk, or culling risk. The results indicated no additional effect of homeopathic treatment compared with placebo. The advantages or disadvantages of homeopathy should be carefully assessed for individual farms.     

Treatments of clinical mastitis occurring in cows on 51 large dairy herds in Wisconsin

Antimicrobials are frequently used for treatment of bovine mastitis and few studies have examined modern treatment strategies on large US dairy farms. The objective of this study was to describe treatment practices for clinical mastitis occurring in cows on large dairy herds in Wisconsin. Treatments performed on 747 cows experiencing cases of mild, moderate, or severe symptoms of clinical mastitis were recorded on 51 Wisconsin dairy farms. Duplicate milk samples were collected from the affected quarter for microbiological analysis at the onset of clinical mastitis and 14 to 21 d after treatment ended. Cows were treated according to individual farm protocol. Drugs and doses used for treatments were recorded for each case. Among all herds, 5 intramammary (IMM) antimicrobials (amoxicillin, hetacillin, pirlimycin, ceftiofur, and cephapirin) were used to treat cows for clinical mastitis. Of 712 cows with complete treatment data, 71.6% were treated with IMM ceftiofur either solely or combined with other antimicrobials (administered either IMM or systemically). Of cows experiencing severe symptoms of clinical mastitis, 43.8% received IMM treatment concurrent with systemic antimicrobials. Of all cows treated, 23.1% received an additional secondary treatment (either IMM, systemic, or both) because of perceived lack of response to the initial treatment. The majority of IMM treatments were administered to cows with a microbiological diagnosis of no growth (34.9%) or Escherichia coli (27.2%). Half of the cows experiencing cases caused by E. coli were treated using systemic antimicrobials in contrast to only 6.8% of cows experiencing cases caused by coagulase-negative staphylococci. In conflict with FDA regulations, which do not allow extra-label treatments using sulfonamides, a total of 22 cows from 8 farms were treated with systemic sulfadimethoxine either solely or in combination with oxytetracycline. Antimicrobial drugs were used on all herds and many cows received extra-label treatments. Great opportunity exists to improve mastitis therapy on large dairy herds, but use of more diagnostic methodologies is necessary to guide treatments. Farmers and veterinarians should work together to create protocols based on the herd needs considering reduced inappropriate and excessive use of antimicrobials.     

A model for the genetic evaluation of number of clinical mastitis cases per lactation in Czech Holstein cows

Cases of mastitis from 9,550 lactations of 6,242 cows were recorded on 5 farms in the Czech Republic from 1996 to 2008. The number of clinical mastitis (CM) cases per cow adjusted to a lactation length of 305 d was analyzed with 4 linear single-trait animal models and one 3-trait model, which also included lactation mean somatic cell score (SCS) and 305-d milk yield. Factors included in the model of choice were parity, combined effect of herd and a 2-yr calving period, calving season, permanent environmental effect of the cow, and additive genetic effect of the cow. From both the single-trait and multiple-trait models, estimated heritability of number of CM cases was 0.11 (±0.015 for the multiple-trait model). Permanent environmental effects accounted for approximately one-third of the phenotypic variance. Heritability estimates for lactation mean SCS and 305-d milk yield were 0.17 ± 0.019 and 0.25 ± 0.011, respectively, and genetic correlations of these traits with number of CM cases were 0.80 ± 0.059 and 0.34 ± 0.079, respectively. Genetic evaluation of the number of CM cases in Czech Holsteins could be carried out including data from all parities using a 3-trait animal model with SCS and milk yield as additional traits.     

Discriminating between true-positive and false-positive clinical mastitis alerts from automatic milking systems

