The Opportunities for and Barriers to Antimicrobial Resistance Surveillance by Lot Quality Assurance Sampling in Livestock: Findings from Interviews with Stakeholders in Germany

IntroductionThe emergence of bacterial pathogens exhibiting antimicrobial resistance (AMR) is a global health threat for humans, companion animals and livestock. For livestock, the implications of AMR include more treatment failures, financial losses and threats to food security. Surveillance underpins appropriate AMR responses, but can be biased or expensive. Surveillance using Lot Quality Assurance Sampling (LQAS) is a novel approach, which has shown promise in human health settings. More evidence is needed on its applicability and acceptability. Drawing on in-depth interviews, this article examines stakeholder perspectives on LQAS for AMR surveillance in livestock in Germany.MethodsTwenty-five stakeholders were interviewed. They included employees of German universities and research institutes, Federal animal health services and veterinary laboratories, associations of animal producers, and partners in veterinary practices. Detailed notes were taken during online interviews, which were analyzed using a framework approach.ResultsRespondents were concerned about AMR in livestock and also about restriction on antibiotic treatment options. They described the multifaceted, legally prescribed data gathering for farmers to monitor antibiotic consumption and the widespread use of antibiograms to guide treatment in Germany. Respondents saw potential benefits of LQAS for AMR surveillance, in terms of reducing the sample sizes and the need for antimicrobial susceptibility tests, but there were questions about surveilling commensal bacteria, it leading to further restrictions on antibiotic consumption and driving food production overseas.ConclusionAn LQAS approach to AMR surveillance requires corresponding locally responsive guidance to alleviate concerns about further restriction of treatment options (and about animal welfare). Given the existing data collection, recording and reporting burden for farmers and veterinarians, early engagement is needed to agree the rationale and benefits of LQAS, particularly if surveilling resistance in commensal bacteria is considered.