Combatting antimicrobial resistance (AMR) through optimal gut health strategies

If left unchecked, the potential global impact of antimicrobial resistance (AMR) could result in a tenfold increase in AMR-associated human deaths by 2050. On this episode of the Ag Future podcast, Dr. Jules Taylor-Pickard, director of gut health at Alltech, discusses the primary contributors to AMR — including factors such as antimicrobial misuse in humans and animals, as well as the influence of climate change on animal health. Dr. Taylor-Pickard also explores optimal gut-health strategies that producers can adopt to enhance the resilience of animals to infectious and non-infectious stresses, ultimately reducing their reliance on antibiotics.

The following is an edited transcript of the Ag Future podcast episode with Dr. Jules Taylor-Pickard hosted by Tom Martin. Click below to hear the full audio or listen to the episode on Apple Podcasts, Spotify or Google Podcasts.

Tom Martin:           I’m Tom Martin.

And for this episode of Ag Future, we’re joined by Dr. Jules Taylor-Pickard, director of (the) Alltech gut health management (platform).

                               Welcome, Jules.

Jules Taylor-Pickard:         Thank you. I’m delighted to be here.

Tom Martin:           So, let’s — let’s just dig right into AMR. What are the main drivers of antimicrobial resistance in animals?

Jules Taylor-Pickard:         The main driver is — there’s a lot of different drivers, actually. But some of the main ones include the misuse and overuse of antimicrobials, both in animals and humans, but also poor husbandry and management, inadequate nutrition, poor biosecurity practices, but also poor infection (mitigation), together with disease prevention and control, in both human health care facilities and farms.

But there’s also a lot to do around awareness and knowledge and enforcement of legislation. So, there’s lots of steps that can be taken, at all levels of society, to reduce the impact and limit the spread of resistance.

Tom Martin:           We’re looking at all of the effects of climate change in so many walks of life, and I’m wondering if it affects this one. Is climate change affecting antimicrobial resistance in animals?

Jules Taylor-Pickard:         Climate change has an impact by creating more environmental stress for animals, such as heat stress, drought, floods and wildfires — which, of course, we’re seeing an awful lot (of) in the present. And this can result in a weakened immune system (for) both animals and humans and can make them most susceptible to infections and less responsive to antibiotics.

                               But what’s also interesting (is that) there’s research that showed that increase in temperatures can increase both the rate of bacterial growth and the rate of spread of antibiotic-resistant genes between microorganisms.

                               And the increased use — and, sometimes, the misuse — of antimicrobials and other microbial stresses, such as pollution, could also create favorable conditions for microorganisms to develop resistance in animals and humans, but also in the surrounding environment.

                               So, for example, bacteria in water, soil and air can acquire resistance following contact with resistant microorganisms.

Tom Martin:           We’ve been seeing a lot of heat extremes this summer. Have you heard of any effects from that?

Jules Taylor-Pickard:         Not directly yet, but I don’t think people are specifically looking at it.

But one good example is if we look at colistin, which has been bound as an antibiotic. When they first discovered resistance (to it) — which was in a pig farm in China that was using it quite extensively — it wasn’t really found anywhere else, but within a year, it was found globally. And they put that down to the wild birds and the migration, which, I think, we can resonate with avian influenza at the minute — you know, (with) the migratory birds, of course, avian influenza (is able) to move around the world at much faster rate than we’ve ever experienced before.

Tom Martin:           You mentioned that AMR reduction efforts prioritize strengthening the intestinal barrier and gut health strategies. And first, if you would, tell us about the challenges to improving animal gut health.

Jules Taylor-Pickard:         Gut health is really fundamental — optimal gut health is really fundamental — to the whole functionality of the animal. So, it’s the gateway to optimal nutritional health, if you like.

                               So, good or optimal gut health increases the resilience of animals to infectious and non-infectious stresses, and that in itself reduces the requirement to use antibiotics. If you can reduce the requirement, then that will have an impact on antimicrobial resistance.

                               But, as well, some of the work we’ve been doing (shows that) optimal gut health is also critical for optimal and cost-effective productivity. So, we know, for example, that 70% of the immune system is associated with the gut, so it’s logical that, if we can keep gut health in check, then we can reduce antibiotic use.

                               And it’s also important to ensure that our animals have the immune competence to handle any insults or disease that may come along, and that’s all related to gut health.

Tom Martin:           What are some important opportunities for improving animal gut health?

Jules Taylor-Pickard:         Actually, there’s lots of opportunities — it’s a really exciting area to work in.

So, here at Alltech, we’ve researched nutritional strategies to improve gut health extensively. So, for example, we know that one of our technologies, Actigen, can improve the integrity of tight junctions in the gut, which give us better intestinal barrier function. So, if we have better intestinal barrier function, we can help to prevent pathogenic bacteria from actually entering the animal’s system and also making them sick.

                               And we also know that the main multiplication of resistant bacteria are in the gut, which acts as a reservoir for these resistant bacteria and resistant genes. Again, this highlights the importance of good gut health.