Automatic milking systems (AMS) generate alert lists reporting cows likely to have clinical mastitis (CM). Dutch farmers indicated that they use non-AMS cow information or the detailed alert information from the AMS to decide whether to check an alerted cow for CM. However, it is not yet known to what extent such information can be used to discriminate between true-positive and false-positive alerts. The overall objective was to investigate whether selection of the alerted cows that need further investigation for CM can be made. For this purpose, non-AMS cow information and detailed alert information were used. During a 2-yr study period, 11,156 alerts for CM, including 159 true-positive alerts, were collected at one farm in the Netherlands. Non-AMS cow information on parity, days in milk, season of the year, somatic cell count history, and CM history was added to each alert. In addition, 6 alert information variables were defined. These were the height of electrical conductivity, the alert origin (electrical conductivity, color, or both), whether or not a color alert for mastitic milk was given, whether or not a color alert for abnormal milk was given, deviation from the expected milk yield, and the number of alerts of the cow in the preceding 12 to 96 h. Subsequently, naive Bayesian networks (NBN) were constructed to compute the posterior probability of an alert being truly positive based only on non-AMS cow information, based on only alert information, or based on both types of information. The NBN including both types of information had the highest area under the receiver operating characteristic curve (AUC; 0.78), followed by the NBN including only alert information (AUC = 0.75) and the NBN including only non-AMS cow information (AUC = 0.62). By combining the 2 types of information and by setting a threshold on the computed probabilities, the number of false-positive alerts on a mastitis alert list was reduced by 35%, and 10% of the true-positive alerts would not be identified. To detect CM cases at a farm with an AMS, checking all alerts is still the best option but would result in a high workload. Checking alerts based on a single alert information variable would result in missing too many true-positive cases. Using a combination of alert information variables, however, is the best way to select cows that need further investigation. The effect of adding non-AMS cow information on making a distinction between true-positive and false-positive alerts would be minor.     

Effect of repeated episodes of generic clinical mastitis on milk yield in dairy cows

Our objective was to estimate the milk losses associated with multiple occurrences of generic bovine clinical mastitis (CM) within and across lactations. We studied 10,380 lactations from 5 large, high-producing dairy herds that used automatic recording of daily milk yields. Mixed models, with a random herd effect and an autoregressive covariance structure to account for repeated measurements, were used to quantify the effect of CM and other control variables (parity, week of lactation, other diseases) on milk yield. Many cows that developed CM were higher producers than their non-mastitic herdmates before CM occurred. Milk yield began to drop after diagnosis; the greatest loss occurred in the first weeks (up to 126 kg) and then gradually tapered to a constant value approximately 2 mo after CM. Mastitic cows often never recovered their potential yield. First-lactation cows lost 164 kg of milk for the first episode and 198 kg for the second in the 2 mo after CM diagnosis, compared with their potential yield. Among older cows, this estimate was 253 kg for the first, 238 kg for the second, and 216 kg for the third CM case. A cow that had 1 or more CM episodes in her previous lactation produced 1.2 kg/d less milk over the whole current lactation (95% confidence interval: 0.6, 1.7) than a cow without CM in her previous lactation. These findings provide dairy producers with information on the average milk loss associated with CM cases without considering the causative agent, and can be used for economic analysis.     

Prevalence of mastitis pathogens and their resistance against antimicrobial agents in dairy cows in Brandenburg, Germany

The primary objective of this study was to determine management practices concerning mastitis in Brandenburg, Germany, the prevalence of mastitis pathogens in dairy cows, and their resistance to selected antimicrobial agents. A further objective was to study the potential effect of parity and stage of lactation on the resistance of Staphylococcus aureus isolates against ampicillin. Milk samples for microbiological culture were collected from 4 groups of clinically healthy cows (first lactation, >1 lactation, >50 d in milk, and >250 d in milk; 8 cows/group) in 80 dairy herds. Resistance of gram-positive pathogens against 6 antimicrobial agents was tested using the broth microdilution method. Mastitis pathogens were isolated from 26.4% of the milk samples. Coagulase-negative staphylococci (CNS, 9.1% of quarters) and Corynebacterium bovis (7.3%) were the pathogens most frequently isolated. Among the major pathogens, Staph. aureus (5.7%) and Streptococcus uberis (1.0%) had the highest prevalence. Streptococcus agalactiae was isolated in samples from 29% of the herds. Although the prevalence of most pathogens was higher in older cows, the prevalence of CNS was higher in primiparous cows. Results of the mastitis control questionnaire showed that cows with clinical mastitis were transferred to a sick cow pen in 70% of the herds. Cephalosporins were the drug of first choice for treatment of clinical mastitis cases followed by fixed combinations of antimicrobial agents, β-lactamase-resistant penicillins, and penicillin. Most farmers treated cows 3 to 4 times per case. Cloxacillin, alone or in combination, and penicillin were most often used for dry-cow therapy. Antimicrobial resistance of the pathogens was within the range of other reports. Resistance of Staph. aureus to ampicillin increased significantly during the first lactation. Further research is required to determine the factors that lead to the selection of Staph. aureus strains that are resistant to ampicillin during the first lactation.     

