Barlow John W, White Lisa J, Zadoks Ruth N, Schukken Ynte H
Department of Animal Science, University of Vermont, 204 Terrill Hall, 570 Main Street, Burlington, VT 05405, USA.
Prev Vet Med. 2009 Jul 1;90(1-2):31-42. doi: 10.1016/j.prevetmed.2009.03.016. Epub 2009 May 13.
A deterministic state-transition model for mastitis transmission was developed to explore population level effects of antibiotic treatment regimens targeting chronic subclinical mastitis caused by major gram-positive pathogens in lactating dairy cows. Behavior and sensitivity of model outputs to changes in key parameters were explored. Outcomes included the size of the state variables describing proportions of infected quarters and basic and effective reproductive numbers. Treatment effects were estimated by calculating proportional reductions in state variables at equilibrium for populations implementing a treatment program relative to populations with no intervention. In general the relationships between parameters were complex and non-linear, although the model outputs were especially sensitive to changes in the value of the transmission rate parameter. Interaction between the parameters resulted in large variations in treatment effect estimates. Effect estimates calculated from model outputs showed a quadratic curve with a clear optimum at low, but not the lowest, transmission rates. These results indicated that overall positive population level effects of lactation therapy would be realized for herds that have successfully implemented practices that reduce the transmission rate of pathogens. A key finding is that in herds with high transmission rates, treatment of chronically infected quarters was predicted to have little impact on the proportion of infected quarters and no positive population level effect in reducing the force of infection and new infection rates. Results of this study suggest that field trials to evaluate efficacy of antimicrobial treatment should include estimates of indirect treatment effects.
建立了一个乳腺炎传播的确定性状态转换模型,以探讨针对泌乳奶牛主要革兰氏阳性病原体引起的慢性亚临床乳腺炎的抗生素治疗方案对群体水平的影响。研究了模型输出对关键参数变化的行为和敏感性。结果包括描述感染乳腺比例的状态变量大小以及基本繁殖数和有效繁殖数。通过计算实施治疗方案的群体相对于无干预群体在平衡状态下状态变量的比例减少来估计治疗效果。总体而言,参数之间的关系复杂且呈非线性,尽管模型输出对传播率参数值的变化特别敏感。参数之间的相互作用导致治疗效果估计值有很大差异。根据模型输出计算的效果估计显示为一条二次曲线,在低但不是最低的传播率下有明显的最优值。这些结果表明,对于成功实施了降低病原体传播率措施的牛群,泌乳期治疗将在总体上对群体水平产生积极影响。一个关键发现是,在传播率高的牛群中,预计对慢性感染乳腺的治疗对感染乳腺的比例影响很小,并且在降低感染强度和新感染率方面对群体水平没有积极影响。本研究结果表明,评估抗菌治疗疗效的现场试验应包括间接治疗效果的估计。