                               But I think it’s also important to remember that antibiotics only affect the microbiota. So, if an animal experiences a combination of heat stress, for example, together with an impairment to barrier function, classical antibiotics aren’t effective, as they don’t have any anti-inflammatory effects; they just deal with the bugs and don’t have any impacts on the gut level.

                               So, if we’re trying to approach antimicrobial resistance (and) antibiotic use via gut health, this strategy deals with the intestinal barrier as well as the pathogens.

Tom Martin:           Are there economic and social consequences — and I realize that the two often intersect — but are there economic and social consequences from failing to take action against AMR?

Jules Taylor-Pickard:         Absolutely. So, The Lancet put this to report in 2019. And in that report, they quoted that 5 million human deaths were associated with bacterial antimicrobial resistance. And 1.3 million deaths are directly attributed to bacterial antimicrobial resistance.

                               And they also, in that report, stated that if we don’t do anything, if it’s left unchecked, these numbers are projected to amplify ten times by 2050. That’s ten times by 2050.

                               And they also went on to say that we should expect AMR, which is quite logical, to impact lower-income or less-developed countries to an even greater extent — especially those with poor infection control and prevention measures and inadequate nutrition, for example.

Tom Martin:           Well, how would you suggest we raise awareness and, maybe more importantly, change behavior amongst stakeholders in animal health — and would that call for different approaches in different regions?

Jules Taylor-Pickard:         Yeah, I think so. I think it’s not a one-size-fits-all. So, in terms of raising awareness, I think it’s about education — and education of everyone. And we need to try and bring people with us on this journey.

                               So, for me, first of all, you need to create awareness of the issue, and then, once you’ve got that awareness, then we need to build the desire to do something about it. And then, finally, (we need to create) the call to action and make people realize that we can all do our piece. It’s not just an agricultural issue; we can do a lot from our side, from the human side.

                               You mentioned regional differences. (There can be) massive differences, because if you think about some parts of the world, they have limited access to clean water; they don’t have enough food to feed their families. So, our strategies have to be adapted for what’s realistic and what they can achieve.

So, in those circumstances, we can work with producers to help them to understand how they can raise their animals in the best possible way to keep them healthy — whereas, obviously, in the more developed regions of the world, the fundamentals are the same, but we have more access to alternative feeding strategies, for example, using different genetics that may be more resilient, precision nutrition, better hygiene and biosecurity, health plans, etc., to help us.

And that’s something that we’ve been doing, is making sure that we do have a different approach that is appropriate to the conditions in different parts of the world.

Tom Martin:           Who would you say are the key actors or influencers in promoting alternatives to antibiotic growth promoters in reducing antibiotic use in animal health? Who should be driving this conversation?

Jules Taylor-Pickard:         Again, I think everybody has a role to play. It’s not just an agricultural issue; society in general can have a really active role.

                               So, for example, if we consider some of those main drivers of antimicrobial resistance, which we discussed earlier — including the use and misuse of antimicrobials for infection and disease prevention and control on farms — all stakeholders can help. And that’s something that we’ve been doing: trying to work with everybody across the chain.

                               But it’s interesting. The EU Public Health Alliance, in 2022, published four overarching policies and targets to combat AMR. And they were to reduce the levels of antibiotic use on-farm, (which) makes sense; trying to only use antibiotics for individual treatments — so, rather than treating the whole group of animals, just try to treat those that are specifically sick. Because obviously, if our animals are sick, we do need to treat them, because that’s a welfare issue.

                               But also, making better use of data — making sure that we’re recording, quite accurately, antibiotic-use data collected by species and farming system — so that we can really understand what’s happening in terms of, “Is it the antibiotic use on a specific farm or is it some of this environmental resistance that we’re picking up?”

                               And then, really looking at having restrictions on some of those highest-priority, critically important antibiotics for both humans and animals to make sure that we’re using the most appropriate antibiotics in the most appropriate circumstances.

Tom Martin:           Are there some general practices and recommendations that you would offer for improving animal health, welfare and environmental sustainability, for that matter?

Jules Taylor-Pickard:         Yeah. So, as I’ve said, we need to take a holistic approach to animal production. There are lots of alternatives that can promote health and prevent disease.

                               So, in terms of the general practices, we’re talking about precision feeding — so altering the nutrition and the diets to match the critical phases of life. So, for example, the neonatal period or the transition period or, for example, when birds stress at peak lay.

Quite often, water is overlooked, and we don’t think about the sanitation of the water. (Other factors include) farming management, biosecurity, hygiene. I mentioned genetics earlier in terms of having more resilient breeds. Vaccination programs have a huge part to play, together with working with the veterinarians and the nutritionists.

And, of course, nutritional alternatives; I touched on Actigen earlier. That’s been demonstrated to positively impact gut health, reduce antibiotic use, improve food safety — because you’re reducing some of those pathogens — and reduce the prevalence of antimicrobial resistance.

Tom Martin:           All right. That’s Dr. Jules Taylor-Pickard, director of Alltech gut health management.

                               Thank you so much for joining us, Dr. Taylor-Pickard.

Jules Taylor-Pickard:         That’s great. And thank you very much for having me.

Tom Martin:           And for Ag Future, I’m Tom Martin.