Randomized noninferiority field trial evaluating cephapirin sodium for treatment of nonsevere clinical mastitis

The general objective of this study was to evaluate whether cephapirin sodium is noninferior compared with a positive control broad-spectrum product formulated with a combination of antimicrobials for intramammary treatment of nonsevere clinical mastitis. In addition, we compared the efficacy of treatments on the cure risks of pathogen groups (gram-positive, gram-negative, and cultures with no growth) based on culture results. A total of 346 cows distributed in 31 commercial dairy herds were selected to participate in the study, although only 236 met the criteria for evaluation of microbiological cure. Coagulase-negative staphylococci were the most isolated gram-positive pathogens in pretreatment milk samples, whereas the most common gram-negative bacterium was Escherichia coli. Cows attending the postadmission criteria were treated with 4 intramammary infusions (12 h apart) of one of the following antimicrobials: 300 mg of cephapirin sodium + 20 mg of prednisolone (CS), or the positive control treatment formulated with a combination of antimicrobials (200 mg of tetracycline + 250 mg of neomycin + 28 mg of bacitracin + 10 mg of prednisolone; TNB). Noninferiority analysis and mixed regression models (overall and considering the pathogen groups) were performed for the following outcomes: bacteriological cure (absence of the causative pathogens in cultures performed in milk samples collected at 14 and 21 ± 3 d after enrollment), pathogen cure (absence of any pathogen on both follow-up samples), clinical cure (absence of clinical sign in the milk and mammary gland at 48 h after the last antimicrobial infusion), extended clinical cure (normal milk and normal gland on the second posttreatment sample collection (d 21), and linear score of somatic cell count cure [linear score of somatic cell count recovery (≤4.0) on d 21 ± 3 after enrollment]. No significant differences were observed between treatments regarding any of the evaluated outcomes in both regression models (overall and considering the pathogen groups). Noninferiority of CS relative to TNB was inconclusive for bacteriological cure (CS = 0.68; TNB = 0.73) and clinical cure (CS = 0.88; TNB = 0.94), as the confidence intervals crossed the pre-stated margin of noninferiority (Δ = ?0.15). Cephapirin sodium was noninferior compared with TNB for pathogen cure (CS = 0.36; TNB = 0.35), extended clinical cure (CS = 0.93; TNB = 0.92), and linear score of somatic cell count cure (CS = 0.29; TNB = 0.28). In conclusion, the use of intramammary CS for treatment of nonsevere clinical mastitis has similar efficacy as a treatment regimen with a combination of antimicrobial agents (tetracycline + neomycin + bacitracin), although noninferiority analysis showed inconclusive results for bacteriological and clinical cures.     

Development of a new clinical mastitis detection method for automatic milking systems

This study investigated the potential for accurate detection of clinical mastitis (CM) in an automatic milking system (AMS) using electronic data from the support software. Data from cows were used to develop the model, which was then tested on 2 independent data sets, 1 with 311 cows (same farm but from a different year) and 1 with 568 cows (from a different farm). In addition, the model was used to test how well it could predict CM 1 to 3 d before actual clinical diagnosis. Logistic mixed models were used for the analysis. Twelve measurements were included in the initial model before a backward elimination, which resulted in the following 6 measurements being included in the final model: quarter-level milk yield (MY; kg), electrical conductivity (EC; mS/cm), average milk flow rate (MF; kg/min), occurrence of incompletely milked quarters in each milking session (IM; yes or no), MY per hour (MYH; kg/h), and EC per hour (ECH; mS/cm/h) between successive milking sessions. The other 6 measurements tested but not included in the final model were peak milk flow rate (kg/min), kick-offs (yes or no) in each milking session, lactation number, days in milk (d), blood in milk (yes or no), and a calculated mastitis detection index used by DeLaval (DelPro software; DeLaval International AB, Tumba, Sweden). All measurements were assessed to determine their ability to detect CM as both individual variables and combinations of the 12 above-mentioned variables. These were assessed by producing a receiver operating characteristic curve and calculating the area under the curve (AUC) for each model. Overall, 9 measurements (i.e., EC, ECH, MY, MYH, MF, IM, peak flow rate, lactation number, and mastitis detection index) had significant mastitis detection ability as separate predictors. The best mastitis prediction was possible by incorporating 6 measurements (i.e., EC, ECH, MY, MYH, MF, and IM) as well as the random cow and quarter effects in the model, resulting in 90% sensitivity and 91% specificity with excellent AUC (0.96). Assessment of the model was found to produce robust results (AUC >0.9) in different data sets and could detect CM with reductions in sensitivity and specificity with increasing days before actual diagnosis. This study demonstrated that improved mastitis status prediction can be achieved by using multiple measurements, and new indexes based on that are expected to result in improved accuracy of mastitis alerts, thereby improving the detection ability and utility on farm.     

The cost of generic clinical mastitis in dairy cows as estimated by using dynamic programming

The objective of this study was to estimate the cost of generic clinical mastitis (CM) in high-yielding dairy cows given optimal decisions concerning handling of CM cases. A specially structured optimization and simulation model that included a detailed representation of repeated episodes of CM was used to study the effects of various factors on the cost of CM. The basic scenario was based on data from 5 large herds in New York State. In the basic scenario, 92% of the CM cases were recommended to be treated. The average cost of CM per cow and year in these herds was $71. The average cost of a CM case was $179. It was composed of $115 because of milk yield losses, $14 because of increased mortality, and $50 because of treatment-associated costs. The estimated cost of CM was highly dependent on cow traits: it was highest ($403) in cows with high expected future net returns (e.g., young, high-milk-yielding cows), and was lowest ($3) in cows that were recommended to be culled for reasons other than mastitis. The cost per case of CM was 18% higher with a 20% increase in milk price and 17% lower with a 20% decrease in milk price. The cost per case of CM was affected little by a 20% change in replacement cost or pregnancy rate. Changes in CM incidence, however, resulted from changes in these factors, thus affecting whole-farm profitability. The detailed results obtained from this insemination and replacement optimization model can assist farmers in making CM treatment decisions.     

Relationship between milk cathelicidin abundance and microbiologic culture in clinical mastitis

The availability of reliable tools to enable the sensitive and specific detection of mastitis in dairy cows can assist in developing control strategies and promote the more rational use of antibiotics. We have developed a milk cathelicidin ELISA that shows high sensitivity and specificity for dairy cow mastitis, based on latent class analysis. In this study, we investigated the effect of microbial agents on cathelicidin abundance in the milk of cows with clinical mastitis. We subjected 535 quarter milk samples (435 from quarters showing signs of clinical mastitis and 100 from healthy quarters as a control) to milk cathelicidin ELISA, somatic cell count (SCC), and microbiologic culture. Of the 435 clinical mastitis samples, 431 (99.08%) were positive for cathelicidin, 424 (97.47%) had SCC >200,000 cells/mL, and 376 (86.44%) were culture-positive. Of the 59 culture-negative samples, 58 (98.30%) were positive for cathelicidin and 55 (93.22%) had SCC >200,000 cells/mL. The abundance of cathelicidin and the extent of SCC increase depended on the causative agent: Streptococcus agalactiae and coagulase-negative staphylococci showed the highest and lowest changes, respectively. We also observed differences in behavior between the 2 markers depending on the pathogen: Streptococcus agalactiae induced the highest cathelicidin abundance, and Serratia spp. induced the highest SCC. Nevertheless, the different ability of microorganisms to induce cathelicidin release in milk did not compromise its value as a mastitis marker, given its higher sensitivity compared to SCC or microbiologic culture. All 100 negative control samples (collected from healthy quarters with SCC <100,000 cells/mL and culture-negative) were also negative for cathelicidin, corresponding to 100% specificity in the evaluated sample cohort. This study confirmed the value of the milk cathelicidin ELISA for detecting bovine mastitis, and highlighted the influence of mastitis-causing microorganisms on cathelicidin abundance. This influence did not compromise diagnostic performance; instead, it may have better reflected disease severity and evolution than SCC.     

Short communication: correlated selection responses in somatic cell count from selection against clinical mastitis

Correlated selection responses in lactation mean somatic cell score (LSCS) were estimated for groups of cows selected for high protein yield and low mastitis frequency, respectively. Selection for increased milk production resulted in an unfavorable correlated response for LSCS, whereas direct selection against clinical mastitis resulted in a favorable correlated selection response. After 6 cow generations, the genetic difference between the high protein yield group and the low mastitis group was 0.3 units LSCS, equivalent to a difference in somatic cell count of approximately 15,000, assuming deviations from a population mean LSCS of 4.1.